Evidence map›Paper›PMID 39658133›Full record

ArticleJournal of epidemiology and community health2025

Examining causal relationships between educational attainment and type 2 diabetes using genetic analysis: findings from the EPIC-InterAct study through Mendelian randomisation.

Alessandra Macciotta, Carlotta Sacerdote, Claudia Giachino, Chiara Di Girolamo, Matteo Franco, Yvonne T van der Schouw, Raul Zamora-Ros, Elisabete Weiderpass, Cloé Domenighetti, Alexis Elbaz and 18 more

Abstract read
In one paragraph

Article in Journal of epidemiology and community health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Alessandra MacciottaDepartment of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.ORCID http://orcid.org/0000-0002-0287-7979
Carlotta SacerdoteDepartment of Health Sciences, University of Eastern Piedmont, Novara, Italy carlotta.sacerdote@uniupo.it.
Claudia GiachinoDepartment of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.
Chiara Di GirolamoDepartment of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.
Matteo FrancoDepartment of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.
Yvonne T van der SchouwJulius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands.
Raul Zamora-RosUnit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain.
Elisabete WeiderpassInternational Agency for Research on Cancer, Lyon, France.
Cloé DomenighettiUniversité Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France.
Alexis ElbazUniversité Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France.ORCID http://orcid.org/0000-0001-9724-5490
Thérèse TruongUniversité Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805, Villejuif, France.
Claudia AgnoliEpidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Benedetta BendinelliClinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.
Salvatore PanicoSchool of Medicine, Federico II University, Naples, Italy.
Paolo VineisDepartment of Epidemiology and Biostatistics, Imperial College London, London, UK.ORCID http://orcid.org/0000-0001-8935-4566
Sofia ChristakoudiDepartment of Epidemiology and Biostatistics, Imperial College London, London, UK.
Matthias B SchulzeGerman Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Verena KatzkeGerman Cancer Research Center, Heidelberg, Germany.
Rashmita BajracharyaGerman Cancer Research Center, Heidelberg, Germany.
Christina C DahmDepartment of Public Health, Aarhus University, Aarhus C, Denmark.
Susanne Oksbjerg DaltonDanish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark.
Sandra M Colorado-YoharDepartment of Epidemiology, Murcia Regional Health Council, Murcia, Spain.
Conchi Moreno-IribasPublic Health Institute of Navarra, Pamplona, Spain.
Pilar Amiano EtxezarretaCIBERESP, Madrid, Spain.
María José SanchezCIBERESP, Madrid, Spain.
Nita G ForouhiMRC Epidemiology, University of Cambridge, Cambridge, UK.
Nicholas Wareham *MRC Epidemiology, University of Cambridge, Cambridge, UK.
Fulvio Ricceri *Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.ORCID http://orcid.org/0000-0001-8749-9737

Funding

Medical Research Council MC_UU_12015/1World Health Organization 001
6 · The paper itself

Abstract

introductionObservational studies have shown that more educated people are at lower risk of developing type 2 diabetes (T2D). However, robust study designs are needed to investigate the likelihood that such a relationship is causal. This study used genetic instruments for education to estimate the effect of education on T2D using the Mendelian randomisation (MR) approach.

methodsAnalyses have been conducted in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study (more than 20 000 individuals), a case-cohort study of T2D nested in the EPIC cohort. Education was measured as Years of Education and Relative Index of Inequality. Prentice-weighted Cox models were performed to estimate the association between education and T2D. One-sample MR analyses investigated whether genetic predisposition towards longer education was associated with risk of T2D and investigated potential mediators of the association.

resultsMR estimates indicated a risk reduction of about 15% for each year of longer education on the risk of developing T2D, confirming the protective role estimated by observational models (HR 0.96, 95% CI 0.95 to 0.96). MR analyses on putative mediators showed a significant role of education on body mass index, alcohol consumption, adherence to the Mediterranean diet and smoking habits.

conclusionThe results supported the hypothesis that higher education is a protective factor for the risk of developing T2D. Based on its position in the causal chain, education may be antecedent of other known risk factors for T2D including unhealthy behaviours. These findings reinforce evidence obtained through observational study designs and bridge the gap between correlation and causation.

Indexed as

Diabetes Mellitus, Type 2Educational StatusAdultAgedEuropeFemaleGenetic Predisposition to DiseaseHumansMaleMendelian Randomization AnalysisMiddle AgedProspective StudiesRisk FactorsDIABETES MELLITUSEDUCATIONMENDELIAN RANDOMIZATION ANALYSIS

Identifiers

PMID39658133
PMCPMC12015027

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.