Age-related disparities in diabetes risk attributable to modifiable risk factor profiles in Chinese adults: a nationwide, population-based, cohort study
Tiange Wang, Zhiyun Zhao, Guixia Wang, Qiang Li, Yu Xu, Mian Li, Ruying Hu, Gang Chen, Qing Su, Yiming Mu, Xulei Tang, Li Yan, Guijun Qin, Qin Wan, Zhengnan Gao, Xuefeng Yu, Feixia Shen, Zuojie Luo, Yingfen Qin, Li Chen, Yanan Huo, Tianshu Zeng, Lulu Chen, Zhen Ye, Yinfei Zhang, Chao Liu, Youmin Wang, Shengli Wu, Tao Yang, Huacong Deng, Jiajun Zhao, Lixin Shi, Yiping Xu, Min Xu, Yuhong Chen, Shuangyuan Wang, Jieli Lu, Yufang Bi, Guang Ning, Weiqing Wang
Abstract
BACKGROUND: National investigations of age-specific modifiable risk profiles for diabetes are crucial to promote personalised strategies for the prevention and control of diabetes, particularly in countries such as China, which is experiencing both a diabetes epidemic and a rapidly ageing population. We aimed to examine the associations of 12 potentially modifiable socioeconomic, lifestyle, and metabolic risk factors with diabetes in a nationwide prospective cohort of Chinese adults across four age groups. METHODS: We analysed data from the China Cardiometabolic Disease and Cancer Cohort Study, a nationwide, population-based, cohort study done between Jan 1, 2011, and Dec 31, 2016. Among 93 781 participants without diabetes at baseline and with complete information available about risk factors and diabetes incidence, we examined the hazard ratios (HRs) and population-attributable risk percentages (PAR%s) of incident diabetes associated with 12 potentially modifiable risk factors: two socioeconomic risk factors (less education and intermediate or low grade occupation), five lifestyle risk factors (unhealthy diet, physical inactivity, current alcohol consumption, current smoking, and unhealthy sleep), and five metabolic risk factors (general or central obesity, insulin resistance, prediabetes, hypertension, and dyslipidaemia) across four age groups (40 to <55 years, 55 to <65 years, 65 to <75 years, and ≥75 years). FINDINGS: =0·016). INTERPRETATION: These findings provide novel insights into age-related modifiable risk factor profiles for diabetes in Chinese adults, highlighting the importance of prioritising risk factors according to age groups for effective prevention and management of diabetes. FUNDING: National Natural Science Foundation of China. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.