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Body mass index and height in relation to type 2 diabetes by levels of intelligence and education in a large cohort of Danish men

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Abstract

Socioeconomic status (SES) is inversely associated with risks of type 2 diabetes (T2D). We investigated if young men’s cognitive function, measured by intelligence test scores and educational level, as determinants of SES modified associations between body mass index (BMI) and height with the risk of T2D. 369 989 young men from the Danish Conscription Database born between 1939 and 1959 with information on measured height, weight, intelligence test scores, and education were linked to the Danish National Patient Register. During follow-up from 1977 through 2015, T2D was recorded in 32 188 men. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated by Cox regressions. BMIs below-average (z-scores ≤ 0) were not related to risks of T2D. For BMIs above-average (z-scores > 0), positive associations between BMI and T2D were slightly stronger among men with higher intelligence test scores or longer educations than among men with lower levels of these factors (pinteraction-values < 0.004). Irrespective of BMI, incidence rates of T2D were higher among men with low levels of intelligence test score and education. Height was inversely associated with T2D (per z-score, HR = 0.96 (95% CI 0.95–0.97) and the association did not vary by intelligence test scores or education (all pinteraction-values > 0.59). While below-average BMI was not associated with T2D risk, above-average BMIs were and these association were stronger among men with high cognitive function. Nevertheless, T2D risk was higher at lower levels of cognitive function throughout the range of BMI. Height was inversely associated with T2D and it was not modified by cognitive function.

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Acknowledgements

The Danish Conscription Database at the Department of Public Health, University of Copenhagen. The authors thank M Osler, K Christensen, D Molbo, EL Mortensen, TIA Sørensen who established the database.

Funding

This work was supported by the European Union’s Horizon 2020 research and innovation programme [Grant Agreement No. 633595, DynaHEALTH] and by The Novo Nordisk Foundation [Grant Number NNF17OC0028338].

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Author notes

  1. Lise G. Bjerregaard and Mille L. Damborg: Shared first authorship.

Authors and Affiliations

  1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Hovedvejen 5, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark

    Lise G. Bjerregaard, Mille L. Damborg, Merete Osler & Jennifer L. Baker

  2. Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Copenhagen, Denmark

    Thorkild I. A. Sørensen & Jennifer L. Baker

  3. Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Thorkild I. A. Sørensen

Authors
  1. Lise G. Bjerregaard
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  3. Merete Osler
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  4. Thorkild I. A. Sørensen
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  5. Jennifer L. Baker
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Contributions

LGB, TIAS, and JLB conceived the study, and all authors were involved in the design of the study. MLD and LGB conducted the statistical analysis. All authors were involved in the data interpretation. LGB, MLD, and JLB drafted the manuscript. All authors critically revised the manuscript for important intellectual content, read and approved the final version of this manuscript. LGB, MLD, and JLB had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Jennifer L. Baker.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Danish Data Protection Agency. According to Danish law, informed consent is not required for purely register-based research of preexisting personal data.

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Bjerregaard, L.G., Damborg, M.L., Osler, M. et al. Body mass index and height in relation to type 2 diabetes by levels of intelligence and education in a large cohort of Danish men. Eur J Epidemiol 35, 1167–1175 (2020). https://doi.org/10.1007/s10654-020-00641-4

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