A low socio-economic status is an additional risk factor for glucose intolerance in high risk Hong Kong Chinese

To examine whether a low socio-economic status (SES) is an additional risk factor for glucose intolerance in Hong Kong Chinese with known risk factors for glucose intolerance, a total of 2847 Chinese subjects (473 men and 237 4 women) were recruited from the community for assessment. They had known r isk factors for glucose intolerance including a previous history of gestati onal diabetes, positive family history of diabetes in first degree relative s and equivocal fasting plasma glucose concentrations between 7 and 8 mmol/ l or random plasma glucose concentrations between 8 and 11 mmol/l. The 2847 subjects were classified according to their education levels and occupatio ns: education group 1 = high school or university, group 2 = middle school, group 3 = illiterate or up to elementary school; occupational group 1 = pr ofessional or managerial, group 2 = non-manual, group 3 = manual, group 4 = unskilled, group 5 = housewife or unemployed. Different socio-economic gro ups were well represented in this selected population. The distribution of educational groups in this study was similar to that recorded in the 1991 H ong Kong Census. When analysed according to education levels and after adju stment for age, women in the lowest social class had the highest prevalence of diabetes, body mass index, blood pressure and plasma glucose concentrat ions. Men with the lowest education level had the highest prevalence of dia betes after age adjustment. The age-adjusted odds ratio (95% confidence int ervals) of having diabetes was 2.3 (1.3, 4.3) in female subjects and 2.5 (1 .2, 5.4) in male subjects with the lowest SES compared to subjects with the highest SES. When categorised according to occupation and after adjustment for age, women in the lowest social class had the highest prevalence of di abetes and glycaemic indexes. The age-adjusted odds ratio of having diabete s was 4.5 (1.9, 10.9) in female subjects with the lowest SES compared to th ose with the highest SES. The corresponding age-adjusted odds ratio in male subjects was 1.9 (0.9, 3.9) but this was not statistically significant. In conclusion, a lower socio-economic class, categorised either by occupation al or educational level, was an additional risk factor for diabetes in Hong Kong Chinese who had known risk factors for glucose intolerance. These sub jects should have increased priority for health education and regular diabe tes screening. Our findings further emphasise the complex relationships bet ween societal affluence, personal income and educational level.