Abstract
BackgroundUsing cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and T2DM in adulthood. We also examined potential mediating pathways via both adulthood socioeconomic conditions and adult BMI and health behaviours.MethodsOf the 3263 participants (aged 40–75 years), 493 had prediabetes and 906 were diagnosed with T2DM. By using logistic regression analyses, the associations and possible mediating pathways were examined.ResultsParticipants with low early life socioeconomic conditions had a 1.56 times higher odds of prediabetes (95% confidence interval (CI) = 1.21-2.02) and a 1.61 times higher odds of T2DM (95% CI = 1.31-1.99). The relation between low early life socioeconomic conditions and prediabetes was independent of current socioeconomic conditions (OR = 1.38, 95% CI = 1.05-1.80), whereas the relation with T2DM was not independent of current socioeconomic conditions (OR = 1.10, 95% CI = 0.87-1.37). BMI party mediated the association between early life socioeconomic conditions and prediabetes.ConclusionsSocioeconomic inequalities starting in early life were associated with diabetes-related outcomes in adulthood and suggest the usefulness of early life interventions aimed at tackling these inequalities.
Highlights
Using cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and Type 2 diabetes mellitus (T2DM) in adulthood
Participants with low early life socioeconomic conditions had a 1.83 times higher odds of obesity compared to participants with high early life socioeconomic conditions [Additional file 1]
After adjustment for age, sex and adulthood socioeconomic conditions, this was reduced to 1.27
Summary
Using cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and T2DM in adulthood. Socioeconomic conditions early in life may have lasting effects on different social, biological, and behavioural factors that might act as mechanisms connecting the socioeconomic conditions to later T2DM [16]. Children with low socioeconomic backgrounds have a higher risk of developing obesity during childhood [18] Children often maintain their overweight status through adulthood, which puts them at high risk of developing T2DM later in life [19]. Health behaviours, such as physical inactivity, Derks et al International Journal for Equity in Health (2017) 16:61 smoking and alcohol use, might be other mechanisms. Low early life socioeconomic conditions have been linked to higher tobacco use and less physical activity in later-life [20,21,22]
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