Urban-Rural Differences in Cardiovascular Disease Risk Factors: A Cross-Sectional Study of Schoolchildren in Wuhan, China

BACKGROUND China's rapid population growth and urban migration has developed healthcare inequity across the urban-rural divide. Past studies comparing cardiovascular disease (CVD) risk factor prevalence amongst urban-rural Chinese children are sparse and conflicting. We examined the association between urban-rural residence and risk of offspring CVD in Chinese children. METHODS A cross-sectional study was conducted in Wuhan, China, during May and June 2010. CVD risk factors include; waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, body mass index (BMI), cardiorespiratory fitness (CRF), metabolic syndrome (MetS), and metabolic risk score (MRS). Analysis of covariance and multivariable logistic regression were used to estimate associations between urban-rural residence and offspring CVD risks. FINDINGS A total of 579 Chinese children (338 boys and 241 girls) aged 9.6 (0.7) years participated in this study. Rural boys had significantly lower CRF and higher FBG, TG, and MRS, while urban boys had significantly higher LDL and DBP. Rural girls had significantly higher BMI, FBG, and TG, as well as lower CRF. Rural children were at increased risks for decreased CRF, elevated MRS, and TG, (OR:2.04, 95%CI:1.29-3.25), (OR:2.33, 95%CI:1.50-3.62), and (OR:2.40, 95%CI:1.62-3.57), respectively. Rural girls and mothers were at increased risks for overweight(OR:7.19, 95%CI:1.64-31.6)/obesity (OR:1.683, 95%CI:1.01-2.82). However, rural boys and fathers were less likely to have overweight(OR:0.62, 95%CI:0.34-1.12)/obesity (OR:0.68, 95%CI:0.48-0.97). CONCLUSIONS Rural residence was significantly associated with increased CVD risks amongst Chinese children. It is important to provide interventions aiming at China's urban-rural healthcare inequity and community-based approaches that reduce familial CVD risk.