Yunnan Provincial Key Laboratory of Public Health and Biosafety and School of Public Health, Kunming Medical University, Kunming, China.
The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
BMJ Open. 2024 Oct 8;14(10):e086050. doi: 10.1136/bmjopen-2024-086050.
This study aimed to investigate the prevalence of diabetes using structural equation modelling (SEM) to examine the pathways and associations of socioeconomic and lifestyle factors on diabetes in rural southwest China.
Data were collected from a cross-sectional health interview and examination survey among individuals aged ≥35 years in rural southwest China. Fasting blood glucose, blood pressure, height, weight and waist circumference (WC) were measured for each participant. SEM was employed to assess the relationships between demographic characteristics (sex, age and ethnicity), socioeconomic position (SEP; annual household income, education level and access to medical services), lifestyle factors (obesity status (body mass index and WC) and physical inactivity), hypertension, hyperlipidaemia and family history of diabetes.
This study was conducted in rural Yunnan Province of China.
7536 individuals aged ≥35 years consented to participate in the study.
The overall prevalence of diabetes in the present study was 8.3%. Prevalence did not differ by gender (prevalence for both men and women was 8.3% (p>0.05)). The results of SEM indicated that SEP, age, ethnicity, obesity status and physical inactivity had both significant direct and indirect effects on diabetes, with total effect size of 0.091, 0.149, -0.094, 0.212 and 0.089, respectively (p<0.01). Family history of diabetes (0.128, p<0.01), hypertension (0.135, p<0.01) and hyperlipidaemia (0.137, p<0.01) were directly associated with diabetes.
Socioeconomic and lifestyle factors have both direct and indirect effects on prevalence of diabetes in rural southwest China. Future efforts to implement comprehensive interventions to promote the prevention and control of diabetes should in particular focus on obese individuals.
本研究旨在采用结构方程模型（SEM）调查中国西南农村地区社会经济和生活方式因素对糖尿病的流行途径和关联，以调查糖尿病的患病率。
数据来自中国西南农村地区一项针对≥35 岁人群的横断面健康访谈和体检调查。对每位参与者进行空腹血糖、血压、身高、体重和腰围（WC）测量。采用 SEM 评估人口统计学特征（性别、年龄和种族）、社会经济地位（年收入、教育水平和医疗服务可及性）、生活方式因素（肥胖状况（BMI 和 WC）和身体活动不足）、高血压、高血脂和糖尿病家族史与糖尿病之间的关系。
本研究在中国云南省农村进行。
7536 名≥35 岁的个体同意参与研究。
本研究中糖尿病的总体患病率为 8.3%。性别之间的患病率无差异（男性和女性的患病率均为 8.3%（p>0.05））。SEM 的结果表明，社会经济地位、年龄、种族、肥胖状况和身体活动不足对糖尿病既有直接影响，也有间接影响，总效应大小分别为 0.091、0.149、-0.094、0.212 和 0.089（p<0.01）。糖尿病家族史（0.128，p<0.01）、高血压（0.135，p<0.01）和高血脂（0.137，p<0.01）与糖尿病直接相关。
社会经济和生活方式因素对中国西南农村地区糖尿病的患病率既有直接影响，也有间接影响。未来应努力实施综合干预措施，以促进糖尿病的预防和控制，尤其应关注肥胖个体。
