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Educational attainment protects against type 2 diabetes independently of cognitive performance: a Mendelian randomization study

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Abstract

Aims

Observational studies have reported a negative association between educational attainment and type 2 diabetes (T2D), but the causality remains largely unknown. The aim of this study is to investigate the potential causal effect of educational attainment on T2D and whether such an effect is independent of cognitive performance.

Methods

We conducted two-sample Mendelian randomization (MR) analysis using genetic variants strongly associated with educational attainment and cognitive performance to estimate the causal associations with T2D, among 61,714 T2D cases and 593,952 controls. We also performed multivariable MR to explore the independent effects of educational attainment and cognitive performance on T2D risk.

Results

In univariable MR, we found evidence that genetically predicted higher educational attainment [odds ratio (OR) 0.53 per 1-standard deviation (SD) increase; 95% confidence interval (CI) 0.47–0.60] and cognitive performance (OR 0.79 per 1-SD increase; 95%CI 0.69–0.91) were related to decreased risk of T2D. Our further multivariable MR results suggested that more years of education led to a reduced likelihood of T2D independently of cognitive performance (OR 0.52; 95%CI 0.42–0.64). However, the protective effect of cognitive performance on T2D was attenuated once educational attainment was controlled for (OR 1.08; 95%CI 0.88–1.32).

Conclusions

We provided evidence to suggest that educational attainment protects against T2D independently of cognitive performance, but does not support a negative causal association between cognitive performance and T2D independently of educational attainment. Education might represent a potential target for intervention to battle type 2 diabetes risk.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

The code that supports the findings of this study is available from the corresponding author upon reasonable request.

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Acknowledgements

We gratefully thank the Social Science Genetic Association consortium, UK Biobank, COGENT consortium, DIAGRAM consortium, GERA consortium and MAGIC consortium for providing summary statistics data.

Funding

This study received the support of Social Welfare Science and Technology Research Project of Zhongshan City (Grant Number 2018b1065).

Author information

Author notes

  1. Jialin Liang and Huan Cai have contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Zhongshan City People’s Hospital, 2 East Sunwen Road, Zhongshan, 528403, Guangdong, China

    Jialin Liang, Ganxiong Liang, Baile Zhu & Baoying Liu

  2. Department of Rehabilitation, Zhongshan City People’s Hospital, 2 East Sunwen Road, Zhongshan, 528403, Guangdong, China

    Huan Cai, Zhonghua Liu & Liang Fang

  3. Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China

    Hao Zhang

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  1. Jialin Liang
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Correspondence to Ganxiong Liang or Hao Zhang.

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All data sources were approved by relevant institutional review boards. The studies were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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This article belongs to the topical collection Health Education and Psycho-Social Aspects, managed by Massimo Porta and Marina Trento

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Liang, J., Cai, H., Liang, G. et al. Educational attainment protects against type 2 diabetes independently of cognitive performance: a Mendelian randomization study. Acta Diabetol 58, 567–574 (2021). https://doi.org/10.1007/s00592-020-01647-w

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