Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study

作者全名："Zhu, Yuanyue; Hu, Chunyan; Lin, Lin; Wang, Shuangyuan; Lin, Hong; Huo, Yanan; Wan, Qin; Qin, Yingfen; Hu, Ruying; Shi, Lixin; Su, Qing; Yu, Xuefeng; Yan, Li; Qin, Guijun; Tang, Xulei; Chen, Gang; Xu, Min; Xu, Yu; Wang, Tiange; Zhao, Zhiyun; Gao, Zhengnan; Wang, Guixia; Shen, Feixia; Luo, Zuojie; Chen, Li; Li, Qiang; Ye, Zhen; Zhang, Yinfei; Liu, Chao; Wang, Youmin; Wu, Shengli; Yang, Tao; Deng, Huacong; Chen, Lulu; Zeng, Tianshu; Zhao, Jiajun; Mu, Yiming; Wang, Weiqing; Ning, Guang; Bi, Yufang; Chen, Yuhong; Lu, Jieli"

作者地址："[Zhu, Yuanyue; Hu, Chunyan; Lin, Lin; Wang, Shuangyuan; Lin, Hong; Xu, Min; Xu, Yu; Wang, Tiange; Zhao, Zhiyun; Wang, Weiqing; Ning, Guang; Bi, Yufang; Chen, Yuhong; Lu, Jieli] Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Endocrine & Metab Dis, Dept Endocrine & Metab Dis,Sch Med, Shanghai 200025, Peoples R China; [Zhu, Yuanyue; Hu, Chunyan; Lin, Lin; Wang, Shuangyuan; Lin, Hong; Xu, Min; Xu, Yu; Wang, Tiange; Zhao, Zhiyun; Wang, Weiqing; Ning, Guang; Bi, Yufang; Chen, Yuhong; Lu, Jieli] Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Key Lab Endocrine Tumors,Shanghai Natl C, State Key Lab Med Genom,Sch Med,Key Lab Endocrine, Shanghai 200025, Peoples R China; [Huo, Yanan] Nanchang Univ, Jiangxi Prov Peoples Hosp, Nanchang, Jiangxi, Peoples R China; [Wan, Qin] Luzhou Med Coll, Affiliated Hosp, Luzhou, Peoples R China; [Qin, Yingfen; Luo, Zuojie] Guangxi Med Univ, Affiliated Hosp 1, Nanning, Peoples R China; [Hu, Ruying; Ye, Zhen] Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Peoples R China; [Shi, Lixin] Guiyang Med Univ, Affiliated Hosp, Guiyang, Peoples R China; [Su, Qing] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Shanghai, Peoples R China; [Yu, Xuefeng] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Yan, Li] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China; [Qin, Guijun] Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Peoples R China; [Tang, Xulei] Lanzhou Univ, Hosp 1, Lanzhou, Peoples R China; [Chen, Gang] Fujian Med Univ, Fujian Prov Hosp, Fuzhou, Peoples R China; [Gao, Zhengnan] Dalian Med Univ, Dalian Municipal Cent Hosp, Dalian, Peoples R China; [Wang, Guixia] Jilin Univ, Hosp 1, Changchun, Peoples R China; [Shen, Feixia] Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China; [Chen, Li] Shandong Univ, Qilu Hosp, Jinan, Peoples R China; [Li, Qiang] Harbin Med Univ, Affiliated Hosp 2, Harbin, Peoples R China; [Zhang, Yinfei] Cent Hosp Shanghai Jiading Dist, Shanghai, Peoples R China; [Liu, Chao] Jiangsu Prov Hosp Integrat Chinese & Western Med, Nanjing, Peoples R China; [Wang, Youmin] Anhui Med Univ, Affiliated Hosp 1, Hefei, Peoples R China; [Wu, Shengli] Karamay Municipal Peoples Hosp, Karamay, Xinjiang, Peoples R China; [Yang, Tao] Nanjing Med Univ, Affiliated Hosp 1, Nanjing, Peoples R China; [Deng, Huacong] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China; [Chen, Lulu; Zeng, Tianshu] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Peoples R China; [Zhao, Jiajun] Shandong Univ, Shandong Prov Hosp, Jinan, Peoples R China; [Mu, Yiming] Chinese Peoples Liberat Army Gen Hosp, Beijing, Peoples R China"

通信作者："Chen, YH; Lu, JL (通讯作者)，Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Inst Endocrine & Metab Dis, Dept Endocrine & Metab Dis,Sch Med, Shanghai 200025, Peoples R China.; Chen, YH; Lu, JL (通讯作者)，Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai Key Lab Endocrine Tumors,Shanghai Natl C, State Key Lab Med Genom,Sch Med,Key Lab Endocrine, Shanghai 200025, Peoples R China."

来源：JOURNAL OF DIABETES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000865698900001

JCR分区：Q2

影响因子：4.5

年份：2022

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：diabetes; education; gender-dependent; mediation; obesity

摘要："Background Evidence regarding the impact of education on diabetes risk is scarce in developing countries. We aimed to explore the association between education and diabetes within a large population in China and to identify the possible mediators between them. Methods Information on educational level and lifestyle factors was collected through questionnaires. Diabetes was diagnosed from self-report and biochemical measurements. A structural equation model was constructed to quantify the mediation effect of each mediator. Results Compared with their least educated counterparts, men with college education had a higher risk of diabetes (odds ratio [OR] 1.19; 95% confidence interval [CI], 1.12-1.27), while college-educated women were less likely to have diabetes (OR 0.77; 95% CI, 0.73-0.82). Obesity was the strongest mediator in both genders (proportion of mediation: 11.6% in men and 23.9% in women), and its association with education was positive in men (beta[SE] 0.0387 [0.0037]) and negative in women (beta[SE] -0.0824 [0.0030]). Taken together, all behavioral factors explained 12.4% of the excess risk of diabetes in men and 33.3% in women. Conclusions In a general Chinese population, the association between education level and diabetes was positive in men but negative in women. Obesity was the major mediator underlying the education disparities of diabetes risk, with a stronger mediation effect among women."

基金机构："National Natural Science Foundation of China [81970728, 81930021, 81970691, 82170819, 21904084]; Shanghai Outstanding Academic Leaders Plan [20XD1422800]; Shanghai Medical and Health Development Foundation [DMRFP_I_01]; Clinical Research Plan of SHDC [SHDC2020CR3064B, SHDC2020CR1001A]; Clinical Research Project of Shanghai Municipal Health Commission [20214Y0002]; Science and Technology Committee of Shanghai [19411964200, 20Y11905100]"

基金资助正文："This work was supported by the National Natural Science Foundation of China (Grant No. 81970728, 81930021, 81970691, 82170819, and 21904084), Shanghai Outstanding Academic Leaders Plan (Grant No. 20XD1422800), Shanghai Medical and Health Development Foundation (Grant No. DMRFP_I_01), Clinical Research Plan of SHDC (Grant No. SHDC2020CR3064B, SHDC2020CR1001A), Clinical Research Project of Shanghai Municipal Health Commission (20214Y0002) and Science and Technology Committee of Shanghai (Grant No. 19411964200 and 20Y11905100)."