Association Between Socioeconomic Status and the Prevalence of Metabolic Diseases: A Nationwide Cross‐Sectional Study in China

BACKGROUND: Metabolic diseases remain a fast-growing global health burden. Besides other known factors, socioeconomic status (SES) has been recognized as a key determinant of metabolic health. This study aimed to investigate the association between SES and the prevalence of metabolic diseases in the Chinese population. METHODS: We analyzed data from a nationwide community-based cross-sectional study in China. SES was derived to a composite score (range 0-3) using three indicators (educational attainment, living conditions, and marital status), with higher scores indicating better SES. Chronic diseases were diagnosed through biochemical testing and clinical assessments. Logistic regression models were applied to estimate associations between SES scores and metabolic diseases. RESULTS: Among 201 532 participants, the lowest SES group had 87.1% higher odds of metabolic diseases than the highest SES group (odds ratio [OR] = 1.871, 95% confidence interval [CI]: 1.739, 2.016). One-point decrease in SES score was associated with increased prevalence of hypertension (OR = 1.096, 95% CI: 1.080, 1.113) and obesity (OR = 1.112, 95% CI: 1.091, 1.134). In contrast, lower SES scores were linked to a reduced prevalence of dyslipidemia (OR = 0.931, 95% CI: 0.918, 0.945) and diabetes (OR = 0.974, 95% CI: 0.958, 0.990) after adjusting for covariates. We also observed that lower SES scores showed stronger associations with increased prevalence of obesity and hypertension in women but decreased risks of diabetes, dyslipidemia, and obesity in men. CONCLUSIONS: Lower SES was associated with a higher prevalence of hypertension and obesity but a lower prevalence of dyslipidemia and diabetes, with significant gender differences.

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Journal
Journal of Diabetes
Published
2026-04-01
DOI
https://doi.org/10.1111/1753-0407.70222
Primary Topic
Health disparities and outcomes
Type
article
Field-Weighted Citation Impact
0.00

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article

Association Between Socioeconomic Status and the Prevalence of Metabolic Diseases: A Nationwide Cross‐Sectional Study in China

Y Wang, Xuejiang Gu, L X Shi, Yan Bi et al.
Journal of Diabetes
Health disparities and outcomes
article

Association Between Socioeconomic Status and the Prevalence of Metabolic Diseases: A Nationwide Cross‐Sectional Study in China

Y Wang, Xuejiang Gu, L X Shi, Yan Bi, GuiXia Wang, Zhengnan Gao, Feixia Shen, Wei Wang, Shengli Wu, Yanan Huo, Ruying Hu, Minghan Zhang, Taoyue Yang, Jiajun Zhao, Qing Su, Xinguo Hou, Huacong Deng, Tianshu Zeng, the 4C Study Group, Li Chen, Yiming Mu, Min Xu, Guijun Qin, Qiuyu Cao, Chao Liu, Yinfei Zhang, Guang Ning, Jieli Lu, Yu Xu, Gang Chen, Yuhong Chen, Yingfen Qin, Qin Wan, Li Yan, Junru Fan, Qiang Li
article en

Abstract

BACKGROUND: Metabolic diseases remain a fast-growing global health burden. Besides other known factors, socioeconomic status (SES) has been recognized as a key determinant of metabolic health. This study aimed to investigate the association between SES and the prevalence of metabolic diseases in the Chinese population. METHODS: We analyzed data from a nationwide community-based cross-sectional study in China. SES was derived to a composite score (range 0-3) using three indicators (educational attainment, living conditions, and marital status), with higher scores indicating better SES. Chronic diseases were diagnosed through biochemical testing and clinical assessments. Logistic regression models were applied to estimate associations between SES scores and metabolic diseases. RESULTS: Among 201 532 participants, the lowest SES group had 87.1% higher odds of metabolic diseases than the highest SES group (odds ratio [OR] = 1.871, 95% confidence interval [CI]: 1.739, 2.016). One-point decrease in SES score was associated with increased prevalence of hypertension (OR = 1.096, 95% CI: 1.080, 1.113) and obesity (OR = 1.112, 95% CI: 1.091, 1.134). In contrast, lower SES scores were linked to a reduced prevalence of dyslipidemia (OR = 0.931, 95% CI: 0.918, 0.945) and diabetes (OR = 0.974, 95% CI: 0.958, 0.990) after adjusting for covariates. We also observed that lower SES scores showed stronger associations with increased prevalence of obesity and hypertension in women but decreased risks of diabetes, dyslipidemia, and obesity in men. CONCLUSIONS: Lower SES was associated with a higher prevalence of hypertension and obesity but a lower prevalence of dyslipidemia and diabetes, with significant gender differences.

Journal of DiabetesVol. 18(4)
Fujian Medical University (CN), Shandong University (CN), Harbin Medical University (CN), Sun Yat-sen University (CN), Shanghai Jiao Tong University (CN), Jilin University (CN), Anhui Medical University (CN), Wenzhou Medical University (CN), XinHua Hospital (CN), Ruijin Hospital (CN), First Affiliated Hospital of Wenzhou Medical University (CN), Chinese General Hospital College of Nursing and Liberal Arts (PH), Affiliated Hospital of Southwest Medical University (CN), Jiading District Central Hospital (CN), Sun Yat-sen Memorial Hospital (CN), People's Liberation Army No. 150 Hospital (CN), Dalian Municipal Central Hospital (CN), Jiangxi Provincial People's Hospital (CN), Shandong Provincial Hospital (CN), First Hospital of Jilin University (CN), First Affiliated Hospital of GuangXi Medical University (CN), Wuhan Union Hospital (CN), The Affiliated Yongchuan Hospital of Chongqing Medical University (CN), Second Affiliated Hospital of Harbin Medical University (CN), Nanyang Medical College (CN), Zhejiang Center for Disease Control and Prevention (CN), First Affiliated Hospital of Anhui Medical University (CN), Fujian Provincial Hospital (CN), Karamay Central Hospital (CN), Jiangsu Province Hospital (CN), Karamay Central Hospital of Xinjiang (CN), First Affiliated Hospital of Zhengzhou University (CN), Tongji Hospital (CN), Qilu Hospital of Shandong University (CN), Chinese People’s Liberation Army 263 hospital (CN), First Hospital of Lanzhou University (CN), Huazhong University of Science and Technology (CN), Lanzhou University (CN), Nanjing Medical University (CN), Chongqing Medical University (CN)
Shanghai Municipal Health Commission, National Natural Science Foundation of China, Ministry of Science and Technology of the People's Republic of China, National Science and Technology Major Project
Gender equality
Openalex Percentile: Top 24%
Health disparities and outcomes
DOIOpen Access PDFOpenAlex
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