Associations of Social Determinants and Lifestyle Factors With Incidence and Dynamic Progression of Type 2 Diabetes in the Chinese Population
Authors' conclusion
Social determinants and lifestyle behaviours show dynamic, stage-specific associations with T2D progression in China, with lifestyle mediating a modest portion of social risks.
Study context
- Population
- China Kadoorie Biobank participants without baseline diabetes and related complications
- Participants
- 456,846 participants
- Exposure
- Higher vs lower polysocial risk score and healthy lifestyle score
- Outcome
- Transitions from baseline to T2D, subsequently vascular complications (macro- and microvascular), and finally to death
- Follow-up
- median 10.2-year follow-up
Methodological detailsmulti-state models, mediation analysis
- Multi-state models
- Mediation analysis
Main finding
As reported in the abstract
Transitions in T2D progression per point increase in PsRS
PsRS per point increaseHazard ratio (95% CI)
T2D incidence
1.02(1.00–1.05)
Complication risk after T2D diagnosis
1.06(1.02–1.11)
Per point increase, as printed
- Higher mortality risks per point increase in polysocial risk score (PsRS)
- 18%-25%
- Healthier lifestyle patterns: lower risks across transitions
- 3%-20%
Observational data: associations, not effects.
Further findings
Lifestyle mediation of social risk associations
- Proportion of social risk associations mediated by lifestyle
- 7.45%-14.92%
Component-specific contributions
- Education, accommodation stability and employment were predominant social determinants; smoking was the most influential behaviour
Original publication
Associations of Social Determinants and Lifestyle Factors With Incidence and Dynamic Progression of Type 2 Diabetes in the Chinese Population. Diabetes Obes Metab. Published 17 May 2026. doi:10.
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