The European Journal of Public Health Advance Access originally published online on July 28, 2005
The European Journal of Public Health 2005 15(6):627-633; doi:10.1093/eurpub/cki037
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Health Inequalities |
Sex differences in the associations of socioeconomic status with undiagnosed diabetes mellitus and impaired glucose tolerance in the elderly population: the KORA Survey 2000
W. Rathmann1, B. Haastert1, A. Icks1, G. Giani1, R. Holle2, C. Meisinger3, A. Mielck2 The KORA Study Group
1 Institute of Biometrics and Epidemiology, German Diabetes Center, Heinrich Heine University, Düsseldorf, Germany
2 Institute of Health Economics and Health Care Management, GSF, National Research Centre for Environment and Health, Neuherberg, Germany
3 Institute of Epidemiology, GSF, National Research Centre for Environment and Health, Neuherberg, Germany
Correspondence: Dr Wolfgang Rathmann MSPH, German Diabetes Center, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany, tel: +49 211 3382 663, fax: +49 211 3382 677, e-mail: rathmann{at}ddfi.uni-duesseldorf.de
Background: Sex differences in the associations of socioeconomic status (SES) with prevalence of undiagnosed diabetes mellitus, impaired glucose tolerance (IGT) and known risk factors of type 2 diabetes mellitus were investigated in an elderly population. Methods: Oral glucose tolerance tests were carried out in 1354 randomly selected subjects (697 men, 657 women) aged 55–74 years in the population-based KORA Survey 2000, Augsburg, Germany. Odds ratios (ORs) and 95% confidence intervals (CIs) for undiagnosed diabetes or IGT by education, occupation and income were estimated using logistic regression controlling for age, waist circumference, blood pressure, triglycerides, physical activity, smoking and alcohol intake. Results: All three SES variables were significantly inversely related to body mass index, waist circumference and low physical activity in women (P < 0.05). In men, these associations were weaker or absent. Using the lowest category as reference, occupational status was significantly associated with undiagnosed diabetes in women (adjusted OR 0.5; 95% CI 0.3–0.8) after controlling for risk factors in multivariate regression. The OR was also reduced with higher income in women (adjusted OR, diabetes: 0.7; 95% CI 0.5–1.03). Among men, no significant relations of the SES indicators with unknown diabetes were observed. However, the odds of having IGT was lower with higher occupational status in men (adjusted OR 0.7; 95% CI 0.5–0.9). Conclusions: Undiagnosed type 2 diabetes was related to low SES defined by occupation or income in women only. In men, low occupational status was independently associated with higher IGT risk. Educational level was not related to glucose disorders in both sexes in the elderly population.
Keywords: diabetes mellitus, impaired glucose tolerance, obesity, socioeconomic status
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