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Diabetes Ther. 2019 Sep 11. doi: 10.1007/s13300-019-00690-3. [Epub ahead of print]

Prevalence and the Association of Body Mass Index and Other Risk Factors with Prediabetes and Type 2 Diabetes Among 50,867 Adults in China and Sweden: A Cross-Sectional Study.

Author information

1
School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
2
Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden.
3
Department of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
4
Songjiang District Centre for Disease Prevention and Control, Shanghai, China.
5
Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden. lars.weinehall@umu.se.
6
School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China. gmzhao@shmu.edu.cn.

Abstract

INTRODUCTION:

Understanding socioeconomic differences for prediabetes and type 2 diabetes (T2DM) can offer guidance for the most effective development of both prevention and intervention programmes in different settings. This study aims to determine the prevalence and risk factors for prediabetes and T2DM and to explore the effect of high body mass index (BMI) on the probability of T2DM being present among adults in China and Sweden.

METHODS:

This study enrolled 25,356 adults (35-64 years old) from the Shanghai Survey in China and 25,511 adults (aged 40, 50, 60) from the Västerbotten Intervention Programme in Sweden. Data on haemoglobin A1c, capillary fasting plasma glucose, 2-h plasma glucose and self-reported diagnoses of T2DM were used in the analysis. Multinomial logistic regression was used to examine the determinants of prediabetes and T2DM. The average predicted probabilities of T2DM developing or presenting were determined for the different ages and levels of BMI in each population.

RESULTS:

Chinese participants had a higher adjusted prevalence of T2DM (men 12.8% vs. 4.6%; women 10.6% vs. 3.1%) and prediabetes (men 12.4% vs. 12.2%; women 14.4% vs. 12.2%) than Swedish participants. Age, overweightedness/obesity, hypertension and a family history of diabetes were significant risk factors for prediabetes and T2DM. In both populations, the predicted probability of T2DM increased as the BMI increased in all age groups. At the same BMI level, Chinese participants were more likely to have T2DM compared to their Swedish counterparts. The average predicted probability of T2DM was less than 20% in nearly all age groups among Swedish women.

CONCLUSIONS:

Chinese adults had the higher prevalence of prediabetes and T2DM and a higher probability of T2DM at the same BMI level compared with Swedish adults. These results indicate the importance of addressing the ongoing obesity epidemic as a matter of urgency in order to curb what has become an apparent diabetes epidemic in both countries.

KEYWORDS:

Body mass index; Prediabetes; Prevalence; Risk factors; Type 2 diabetes

PMID:
31512070
DOI:
10.1007/s13300-019-00690-3

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