European Journal of Epidemiology

, Volume 21, Issue 1, pp 55–60

Is Inflammation a Causal Chain between Low Socioeconomic Status and Type 2 Diabetes? Results from the KORA Survey 2000

Authors

  • Wolfgang Rathmann
    • Institute of Biometrics and Epidemiology, German Diabetes CenterLeibniz Institute at the Heinrich-Heine-University
  • Burkhard Haastert
    • Institute of Biometrics and Epidemiology, German Diabetes CenterLeibniz Institute at the Heinrich-Heine-University
  • Guido Giani
    • Institute of Biometrics and Epidemiology, German Diabetes CenterLeibniz Institute at the Heinrich-Heine-University
    • The University of Ulm Medical Center
  • Armin Imhof
    • The University of Ulm Medical Center
  • Christian Herder
    • German Diabetes ClinicGerman Diabetes Center at Düsseldorf University
  • Rolf Holle
    • Institute of Health Economics and Health Care ManagementNational Research Center for Environment and Health
  • Andreas Mielck
    • Institute of Health Economics and Health Care ManagementNational Research Center for Environment and Health
Diabetes Mellitus

DOI: 10.1007/s10654-005-5085-6

Cite this article as:
Rathmann, W., Haastert, B., Giani, G. et al. Eur J Epidemiol (2006) 21: 55. doi:10.1007/s10654-005-5085-6

Abstract

Low socioeconomic status (SES) is associated with type 2 diabetes. Inflammatory markers like C-reactive protein (CRP) are predictive of diabetes. It is unclear, whether inflammation may be a mechanism linking low SES to type 2 diabetes. In the population-based KORA Survey 2000, 766 men and 710 women aged 55 to 74 years were randomly selected in the Augsburg region (Southern Germany). An index for SES was defined using education, occupation, and income. In women but not in men, increased CRP concentrations were found with lower SES (p<0.01). This significant trend was no longer observed after adjusting for BMI and waist circumference (p=0.23). Low SES was significantly associated with the age-adjusted odds of having type 2 diabetes both in men (OR; 95%CI: 1.35; 1.14–1.60) and in women (2.01; 1.37–2.96). The risk of having diabetes associated with low SES was only slightly changed after adjusting for CRP, which was itself significantly related to diabetes. In multivariate analyses, adjusting for age, obesity, physical activity, smoking, alcohol intake, and CRP, low SES yielded only a borderline statistical significance in women (p=0.07), whereas no significant association with diabetes remained in men (p=0.14). After CRP was dropped from the full model, there was no change in the OR obtained for low SES (men: 1.30; 0.92–1.83; women: 1.54; 0.97–2.45). Low SES was not related to prediabetes (IFG, IGT), whereas CRP was significantly associated with diabetes precursors. In conclusion, inflammation appears not to play a major role linking low SES and type 2 diabetes in the elderly population.

Keywords

InflammationImpaired glucose toleranceSocio-economic statusType 2 diabetes

Abbreviations

CI

confidence interval

CRP

C reactive protein

KORA

Cooperative Health Research in the Augsburg Region

OR

odds ratio

SES

socio-economic status

Copyright information

© Springer 2006