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Self-rated health and type 2 diabetes risk in the European Prospective Investigation into Cancer and Nutrition-InterAct study a case-cohort study

Wennberg, Patrik (author)
Rolandsson, Olov (author)
van der A, Daphne L. (author)
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Spijkerman, Annemieke M. W. (author)
Kaaks, Rudolf (author)
Boeing, Heiner (author)
Feller, Silke (author)
Bergmann, Manuela M. (author)
Langenberg, Claudia (author)
Sharp, Stephen J. (author)
Forouhi, Nita (author)
Riboli, Elio (author)
Wareham, Nicholas (author)
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 (publisher)
2013
2013
English.
In: BMJ Open. - 2044-6055. ; 3:3, e002436
Related links:
http://www.umu.se/ (web site)
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Abstract Subject headings
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  • Objectives: To investigate the association between self-rated health and risk of type 2 diabetes and whether the strength of this association is consistent across five European centres. Design: Population-based prospective case-cohort study. Setting: Enrolment took place between 1992 and 2000 in five European centres (Bilthoven, Cambridge, Heidelberg, Potsdam and Umea). Participants: Self-rated health was assessed by a baseline questionnaire in 3399 incident type 2 diabetic case participants and a centre-stratified subcohort of 4619 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study which was drawn from a total cohort of 340 234 participants in the EPIC. Primary outcome measure: Prentice-weighted Cox regression was used to estimate centre-specific HRs and 95% CIs for incident type 2 diabetes controlling for age, sex, centre, education, body mass index (BMI), smoking, alcohol consumption, energy intake, physical activity and hypertension. The centre-specific HRs were pooled across centres by random effects meta-analysis. Results: Low self-rated health was associated with a higher hazard of type 2 diabetes after adjusting for age and sex (pooled HR 1.67, 95% CI 1.48 to 1.88). After additional adjustment for health-related variables including BMI, the association was attenuated but remained statistically significant (pooled HR 1.29, 95% CI 1.09 to 1.53). I-2 index for heterogeneity across centres was 13.3% (p=0.33). Conclusions: Low self-rated health was associated with a higher risk of type 2 diabetes. The association could be only partly explained by other health-related variables, of which obesity was the strongest. We found no indication of heterogeneity in the association between self-rated health and type 2 diabetes mellitus across the European centres.

Subject headings

Medical and Health Sciences  (ssif)
Clinical Medicine  (ssif)
General Practice  (ssif)
Medicin och hälsovetenskap  (ssif)
Klinisk medicin  (ssif)
Allmänmedicin  (ssif)

Genre

government publication  (marcgt)

Keyword

diabetes

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