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author:

Huang, Yikeng (Huang, Yikeng.) [1] | Zheng, Zhi (Zheng, Zhi.) [2] | Chen, Haibing (Chen, Haibing.) [3] | Gu, Chufeng (Gu, Chufeng.) [4]

Indexed by:

Scopus SCIE

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.

Keyword:

Diabetes inequity Diabetic nephropathy Diabetic peripheral neuropathy Diabetic retinopathy Socioeconomic status UK Biobank

Community:

  • [ 1 ] [Gu, Chufeng]Fujian Med Univ, Dept Ophthalmol, Shengli Clin Coll, Fuzhou, Fujian, Peoples R China
  • [ 2 ] [Gu, Chufeng]Fuzhou Univ, Affiliated Prov Hosp, Sch Med, Fuzhou, Fujian, Peoples R China
  • [ 3 ] [Huang, Yikeng]Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Ophthalmol, Sch Med, Shanghai, Peoples R China
  • [ 4 ] [Zheng, Zhi]Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Ophthalmol, Sch Med, Shanghai, Peoples R China
  • [ 5 ] [Huang, Yikeng]Shanghai Jiao Tong Univ, Natl Clin Res Ctr Eye Dis, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 6 ] [Zheng, Zhi]Shanghai Jiao Tong Univ, Natl Clin Res Ctr Eye Dis, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 7 ] [Huang, Yikeng]Shanghai Jiao Tong Univ, Shanghai Clin Res Ctr Eye Dis, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 8 ] [Zheng, Zhi]Shanghai Jiao Tong Univ, Shanghai Clin Res Ctr Eye Dis, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 9 ] [Huang, Yikeng]Shanghai Jiao Tong Univ, Sch Med, Shanghai Key Clin Specialty, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 10 ] [Zheng, Zhi]Shanghai Jiao Tong Univ, Sch Med, Shanghai Key Clin Specialty, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 11 ] [Huang, Yikeng]Shanghai Jiao Tong Univ, Sch Med, Shanghai Key Lab Ocular Fundus Dis, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 12 ] [Zheng, Zhi]Shanghai Jiao Tong Univ, Sch Med, Shanghai Key Lab Ocular Fundus Dis, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 13 ] [Huang, Yikeng]Shanghai Jiao Tong Univ, Shanghai Engn Ctr Visual Sci & Photomed, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 14 ] [Zheng, Zhi]Shanghai Jiao Tong Univ, Shanghai Engn Ctr Visual Sci & Photomed, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 15 ] [Huang, Yikeng]Shanghai Jiao Tong Univ, Shanghai Engn Ctr Precise Diag & Treatment Eye Dis, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 16 ] [Zheng, Zhi]Shanghai Jiao Tong Univ, Shanghai Engn Ctr Precise Diag & Treatment Eye Dis, Sch Med, Shanghai Gen Hosp, Shanghai, Peoples R China
  • [ 17 ] [Chen, Haibing]Tongji Univ, Shanghai 10 Peoples Hosp, Sch Med, Dept Endocrinol & Metab, Shanghai, Peoples R China
  • [ 18 ] [Zheng, Zhi]Ningde Normal Univ, Ningde Municipal Hosp, Ningde, Fujian, Peoples R China
  • [ 19 ] [Zheng, Zhi]Fujian Med Univ, Fuzhou, Fujian, Peoples R China

Reprint 's Address:

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    [Gu, Chufeng]Fujian Med Univ, Dept Ophthalmol, Shengli Clin Coll, Fuzhou, Fujian, Peoples R China;;[Gu, Chufeng]Fuzhou Univ, Affiliated Prov Hosp, Sch Med, Fuzhou, Fujian, Peoples R China;;[Chen, Haibing]Tongji Univ, Shanghai 10 Peoples Hosp, Sch Med, Dept Endocrinol & Metab, Shanghai, Peoples R China

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Source :

DIABETOLOGY & METABOLIC SYNDROME

Year: 2025

Issue: 1

Volume: 17

3 . 4 0 0

JCR@2023

CAS Journal Grade:3

Cited Count:

WoS CC Cited Count:

SCOPUS Cited Count:

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 0

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