The prevalence of and risk factors for diabetes mellitus and impaired glucose tolerance among Tibetans in China: a cross-sectional study
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Shaopeng Xu1,*, Qing Wang1,*, Jie Liu2,3, Bo Bian1, Xuefang Yu1, Xiangdong Yu1, Xianjia Ning2,3,4,5 and Jinghua Wang2,3,4,5
1Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, China
2Department of Neurology, Tianjin Medical University General Hospital, Tianjin 300052, China
3Department of Epidemiology, Tianjin Neurological Institute & Tianjin Medical University General Hospital, Tianjin 300052, China
4Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin 300052, China
5Central of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin 300052, China
*These authors contributed equally to this work
Jinghua Wang, email: firstname.lastname@example.org
Xianjia Ning, email: email@example.com
Keywords: diabetes mellitus, epidemiology, prevalence, risk factors, Tibetans
Received: June 24, 2017 Accepted: August 28, 2017 Published: September 28, 2017
The prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) has increased worldwide, although their prevalence and determinants among Tibetans are currently unknown. We thus aimed to explore the prevalence of and risk factors for DM and IGT among Tibetans in China. In 2011, 1659 Tibetan adults (aged ≥ 18 years) from Changdu, China, were recruited to this cross-sectional study. They completed a questionnaire and underwent physical examinations and laboratory testing to assess risk factors for DM and IGT. The age-standardized prevalence of DM and IGT among Tibetans was 6.2% and 19.7%, respectively. A higher annual family income, alcohol consumption, and higher fasting plasma glucose (FPG) level were risk factors for DM, with odds ratio (ORs) and 95% confidence intervals (CIs) of 3.48 (1.43–8.48; P = 0.006) for those with family incomes of > 1600 USD/year, 3.06 (1.31–7.17; P = 0.010) for alcohol consumption, and 13.99 (7.76–25.22; P < 0.001) for FPG level. However, altitude was found to be negatively associated with the risk of DM; compared to individuals living at < 3500 meters, the risk of DM decreased by 65% for those living at 3500–3999 meters (P = 0.034) and by 89% for those living at ≥ 4000 meters (P = 0.015). Age, FPG levels, and low-density lipoprotein cholesterol levels were significantly associated with IGT among Tibetans aged ≥ 18 years. These findings suggest that the prevalence of DM in Tibetans may continue to increase in future decades following rapid economic development, and it is crucial to address the management of conventional risk factors for reducing the disease burden of DM among Tibetans.
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