The Prevalence And Relevant Factors Of Prediabetes And Diabetes Mellitus Among Chinese Residents Aged 45-79y

Objective:1.To analyze the level of FPG,prevalence of prediabetes and DM among Chinese residents aged 45-79 years in 2002 and 20122.To identify the dietary patterns by factor analysis among Chinese middle-aged and elderly,in 2002 and 20123.To explore the influencing factors of prediabetes and DM for making prevention and treatment strategy among Chinese middle-aged and elderly.Methods:1.SubjectsThe data of the study was from Chinese Nutrition and Health Survey in 2002 and Chinese Nutrition and Health Surveillance in 2012.The participants aged 45-79 years with tested FPG was collected in the study.Logistic regression was conducted in those with complete basic information,health status,physical activity,anthropometric measurement,food intake in 2002 and 20122.MethodsSAS 9.4 software was used to process and analyze the data.Estimated level of FPG,prevalence of prediabetes and DM were calculated by complex weighting adjustment procedure according to demographic data published by national bureau of statistics in 2009.Factor analysis was used to identify dietary patterns,with weekly intake frequency of foods as variables,according to the data of food frequency questionnaire in 2002 and 2012.Multi-factor logistic regression model was used to analyze the association of prediabetes and DM with influencing factorsResults:1.Distribution and trend of FPG and prevalence of prediabetes,DMThe average FPG was 5.14 mmol/L among 26 432 subjects aged 45-79 years in 2002.And,the average FPG was 5.54 mmol/L among 75 235 subjects aged 45-79 years in 2012.The results showed an increased trend of the FPG of Chinese middle-aged and elderly in 2012 compared to 2002.But,as compared to the level of FPG in urban elderly,the increase amplitude in rural areas was greater.The prevalence of prediabetes among Chinese middle-aged and elderly increased from 3.04%in 2002 to 13.37%in 2012.The prevalence of prediabetes increased with age,and the prevalence in rural middle-aged and elderly people was higher than in urban areas in 2012.And the prevalence of diabetes increased from 6.68%to 11.65%,and the prevalence was highest in 65～years old(15.53%)in 20122.Dietary patternsAccording to the FFQ and related data from two Chinese Nutrition and Health Surveillance/Survey,there were various dietary patterns among Chinese middle-aged and elderly,compared 2012 to 2002.And four dietary patterns of Chinese residents aged 45-79y in 2002 were obtained by using factor analysis.A meat-dairy pattern was rich in other meat,dairy and poultry.A beverages-wine pattern was rich in beverages,wine and nuts.A rice-vegetables pattern was rich in rice and vegetables.A eggs-beans-fruits pattern was rich in eggs,beans and fruits.And also,there were four dietary patterns in 2012.A food-diversity pattern was rich in eggs,cakes,nuts and fruits.A wheat-other cereals pattern was rich in flour,other cereals and tubers.A meat-vegetables pattern was rich in other meat,vegetables and poultry.A wine-beverages pattern was rich in wine and beverages3.Influencing factors of prediabetes and DM in middle-aged and elderly3.1 Influencing factors of prediabetesLogistic regression analysis results in 2002 showed that prediabetes positively associated with older age(OR=2.26,95%CI:1.52～3.37),the T3 level of beverages-wine pattern(OR=1.29,95%CI:1.05～1.60),overweight(OR=1.79,95%CI:1.46～2.11)and obesity(OR=2.09,95%CI:1.59～2.75).central obesity(OR=1.72,95%CI:1.41～2.11)and drinking(OR=1.51,95%CI:1.27～1.78),whereas negatively associated with rural areas(OR=0.85,95%CI:0.73～0.99),after adjusting factors such as income and physical activity.Logistic regression analysis results in 2012 demonstrated that prediabetes positively associated with older age(OR=2.12,95%CI:1.79-2.52),overweight(OR=1.35,95%CI:1.23～1.48),obesity(OR=1.62,95%CI:1.42～1.86),central obesity(OR=1.35,95%CI:1.23～1.49),drinking(OR=1.1 5,95%CI:1.06～1.25),whereas negatively associated with high income(OR=0.91,95%CI:0.83-0.99),the T4 level of wheat-other cereals pattern(OR=0.73,95%CI:0.65-0.81)and the T4 level of meat-vegetables pattern(OR=0.90,95%CI:0.81-0.99),after adjusting factors such as marriage and sedentariness time.The results of logistic regression in two Surveillance/Survey found that older age,overweight,obesity,central obesity,drinking were related to the high risk of prediabetes among the middle-aged and elderly.The result of data from two years also showed that prediabetes may be related to beverages-wine pattern,wheat-other cereals pattern,and meat-vegetables pattern.3.2 Influencing factors of DMLogistic regression analysis results in 2002 demonstrated that DM positively associated with older age(OR=1.62,95%CI:1.02-2.57),overweight(OR=1.52,95%CI:1.23～1.88),obesity(OR=1.93,95%CI:1.47-2.53),central obesity(OR=2.22,95%CI:1.81～2.74),the T4 level of meat-dairy pattern(OR=1.43,95%CII.14～1.78),the T4 level of eggs-beans-fruit pattern(OR=1.38.95%CI:1.09-1.76),whereas negatively associated with rural areas(OR=0.64,95%CI:0.56-0.76),after adjusting factors such as income,education and smokingLogistic regression analysis results in 2012 showed that DM positively associated with older age(OR=1.95,95%CI:1.54～2.48),overweight(OR=1.35,95%CI:1.1 8～1.54).obesity(OR=1.63,95%CI:1.36～1.94),central obesity(OR=2.05,95%CI:1.80～2.33),and more than 5 hours per day of sedentariness(OR=l.37,95%CI:1.08～1.75),whereas negatively associated with the T4 level of wheat-other cereals pattern(OR=0.81,95%CI:0.7 1～0.94),after adjusting factors such as areas and marriage.The results of multi-factor logistic regression in two Surveillance/Survey found that older age,overweight and obesity,central obesity were related to the high risk of DM among middle-aged and elderly.Besides,the result of 2012 also suggested that DM may be related to sedentariness time.Also,the result of data from two years indicated that DM may be related to meat-dairy pattern,eggs-beans-fruits pattern,and wheat-other cereals pattern.Conclusion:Two Surveillance/Survey data showed that there was an increased trend of FPG level,and the prevalence of prediabetes and DM among Chinese residents aged 45-79y compared 2012 to 2002.Among them,the rural middle-aged and elderly people have a rapid rise in prediabetes disease,suggesting that the future rural diabetes disease pressure will even exceed the city,rural people will be the focus of diabetes prevention and treatment.Age,overweight and obesity,central obesity may be associated with high risk of prediabetes and DM among middle-aged and elderly.Furthermore,alcohol consumption,beverage-wine pattern may be associated with high risk of prediabetes,but wheat-other cereals pattern,and meat-vegetables may be associated with low risk of prediabetes.Sedentariness,meat-dairy pattern and egg-beans-fruit pattern may be also associated with high risk of DM,but wheat-other cereals pattern has an negative effect on DM.This study finds that maintaining a balanced diet,such as,appropriate intake of cereals,vegetables,meat and reducing the consumption of beverages and alcohol are beneficial to reducing the risk of prediabetes and DM among middle-aged and elderly.In addition,avoiding overweight,obesity,and central obesity may also be beneficial to the prevention and control of prediabetes and DM among middle-aged and elderly.