Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach

Introduction Type 2 diabetes is multifactorial and influenced by the intersection of gender-related variables and other determinants of health. The aim of this study was to highlight the intersectional social position of the participants and disentangle its role from administrative sex in predicting...

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Main Authors: Julien Vaucher, Michael Amiguet, Carole Clair, Joelle Schwarz, Jeanne Marie Barbier, Aurélie M Lasserre
Format: Article
Language:English
Published: BMJ Publishing Group 2024-07-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/2/1/e000472.full
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author Julien Vaucher
Michael Amiguet
Carole Clair
Joelle Schwarz
Jeanne Marie Barbier
Aurélie M Lasserre
author_facet Julien Vaucher
Michael Amiguet
Carole Clair
Joelle Schwarz
Jeanne Marie Barbier
Aurélie M Lasserre
author_sort Julien Vaucher
collection DOAJ
description Introduction Type 2 diabetes is multifactorial and influenced by the intersection of gender-related variables and other determinants of health. The aim of this study was to highlight the intersectional social position of the participants and disentangle its role from administrative sex in predicting the development of type 2 diabetes.Methods Using CoLaus|PsyCoLaus study, a Swiss single-centre prospective cohort initiated in 2003 and including 6733 participants (age 35–75 years; 54% women) at baseline, we conducted latent class analyses using gender-related variables (eg, risk-taking behaviours, gender roles represented by employment status, etc) and socioeconomic determinants at baseline (2003–2006) to construct intersectional classes and we tested their association with the development of type 2 diabetes at follow-up (2018–2021).Results Of the 6733 participants enrolled at baseline, 3409 were included in our analyses (50.6%). Over a median follow-up time of 14.5 years, 255 (7.5%) participants developed type 2 diabetes, of which 158 men (62.0%). We identified seven latent classes highlighting different intersectional social position groups (ie, young, fit, educated men (N=413), non-White physically inactive men and women (N=170), highly qualified men, former or current smokers (N=557), working women living alone (N=914), low qualified working men with overweight (N=445), women with obesity, low education and low qualified job or housewives (N=329), low educated retired participants (N=581)). Using the class labelled as ‘young, fit, educated men’ as reference, the risk of incident type 2 diabetes was higher in all other classes (adjusted OR values between 4.22 and 13.47). Classes mostly feminine had a more unfavourable intersectional social position than that of the predominantly masculine classes. The corresponding OR increased in sex-adjusted regressions analyses.Conclusions We observe cumulative intersectional effects across behavioural and socioeconomic profiles with different risks of developing type 2 diabetes emphasising the deleterious effect of a feminine gender profile. These patterns are only partly captured by traditional sex-stratified analyses.
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spelling doaj-art-d9bf52285c6c41e5a340189cceed61132025-01-28T19:40:09ZengBMJ Publishing GroupBMJ Public Health2753-42942024-07-012110.1136/bmjph-2023-000472Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approachJulien Vaucher0Michael Amiguet1Carole Clair2Joelle Schwarz3Jeanne Marie Barbier4Aurélie M Lasserre5Department of Medicine and Specialties, University of Fribourg, Fribourg, Switzerland1 Department of Ambulatory Care, Unisanté, Lausanne, Vaud, SwitzerlandDepartment of Ambulatory Care and Community Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Vaud, Switzerland1 Department of Ambulatory Care, Unisanté, Lausanne, Vaud, Switzerland1 Department of Ambulatory Care, Unisanté, Lausanne, Vaud, Switzerland4 Department of Psychiatry, Lausanne University Hospital, Lausanne, SwitzerlandIntroduction Type 2 diabetes is multifactorial and influenced by the intersection of gender-related variables and other determinants of health. The aim of this study was to highlight the intersectional social position of the participants and disentangle its role from administrative sex in predicting the development of type 2 diabetes.Methods Using CoLaus|PsyCoLaus study, a Swiss single-centre prospective cohort initiated in 2003 and including 6733 participants (age 35–75 years; 54% women) at baseline, we conducted latent class analyses using gender-related variables (eg, risk-taking behaviours, gender roles represented by employment status, etc) and socioeconomic determinants at baseline (2003–2006) to construct intersectional classes and we tested their association with the development of type 2 diabetes at follow-up (2018–2021).Results Of the 6733 participants enrolled at baseline, 3409 were included in our analyses (50.6%). Over a median follow-up time of 14.5 years, 255 (7.5%) participants developed type 2 diabetes, of which 158 men (62.0%). We identified seven latent classes highlighting different intersectional social position groups (ie, young, fit, educated men (N=413), non-White physically inactive men and women (N=170), highly qualified men, former or current smokers (N=557), working women living alone (N=914), low qualified working men with overweight (N=445), women with obesity, low education and low qualified job or housewives (N=329), low educated retired participants (N=581)). Using the class labelled as ‘young, fit, educated men’ as reference, the risk of incident type 2 diabetes was higher in all other classes (adjusted OR values between 4.22 and 13.47). Classes mostly feminine had a more unfavourable intersectional social position than that of the predominantly masculine classes. The corresponding OR increased in sex-adjusted regressions analyses.Conclusions We observe cumulative intersectional effects across behavioural and socioeconomic profiles with different risks of developing type 2 diabetes emphasising the deleterious effect of a feminine gender profile. These patterns are only partly captured by traditional sex-stratified analyses.https://bmjpublichealth.bmj.com/content/2/1/e000472.full
spellingShingle Julien Vaucher
Michael Amiguet
Carole Clair
Joelle Schwarz
Jeanne Marie Barbier
Aurélie M Lasserre
Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach
BMJ Public Health
title Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach
title_full Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach
title_fullStr Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach
title_full_unstemmed Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach
title_short Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach
title_sort exploring the gender difference in type 2 diabetes incidence in a swiss cohort using latent class analysis an intersectional approach
url https://bmjpublichealth.bmj.com/content/2/1/e000472.full
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