Socioeconomic Status, Modifiable Factors, and Risk of Microvascular Complications in Individuals With Type 2 Diabetes: A Cohort Study From the UK Biobank

作者：Ying Li, Qiqi You, Menglin Fan, Lingqi Wei, Jingjing Zeng, Bo Chen, Jie Wang, Shaoyong Xu · 发表于：Journal of Diabetes · 年份：2025 · DOI：10.1111/1753-0407.70079 · 被引用次数：3 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Health disparities and outcomes、Cardiovascular Health and Risk Factors

BACKGROUND: To investigate whether lower socioeconomic status (SES) was associated with an increased risk of diabetic microvascular complications and to analyze the potential mediating role of several modifiable factors. METHODS: The study included 11 309 patients with type 2 diabetes at baseline from the UK Biobank cohort. SES was grouped based on income, education, and employment status by using latent class analysis. Microvascular complications of diabetes were identified through electronic health records. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for microvascular complications across SES groups. Mediation analysis was applied to explore potential mediators in these associations. RESULTS: During a median follow-up of 12.2 years, 262, 764, and 1017 participants in the high, medium, and low SES groups were diagnosed with microvascular complications. Compared to participants with high SES, those with low SES had a HR of 1.75 (95% CI: 1.53, 2.01) for total microvascular complications, a HR of 2.11 (95% CI: 1.74, 2.55) for nephropathy, a HR of 1.40 (95% CI: 1.14, 1.72) for retinopathy, and a HR of 1.79 (95% CI: 1.32, 2.43) for neuropathy. Mediation analysis indicated that alcohol consumption, body mass index, triglycerides, high density lipoprotein cholesterol, and glycated hemoglobin mediated the association between SES and microvascular complications, with mediation percentages of 1.3%, 12.2%, 4.4%, 10.9%, and 10.8%, r...