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

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.