Journal article
Age-dependent sex differences in prevalence and incidence of diabetes: data from half a million Chinese adults
- Abstract:
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Aims/hypothesis
It remains unclear how sex differences in diabetes risk vary across the adult life course. We aimed to examine age-specific sex differences in prevalent and incident diabetes among Chinese adults and to identify factors that may explain these differences.
Methods
The China Kadoorie Biobank recruited over half a million adults from ten regions across China in 2004-2008 and followed them until 2019. We used logistic regression models and Cox proportional hazards models, respectively, to estimate odds ratios (ORs) for prevalent diabetes and hazard ratios (HRs) for incident diabetes in relation to sex.
Results
Among individuals aged <50 years, women had a lower prevalence (2.4% [95% CI: 2.3%, 2.5%] vs. 3.2% [3.0%, 3.3%]) and incidence (1.16 [1.09, 1.22] vs. 1.63 [1.53, 1.73] per 1,000 person-years) of diabetes than men. However, from around age 50 years onwards, this pattern reversed, with women having a higher prevalence (9.4% [9.3%, 9.6%] vs. 7.3% [7.2%, 7.5%]) and incidence (4.68 [4.60, 4.77] vs. 4.07 [3.97, 4.17] per 1,000 person-years) than men. The adjusted ORs and HRs for diabetes comparing women with men were 0.78 (0.74, 0.82) and 0.71 (0.66, 0.78), respectively, before age 50 years, and 1.31 (1.27, 1.34) and 1.17 (1.14, 1.21), respectively, thereafter. This age-dependent reversal mirrored the sex-specific changes in adiposity, with waist circumference and body fat percentage as the key explanatory factors for the higher diabetes risk observed in older women.
Conclusions / Interpretation
Among Chinese adults, women had a lower risk of diabetes than men before age 50 years, but a higher risk thereafter. This reversal was largely associated with sex-specific changes in adiposity, suggesting the importance of preventing excess adiposity accumulation in older women.
- Publication status:
- Accepted
- Peer review status:
- Peer reviewed
Actions
Authors
- Funder identifier:
- https://ror.org/029chgv08
- Grant:
- 104085/Z/14/Z
- 202922/Z/16/Z
- 088158/Z/09/Z
- Publisher:
- Springer Nature
- Journal:
- Metabologia More from this journal
- Acceptance date:
- 2026-09-11
- EISSN:
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3091-3241
- Language:
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English
- Keywords:
- Pubs id:
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2456493
- Local pid:
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pubs:2456493
- Deposit date:
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2026-09-14
- ARK identifier:
Terms of use
- Notes:
- This article has been accepted for publication in Metabologia.
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