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Factors associated with stroke among patients with type 2 diabetes mellitus in China: a propensity score matched study

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Abstract

Objective

This study aimed to examine the prevalence of stroke and associated factors of stroke in patients with type 2 diabetes(T2DM) in China.

Methods

Participants were 18,013 T2DM patients recruited with stratified random cluster sampling method from December 2013 to January 2014 in China. Propensity score matching was used to eliminate confounding effects between groups and logistic regression analysis was used to examine factors associated with stroke among T2DM patients.

Results

Overall, the prevalence of stroke in the subjects with T2DM was 9.5%. After nearest neighbor matching, smoking (OR = 1.60, 95%CI: 1.26–2.03), hypertension (OR = 2.96, 95%CI: 2.55–3.43), dyslipidemia (OR = 2.00, 95%CI: 1.71–2.33), family history of stroke (OR = 2.02, 95%CI: 1.61–2.54), obesity (OR = 1.21, 95%CI: 1.01–1.45) and sleep duration < 6 h/day (OR = 1.44, 95%CI: 1.20–1.73) or > 8 h/day (OR = 1.22, 95%CI: 1.05–1.42) were positively associated with stroke, whereas drinking 1–3 days/week (OR = 0.64, 95%CI: 0.45–0.90) or daily (OR = 0.45, 95%CI: 0.33–0.60), effective exercise (OR = 0.65, 95%CI: 0.57–0.73) and underweight (OR = 0.30, 95%CI: 0.13–0.71) were negatively related to stroke. Besides, the risk of stroke increased substantially with accumulation of above seven modified risk factors. The odds ratio values of stroke in patients having ≥ 5 of the above seven risk factors was 14.39 (95% CI: 8.87–23.26).

Conclusions

The prevalence of stroke was high among T2DM in China. It is of great significance to strengthen comprehensive management of health-related behaviors including smoking cessation, moderate alcohol consumption, effective exercise, 6–8 h of sleep duration, keeping normal weight and the prevention of hypertension and dyslipidemia to have sustained beneficial effects on improvements of stroke risk factors.

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Data availability

Data supporting the results presented in the paper are available upon reasonable requests.

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Acknowledgements

The authors would like to thank all the participants involved in the survey. The authors would also like to thank the Huai´an Center for Disease Control and Prevention.

Funding

This work was supported by the National Natural Science Foundation of China [grant number [82003484] and Universities' philosophy and social science researches in Jiangsu Province [2020SJA1053], Natural Science Foundation for Colleges Universities in Jiangsu Province [20KJB330005].

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  1. Chenlu He and Wei Wang. These authors contributed equally to this work.

Authors and Affiliations

  1. School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China

    Chenlu He, Wei Wang, Qian Chen, Ziyuan Shen & Xunbao Zhang

  2. Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China

    Enchun Pan & Zhongming Sun

  3. Xuzhou Center for Disease Control and Prevention, Xuzhou, 221000, Jiangsu, China

    Peian Lou

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Contributions

Wei Wang and Xunbao Zhang involved in conceptualization and methodology; Chenlu He participated in data curation and writing—original draft preparation; Peian Lou, Zhongming Sun and Enchun Pan supervised and validated the study; Wei Wang participated in writing—reviewing and editing.

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Correspondence to Wei Wang or Xunbao Zhang.

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Approval was obtained from the ethics committee of the Huai´an Center for Disease Control and Prevention and Xuzhou Medical University. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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He, C., Wang, W., Chen, Q. et al. Factors associated with stroke among patients with type 2 diabetes mellitus in China: a propensity score matched study. Acta Diabetol 58, 1513–1523 (2021). https://doi.org/10.1007/s00592-021-01758-y

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