Sex-dependent effect of socioeconomic status on cardiovascular event risk in a population-based cohort of patients with type 2 diabetes

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dc.contributor.authorEnguita Germán, Mónica
dc.contributor.authorTamayo Rodríguez, Ibai
dc.contributor.authorLibrero, Julián
dc.contributor.authorBallesteros-Domínguez, Asier
dc.contributor.authorOscoz-Villanueva, Ignacio
dc.contributor.authorGalbete Jiménez, Arkaitz
dc.contributor.authorArnedo Ajona, Laura
dc.contributor.authorCambra Contin, Koldo
dc.contributor.authorGorricho Mendívil, Javier
dc.contributor.authorMoreno Iribas, Conchi
dc.contributor.authorMillán-Ortuondo, Eduardo
dc.contributor.authorIbáñez Beroiz, Berta
dc.contributor.departmentEstadística, Informática y Matemáticases_ES
dc.contributor.departmentEstatistika, Informatika eta Matematikaeu
dc.contributor.departmentCiencias de la Saludes_ES
dc.contributor.departmentOsasun Zientziakeu
dc.contributor.departmentGestión de Empresases_ES
dc.contributor.departmentEnpresen Kudeaketaeu
dc.date.accessioned2024-09-12T18:57:29Z
dc.date.available2024-09-12T18:57:29Z
dc.date.issued2024
dc.date.updated2024-09-12T18:16:56Z
dc.description.abstractBackground: Socioeconomic status (SES) factors often result in profound health inequalities among populations, and their impact may differ between sexes. The aim of this study was to estimate and compare the effect of socioeconomic status indicators on incident cardiovascular disease (CVD)-related events among males and females with type 2 diabetes (T2D). Methods: A population-based cohort from a southern European region including 24,650 patients with T2D was followed for five years. The sex-specific associations between SES indicators and the first occurring CVD event were modeled using multivariate Fine-Gray competing risk models. Coronary Heart Disease (CHD) and stroke were considered secondary outcomes. Results: Patients without a formal education had a significantly higher risk of CVD than those with a high school or university education, with adjusted hazard ratios (HRs) equal to 1.24 (95%CI: 1.09-1.41) for males and 1.50 (95%CI: 1.09-2.06) for females. Patients with <18 000euro income had also higher CVD risk than those with >= 18 000euro, with HRs equal to 1.44 (95%CI: 1.29-1.59) for males and 1.42 (95%CI: 1.26-1.60) for females. Being immigrant showed a HR equal to 0.81 (95%CI: 0.66-0.99) for males and 1.13 (95%CI: 0.68-1.87) for females. Similar results were observed for stroke, but differed for CHD when income is used, which had higher effect in females. Conclusion: Socioeconomic inequalities in CVD outcomes are present among T2D patients, and their magnitude for educational attainment is sex-dependent, being higher in females, suggesting the need to consider them when designing tailored primary prevention and management strategies.en
dc.description.sponsorshipThis research was funded by the Instituto de Salud Carlos III, via grant PI15/02196 and via CONCEPT project (grants PI19/00154, PI19/00381). It has also received funding from the Research Network on Health Services in Chronic Diseases-REDISSEC grant RD16/0001/0014 and RICAPPS RD21/0016/0016, Spanish Networks supported by Instituto de Salud Carlos III and the European Regional Development Funding (FEDER).
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dc.identifier.citationEnguita-Germán, M., Tamayo, I., Librero, J., Ballesteros-Domínguez, A., Oscoz-Villanueva, I., Galbete, A., Arnedo, L., Cambra, K., Gorricho, J., Moreno-Iribas, C., Millán-Ortuondo, E., Ibáñez-Beroiz, B. (2024) Sex-dependent effect of socioeconomic status on cardiovascular event risk in a population-based cohort of patients with type 2 diabetes. European Journal of Public Health, 34(3), 441-448. https://doi.org/10.1093/eurpub/ckae048.
dc.identifier.doi10.1093/eurpub/ckae048
dc.identifier.issn1101-1262
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/51620
dc.language.isoeng
dc.publisherOxford University Press
dc.relation.ispartofEuropean Journal of Public Health 34(3), 2024, 441–448
dc.relation.projectIDinfo:eu-repo/grantAgreement/MINECO//PI15%2F02196/ES/
dc.relation.projectIDinfo:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI19%2F00154/ES/
dc.relation.projectIDinfo:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI19%2F00381/ES/
dc.relation.projectIDinfo:eu-repo/grantAgreement/MINECO//RD16%2F0001%2F0014/ES/
dc.relation.projectIDinfo:eu-repo/grantAgreement/AEI/RD21%2F 0016%2F0016/
dc.relation.publisherversionhttps://doi.org/10.1093/eurpub/ckae048
dc.rights© The Author(s) 2024. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectSocioeconomic status (SES)en
dc.subjectType 2 diabetes (T2D)en
dc.subjectCardiovascular disease (CVD)en
dc.subjectHealth inequalitiesen
dc.subjectMultivariate fine-gray competing risk modelsen
dc.subjectEducational attainmenten
dc.titleSex-dependent effect of socioeconomic status on cardiovascular event risk in a population-based cohort of patients with type 2 diabetesen
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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