Association of socioeconomic and lifestyle factors with prevalence of diabetes in rural southwest China: a structural equation modelling approach

• Published in: BMJ open Vol. 14; no. 10; p. e086050
• Main Authors: Liu, Lan, Wu, Xia, Li, Guo-Hui, Yu, Zi-Zi, Liu, Du-Li, Rabkin Golden, Allison, Yin, Xiang-Yang, Cai, Le
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 08.10.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Adult; Aged; Body Mass Index; China; China - epidemiology; Cohort analysis; Cross-Sectional Studies; Developing countries; Diabetes; diabetes & endocrinology; Diabetes Mellitus - epidemiology; Education; Epidemiology; Ethnicity; Family income; Female; general diabetes; Health services; Humans; Hypertension; Hypertension - epidemiology; Latent Class Analysis; LDCs; Life Style; Lifestyles; Male; Middle Aged; Obesity; Obesity - epidemiology; Original Research; Population; Prevalence; Public health; Risk Factors; Rural areas; Rural Population - statistics & numerical data; Self report; Socioeconomic Factors; Trends; Variables; China; United States > US; Yunnan China; general diabetes; risk factors; China; diabetes & endocrinology
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2024-086050

ObjectivesThis study aimed to investigate the prevalence of diabetes using structural equation modelling (SEM) to examine the pathways and associations of socioeconomic and lifestyle factors on diabetes in rural southwest China.DesignData were collected from a cross-sectional health interview and examination survey among individuals aged ≥35 years in rural southwest China. Fasting blood glucose, blood pressure, height, weight and waist circumference (WC) were measured for each participant. SEM was employed to assess the relationships between demographic characteristics (sex, age and ethnicity), socioeconomic position (SEP; annual household income, education level and access to medical services), lifestyle factors (obesity status (body mass index and WC) and physical inactivity), hypertension, hyperlipidaemia and family history of diabetes.SettingThis study was conducted in rural Yunnan Province of China.Participants7536 individuals aged ≥35 years consented to participate in the study.ResultsThe overall prevalence of diabetes in the present study was 8.3%. Prevalence did not differ by gender (prevalence for both men and women was 8.3% (p>0.05)). The results of SEM indicated that SEP, age, ethnicity, obesity status and physical inactivity had both significant direct and indirect effects on diabetes, with total effect size of 0.091, 0.149, –0.094, 0.212 and 0.089, respectively (p<0.01). Family history of diabetes (0.128, p<0.01), hypertension (0.135, p<0.01) and hyperlipidaemia (0.137, p<0.01) were directly associated with diabetes.ConclusionsSocioeconomic and lifestyle factors have both direct and indirect effects on prevalence of diabetes in rural southwest China. Future efforts to implement comprehensive interventions to promote the prevention and control of diabetes should in particular focus on obese individuals.