Impact of socioeconomic status on diabetes and cardiovascular risk factors: Results of a large French survey

• Published in: Diabetes & metabolism 2013-02, Vol.39 (1), p.56-62
• Main Authors: Jaffiol, C, Thomas, F, Bean, K, Jégo, B, Danchin, N
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood Pressure; Body Mass Index; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - psychology; Depression; Depression - blood; Depression - epidemiology; Deprivation; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - psychology; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - blood; Diabetic Angiopathies - epidemiology; Diabetic Angiopathies - psychology; Diabète; Dépression; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Facteurs de risque; Female; Health Surveys; Humans; Internal Medicine; Maladies cardiovasculaires; Male; Medical sciences; Middle Aged; Obesity - epidemiology; Odds Ratio; Paris - epidemiology; Prevalence; Précarité; Risk Factors; Score EPICES; Sedentary Lifestyle; Social Class; Épidémiologie
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2012.09.002

Abstract Aim This study examined the association between deprivation and diabetes in a large French population, and evaluated the impact of deprivation on diabetes after taking in account a number of confounding factors. Methods A total of 32,435 men and 16,378 women, aged 35 to 80 years, who had a health checkup at the “Centre d’Investigations Préventives et Cliniques” (IPC Centre: a preventive medical center in Paris, France), between January 2003 and December 2006, were evaluated. Socioeconomic deprivation was assessed using the EPICES score. The most deprived subjects were those in the fifth quintile of score distribution. Results Several cardiovascular risk markers increased significantly in deprived subjects. In both genders, deprivation was associated with deleterous health status and lifestyle habits. In women, BMI, central obesity and the metabolic syndrome were associated with deprivation. The prevalence of diabetes increased with deprivation level. Compared with the first quintile of EPICES score distribution, the prevalence of diabetes was three to eight times higher in the fifth quintile. After taking into account age, and biological, clinical and lifestyle parameters, the risk of diabetes onset (odds ratio) among deprived vs. non-deprived subjects was 2.54 (95% CI: 1.99–3.24) in men and 2.2 (95% CI: 1.44–3.35) in women. Conclusion In the general French population, deprivation was associated with deleterious health status and lifestyle. Risk of diabetes increased linearly with deprivation level and, after taking into account various confounding factors, the risk of diabetes remained significantly higher among deprived subjects. Other factors such as nutrition should now be examined to explain the excess risk of diabetes among the most deprived people.