Determinants And Cardiometabolic Characteristics Of Chinese Adults With Type 2 Diabetes

Background Diabetes has become an important public health problem worldwide.Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades,especially in China.Cardiovascular diseases(CVDs)are the predominant cause of death in patients with diabetes.Study design and methods 1.We conducted a nationally representative survey of 98,658 noninstitutionalized Chinese adults aged ?18 years using a complex,multistage,probability sampling design in 2010.All estimates were weighted to represent the overall Chinese adults aged ?18 years.2.We conducted a cross-sectional study in 10122 participants aged 40 years or older in Jiading District of Shanghai,and another cross-sectional study in 548 residents aged 40–60 years without previous history or clinical symptoms of CVDs in Baoshan District of Shanghai.Coronary CT angiography was used to evaluate subclinical coronary atherosclerosis in the latter study.Results1.Among Chinese adults with diabetes,the weighted prevalence estimates were 27.2%(95% confidence interval(CI): 26.2%-28.3%)for current smoking,10.9%(10.3%-11.7%)for obesity,52.2%(51.0%-53.3%)for systolic blood pressure ?140 mmHg,46.8%(45.6%-47.9%)for low-density lipoprotein cholesterol ?100 mg/dL,36.4%(35.3%-37.5%)for hemoglobin A1 c ?7.0%(53 mmol/mol),and 69.5%(68.4%-70.6%)for metabolic syndrome.In addition,the prevalence,awareness,treatment,and control of diabetes in Chinese adults vary according to age and body-mass index(BMI)levels,as well as proportions of individuals with known hypertension or known dyslipidemia.2.We observed a strong inverse association between serum lipoprotein(a)concentrations and prevalence of diabetes,insulin resistance,and metabolic syndrome.In addition,the multivariable multinomial logistic regression analysis showed that among all the obesity indicators such as BMI,waist circumference,visceral fat areas,and?-glutamyltranspeptidase(GGT)levels,only GGT levels were significantly associated with risks of having significant coronary stenosis after adjustment for conventional cardiovascular risk factors.Conclusions Cardiometabolic risk factors were highly prevalent among Chinese adults with diabetes.Serum lipoprotein(a)leves were inversely associated with risks of diabetes,insulin resistance,and metabolic syndorme.Liver fat accumulation might be more important in the association with subclinical coronary atherosclerosis compared with general and abdominal fat accumulation.In conclusion,national policies and lifestyle interventions should be implemented to tackle the increasing trend of diabetes-related cardiometabolic disorders in China.