title: Socio-economic position and type 2 diabetes risk factors: patterns in UK children of South Asian, black African-Caribbean and white European origin.
abstract: BACKGROUND
  Socio-economic position (SEP) and ethnicity influence type 2 diabetes mellitus (T2DM) risk in adults. However, the influence of SEP on emerging T2DM risks in different ethnic groups and the contribution of SEP to ethnic differences in T2DM risk in young people have been little studied. We examined the relationships between SEP and T2DM risk factors in UK children of South Asian, black African-Caribbean and white European origin, using the official UK National Statistics Socio-economic Classification (NS-SEC) and assessed the extent to which NS-SEC explained ethnic differences in T2DM risk factors.
  
  
  RESULTS
  Cross-sectional school-based study of 4,804 UK children aged 9-10 years, including anthropometry and fasting blood analytes (response rates 70%, 68% and 58% for schools, individuals and blood measurements). Assessment of SEP was based on parental occupation defined using NS-SEC and ethnicity on parental self-report. Associations between NS-SEC and adiposity, insulin resistance (IR) and triglyceride differed between ethnic groups. In white Europeans, lower NS-SEC status was related to higher ponderal index (PI), fat mass index, IR and triglyceride (increases per NS-SEC decrement [95%CI] were 1.71% [0.75, 2.68], 4.32% [1.24, 7.48], 5.69% [2.01, 9.51] and 3.17% [0.96, 5.42], respectively). In black African-Caribbeans, lower NS-SEC was associated with lower PI (-1.12%; [-2.01, -0.21]), IR and triglyceride, while in South Asians there were no consistent associations between NS-SEC and T2DM risk factors. Adjustment for NS-SEC did not appear to explain ethnic differences in T2DM risk factors, which were particularly marked in high NS-SEC groups.
  
  
  CONCLUSIONS
  SEP is associated with T2DM risk factors in children but patterns of association differ by ethnic groups. Consequently, ethnic differences (which tend to be largest in affluent socio-economic groups) are not explained by NS-SEC. This suggests that strategies aimed at reducing social inequalities in T2DM risk are unlikely to reduce emerging ethnic differences in T2DM risk.
authors.affiliation: Population Health Research Centre, Division of Population Health Sciences and Education, St Georges, University of London, London, United Kingdom. clthomas@sgul.ac.uk
authors.forename: Claudia
authors.initials: C
authors.lastname: Thomas
authors.forename: Claire M
authors.initials: CM
authors.lastname: Nightingale
authors.forename: Angela S
authors.initials: AS
authors.lastname: Donin
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Owen
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
mesh_terms: D001208:Asia / Q000208:ethnology; D044383:Black People; D017691:Caribbean Region / Q000208:ethnology; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D044465:White People