Cui Guanghui, Li Shaojie, Qin Yu, Zhang Yuqin, Hui Kunpeng, Feng Mengfan, Li Weiwei, Zhang Xuezhi
Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China.
Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China.
J Diabetes. 2025 Aug;17(8):e70142. doi: 10.1111/1753-0407.70142.
The dual burden of diabetes and kidney disease poses a growing public health challenge in aging populations, yet its longitudinal trends and modifiable determinants in China remain understudied. This study aims to track the trends in the prevalence of the comorbidity of diabetes and kidney disease in Chinese middle-aged and older adults over a 10-year period (2011-2020) and identify social determinants and lifestyle factors associated with this comorbidity.
This study utilized data from five waves of the China Health and Retirement Longitudinal Study (CHARLS). Temporal trends and geographical distributions of the comorbidity of diabetes and kidney diseases were analyzed across survey years; disaggregated by sex, residence, and geographical region. Cox proportional hazards regression models were employed to explore the associations between SDOH burden, lifestyle factors, and the risk of comorbidity.
The prevalence of diabetes and kidney disease comorbidity exhibited a clear upward trend among Chinese adults aged ≥ 45 years, increasing from 0.60% in 2011 to 3.10% in 2020. Geographical analysis revealed significant regional disparities, with Northeast China having the highest prevalence throughout the decade (4.76% in 2020). High SDOH burden was associated with an increased risk of comorbidity (HR = 1.24, 95% CI = 1.01-1.52). Conversely, maintaining a good (HR = 0.38, 95% CI = 0.27-0.54) or moderate (HR = 0.74, 95% CI = 0.59-0.91) lifestyle was associated with a reduced risk.
The rising prevalence and significant regional disparities of diabetes and kidney disease comorbidity underscore the urgent need for targeted public health interventions in China.
糖尿病和肾脏疾病的双重负担给老龄化人口带来了日益严峻的公共卫生挑战，但在中国，其纵向趋势和可改变的决定因素仍未得到充分研究。本研究旨在追踪中国中老年成年人在10年期间（2011 - 2020年）糖尿病和肾脏疾病合并症患病率的趋势，并确定与这种合并症相关的社会决定因素和生活方式因素。
本研究利用了中国健康与养老追踪调查（CHARLS）五轮的数据。分析了各调查年份糖尿病和肾脏疾病合并症的时间趋势和地理分布；按性别、居住地和地理区域进行了细分。采用Cox比例风险回归模型来探讨社会经济地位负担、生活方式因素与合并症风险之间的关联。
在中国45岁及以上成年人中，糖尿病和肾脏疾病合并症的患病率呈现出明显的上升趋势，从2011年的0.60%增至2020年的3.10%。地理分析显示存在显著的地区差异，东北地区在这十年间患病率最高（2020年为4.76%）。高社会经济地位负担与合并症风险增加相关（风险比[HR]=1.24，95%置信区间[CI]=1.01 - 1.52）。相反，保持良好（HR = 0.38，95% CI = 0.27 - 0.54）或适度（HR = 0.74，95% CI = 0.59 - 0.91）的生活方式与风险降低相关。
糖尿病和肾脏疾病合并症患病率的上升以及显著的地区差异凸显了中国针对性公共卫生干预措施的迫切需求。
