| Title: | Socioeconomic Deprivation, Unhealthy Lifestyle, and Premature Mortality in Patients With Type 2 Diabetes: A Population-Based Longitudinal Study |
| Journal: | The American Journal of Medicine |
| Published: | 5 May 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40334765/ |
| DOI: | https://doi.org/10.1016/j.amjmed.2025.05.001 |
Publication 15434
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Abstract
BACKGROUND: Adverse health behaviors have been found to play a role in linking socioeconomic deprivation and mortality, but relevant evidence in patients with type 2 diabetes is lacking. We aimed to quantify the mediation effect of overall lifestyles on the association between socioeconomic deprivation and premature mortality as well as the interaction of deprivation and lifestyle in diabetes.</p>
METHODS: This cohort study included 20,463 UK Biobank participants with type 2 diabetes at recruitment between 2006 and 2010. Socioeconomic deprivation level was determined using the Townsend deprivation index. An overall lifestyle score was constructed based on 6 health behaviors including smoking, alcohol consumption, physical activity, diet, sleep duration, and television viewing time. Cox proportional hazards models were employed to investigate the associations of socioeconomic deprivation and lifestyle with premature mortality.</p>
RESULTS: Over a mean follow-up of 7.4-12.7 years, 3381, 2382, 1281, and 577 patients with diabetes died before ages 80, 75, 70, and 65 years, respectively. High socioeconomic deprivation showed an association with a higher risk of premature mortality that was partially mediated by overall lifestyles. A significant interaction was found between lifestyle and deprivation on premature mortality, which became more apparent as age at death decreased. The adjusted hazard ratio (HR) for death before age 80 years when comparing the unfavorable versus favorable lifestyle was 1.49 (95% CI 1.21-1.82) in the least deprived group and 1.92 (1.56-2.36) in the most deprived group. Equivalent HRs for death before age 65 years were 1.33 (0.76-2.33) and 3.78 (2.04-7.02), respectively.</p>
CONCLUSIONS: In patients with type 2 diabetes, unhealthy lifestyles mediated the association between socioeconomic deprivation and premature mortality and conferred disproportionate risk of premature mortality in more deprived groups.</p>
14 Keywords
- Aged
- Diabetes Mellitus, Type 2
- Female
- Health Behavior
- Humans
- Life Style
- Longitudinal Studies
- Male
- Middle Aged
- Mortality, Premature
- Proportional Hazards Models
- Social Deprivation
- Socioeconomic Factors
- United Kingdom
9 Authors
- Jie Li
- Jiang Li
- Yanqi Fu
- Kun Zhang
- Xiao Tan
- Ningjian Wang
- Lu Qi
- Yingli Lu
- Bin Wang
1 Application
| Application ID | Title |
|---|---|
| 77740 | Environmental factors in adulthood, genetic predisposition, and human common diseases |
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