Population attributable fractions of modifiable risk factors for microvascular complications of type 2 diabetes in China: An analysis using national cross‐sectional data
Aim To assess the population attributable fractions (PAFs) for modifiable risk factors for microvascular complications of type 2 diabetes (T2D) in China. Materials and Methods Data collected from the China National HbA1c Surveillance System from 2009 to 2013 were used. The PAFs of four predefined ri...
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| Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2023-04, Vol.25 (S1), p.5-12 |
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| creator | Lin, Chu Zhu, Xingyun Jiao, Ruoyang Cai, Xiaoling Hu, Suiyuan Lv, Fang Yang, Wenjia Li, Zonglin Ji, Linong |
| description | Aim
To assess the population attributable fractions (PAFs) for modifiable risk factors for microvascular complications of type 2 diabetes (T2D) in China.
Materials and Methods
Data collected from the China National HbA1c Surveillance System from 2009 to 2013 were used. The PAFs of four predefined risk factors, including an HbA1c of 7% or higher, blood pressure (BP) of 130/80 mmHg or higher, low‐density lipoprotein‐cholesterol (LDL‐C) of 1.8 mmol/L or higher and body mass index (BMI) of 24 kg/m2 or higher, were calculated for diabetic microvascular complications, including diabetic retinopathy (DR), diabetic kidney disease (DKD) and distal symmetric polyneuropathy (DSPN). PAFs were further adjusted for age, sex and duration of diabetes.
Results
In total, there were 998 379 participants with T2D from nationwide mainland China included in this analysis. As for DR, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher conferred PAFs of 16.2%, 15.2%, 5.8% and 2.8%, respectively. In the case of DKD, BP of 130/80 mmHg or higher provided a PAF of 25.2%, followed by an HbA1c of 7% or higher (13.9%), BMI of 24 kg/m2 or higher (8.0%) and LDL‐C of 1.8 mmol/L or higher (5.6%). As for DSPN, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher contributed to PAFs of 14.2%, 11.7%, 5.9% and 5.8%, respectively. PAFs for diabetic microvascular complications were mildly to moderately reduced after adjusting for participants' age, sex and duration of diabetes.
Conclusions
Suboptimal glycaemic and BP control were the main contributors to diabetic microvascular complications, while the PAFs of unmet LDL‐C and BMI control targets were quite limited for diabetic microvascular complications. In addition to glycaemic control, BP control should be especially prioritized in the management of diabetic microvascular complications to further reduce the disease burden. |
| doi_str_mv | 10.1111/dom.15029 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2779352188</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2803135931</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3889-82e516261807dd2ee1717e911f8070bb715f528f12ec28beb7a5110058399add3</originalsourceid><addsrcrecordid>eNp1kU9u3CAYxVHVqkmnXfQCEVI36cIJH8Q2zi6a_pVSpYtkbWH4aEmwccBONLseofforXqSEs80i0plAejxew_QI-Q1sCPI49iE_ghKxpsnZB9OKlGA4NXTZc8L2TC-R16kdM0YOxGyfk72RCUBOOf75NfXMM5eTS4MVE1TdN08qc4jtVHpBzXRYGkfjLNu0aNLN9TmsxATtSHS3ukY7lTSOSZSHfrRO60erdNmRMqpyW6cMFE30PV3N6hTepZvHJTfJJfonNzwjQ6LTXmaE1P6_eNnQr1TjJrUS_LMKp_w1W5dkasP7y_Xn4rzi4-f12fnhRZSNoXkWELFK5CsNoYjQg01NgA2C6zraihtyaUFjprLDrtalQCMlVI0jTJGrMjhNneM4XbGNLW9Sxq9VwOGObW8rhtRcpAyo2_-Qa_DHPODMyWZAFE2eVqRt1tq-VdE247R9SpuWmDtQ4NtbrBdGszswS5x7no0j-TfyjJwvAXuncfN_5PadxdftpF_AB04qIE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2803135931</pqid></control><display><type>article</type><title>Population attributable fractions of modifiable risk factors for microvascular complications of type 2 diabetes in China: An analysis using national cross‐sectional data</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Lin, Chu ; Zhu, Xingyun ; Jiao, Ruoyang ; Cai, Xiaoling ; Hu, Suiyuan ; Lv, Fang ; Yang, Wenjia ; Li, Zonglin ; Ji, Linong</creator><creatorcontrib>Lin, Chu ; Zhu, Xingyun ; Jiao, Ruoyang ; Cai, Xiaoling ; Hu, Suiyuan ; Lv, Fang ; Yang, Wenjia ; Li, Zonglin ; Ji, Linong</creatorcontrib><description>Aim
To assess the population attributable fractions (PAFs) for modifiable risk factors for microvascular complications of type 2 diabetes (T2D) in China.
Materials and Methods
Data collected from the China National HbA1c Surveillance System from 2009 to 2013 were used. The PAFs of four predefined risk factors, including an HbA1c of 7% or higher, blood pressure (BP) of 130/80 mmHg or higher, low‐density lipoprotein‐cholesterol (LDL‐C) of 1.8 mmol/L or higher and body mass index (BMI) of 24 kg/m2 or higher, were calculated for diabetic microvascular complications, including diabetic retinopathy (DR), diabetic kidney disease (DKD) and distal symmetric polyneuropathy (DSPN). PAFs were further adjusted for age, sex and duration of diabetes.
Results
In total, there were 998 379 participants with T2D from nationwide mainland China included in this analysis. As for DR, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher conferred PAFs of 16.2%, 15.2%, 5.8% and 2.8%, respectively. In the case of DKD, BP of 130/80 mmHg or higher provided a PAF of 25.2%, followed by an HbA1c of 7% or higher (13.9%), BMI of 24 kg/m2 or higher (8.0%) and LDL‐C of 1.8 mmol/L or higher (5.6%). As for DSPN, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher contributed to PAFs of 14.2%, 11.7%, 5.9% and 5.8%, respectively. PAFs for diabetic microvascular complications were mildly to moderately reduced after adjusting for participants' age, sex and duration of diabetes.
Conclusions
Suboptimal glycaemic and BP control were the main contributors to diabetic microvascular complications, while the PAFs of unmet LDL‐C and BMI control targets were quite limited for diabetic microvascular complications. In addition to glycaemic control, BP control should be especially prioritized in the management of diabetic microvascular complications to further reduce the disease burden.</description><identifier>ISSN: 1462-8902</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.15029</identifier><identifier>PMID: 36811222</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Blood pressure ; Body mass index ; China - epidemiology ; Cholesterol ; Cholesterol, LDL ; Cross-Sectional Studies ; Diabetes ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetic retinopathy ; Diabetic Retinopathy - epidemiology ; Diabetic Retinopathy - etiology ; Diabetic Retinopathy - prevention & control ; dyslipidaemia ; Glycated Hemoglobin ; Humans ; hyperglycaemia ; Hyperglycemia ; hypertension ; Hypertension - complications ; Kidney diseases ; Low density lipoprotein ; Metabolic disorders ; microvascular complications ; Microvasculature ; Polyneuropathy ; Retinopathy ; Risk Factors ; type 2 diabetes</subject><ispartof>Diabetes, obesity & metabolism, 2023-04, Vol.25 (S1), p.5-12</ispartof><rights>2023 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3889-82e516261807dd2ee1717e911f8070bb715f528f12ec28beb7a5110058399add3</citedby><cites>FETCH-LOGICAL-c3889-82e516261807dd2ee1717e911f8070bb715f528f12ec28beb7a5110058399add3</cites><orcidid>0000-0002-2365-9831 ; 0000-0002-3262-2168 ; 0000-0002-8949-9455 ; 0000-0002-7881-0543</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdom.15029$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdom.15029$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36811222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Chu</creatorcontrib><creatorcontrib>Zhu, Xingyun</creatorcontrib><creatorcontrib>Jiao, Ruoyang</creatorcontrib><creatorcontrib>Cai, Xiaoling</creatorcontrib><creatorcontrib>Hu, Suiyuan</creatorcontrib><creatorcontrib>Lv, Fang</creatorcontrib><creatorcontrib>Yang, Wenjia</creatorcontrib><creatorcontrib>Li, Zonglin</creatorcontrib><creatorcontrib>Ji, Linong</creatorcontrib><title>Population attributable fractions of modifiable risk factors for microvascular complications of type 2 diabetes in China: An analysis using national cross‐sectional data</title><title>Diabetes, obesity & metabolism</title><addtitle>Diabetes Obes Metab</addtitle><description>Aim
To assess the population attributable fractions (PAFs) for modifiable risk factors for microvascular complications of type 2 diabetes (T2D) in China.
Materials and Methods
Data collected from the China National HbA1c Surveillance System from 2009 to 2013 were used. The PAFs of four predefined risk factors, including an HbA1c of 7% or higher, blood pressure (BP) of 130/80 mmHg or higher, low‐density lipoprotein‐cholesterol (LDL‐C) of 1.8 mmol/L or higher and body mass index (BMI) of 24 kg/m2 or higher, were calculated for diabetic microvascular complications, including diabetic retinopathy (DR), diabetic kidney disease (DKD) and distal symmetric polyneuropathy (DSPN). PAFs were further adjusted for age, sex and duration of diabetes.
Results
In total, there were 998 379 participants with T2D from nationwide mainland China included in this analysis. As for DR, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher conferred PAFs of 16.2%, 15.2%, 5.8% and 2.8%, respectively. In the case of DKD, BP of 130/80 mmHg or higher provided a PAF of 25.2%, followed by an HbA1c of 7% or higher (13.9%), BMI of 24 kg/m2 or higher (8.0%) and LDL‐C of 1.8 mmol/L or higher (5.6%). As for DSPN, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher contributed to PAFs of 14.2%, 11.7%, 5.9% and 5.8%, respectively. PAFs for diabetic microvascular complications were mildly to moderately reduced after adjusting for participants' age, sex and duration of diabetes.
Conclusions
Suboptimal glycaemic and BP control were the main contributors to diabetic microvascular complications, while the PAFs of unmet LDL‐C and BMI control targets were quite limited for diabetic microvascular complications. In addition to glycaemic control, BP control should be especially prioritized in the management of diabetic microvascular complications to further reduce the disease burden.</description><subject>Blood pressure</subject><subject>Body mass index</subject><subject>China - epidemiology</subject><subject>Cholesterol</subject><subject>Cholesterol, LDL</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetic retinopathy</subject><subject>Diabetic Retinopathy - epidemiology</subject><subject>Diabetic Retinopathy - etiology</subject><subject>Diabetic Retinopathy - prevention & control</subject><subject>dyslipidaemia</subject><subject>Glycated Hemoglobin</subject><subject>Humans</subject><subject>hyperglycaemia</subject><subject>Hyperglycemia</subject><subject>hypertension</subject><subject>Hypertension - complications</subject><subject>Kidney diseases</subject><subject>Low density lipoprotein</subject><subject>Metabolic disorders</subject><subject>microvascular complications</subject><subject>Microvasculature</subject><subject>Polyneuropathy</subject><subject>Retinopathy</subject><subject>Risk Factors</subject><subject>type 2 diabetes</subject><issn>1462-8902</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9u3CAYxVHVqkmnXfQCEVI36cIJH8Q2zi6a_pVSpYtkbWH4aEmwccBONLseofforXqSEs80i0plAejxew_QI-Q1sCPI49iE_ghKxpsnZB9OKlGA4NXTZc8L2TC-R16kdM0YOxGyfk72RCUBOOf75NfXMM5eTS4MVE1TdN08qc4jtVHpBzXRYGkfjLNu0aNLN9TmsxATtSHS3ukY7lTSOSZSHfrRO60erdNmRMqpyW6cMFE30PV3N6hTepZvHJTfJJfonNzwjQ6LTXmaE1P6_eNnQr1TjJrUS_LMKp_w1W5dkasP7y_Xn4rzi4-f12fnhRZSNoXkWELFK5CsNoYjQg01NgA2C6zraihtyaUFjprLDrtalQCMlVI0jTJGrMjhNneM4XbGNLW9Sxq9VwOGObW8rhtRcpAyo2_-Qa_DHPODMyWZAFE2eVqRt1tq-VdE247R9SpuWmDtQ4NtbrBdGszswS5x7no0j-TfyjJwvAXuncfN_5PadxdftpF_AB04qIE</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Lin, Chu</creator><creator>Zhu, Xingyun</creator><creator>Jiao, Ruoyang</creator><creator>Cai, Xiaoling</creator><creator>Hu, Suiyuan</creator><creator>Lv, Fang</creator><creator>Yang, Wenjia</creator><creator>Li, Zonglin</creator><creator>Ji, Linong</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2365-9831</orcidid><orcidid>https://orcid.org/0000-0002-3262-2168</orcidid><orcidid>https://orcid.org/0000-0002-8949-9455</orcidid><orcidid>https://orcid.org/0000-0002-7881-0543</orcidid></search><sort><creationdate>202304</creationdate><title>Population attributable fractions of modifiable risk factors for microvascular complications of type 2 diabetes in China: An analysis using national cross‐sectional data</title><author>Lin, Chu ; Zhu, Xingyun ; Jiao, Ruoyang ; Cai, Xiaoling ; Hu, Suiyuan ; Lv, Fang ; Yang, Wenjia ; Li, Zonglin ; Ji, Linong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3889-82e516261807dd2ee1717e911f8070bb715f528f12ec28beb7a5110058399add3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Blood pressure</topic><topic>Body mass index</topic><topic>China - epidemiology</topic><topic>Cholesterol</topic><topic>Cholesterol, LDL</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetic retinopathy</topic><topic>Diabetic Retinopathy - epidemiology</topic><topic>Diabetic Retinopathy - etiology</topic><topic>Diabetic Retinopathy - prevention & control</topic><topic>dyslipidaemia</topic><topic>Glycated Hemoglobin</topic><topic>Humans</topic><topic>hyperglycaemia</topic><topic>Hyperglycemia</topic><topic>hypertension</topic><topic>Hypertension - complications</topic><topic>Kidney diseases</topic><topic>Low density lipoprotein</topic><topic>Metabolic disorders</topic><topic>microvascular complications</topic><topic>Microvasculature</topic><topic>Polyneuropathy</topic><topic>Retinopathy</topic><topic>Risk Factors</topic><topic>type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Chu</creatorcontrib><creatorcontrib>Zhu, Xingyun</creatorcontrib><creatorcontrib>Jiao, Ruoyang</creatorcontrib><creatorcontrib>Cai, Xiaoling</creatorcontrib><creatorcontrib>Hu, Suiyuan</creatorcontrib><creatorcontrib>Lv, Fang</creatorcontrib><creatorcontrib>Yang, Wenjia</creatorcontrib><creatorcontrib>Li, Zonglin</creatorcontrib><creatorcontrib>Ji, Linong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Chu</au><au>Zhu, Xingyun</au><au>Jiao, Ruoyang</au><au>Cai, Xiaoling</au><au>Hu, Suiyuan</au><au>Lv, Fang</au><au>Yang, Wenjia</au><au>Li, Zonglin</au><au>Ji, Linong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Population attributable fractions of modifiable risk factors for microvascular complications of type 2 diabetes in China: An analysis using national cross‐sectional data</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2023-04</date><risdate>2023</risdate><volume>25</volume><issue>S1</issue><spage>5</spage><epage>12</epage><pages>5-12</pages><issn>1462-8902</issn><eissn>1463-1326</eissn><abstract>Aim
To assess the population attributable fractions (PAFs) for modifiable risk factors for microvascular complications of type 2 diabetes (T2D) in China.
Materials and Methods
Data collected from the China National HbA1c Surveillance System from 2009 to 2013 were used. The PAFs of four predefined risk factors, including an HbA1c of 7% or higher, blood pressure (BP) of 130/80 mmHg or higher, low‐density lipoprotein‐cholesterol (LDL‐C) of 1.8 mmol/L or higher and body mass index (BMI) of 24 kg/m2 or higher, were calculated for diabetic microvascular complications, including diabetic retinopathy (DR), diabetic kidney disease (DKD) and distal symmetric polyneuropathy (DSPN). PAFs were further adjusted for age, sex and duration of diabetes.
Results
In total, there were 998 379 participants with T2D from nationwide mainland China included in this analysis. As for DR, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher conferred PAFs of 16.2%, 15.2%, 5.8% and 2.8%, respectively. In the case of DKD, BP of 130/80 mmHg or higher provided a PAF of 25.2%, followed by an HbA1c of 7% or higher (13.9%), BMI of 24 kg/m2 or higher (8.0%) and LDL‐C of 1.8 mmol/L or higher (5.6%). As for DSPN, an HbA1c of 7% or higher, BP of 130/80 mmHg or higher, LDL‐C of 1.8 mmol/L or higher and BMI of 24 kg/m2 or higher contributed to PAFs of 14.2%, 11.7%, 5.9% and 5.8%, respectively. PAFs for diabetic microvascular complications were mildly to moderately reduced after adjusting for participants' age, sex and duration of diabetes.
Conclusions
Suboptimal glycaemic and BP control were the main contributors to diabetic microvascular complications, while the PAFs of unmet LDL‐C and BMI control targets were quite limited for diabetic microvascular complications. In addition to glycaemic control, BP control should be especially prioritized in the management of diabetic microvascular complications to further reduce the disease burden.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>36811222</pmid><doi>10.1111/dom.15029</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2365-9831</orcidid><orcidid>https://orcid.org/0000-0002-3262-2168</orcidid><orcidid>https://orcid.org/0000-0002-8949-9455</orcidid><orcidid>https://orcid.org/0000-0002-7881-0543</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Blood pressure Body mass index China - epidemiology Cholesterol Cholesterol, LDL Cross-Sectional Studies Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology Diabetic retinopathy Diabetic Retinopathy - epidemiology Diabetic Retinopathy - etiology Diabetic Retinopathy - prevention & control dyslipidaemia Glycated Hemoglobin Humans hyperglycaemia Hyperglycemia hypertension Hypertension - complications Kidney diseases Low density lipoprotein Metabolic disorders microvascular complications Microvasculature Polyneuropathy Retinopathy Risk Factors type 2 diabetes |
| title | Population attributable fractions of modifiable risk factors for microvascular complications of type 2 diabetes in China: An analysis using national cross‐sectional data |
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