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. 2025 Apr 12;15(1):12550.
doi: 10.1038/s41598-025-95813-1.

Identification of risk factors for diabetes in Chinese middle-aged and elderly adults

Shuzhen Ma  1   2 , Qianqian Sun  3 , Yanqi Xu  4 , Qiang Tu  5 , Simao Xu  6
Affiliations

Identification of risk factors for diabetes in Chinese middle-aged and elderly adults

Shuzhen Ma et al. Sci Rep. .

Abstract

This study aimed to identify and analyze the factors associated with the prevalence of diabetes among Chinese adults, using data from the China Health and Retirement Longitudinal Study (CHARLS). Data from the CHARLS cohort, with a mean age of 63.3 years, were analyzed using SPSS software. Descriptive statistics were performed for the overall population, as well as urban and rural subgroups. Logistic regression models were employed to assess the association between diabetes and variables such as age, gender, smoking, alcohol consumption, hypertension, and mental health disorders. Paired-sample t-tests were conducted to evaluate changes in diabetes prevalence across 2015, 2018, and 2020. The average of diabetes increased from 1.08 in 2015 to 1.15 in 2020, with a statistically significant difference (P < 0.001). Paired-sample t-tests showed significant differences between 2020 and 2018, as well as between 2018 and 2015 (P < 0.001). Logistic regression analysis identified hypertension (aOR = 0.447, 95% CI: 0.410-0.488, P < 0.001) and chronic disease (aOR = 0.024, 95% CI: 0.013-0.042, P < 0.001) as key risk factors for diabetes. Mild physical exercise was a protective factor (aOR = 0.813, 95% CI: 0.708-0.935, P < 0.01), while smoking (aOR = 1.220, 95% CI: 1.088-1.369, P < 0.001) and alcohol consumption (aOR = 1.125, 95% CI: 1.020-1.242, P < 0.05) increased the risk. Smoking and alcohol had a greater impact in urban areas, while hypertension and mental health disorders were more influential in rural areas. This study demonstrates that age, gender, smoking, alcohol consumption, hypertension, and mental disorders significantly influence the risk of diabetes among Chinese adults aged 45 and above. Distinct risk factors were identified between urban and rural populations, highlighting the necessity for tailored intervention strategies. The longitudinal analysis from 2015 to 2020 revealed a substantial increase in diabetes prevalence, underscoring the critical need for sustained and targeted public health efforts.

Keywords: CHARLS; Diabetes; Risk factor.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Patient and public involvement: Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Patient consent for publication: Not applicable. Provenance and peer review: Not commissioned, externally peer reviewed.

Figures

Fig. 1
Fig. 1
Geographic distribution of sampled areas (Map created using CorelDRAW X4, version 14.0, https://www.coreldraw.com).
Fig. 2
Fig. 2
Distribution differences in age and sleep time among urban, rural, and overall samples.
Fig. 3
Fig. 3
Trend of Mean Changes for Independent Variables.
See this image and copyright information in PMC

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