Rural-urban differentials of prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China

Abstract

Background Diabetes has become a major public health problem in China. A better understanding of diabetes determinants and urban-rural differences is essential to crafting targeted diabetes prevention measures for the elderly living in both urban and rural areas. This study aimed to compare rural-urban differentials in prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China. Methods A cross-sectional health interview and examination survey was conducted among individuals aged ≥ 60 years in both a rural and urban area of China. Anthropometric measurements, including height, weight, and waist circumference, as well as blood pressure and fasting blood glucose measurements were taken. Associated risk factors for pre-diabetes and diabetes were evaluated using multivariate logistic regression analysis. Results In total, 1,624 urban residents and 1,601 rural residents consented to participate in the study. The urban prevalence of pre-diabetes and diabetes (46.8% and 24.7%, respectively), was higher than the rural prevalence (23.4% and 11.0%, respectively, P<0.01). Urban elderly participants had markedly higher prevalence of obesity, central obesity, and physical inactivity than their rural counterparts (15.3%, 76.0%, and 9.2% vs. 4.6%, 45.6%, and 6.1%, P<0.01). In contrast, rural elderly adults had higher prevalence of smoking than urban ones (23.2% vs. 17.2%, P<0.01). Obese (OR 1.71, 95% CI 1.27–2.30 vs. OR 1.73, 95% CI 1.30–3.28) and centrally obese participants (OR 1.59, 95% CI 1.18–2.15 vs. OR 1.83, 95% CI 1.32–2.54) were more likely to suffer from diabetes in both urban and rural regions. Furthermore, urban current smokers had a higher probability of suffering from diabetes (OR 1.58, 95% CI 1.11–2.25), while hypertension was positively associated with the prevalence of diabetes in the rural area (OR 2.13, 95% CI 1.54–2.95). Obese participants in the rural area were more likely to suffer from pre-diabetes (OR 2.50, 95% CI 1.53–4.08), while physical inactivity was positively associated with prevalence of pre-diabetes in the urban area (OR 1.95, 95% CI 1.37–2.80). Conclusion Pre-diabetes and diabetes are more prevalent among urban older adults than their rural counterparts in southwest China. The identified rural-urban differentials of lifestyle factors have significant impacts on prevalence of pre-diabetes and diabetes. Thus, tailored lifestyle interventions are needed to improve diabetes prevention and management among the elderly in southwest China.

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“…The model learns to predict the likelihood of a person being obese based on these features. MCHC, which measures the average concentration of hemoglobin in red blood cells [23][24][25], is typically between 32 and 36 g per deciliter (g/dL) or 320 to 360 g per liter (g/L).…”

“…A normal white blood cell (leukocytes) count for adults is between 4000 and 11,000 white blood cells per µL or 4.0 and 11.0 × 10 9 per L) [23][24][25][26]. A normal platelet (thrombocyte) count in adults ranges from 150,000 to 450,000 platelets per microliter of blood or 150 to 450 × 10 9 per L. The expected normal cholesterol level in adults is less than 200 mg/dL (less than 5.2 mmol/L) and for glucose is between 70 mg/dL and 100 mg/dL (3.9 to 5.6 mmol/L) [23][24][25]. A normal level of ALT (alanine aminotransferase) for adults, which measures the level of an enzyme in liver, is between 7 and 55 units per liter (U/L) [24][25][26].…”

“…For triglycerides, which measure the amount of fat in the blood, a normal level for adults is less than 150 mg/dL or 1.7 mmol/L [24][25][26]. For TSH (thyroid-stimulating hormone), which measures the level of a hormone that stimulates thyroid gland [23][24][25], a normal level for adults is between 0.4 and 4.0 milliunits per liter (mU/L). Normal magnesium level is typically between 1.5 and 2.4 mg/dL.…”