Analysis of risk factors and their interactions in type 2 diabetes mellitus: A cross‐sectional survey in Guilin, China

AIMS/INTRODUCTION Type 2 diabetes is a metabolic disease characterized by insulin resistance, and is associated with the effects of genetic and environmental factors. The present study aimed to not only analyze the influence of a single factor for type 2 diabetes, but also to investigate the interaction effects between risk factors. MATERIALS AND METHODS A total of 6,660 individuals selected by the method of cluster random sampling accepted a cross-sectional survey (questionnaire investigation, physical measurement, laboratory examination and liver ultrasound examination). The classification tree was used to analyze the risk factors and their interactions in type 2 diabetes. The clinical and metabolic characteristics were compared between type 2 diabetes patients and controls, and the non-conditional logistic regression model was used to quantitatively analyze the interactions. RESULTS A total of 338 participants were classified as type 2 diabetes (217 men and 121 women), the classification tree model showed three variables with close associations with type 2 diabetes: age, triglycerides (TG) and non-alcoholic fatty liver disease (NAFLD). Type 2 diabetes patients had higher age and incidences of high TG, NAFLD, hypertension, high body mass index, high uric acid, high total cholesterol, high low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol. The multivariate logistic regression analysis showed that the following factors had interactions in type2 diabetes: high TG × advanced age (odds ratio 2.499, 95% confidence interval 1.868-3.344, P = 0.000), NAFLD × advanced age (odds ratio 1.250, 95% confidence interval 1.048-1.491, P = 0.013) and NAFLD × high TG (odds ratio 1.349, 95% confidence interval 1.144-1.590, P = 0.000). CONCLUSIONS The present study showed that type 2 diabetes resulted from the interactions of many factors; the interactions among age, TG and NAFLD are important risk factors for type 2 diabetes.