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@ARTICLE{Macciotta:294921,
      author       = {A. Macciotta and C. Sacerdote and C. Giachino and C. Di
                      Girolamo and M. Franco and Y. T. van der Schouw and R.
                      Zamora-Ros and E. Weiderpass and C. Domenighetti and A.
                      Elbaz and T. Truong and C. Agnoli and B. Bendinelli and S.
                      Panico and P. Vineis and S. Christakoudi and M. B. Schulze
                      and V. Katzke$^*$ and R. Bajracharya$^*$ and C. C. Dahm and
                      S. O. Dalton and S. M. Colorado-Yohar and C. Moreno-Iribas
                      and P. A. Etxezarreta and M. J. Sanchez and N. G. Forouhi
                      and N. Wareham and F. Ricceri},
      title        = {{E}xamining causal relationships between educational
                      attainment and type 2 diabetes using genetic analysis:
                      findings from the {EPIC}-{I}nter{A}ct study through
                      {M}endelian randomisation.},
      journal      = {Journal of epidemiology and community health},
      volume       = {79},
      number       = {5},
      issn         = {0143-005X},
      address      = {London},
      publisher    = {BMJ Publ. Group},
      reportid     = {DKFZ-2024-02628},
      pages        = {373-379},
      year         = {2025},
      note         = {2025 Apr 10;79(5):373-379},
      abstract     = {Observational 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.Analyses 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.MR 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.The 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.},
      keywords     = {DIABETES MELLITUS (Other) / EDUCATION (Other) / MENDELIAN
                      RANDOMIZATION ANALYSIS (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39658133},
      doi          = {10.1136/jech-2024-222734},
      url          = {https://inrepo02.dkfz.de/record/294921},
}