{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:36:14Z","timestamp":1793126174597,"version":"4.5.0"},"reference-count":74,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine stage\u2010specific associations of social determinants and lifestyle with type 2 diabetes (T2D) progression, evaluate potential lifestyle\u2010mediated effects, and identify major social and behavioural contributors in Chinese populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>456 846 China Kadoorie Biobank participants without baseline diabetes and related complications were included. Polysocial risk score (PsRS) was derived from seven social risk factors and healthy lifestyle score from five modifiable behaviours. Multi\u2010state models estimated HRs (95% CIs) for transitions from baseline to T2D, subsequently vascular complications (macro\u2010 and microvascular), and finally to death. Mediation analysis quantified lifestyle's mediating effects, and component\u2010specific contributions were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median 10.2\u2010year follow\u2010up, higher PsRS showed consistently increased transition risks: each point increase corresponded to 2% higher T2D incidence (HR: 1.02, 95% CI: 1.00\u20131.05), 6% higher complication risk after T2D diagnosis (1.06, 1.02\u20131.11), and 18%\u201325% higher mortality risks. Healthier lifestyle patterns showed inverse associations, with 3%\u201320% lower risks across transitions. Both scores showed consistent associations with macrovascular but not microvascular complications. Lifestyle mediated 7.45%\u201314.92% of social risk associations. Education, accommodation stability, and employment were predominant social determinants, while smoking was the most influential behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Social determinants and lifestyle behaviours show dynamic, stage\u2010specific associations with T2D progression in China, with lifestyle mediating a modest portion of social risks. Integrated strategies addressing both structural social determinants and key lifestyle behaviours are essential for reducing T2D burden and advancing health equity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70877","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:26:46Z","timestamp":1779064006000},"page":"6824-6835","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Social Determinants and Lifestyle Factors With Incidence and Dynamic Progression of Type 2 Diabetes in the Chinese Population"],"prefix":"10.1111","volume":"28","author":[{"given":"Yanqiu","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanlin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xintong","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Hygiene West China School of Public Health and West China Fourth Hospital, Sichuan University  Chengdu China"},{"name":"Health Promotion and Food Nutrition &amp; 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