School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road,Cheng Gong New City, Kunming, 650500, China.
The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China.
BMC Public Health. 2023 Mar 30;23(1):603. doi: 10.1186/s12889-023-15527-9.
Diabetes has become a major public health problem in China. A better understanding of diabetes determinants and urban-rural differences is essential to crafting targeted diabetes prevention measures for the elderly living in both urban and rural areas. This study aimed to compare rural-urban differentials in prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China.
A cross-sectional health interview and examination survey was conducted among individuals aged ≥ 60 years in both a rural and urban area of China. Anthropometric measurements, including height, weight, and waist circumference, as well as blood pressure and fasting blood glucose measurements were taken. Associated risk factors for pre-diabetes and diabetes were evaluated using multivariate logistic regression analysis.
In total, 1,624 urban residents and 1,601 rural residents consented to participate in the study. The urban prevalence of pre-diabetes and diabetes (46.8% and 24.7%, respectively), was higher than the rural prevalence (23.4% and 11.0%, respectively, P<0.01). Urban elderly participants had markedly higher prevalence of obesity, central obesity, and physical inactivity than their rural counterparts (15.3%, 76.0%, and 9.2% vs. 4.6%, 45.6%, and 6.1%, P<0.01). In contrast, rural elderly adults had higher prevalence of smoking than urban ones (23.2% vs. 17.2%, P<0.01). Obese (OR 1.71, 95% CI 1.27-2.30 vs. OR 1.73, 95% CI 1.30-3.28) and centrally obese participants (OR 1.59, 95% CI 1.18-2.15 vs. OR 1.83, 95% CI 1.32-2.54) were more likely to suffer from diabetes in both urban and rural regions. Furthermore, urban current smokers had a higher probability of suffering from diabetes (OR 1.58, 95% CI 1.11-2.25), while hypertension was positively associated with the prevalence of diabetes in the rural area (OR 2.13, 95% CI 1.54-2.95). Obese participants in the rural area were more likely to suffer from pre-diabetes (OR 2.50, 95% CI 1.53-4.08), while physical inactivity was positively associated with prevalence of pre-diabetes in the urban area (OR 1.95, 95% CI 1.37-2.80).
Pre-diabetes and diabetes are more prevalent among urban older adults than their rural counterparts in southwest China. The identified rural-urban differentials of lifestyle factors have significant impacts on prevalence of pre-diabetes and diabetes. Thus, tailored lifestyle interventions are needed to improve diabetes prevention and management among the elderly in southwest China.
糖尿病已成为中国的一个主要公共卫生问题。深入了解糖尿病的决定因素和城乡差异，对于制定针对城乡老年人的糖尿病预防措施至关重要。本研究旨在比较中国西南地区城乡老年人中糖尿病前期和糖尿病的流行情况和生活方式决定因素的城乡差异。
对中国城乡地区年龄≥60 岁的个体进行了横断面健康访谈和体检调查。测量了身高、体重和腰围等人体测量学指标，以及血压和空腹血糖。使用多变量逻辑回归分析评估与糖尿病前期和糖尿病相关的相关风险因素。
共有 1624 名城市居民和 1601 名农村居民同意参加研究。城市居民糖尿病前期和糖尿病的患病率（分别为 46.8%和 24.7%）高于农村居民（分别为 23.4%和 11.0%，P<0.01）。城市老年人参与者肥胖、中心性肥胖和身体活动不足的比例明显高于农村老年人（15.3%、76.0%和 9.2%，分别为 4.6%、45.6%和 6.1%，P<0.01）。相比之下，农村老年人的吸烟率高于城市老年人（23.2%比 17.2%，P<0.01）。肥胖（OR 1.71，95%CI 1.27-2.30 与 OR 1.73，95%CI 1.30-3.28）和中心性肥胖患者（OR 1.59，95%CI 1.18-2.15 与 OR 1.83，95%CI 1.32-2.54）在城乡地区均更易患糖尿病。此外，城市现吸烟者患糖尿病的可能性更高（OR 1.58，95%CI 1.11-2.25），而高血压与农村地区糖尿病的患病率呈正相关（OR 2.13，95%CI 1.54-2.95）。农村地区肥胖者更易患糖尿病前期（OR 2.50，95%CI 1.53-4.08），而城市地区身体活动不足与糖尿病前期的患病率呈正相关（OR 1.95，95%CI 1.37-2.80）。
与农村老年人相比，中国西南地区城市老年人的糖尿病前期和糖尿病更为普遍。确定的城乡生活方式因素差异对糖尿病前期和糖尿病的患病率有重大影响。因此，需要针对特定人群的生活方式干预措施，以改善中国西南地区老年人的糖尿病预防和管理。
