title: Non-linear associations of risk factors with mild hypoglycemia among Chinese patients with type 2 diabetes.
abstract: OBJECTIVE
  The present study aimed to examine the nonlinear associations between risk factors and mild hypoglycemia in Chinese patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  From May 2013 to August 2013, we conducted a cross sectional survey of 6633 inpatients with T2DM and without severe hypoglycemia, aged 21-77 years, from 81 top tertiary hospitals in China. Mild hypoglycemia was defined as having hypoglycemia with symptoms in one month. Binary logistic regression analysis with restricted cubic splines was used to estimate odds ratio curves of non-linear risk factors for mild hypoglycemia.
  
  
  RESULTS
  Increasing body mass index was associated with decreasing risk of mild hypoglycemia in a linear manner while age, duration of diabetes, glycated hemoglobin (HbA1c), mean artery pressure and lipids were associated with mild hypoglycemia in non-linear manners. Age ≥40 years, duration ≥2 years, HbA1c ≥7.0-<11.5% (≥53-<102 mmol/mol), triglyceride ≥1.7-<3.6 mmol/L, low-density lipoprotein cholesterol (LDL-C) ≥2.6-<4.8 mmol/L, and high-density lipoprotein cholesterol (HDL-C) ≥1.2-<4.8 mmol/L were associated with increased risks of mild hypoglycemia.
  
  
  CONCLUSIONS
  Chinese T2DM patients with age≥40 years, duration of diabetes ≥2-<6 years, HbA1c ≥7.0-<11.5% (≥53-<102 mmol/mol), LDL-C ≥2.6-<4.8mmol/L, HDL-C ≥1.2-<4.8 mmol/L or triglyceride ≥1.7-<3.6 mmol/L were at particularly high risk for mild hypoglycemia.
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Weijun
authors.initials: W
authors.lastname: Gu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: Yanfeng
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Endocrinology, Peking University People's Hospital, Beijing, China.
authors.forename: Linong
authors.initials: L
authors.lastname: Ji
authors.affiliation: Department of Endocrinology, Peking University Third Hospital, Beijing, China. Electronic address: tpho66@bjmu.edu.cn.
authors.forename: Tianpei
authors.initials: T
authors.lastname: Hong
authors.affiliation: Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Mu
authors.affiliation: Department of Endocrinology, Beijing Hospital, Beijing, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Endocrinology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Endocrinology, Peking University Third Hospital, Beijing, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Tian
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China. Electronic address: yangxilin@tmu.edu.cn.
authors.forename: Xilin
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin
keywords: Chinese; Mild hypoglycemia; Nonlinear association; Risk factors; Type 2 diabetes