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Background <p>Diabetes represents a significant public health challenge in China. This comprehensive meta-analysis systematically investigated temporal patterns in diabetes prevalence and evaluated key modifiable risk factors among Chinese adults over a 20-year period (2000–2020).</p> Methods <p>We conducted a systematic search across six major electronic databases to identify population-based epidemiological studies reporting diabetes prevalence and/or associated modifiable risk factors. Eligible studies underwent rigorous quality assessment. Random-effects meta-analyses were performed to calculate pooled prevalence estimates with 95% confidence intervals. Subgroup analyses examined variations across critical demographic and geographic strata, including sex, age groups, urban-rural residence, geographic region, and body mass index (BMI) categories.</p> Results <p>A total of 109 studies involving over 1.74 million adults were included. The results showed that the overall combined prevalence of diabetes among Chinese adults was 9.51% (95% confidence interval: 8.73% -10.30%), corrected for standardization to 8.68% (95% CI: 7.80% - 9.57%) from 2000 to 2020. Prevalence was higher in males (10.19%), urban/suburban residents (10.44%), older adults (≥ 60 years: 19.27%), and regions like Chongqing Municipality (15.74%), Sichuan province (15.40%), and Henan province (15.16%). Higher BMI was associated with increased prevalence (18.84 %, BMI ≥ 28 kg/m<sup>2</sup>). Key modifiable risk factors included nonalcoholic fatty liver disease (NAFLD, OR: 2.87), dyslipidemia (1.94), hypertension (1.84), and obesity (1.24). Among these major risk factors, central obesity had the highest attributable risk proportion (PAF = 20.9%), corresponding to approximately 20.28 million patients. </p> Conclusion <p>Diabetes prevalence among Chinese adults remains alarmingly high, with substantial heterogeneity linked to demographic characteristics and geographic location. NAFLD, hypertension, and specific dyslipidemia are the most established modifiable risk factors. Our findings underscore an urgent public health imperative for implementing regionally tailored strategies and evidence-based interventions addressing these risk factors to mitigate the expanding diabetes burden in China.</p>

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Estimating the burden of adult diabetes in China: a systematic review and meta-analysis with attributable risk assessment

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月3日

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  • Rui Wang,
  • Shuoming Luo,
  • Peng Wang,
  • Meihui Yu,
  • Zhenglu Liu,
  • Jiabi Qin,
  • Yang Xiao,
  • Xia Li,
  • Zhiguang Zhou

摘要

Background

Diabetes represents a significant public health challenge in China. This comprehensive meta-analysis systematically investigated temporal patterns in diabetes prevalence and evaluated key modifiable risk factors among Chinese adults over a 20-year period (2000–2020).

Methods

We conducted a systematic search across six major electronic databases to identify population-based epidemiological studies reporting diabetes prevalence and/or associated modifiable risk factors. Eligible studies underwent rigorous quality assessment. Random-effects meta-analyses were performed to calculate pooled prevalence estimates with 95% confidence intervals. Subgroup analyses examined variations across critical demographic and geographic strata, including sex, age groups, urban-rural residence, geographic region, and body mass index (BMI) categories.

Results

A total of 109 studies involving over 1.74 million adults were included. The results showed that the overall combined prevalence of diabetes among Chinese adults was 9.51% (95% confidence interval: 8.73% -10.30%), corrected for standardization to 8.68% (95% CI: 7.80% - 9.57%) from 2000 to 2020. Prevalence was higher in males (10.19%), urban/suburban residents (10.44%), older adults (≥ 60 years: 19.27%), and regions like Chongqing Municipality (15.74%), Sichuan province (15.40%), and Henan province (15.16%). Higher BMI was associated with increased prevalence (18.84 %, BMI ≥ 28 kg/m2). Key modifiable risk factors included nonalcoholic fatty liver disease (NAFLD, OR: 2.87), dyslipidemia (1.94), hypertension (1.84), and obesity (1.24). Among these major risk factors, central obesity had the highest attributable risk proportion (PAF = 20.9%), corresponding to approximately 20.28 million patients.

Conclusion

Diabetes prevalence among Chinese adults remains alarmingly high, with substantial heterogeneity linked to demographic characteristics and geographic location. NAFLD, hypertension, and specific dyslipidemia are the most established modifiable risk factors. Our findings underscore an urgent public health imperative for implementing regionally tailored strategies and evidence-based interventions addressing these risk factors to mitigate the expanding diabetes burden in China.