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3 WHO Library Cataloguing in Publication Data 2003, Wilkinson,Richard Marmot,Michael Social determinants of health SDH The social gradient Stress Early life Social exclusion Work Unemployment Social support Addiction Food Transport 1

4 402 ( T2DM ) MIN-IREN T2DMU40 STUDY /05/15 ver 1.1

5 2 402MIN-IREN T2DMU40 Study (2): p95-104, BMI30kg/m2 BMI 30kg/m mg/dl JDDM 2 Socioeconomic status and type 2 diabetes complications among young adult patients in Japan PLOS ONE April 24, Long working hours and skipping breakfast concomitant with late evening meals are associated with suboptimal glycemic control among young male Japanese patients with type 2 diabetes Journal of Diabetes Investigation First published: 17 April HbA1c7%

6 23 -HbA1c JDS)6.1%- 40 HbA1c,

7 BMI(Body Mass Index) BMI(kg) ( (m)(m)) BMI 30?

8 /HbA1 20BMI HbA1c

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11 meta-analysis 1 2 Mika Kivimä et al : Long working hours as a risk factor for atrial fibrillation: a multicohort study European Heart Journal, 2017,ehx324, Kivimäki M et al. Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from individuals. (2015) Lancet Diabetes Endocrinol. ;3: Ferrie JE et al: Job insecurity and risk of diabetes: a meta-analysis of individual participant data. CMAJ.2016 Dec 6;188(17-18):E447-E Virtanen M et al. Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis ;347:f

12 HbA1c I + 10reference HbA1c7%352 white collar

13 HbA1c7% BMI A1c

14 352 HbA1c(%)

15 ( Kivimäki M et al. Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from individuals. (2015) Lancet Diabetes Endocrinol. ;3:27-34.

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17 PLOS ONE

18 SES DM SES DM 1 DM( ) 2 DM 2040 SES 2 DM SES DM 4 Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis Emilie Agardh,1 * Peter Allebeck,1 Johan Hallqvist,2,3 Tahereh Moradi4 and Anna Sidorchuk1,5 International Journal of Epidemiology 2011;40: ( ) 2 DM(incidence OR1.31OR1.41 OR

19 DM SES 2004 DM 2006 DM 2010 DM 2011 DM DM SES / / / / / // 2 BMI

20 BMI A1C (SES 3 BMI SES SES BMI

21 + SES DM SES DM2 DM 2040SES 2 DM SES DM 4 SES DM

22 (WHO SDH )

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@08460025ヨコ/伊東 217号 A B B A B A B A B stratification inequality Marmot, Smith, Why are the Japanese living longer?, British Medical Journal, 1989 Kondo, Kawachi, Subramanian, Takeda, Yamagata Do social comparisons

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