Minghan Zhang, Junru Fan, Qiuyu Cao, Ruizhi Zheng, Yu Xu, Min Xu, Feixia Shen, Xuejiang Gu, Yiming Mu, Lulu Chen, Tianshu Zeng, L X Shi, Qing Su, Xuefeng Yu, Li Yan, Guijun Qin, Qin Wan, Gang Chen, Xulei Tang, Zhengnan Gao, Ruying Hu, Zuojie Luo, Yingfen Qin, Li Chen, Xinguo Hou, Yanan Huo, Qiang Li, GuiXia Wang, Yinfei Zhang, Chao Liu, Y Wang, Shengli Wu, Taoyue Yang, Huacong Deng, Jiajun Zhao, Guang Ning, Jieli Lu, Wei Wang, Yan Bi, Yuhong Chen, the 4C Study Group
BACKGROUND: Metabolic diseases remain a fast-growing global health burden. Besides other known factors, socioeconomic status (SES) has been recognized as a key determinant of metabolic health. This study aimed to investigate the association between SES and the prevalence of metabolic diseases in the Chinese population. METHODS: We analyzed data from a nationwide community-based cross-sectional study in China. SES was derived to a composite score (range 0-3) using three indicators (educational attainment, living conditions, and marital status), with higher scores indicating better SES. Chronic diseases were diagnosed through biochemical testing and clinical assessments. Logistic regression models were applied to estimate associations between SES scores and metabolic diseases. RESULTS: Among 201 532 participants, the lowest SES group had 87.1% higher odds of metabolic diseases than the highest SES group (odds ratio [OR] = 1.871, 95% confidence interval [CI]: 1.739, 2.016). One-point decrease in SES score was associated with increased prevalence of hypertension (OR = 1.096, 95% CI: 1.080, 1.113) and obesity (OR = 1.112, 95% CI: 1.091, 1.134). In contrast, lower SES scores were linked to a reduced prevalence of dyslipidemia (OR = 0.931, 95% CI: 0.918, 0.945) and diabetes (OR = 0.974, 95% CI: 0.958, 0.990) after adjusting for covariates. We also observed that lower SES scores showed stronger associations with increased prevalence of obesity and hypertension in women but decreased risks of diabetes, dyslipidemia, and obesity in men. CONCLUSIONS: Lower SES was associated with a higher prevalence of hypertension and obesity but a lower prevalence of dyslipidemia and diabetes, with significant gender differences.