title: Regional differences in diabetes prevalence and awareness between coastal and interior provinces in China: a population-based cross-sectional study.
abstract: BACKGROUND
  Most studies on diabetes prevalence and awareness in China are regional or about a single province, and differences between coastal and interior provinces have not been discussed even in the nation-based studies. The aim of this study was to determine regional differences in diabetes prevalence and awareness between coastal and interior provinces, and to identify the factors associated with diabetes prevalence and awareness.
  
  
  METHODS
  Provinces Fujian and Shaanxi were chosen to represent the coastal and interior provinces, respectively. The data of two provinces were from the China National Diabetes and Metabolic Disorders Study 2007-08. A total of 5926 people (Fujian 2672 and Shaanxi 3254) aged above 20 years were included as participants in the study. Age-standardized prevalence and awareness were compared between provinces. Logistic regression analysis was performed not only to examine risk factors of diabetes prevalence and awareness, but also to examine the association between regional difference and diabetes prevalence and awareness.
  
  
  RESULTS
  The age-standardized prevalence of diabetes in Fujian was higher than that in Shaanxi among total (11.5% vs. 8.0%), male (13.6% vs. 8.9%) and female (10.8% vs. 7.4%) populations. Diabetes awareness for total and male population in Fujian was higher than that in Shaanxi (42.3% vs. 34.9% and 46.8% vs. 35.2%, respectively). Age, sex, central obesity, family history of diabetes, and metabolic risk factors were all significantly associated with diabetes prevalence in both provinces. However, cigarette smoking was significantly associated with prevalence in Fujian and physical activity was significantly associated with the prevalence in Shaanxi. Family history of diabetes was the only independent risk factor of diabetes awareness in both provinces. After being adjusted for all listed risk factors, the regional difference of diabetes prevalence was still significant, but that of diabetes awareness lost significance.
  
  
  CONCLUSIONS
  Both diabetes prevalence and awareness were higher in coastal provinces and lower in interior provinces in China. Lifestyle risk factors were found to contribute differently to diabetes prevalence in the two provinces and other unknown risk factors may account for differences of diabetes prevalence between provinces. In addition, family history of diabetes was the only independent risk factor in both provinces.
authors.forename: Shaoyong
authors.initials: S
authors.lastname: Xu
authors.forename: Jie
authors.initials: J
authors.lastname: Ming
authors.forename: Ying
authors.initials: Y
authors.lastname: Xing
authors.forename: Bin
authors.initials: B
authors.lastname: Gao
authors.forename: Chunbao
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Fourth Military Medical University, 169 Changle Road West, Xi'an, China. qiuheji@hotmail.com.
authors.forename: Qiuhe
authors.initials: Q
authors.lastname: Ji
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001364:Awareness; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications; D015995:Prevalence; D012044:Regression Analysis; D012107:Research Design; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult
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