使用生物标志物和兄弟姐妹的数据来研究2型糖尿病的早期生活经济决定因素
Rob J M Alessie1,2, Viola Angelini1,2, Gerard J van den Berg1,3,4,5
1University of Groningen, Groningen, The Netherlands.
Health economics
|February 25, 2024
概括
儿童时期的不利经济状况显著增加了成年后患2型糖尿病的风险. 依靠自我报告的数据或忽视家庭因素可能会导致关于这种健康联系的不准确结论.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康的社会经济决定因素
背景情况:
- 早期社会经济条件越来越被认为是长期健康的关键决定因素.
- 了解经济逆境对慢性疾病发展的具体影响对于有针对性的干预至关重要.
- 以前的研究可能受到未观察到的混因素和自我报告偏差的限制.
研究的目的:
- 研究生命早期经济状况与成人2型糖尿病发病率之间的关联.
- 用兄弟对分析来区分经济因素的影响与遗传和家族影响.
- 在这种情况下,比较基于生物标志物诊断的有效性与2型糖尿病的自我报告数据.
主要方法:
- 利用了来自生命线纵向队列研究和生物库 (n = 51,270 个兄弟姐妹) 的数据.
- 雇佣的兄弟姐妹固定效应模型用于控制未测量的家族和遗传因素,包括选择性生育.
- 使用客观生物标志物评估2型糖尿病:血红蛋白A1c度和空腹血糖水平.
主要成果:
- 发现出生时的不利经济状况显著增加了男性和女性在以后的生活中患2型糖尿病的可能性.
- 基于自我报告的2型糖尿病数据的推断产生了偏见的结果,表明在存在显著影响的情况下没有影响.
- 不考虑选择性生育的分析也产生了误导性的结论.
结论:
- 早期的经济逆境是成人发病2型糖尿病的重要风险因素,独立于共同的家族因素.
- 基于生物标志物识别的2型糖尿病对于准确的流行病学研究至关重要,因为自我报告的数据可以掩盖真正的关联.
- 方法严谨,包括兄弟固定效应和客观健康措施,对于理解对慢性疾病的社会经济影响至关重要.
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