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Front. Endocrinol. | doi: 10.3389/fendo.2019.00658

Sex-based Differences in Diabetes Prevalence and Risk Factors: A Population-based Cross-sectional Study among Low-income Adults in China

Hongyan Zhang1, Jingxian Ni2, 3, 4,  Changshen Yu5,  Yanan Wu2, 3, 4, Jingyan Li1, Jie Liu2, 3, 4, Jun Tu2, 3, 4,  Xianjia Ning2, 3, 4, Qing He6* and  Jinghua Wang2, 3, 4*
  • 1Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, China
  • 2Tianjin Medical University General Hospital, China
  • 3Tianjin Institute of Neurology, China
  • 4Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, General Hospital of Tianjin Medical University, China
  • 5Department of Neurology, Tianjin Huanhu Hospital, China
  • 6Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, China

Aims: The prevalence of diabetes mellitus (DM) among adults has reached epidemic proportions worldwide, including China. In China, sex-based differences in the prevalence and risk factors of DM may exist, particularly among low-income individuals. Thus, we assessed these differences in the prevalence of DM and its risk factors in a low-income Chinese population.
Materials and Methods: Residents aged ≥45 years without histories of strokes or cardiovascular disease were recruited for this study. Multivariate logistic regression analyses were performed to assess the association of risk factors with DM prevalence.
Results: This study included 3725 participants (41.2%, men; 58.8%, women). The mean age of the women (61.1 years) was higher than that of the men (59.14 years, P < 0.001). There was no significant sex-based difference in DM prevalence (men, 14.1%; women, 14.5%). Overweight, obesity, high triglyceride levels, and hypertension were independent risk factors for DM in both sexes. However, high-density lipoprotein-cholesterol levels were negatively associated with DM risk among men (odds ratio [OR], 0.544; 95% confidence interval [CI], 0.355–0.833; P = 0.005). Among women, advanced age and high low-density lipoprotein-cholesterol levels were independent risk factors for DM; there was a higher DM risk for women aged 55–74 years than for those aged 45–54 years; however, physical activity was associated with an increased risk of DM (OR, 1.705; 95% CI, 1.195–2.432; P = 0.003).
Conclusions: These findings suggest a crucial need to implement individualized blood pressure, weight, and lipid managements in low-income populations in China to reduce the burden of DM, especially among older women.

Keywords: diabetes, Sex diff erences, Prevalence, Risk facors, Epidemiology

Received: 15 Sep 2018; Accepted: 11 Sep 2019.

Copyright: © 2019 Zhang, Ni, Yu, Wu, Li, Liu, Tu, Ning, He and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Qing He, Tianjin Medical University General Hospital, Department of Endocrinology and Metabolism, Tianjin, China,
Prof. Jinghua Wang, Tianjin Medical University General Hospital, Tianjin, China,