Association of unhealthy lifestyle and the risk of type 2 diabetes mellitus with arthritis in middle-aged and elderly Chinese individuals: evidence from the CHARLS.

BACKGROUND

Multimorbidity is an emerging global public health concern. However, the relationship between a healthy lifestyle, type 2 diabetes mellitus (T2DM) and arthritis remains unclear. Our study aimed to evaluate the impact of a healthy lifestyle on the comorbidity of T2DM and arthritis in the Chinese population.

METHODS

The data originated from the China Health and Retirement Longitudinal Study (CHARLS) and comprised 4,706 participants aged 45 years or over. The healthy lifestyle score (0-5) was determined by factors including smoking, drinking, physical activity, sleep and body mass index (BMI). T2DM was assessed using a self-reported physician diagnosis, fasting blood glucose levels ≥ 7.0 mmol/L, or a history of taking hypoglycaemic medication. Arthritis was evaluated using a self-reported physician diagnosis at baseline. Multivariate logistic regression models and stratified analyses were used to estimate the relationship between healthy lifestyles and the risk of T2DM in patients with arthritis. Receiver operating characteristic (ROC) curves were analysed to investigate the association between an unhealthy lifestyle, T2DM and arthritis risk.

RESULTS

Compared with healthy lifestyle participants, those with unhealthy lifestyles had an increased risk of diabetes (OR = 1.41, 95% CI: 1.01-1.95) and comorbid diabetes‒arthritis (OR = 1.73, 95% CI: 1.01-2.96), but no significant associations with arthritis were detected. In the stratified analysis, stronger associations were found between an unhealthy lifestyle and diabetes-arthritis comorbidity in people aged 45-65 years and in those who were married. ROC analysis revealed high diagnostic accuracy of unhealthy lifestyle for both diabetes (AUC = 0.894) and diabetes-arthritis comorbidity (AUC = 0.894).

CONCLUSION

An unhealthy lifestyle was significantly associated with diabetes-arthritis comorbidity among participants ≥ 45 years of age in China, which suggesting that promoting healthy lifestyle may be important for reducing the burden of chronic disease.