The Association Between Family Average Income And Self-reported Type 2 Diabetes Among Urban Adults In Nanjing

Part one The relationship between family average income and self-reported type 2 diabetes among urban adults in Nanjing: a cross-sectional study in 20110bjective To examine the relationship between family average income(FAI)and self-reported type 2 diabetes mellitus(T2DM)among urban residents in Nanjing.Methods A population-based cross-sectional survey was conducted among local regular residents aged 35+ years old in 4 urban districts randomly selected from Nanjing in 2011.The outcome measure was self-reported T2 DM,and the explanatory variable was tertiled FAI.Results The prevalence of self-reported T2 DM was 8.2%(95%CI=7.6%,8.8%)among those urban residents in Nanjing.Significant differences in prevalence of T2 DM were observed in age groups,but not in genders.After adjusting for potential confounding factors,participants within upper(OR=1.58,95%CI=1.23,2.02)and middle(OR=1.35,95%CI=1.06,1.74)tertile of FAI were more likely to have T2 DM compared to their counterparts in lower tertile of FAI.Furthermore,with age growing,participants within upper FAI tertile were at much higher risk to have T2 DM relative to their counterparts with lower FAI.Conclusion Family average income was positively associated with self-reported T2 DM among urban residents in Nanjing,China.Part two Association between socio-economic status and self-reported type 2 diabetes is changing with economic growth among urban adults in Nanjing,ChinaObjective In developed countries,the relationship between socioeconomic status(SES)and type 2 diabetes mellitus(T2DM)was positive several decades ago but is now negative.However in developing societies such as China the relationship remains positive.It is likely that at some stage of economic development the SES-T2 DM association will become negative in developing communities.This study aimed to examine whether this inflexion is approaching in China.Methods Two cross-sectional surveys were undertaken in Nanjing,China,in 2000 and 2011.The same sampling approach was used to randomly select participants.Self-reported T2 DM was the outcome variable.SES was measured using monthly family average income(FAI)and divided into thirds.Mixed-effects models were used to calculate the association between SES and T2 DM.Results There were 19861(response rate=90.1%)and 7824(response rate=82.8%)participants in 2000 and 2011 respectively.A 2.6-fold increase in T2 DM prevalence was observed from 3.0%(95%CI=2.8%,3.3%)in 2000 to 8.2%(95%CI=7.6%,8.8%)in 2011(P<0.01).After controlling for potential confounders,the odds ratios of having T2 DM decreased from 2.06(95%CI=1.55,2.73)and 1.83(95%CI=1.40,2.37)in 2000 to 1.58(95%CI=1.23,2.02)and 1.35(95%CI=1.06,1.74)in 2011 for the higher and middle SES groups respectively,compared to those in the lower SES category.Conclusions The SES-T2 DM association remained positive in Nanjing,China,in 2011 but the disparity diminished significantly compared with 2000.These results can inform the delivery of appropriate interventions to people at risk of developing T2 DM.