title: Socioeconomic status is not associated with type 2 diabetes incidence in an elderly population in Germany: KORA S4/F4 cohort study.
abstract: BACKGROUND
  An association between socioeconomic status (SES) and the incidence of type 2 diabetes mellitus (T2DM) has been found for younger and middle-aged individuals, but studies of this relationship in elderly populations are rare.
  
  
  METHODS
  In a population-based cohort in southern Germany (KORA S4/F4: 1223 subjects aged 55-74 years at baseline, 887 subjects (73%) in the follow-up 7 years later) the identification of incident T2DM was based on oral glucose tolerance tests or on validated physician diagnoses. Regression models were fitted to predict incident T2DM and (pre)diabetes, respectively, with SES as the main independent variable. (Pre)diabetes here means incident T2DM or incident pre-diabetes.
  
  
  RESULTS
  With five different SES measures (global Helmert index, income, educational level, occupational status, subjective social status), the diabetes risk of low SES groups was not significantly different from the risk of higher SES groups (ie, cumulative incidence 10% (low income), 9% (medium income), 13% (high income)). In subjects with normoglycaemia at baseline, (pre)diabetes incidence was more pronounced in lower SES groups, but almost all these associations were not significant. With measures of subjective SES stronger associations were found than with measures of objective SES.
  
  
  CONCLUSIONS
  There was no statistically significant association between objective SES and diabetes incidence in this elderly population. This might be due to a larger socioeconomic homogeneity of elderly populations and to a strong driving force for diabetes, which outweighed the influence of SES, and which was indicated by an adverse baseline metabolic profile in participants developing diabetes in the follow-up.
authors.affiliation: German Diabetes Center, Institute of Biometrics and Epidemiology, Düsseldorf, Germany. rathmann@ddz.uni-duesseldorf.de
authors.forename: Bernd
authors.initials: B
authors.lastname: Kowall
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Strassburger
authors.forename: Christine
authors.initials: C
authors.lastname: Meisinger
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Andreas
authors.initials: A
authors.lastname: Mielck
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012923:Social Class; D012959:Socioeconomic Factors