Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study
Abstract Background Prior studies on the link between socioeconomic status (SES) and diabetic microvascular complications have been inconclusive. This study aimed to explore whether SES is associated with the risk of diabetic retinopathy (DR), nephropathy (DN) and diabetic peripheral neuropathy (DPN...
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BMC
2025-01-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01584-0 |
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| author | Yikeng Huang Zhi Zheng Haibing Chen Chufeng Gu |
| author_facet | Yikeng Huang Zhi Zheng Haibing Chen Chufeng Gu |
| author_sort | Yikeng Huang |
| collection | DOAJ |
| description | Abstract Background Prior studies on the link between socioeconomic status (SES) and diabetic microvascular complications have been inconclusive. This study aimed to explore whether SES is associated with the risk of diabetic retinopathy (DR), nephropathy (DN) and diabetic peripheral neuropathy (DPN) using large prospective cohort. Methods SES was evaluated using education attainment (individual level), household income (household level), and Townsend deprivation index (TDI, neighborhood level). This study included 28,339 participants without DR, 29,951 without DN and 29,762 without DPN at baseline from the UK Biobank. Weighted Cox proportional hazard models were used to investigate the relationship between SES and the risk of diabetic microvascular complications. Results The median follow-ups of the DR, DN and DPN cohorts were 12.95, 12.89 and 13.02 years, respectively. In total, 3,177 (11.2%) participants developed DR, 4,418 (14.8%) developed DN and 1,604 (5.4%) developed DPN. After adjusting for confounders, higher education levels (DN: hazard ratios [HR] = 0.85; 95% CI, 0.82–0.89; P < 0.001; DPN: HR = 0.93; 95% CI, 0.87-1.00; P = 0.040), higher household income (DN: HR = 0.80; 95% CI, 0.75–0.85; P < 0.001; DPN: HR = 0.80; 95% CI, 0.73–0.89; P < 0.001), and lower TDI (DN: HR = 1.19; 95% CI, 1.14–1.23; P < 0.001; DPN: HR = 1.27; 95% CI, 1.19–1.36; P < 0.001) were associated with a lower risk of DN and DPN. In contrast, a lower risk of DR was only related to higher household income (HR = 0.92; 95% CI, 0.87–0.97; P = 0.004) and lower TDI (HR = 1.08; 95% CI, 1.02–1.13; P = 0.004). Conclusions Low SES increases the risk of diabetic microvascular complications, emphasizing the need for equitable medical resource allocation to reduce diabetes-related inequity. |
| format | Article |
| id | doaj-art-809bee93a692405687130fcadabe9fb9 |
| institution | Kabale University |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-809bee93a692405687130fcadabe9fb92025-01-26T12:45:24ZengBMCDiabetology & Metabolic Syndrome1758-59962025-01-0117111110.1186/s13098-025-01584-0Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort studyYikeng Huang0Zhi Zheng1Haibing Chen2Chufeng Gu3Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye DiseasesDepartment of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Eye Diseases; Shanghai Clinical Research Center for Eye Diseases; Shanghai Key Clinical Specialty; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye DiseasesDepartment of Endocrinology and Metabolism, Shanghai 10th People’s Hospital, School of Medicine, Tongji UniversityDepartment of Ophthalmology, Shengli Clinical College of Fujian Medical University; Fuzhou University Affiliated Provincial Hospital, School of Medicine, Fuzhou UniversityAbstract Background Prior studies on the link between socioeconomic status (SES) and diabetic microvascular complications have been inconclusive. This study aimed to explore whether SES is associated with the risk of diabetic retinopathy (DR), nephropathy (DN) and diabetic peripheral neuropathy (DPN) using large prospective cohort. Methods SES was evaluated using education attainment (individual level), household income (household level), and Townsend deprivation index (TDI, neighborhood level). This study included 28,339 participants without DR, 29,951 without DN and 29,762 without DPN at baseline from the UK Biobank. Weighted Cox proportional hazard models were used to investigate the relationship between SES and the risk of diabetic microvascular complications. Results The median follow-ups of the DR, DN and DPN cohorts were 12.95, 12.89 and 13.02 years, respectively. In total, 3,177 (11.2%) participants developed DR, 4,418 (14.8%) developed DN and 1,604 (5.4%) developed DPN. After adjusting for confounders, higher education levels (DN: hazard ratios [HR] = 0.85; 95% CI, 0.82–0.89; P < 0.001; DPN: HR = 0.93; 95% CI, 0.87-1.00; P = 0.040), higher household income (DN: HR = 0.80; 95% CI, 0.75–0.85; P < 0.001; DPN: HR = 0.80; 95% CI, 0.73–0.89; P < 0.001), and lower TDI (DN: HR = 1.19; 95% CI, 1.14–1.23; P < 0.001; DPN: HR = 1.27; 95% CI, 1.19–1.36; P < 0.001) were associated with a lower risk of DN and DPN. In contrast, a lower risk of DR was only related to higher household income (HR = 0.92; 95% CI, 0.87–0.97; P = 0.004) and lower TDI (HR = 1.08; 95% CI, 1.02–1.13; P = 0.004). Conclusions Low SES increases the risk of diabetic microvascular complications, emphasizing the need for equitable medical resource allocation to reduce diabetes-related inequity.https://doi.org/10.1186/s13098-025-01584-0Socioeconomic statusDiabetic retinopathyDiabetic nephropathyDiabetic peripheral neuropathyDiabetes inequityUK Biobank |
| spellingShingle | Yikeng Huang Zhi Zheng Haibing Chen Chufeng Gu Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study Diabetology & Metabolic Syndrome Socioeconomic status Diabetic retinopathy Diabetic nephropathy Diabetic peripheral neuropathy Diabetes inequity UK Biobank |
| title | Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study |
| title_full | Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study |
| title_fullStr | Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study |
| title_full_unstemmed | Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study |
| title_short | Association of socioeconomic status with diabetic microvascular complications: a UK Biobank prospective cohort study |
| title_sort | association of socioeconomic status with diabetic microvascular complications a uk biobank prospective cohort study |
| topic | Socioeconomic status Diabetic retinopathy Diabetic nephropathy Diabetic peripheral neuropathy Diabetes inequity UK Biobank |
| url | https://doi.org/10.1186/s13098-025-01584-0 |
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