New research led by Massachusetts General Hospital (MGH) suggests that socioeconomic and genetic factors likely interact in an additive manner to impact people’s risks of developing obesity and type 2 diabetes.
These findings, published in Diabetes Care, highlight the potential for interventions that address socioeconomic deprivation to reduce metabolic diseases, particularly among individuals at high genetic risk.
Study Design: Exploring Genetic and Socioeconomic Risk
While it’s known that both intrinsic (like genetics) and extrinsic (like socioeconomic conditions) factors can increase the risk of metabolic diseases, understanding the relative contribution of each and how they interact has been unclear.
Researchers examined the additive effects of genetic and socioeconomic risk in a large number of participants from the Mass General Brigham Biobank and the UK Biobank, of both European and non-European genetic ancestry.
The team analyzed genetic data as well as socioeconomic information related to participants’ education, income, and employment.
Educational attainment was chosen as the primary measure of socioeconomic risk, as it showed the strongest correlation with type 2 diabetes and obesity among the socioeconomic factors considered.
Findings: Significant Interaction of Genetic and Socioeconomic Risks
Results showed that individuals in the highest quintile for both genetic and socioeconomic risk had a seven-fold higher prevalence of type 2 diabetes and a three-fold higher prevalence of obesity compared to those in the lowest risk quintiles.
Importantly, there was a significant positive interaction between genetic and socioeconomic risk.
This means that people at higher genetic risk experienced a larger increase in metabolic disease prevalence when also exposed to unfavorable socioeconomic conditions.
For instance, while socioeconomic risk was associated with increased type 2 diabetes prevalence across all genetic risk levels, the absolute increase in prevalence was greatest in those at the highest genetic risk.
The combined effects of genetic and socioeconomic factors accounted for 13.2% and 16.7% of type 2 diabetes and obesity prevalence, respectively.
Implications and Future Research
The findings suggest the importance of a comprehensive approach to preventing metabolic diseases, with public health interventions potentially having the most impact when targeted to those with elevated genetic risk.
The next stages of research will include expanding models to include more risk factors (like lifestyle behaviors), improving models for individuals of non-European ancestry, exploring the predictive value of area-level socioeconomic measures in diverse populations, and studying the interaction of genes and socioeconomic status in relation to other outcomes.
Overall, the study underscores the importance of considering both genetic and socioeconomic factors in assessing the risk of metabolic diseases.
It also emphasizes that genetic risk is not deterministic; people at high genetic risk living in low-risk socioeconomic regions showed similar rates of type 2 diabetes and obesity as those with low genetic risk in high-risk socioeconomic regions.
Further research is needed to explore this aspect.
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The study was published in Diabetes Care.
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