#68 Childhood and Adult Socioeconomic Status and the Development of Type 2 Diabetes Risk Factors in the TMPLR Cohort
Nicole Wiens, University of Manitoba; Dylan MacKay, University of Manitoba; Peter Jones, Univeristy of Manitoba; Heather Blewett, St. Boniface Hospital Albrechtsen Research Centre; Jonathan McGavock, University of Manitoba; Meghan Azad, Children’s Hospital Research Institute of Manitoba
Background: By 2026, an estimated 30% of Manitobans will have type 2 diabetes (T2D) or pre-diabetes. Lower socioeconomic status (SES) in adulthood has been associated with higher T2D prevalence. Our objective was to determine the association between SES throughout life and the development of T2D risk factors.
Methodology: This analysis included 204 participants in The Manitoba Personalized Lifestyle Research (TMPLR) Study, a general population cohort of Manitobans ages 30-46. Participants completed a questionnaire about childhood SES exposures (parental home ownership, paternal education, perceived financial status and financial struggle) and adult SES exposures (home ownership, household income and education level). Participants were categorized as having experienced low or high SES in childhood and adulthood. Multivariable linear regression models were used to examine the association of SES with fasted insulin, body fat percentage (BFP, measured by dual x-ray absorptiometry), body mass index (BMI) and waist circumference (WC).
Results: Overall, 14% of participants experienced persistently low SES in childhood through adulthood, 52% experienced persistently high SES, 19% improved from low SES in childhood to high SES as adults, and 14% declined from high to low SES. Participants experiencing persistently low SES had higher insulin levels, (β=2.0μU/mL, 95%CI 0.07, 3.89), BFP (β=6.12%, 95%CI 2.76, 9.48), BMI (β=4.30kg/m2, 95%CI 1.91, 6.70) and WC (β=8.11cm, 95%CI 2.74, 13.48) compared to those experiencing persistently high SES. Increasing one’s SES from childhood to adulthood appeared to be protective (β=0.26% 95%CI -2.68, 3.19 for BFP), and having high SES in childhood appeared to partially buffer against the detrimental effect of low SES later in life (β=1.84% 95%CI -1.32, 5.01 for BFP). Similar patterns of association were observed for insulin, BMI and WC.
Conclusion/Discussion: Together, these results highlight the importance of childhood SES on developing T2D risk factors, and demonstrate the cumulative and potentially reversible nature of this association.