Lifestyle mediates link between deprivation, premature death in patients with T2D

Unhealthy lifestyles facilitate the association seen between socioeconomic deprivation and premature mortality in patients with type 2 diabetes (T2D) and result in a disproportionate risk of premature death in more deprived individuals, a study has found.

Between 2006 and 2010, 20,463 participants with T2D from the UK Biobank were recruited to this population-based longitudinal study. The Townsend deprivation index was used to determine the level of socioeconomic deprivation.

The authors constructed an overall lifestyle score based on six health behaviours, including smoking, alcohol consumption, physical activity, diet, sleep duration, and television viewing time. They also used Cox proportional hazards models to explore the associations of socioeconomic deprivation and lifestyle with premature mortality.

Of the participants with T2D, 3,381, 2,382, 1,281, and 477 died before the ages of 80, 75, 70, and 65 years, respectively, over a follow-up duration of 7.4–12.7 years.

Individuals with high socioeconomic deprivation were at greater risk of premature mortality that was partially mediated by overall lifestyles. A significant association was noted between lifestyle and deprivation on premature mortality, and this became more pronounced as age at death decreased.

When comparing the unfavourable with favourable lifestyle, the adjusted hazard ratios (HRs) for death before age 80 years were 1.49 (95 percent confidence interval [CI], 1.21–1.82) in the least deprived group and 1.92 (95 percent CI, 1.56–2.36) in the most deprived group. The corresponding HRs for death before age 65 years were 1.33 (95 percent CI, 0.76–2.33) and 3.78 (95 percent CI, 2.04–7.02).