Endocrine Abstracts

JOINT1691

Background: Diabetes is a prevalent chronic condition that can lead to microvascular complications, which significantly affect patients’ health and quality of life. Socioeconomic status (SES) is associated with an increased risk of chronic metabolic diseases and may influence the progression of diabetes. This study aims to investigate whether lower SES was associated with an increased risk of diabetic microvascular complications, and analyze the potential mediating role of several modifiable factors.

Methods: The study included 11, 309 patients with type 2 diabetes at baseline from the UK Biobank cohort. SES was grouped based on income, education, and employment status by using the latent class analysis. The primary endpoint was the occurrence of diabetic microvascular complications, including diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy, which were identified through electronic health records. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for diabetic microvascular complications. Mediation analysis was applied to explore potential mediators between SES and diabetic microvascular complications.

Results: During a median follow-up of 12. 2 years, 2, 043 cases of diabetic microvascular complications were recorded. Compared to participants with high SES, those with low SES had a HR of 1. 75 (95% CI: 1. 53, 2. 01) for total microvascular complications, a HR of 2. 11 (95% CI: 1. 74, 2. 55) for diabetic nephropathy, a HR of 1. 40 (95% CI: 1. 14, 1. 72) for diabetic retinopathy, and a HR of 1. 79 (95% CI: 1. 32, 2. 43) for diabetic neuropathy, respectively. Mediation analysis indicated that alcohol consumption, body mass index, triglycerides, high-density lipoprotein cholesterol, and glycated hemoglobin mediated the association between SES and total microvascular complications, with mediation percentages of 1. 3% (95% CI: 0. 3%, 3. 0%), 12. 2% (95% CI: 8. 4%, 17. 0%), 4. 4% (95% CI: 2. 4%, 7. 0%), 10. 9% (95% CI: 7. 1%, 16. 0%), and 10. 8% (95% CI: 7. 4%, 16. 0%), respectively. Body mass index, high-density lipoprotein cholesterol, and glycated hemoglobin also mediated the association between SES and individual microvascular complications (P < 0. 05).

Conclusions: Our study indicated that lower SES was associated with an increased risk of microvascular complications in patients with type 2 diabetes, in which obesity-related indicators and glycated hemoglobin played important mediating roles. SES is relatively difficult to change, and efforts are suggested be made through other approaches such as increasing financial support for patients of low SES and enhancing weight and blood glucose management to prevent or reduce the occurrence of diabetic microvascular complications.