Associations of Stressful Life Events With Diabetes Incidence in China: Insights From the China Kadoorie Biobank

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-09-01 DOI:10.1111/1753-0407.70149

Jing Qian, Huiying Cheng, Xuening Dai, Dianjianyi Sun, Pei Pei, Meng Wang, Yingjun Li

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Abstract

Background

Limited empirical evidence exists on the link between exposure to various stressful life events (SLEs) and the heightened risk of Diabetes Mellitus (DM) within the mainland Chinese population.

Methods

We conducted this prospective cohort study with 455,464 participants from the China Kadoorie Biobank (CKB); we examined associations between SLEs exposures and DM outcomes. We employed multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.

Results

Over a median follow-up of 10.1 years, 14,218 DM cases were identified. A dose–response relationship was observed between the number of SLEs, personal-related events, and the risk of DM. The higher the number of SLEs experienced, the higher the risk of developing diabetes (HR = 1.06, 95% CI = 1.01–1.12); individuals who experienced personal-related events had a higher risk of developing DM (HR = 1.17, 95% CI = 1.01–1.36), and those who experienced marital separation/divorce had a 53% increased risk of DM (HR = 1.53, 95% CI = 1.12–2.09). Subgroup analyses revealed effect modifications based on birth cohort, sex, and area.

Conclusion

By exploring the association of multiple SLEs with the development of DM, we identified marital separation/divorce as a driver of increased DM risk.

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中国压力生活事件与糖尿病发病率的关系：来自中国嘉道理生物库的见解

背景在中国大陆人群中，暴露于各种应激性生活事件（SLEs）与糖尿病（DM）风险升高之间的联系存在有限的经验证据。方法：我们对来自中国嘉道理生物库（CKB）的455,464名参与者进行了前瞻性队列研究；我们研究了SLEs暴露与糖尿病结局之间的关系。我们采用多变量Cox比例风险模型来估计风险比（hr）和95%置信区间（ci），并对潜在混杂因素进行调整。结果在10.1年的中位随访中，共发现14218例糖尿病病例。SLEs次数、个人相关事件与糖尿病风险之间存在剂量-反应关系。经历SLEs次数越多，发生糖尿病的风险越高（HR = 1.06, 95% CI = 1.01-1.12）；经历过个人相关事件的人患糖尿病的风险更高（HR = 1.17, 95% CI = 1.01-1.36），经历过婚姻分居/离婚的人患糖尿病的风险增加53% （HR = 1.53, 95% CI = 1.12-2.09）。亚组分析显示基于出生队列、性别和地区的效果改变。结论：通过探索多重SLEs与糖尿病发展的关系，我们确定婚姻分居/离婚是糖尿病风险增加的驱动因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.