Risk Factors for Diabetes and Cardiovascular Complications in the Chinese Population

Type 2 diabetes, a major noncommunicable disease, is typified by hyperglycemia, which stems from insulin resistance and dysfunction of pancreatic β-cells (1).Prior multi-ethnic studies hypothesized that type 2 diabetes among Caucasians was primarily driven by insulin resistance, whereas in East Asians, it was predominantly a consequence of β-cell dysfunction (2).Apart from the apparent genetic variations, obesity has been identified as the main factor responsible for the pathophysiological differences in diabetes between Caucasians and East Asians (3).Notably, China has seen a considerable increase in obesity cases in congruence with substantial changes in lifestyle and urbanization over the last four decades.In a recent population-based national cohort study, we showed that insulin resistance, rather than β-cell dysfunction, had a significant role in the pathological progression of diabetes within the Chinese population (1).This correlation was particularly pronounced among obese adults (1).The interplay between environmental dynamics, socioeconomic status (SES), lifestyle practices, and a distinct genetic backdrop results in specific patterns of health preservation and disease onset within the Chinese population.As a result, the risk triggers and origins of diabetes and associated cardiovascular complications among this demographic may not fully align with the international expert consensus, which is primarily informed by findings from European and North American populations.This perspective collates current evidence concerning the profiles of diabetes risk factors and associated cardiovascular complications in the Chinese community, paying special attention to age-linked risk profiles and gene-environment interplays (Figure 1).It also recommends potential avenues for future research, concentrated on developing precise and effective prevention and intervention strategies to arrest the surge of diabetes and cardiovascular complications.