{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T09:10:10Z","timestamp":1758877810926,"version":"3.44.0"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Limited empirical evidence exists on the link between exposure to various stressful life events (SLEs) and the heightened risk of Diabetes Mellitus (DM) within the mainland Chinese population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted this prospective cohort study with 455,464 participants from the China Kadoorie Biobank (CKB); we examined associations between SLEs exposures and DM outcomes. We employed multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a median follow\u2010up of 10.1\u2009years, 14,218 DM cases were identified. A dose\u2013response relationship was observed between the number of SLEs, personal\u2010related events, and the risk of DM. The higher the number of SLEs experienced, the higher the risk of developing diabetes (HR\u2009=\u20091.06, 95% CI\u2009=\u20091.01\u20131.12); individuals who experienced personal\u2010related events had a higher risk of developing DM (HR\u2009=\u20091.17, 95% CI\u2009=\u20091.01\u20131.36), and those who experienced marital separation\/divorce had a 53% increased risk of DM (HR\u2009=\u20091.53, 95% CI\u2009=\u20091.12\u20132.09). Subgroup analyses revealed effect modifications based on birth cohort, sex, and area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>By exploring the association of multiple SLEs with the development of DM, we identified marital separation\/divorce as a driver of increased DM risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.70149","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T10:19:57Z","timestamp":1756721997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Stressful Life Events With Diabetes Incidence in China: Insights From the China Kadoorie Biobank"],"prefix":"10.1111","volume":"17","author":[{"given":"Jing","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics School of Public Health, Hangzhou Medical College  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiying","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics School of Public Health, Hangzhou Medical College  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuening","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics School of Public Health, Hangzhou Medical College  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianjianyi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics School of Public Health, Peking University  Haidian District Beijing China"},{"name":"Peking University, Center for Public Health and Epidemic Preparedness and Response  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei","family":"Pei","sequence":"additional","affiliation":[{"name":"Peking University, Center for Public Health and Epidemic Preparedness and Response  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-916X","authenticated-orcid":false,"given":"Yingjun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics School of Public Health, Hangzhou Medical College  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02317-1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13082748"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-020-01050-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.110773"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031914-122921"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05496-2"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102236"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05258-6"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckab153"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-17307-x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20021050"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.22365\/jpsych.2017.282.107"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.08.019"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01642.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.17.1873"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.30143"},{"issue":"7","key":"e_1_2_9_18_1","first-page":"852","article-title":"Effects Related to Experiences of Famine During Early Life on Diabetes Mellitus and Impaired Fasting Glucose During Adulthood","volume":"35","author":"Li Y.","year":"2014","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"issue":"3","key":"e_1_2_9_19_1","first-page":"249","article-title":"The China Kadoorie Biobank: Related Methodology and Baseline Characteristics of the Participants","volume":"33","author":"Li L. 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