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Prevalence and the association of body mass index and other risk factors with prediabetes and type 2 diabetes among 50,867 adults in China and Sweden: A cross-sectional study

Journal article
Authors Yue Zhang
Ailiana Santosa
Na Wang
Weibing Wang
Nawi Ng
Qi Zhao
Yonggen Jiang
Lars Weinehall
Genming Zhao
Published in Diabetes Therapy
Volume 10
Issue 6
Pages 2061-2077
ISSN 1869-6953
Publication year 2019
Published at Institute of Medicine, School of Public Health and Community Medicine
Pages 2061-2077
Language en
Keywords Body mass index, Prediabetes, Prevalence, Risk factors, Type 2 diabetes, physical-activity, family-history, mellitus, obesity, trends, disparities, diagnosis, disease, Endocrinology & Metabolism
Subject categories Endocrinology and Diabetes


Introduction Understanding socioeconomic differences for prediabetes and type 2 diabetes (T2DM) can offer guidance for the most effective development of both prevention and intervention programmes in different settings. This study aims to determine the prevalence and risk factors for prediabetes and T2DM and to explore the effect of high body mass index (BMI) on the probability of T2DM being present among adults in China and Sweden. Methods This study enrolled 25,356 adults (35-64 years old) from the Shanghai Survey in China and 25,511 adults (aged 40, 50, 60) from the Vasterbotten Intervention Programme in Sweden. Data on haemoglobin A1c, capillary fasting plasma glucose, 2-h plasma glucose and self-reported diagnoses of T2DM were used in the analysis. Multinomial logistic regression was used to examine the determinants of prediabetes and T2DM. The average predicted probabilities of T2DM developing or presenting were determined for the different ages and levels of BMI in each population. Results Chinese participants had a higher adjusted prevalence of T2DM (men 12.8% vs. 4.6%; women 10.6% vs. 3.1%) and prediabetes (men 12.4% vs. 12.2%; women 14.4% vs. 12.2%) than Swedish participants. Age, overweightedness/obesity, hypertension and a family history of diabetes were significant risk factors for prediabetes and T2DM. In both populations, the predicted probability of T2DM increased as the BMI increased in all age groups. At the same BMI level, Chinese participants were more likely to have T2DM compared to their Swedish counterparts. The average predicted probability of T2DM was less than 20% in nearly all age groups among Swedish women. Conclusions Chinese adults had the higher prevalence of prediabetes and T2DM and a higher probability of T2DM at the same BMI level compared with Swedish adults. These results indicate the importance of addressing the ongoing obesity epidemic as a matter of urgency in order to curb what has become an apparent diabetes epidemic in both countries.

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