Sex differences in the association between socioeconomic status and diabetes prevalence and incidence in China: cross-sectional and prospective studies of 0.5 million adults
Year: 2019
Type: article
Study design: Observational Study
Abstract: AIMS/HYPOTHESIS: China has undergone rapid socioeconomic transition accompanied by lifestyle changes that are expected to have a profound impact on the health of its population. However, there is limited evidence from large nationwide studies about the relevance of socioeconomic status (SES) to risk of diabetes. We describe the associations of two key measures of SES with prevalent and incident diabetes in Chinese men and women. METHODS: The China Kadoorie Biobank study included 0.5 million adults aged 30-79 years recruited from ten diverse areas in China during 2004-2008. SES was assessed using the highest educational level attained and annual household income. Prevalent diabetes was identified from self-report and plasma glucose measurements. Incident diabetes was identified from linkage to disease and death registries and national health insurance claim databases. We estimated adjusted ORs and HRs for prevalent and incident diabetes associated with SES using logistic and Cox regression models, respectively. RESULTS: At baseline, 30,066 (5.9%) participants had previously diagnosed (3.1%) or screen-detected (2.8%) diabetes among 510,219 participants included for cross-sectional analyses. There were 480,153 people without prevalent diabetes at baseline, of whom 9544 (2.0%) had new-onset diabetes during follow-up (median 7 years). Adjusted ORs (95% CIs) for prevalent diabetes, comparing highest vs lowest educational level, were 1.21 (1.09, 1.35) in men and 0.69 (0.63, 0.76) in women; for incident diabetes, the corresponding HRs were 1.27 (1.07, 1.51) and 0.80 (0.67, 0.95), respectively. For household income, the adjusted ORs for prevalent diabetes, comparing highest vs lowest categories, were 1.45 (1.34, 1.56) in men and 1.26 (1.19, 1.34) in women; for incident diabetes, the HRs were 1.36 (1.19, 1.55) and 1.06 (0.95, 1.17), respectively. CONCLUSIONS/INTERPRETATION: Among Chinese adults, the associations between education and diabetes prevalence and incidence differed qualitatively between men and women, whereas higher household income was positively associated with diabetes prevalence and incidence in both sexes, with a stronger relationship in men than in women.
Source: Diabetologia
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $4,390
Funders: Wellcome Trust, Cancer Research UK, British Heart Foundation, National Natural Science Foundation of China, Ministry of Science and Technology of the People's Republic of China, China Scholarship Council, BHF Centre of Research Excellence, Oxford, Kadoorie Charitable Foundation, Centers for Disease Control and Prevention, Medical Research Council, National Key Research and Development Program of China
Awards: G1062629391, G1430653553, China Kadoorie Biobank of 0.5 million adults, G1649993721, China Kadoorie Biobank (CKB) of 0.5 million adults., G1881568983, G1900183912, G2196673094, G2212417510, G2243627235, G2343743920, G2579291025, G2596434300, G2680380251, G2800483660, G2934531729, G3109729928, G3217496469, G3344437619, G3389605049, G3432458785, The Kadoorie Biobank study., G4336526930, G4393287264, G4592251203, G5105739736, G5158796881, G5248341131, China Kadoorie Biobank (CKB) of 0.5 million adults., The Kadoorie Biobank study., G5514164640, G5701582600, G5898025071, G6132904278, G6134801487, G6195916859, G676817397, G6959217156, G7086945402, G7146276943, G7473553764, G7594514245, G764355098, G7679059458, G7784652254, G7855137468, G815574155, G8233656547, G8368010179, G8643922336, G8798990729, G8996672588, G948687719, G983956445
OpenAlex ID: W2947201571