Prevalence, trends and risk factors for the diabetes epidemic in China: a systematic review and meta-analysis.
OBJECTIVE
To describe the prevalence and trends of diabetes and to quantitatively assess its risk factors in mainland China.


METHODS
Thirty-one epidemiological studies were identified by a systematic search of four databases. Prevalence estimates were mapped and summarized by meta-analysis in each region of China. The pooled ORs and 95% CIs of risk factors for diabetes were also calculated.


RESULTS
There was a large geographical imbalance with regard to the prevalence of diabetes. Region-pooled prevalence was highest in the eastern region (8.0%, 95% CI: 6.1-10.0%) and lowest in the western region (4.6%, 95% CI: 3.3-6.0%), which was consistent with regional levels of economic development. The overall prevalence of diabetes has been increasing since 1980. Traditional risk factors such as age, family history of diabetes, obesity, hypertension and elevated triglycerides were found to be associated with diabetes. In addition, urban residence and being from ethnic minorities were also significantly associated.


CONCLUSIONS
Based on the meta-analyses, we found that the prevalence of diabetes is different in different parts of China but it has been increasing sharply during the last three decades. Some risk factors were quantitatively derived in the study, which are free from the diversity of a single sample.
Department of Nutrition and Food Hygiene, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China; Section for International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: huizuo97@gmail.com.
Hui
H
Zuo
Department of Nutrition and Food Hygiene, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China; Discipline of Medicine, University of Adelaide, Adelaide, Australia. Electronic address: zumin.shi@gmail.com.
Zumin
Z
Shi
Section for International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: akhtar.hussain@medisin.uio.no.
Akhtar
A
Hussain
D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006801:Humans; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
China; Diabetes; Epidemiology; Meta-analysis; Systematic review