The expanding burden of cardiometabolic risk in China: the China Health and Nutrition Survey

TLDR

China faces a major rise in cardiovascular disease but lacks population‑based data on risk factors, especially in children. The study collected fasting blood samples, anthropometric measures, and blood pressure from 9,244 Chinese children and adults aged ≥ 7 years in 2009 to assess overweight, hypertension, and cardiometabolic risk factors such as glucose, HbA1c, lipids, and CRP. Over 11 % of children and 30 % of adults are overweight, and high rates of diabetes, dyslipidemia, hypertension, and inflammation—particularly in urbanized and older populations—affect up to 90 % of those over 60, with an estimated 27.7 million children and 334 million adults potentially pre‑diabetic or diabetic across China.

Abstract

Summary China faces a major increase in cardiovascular disease, yet there is limited population‐based data on risk factors, particularly in children. Fasting blood samples, anthropometry and blood pressure were collected on 9,244 children and adults aged ≥7 years in late 2009 as part of the national China Health and Nutrition Survey. Prevalent overweight, elevated blood pressure, and cardiometabolic risk factors: glucose, HbA1c, triglycerides (TG), total cholesterol (TC), high‐ and low‐density lipoprotein cholesterol (HDL‐C and LDL‐C), and C‐reactive protein (CRP) are presented. We found that 11% of Chinese children and 30% of Chinese adults are overweight. Rates of diabetes, dyslipidaemia, hypertension and inflammation are high and increased with age and were associated with urbanization. Approximately 42% of children have at least one of the following: pre‐diabetes or diabetes, hypertension, high TC, LDL‐C, TG, and CRP and low HDL‐C, as do 70% men and 60% women aged 18–40 years and >90% of men and women ≥60 years. In sum, the HbA1c findings suggest that as many as 27.7 million Chinese children and 334 million Chinese adults may be pre‐diabetic or diabetic. The high prevalence in less urban areas and across all income levels suggests that cardiometabolic risk is pervasive across rural and urban China.