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High-income country studies link residential proximity to roadways with diabetes, yet evidence from developing countries is limited. This population-based analysis delivers robust evidence for environmental health interventions and age-friendly urban planning for Chinese older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used nationally representative data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). After excluding those with missing values for key variables, 4,702 adults aged\u2009\u2265\u200965 years entered the complete-case primary analysis. Roadway proximity and diabetes status were self-reported. Logistic regression models calculated ORs and 95% CIs with sequential adjustment for demographic, lifestyle and health covariates. Stratified analyses and interaction tests assessed effect modification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample included 4,702 participants (mean age 78.7 years; 55.1% men) with 13.9% diabetes prevalence. Fully adjusted ORs were 1.36 (95% CI:1.11\u20131.67) for residents\u2009&lt;\u2009100\u00a0m from major roadways and 1.31 (95% CI:1.03\u20131.66) for those 100\u2013300\u00a0m away (reference group: &gt; 300\u00a0m). A statistically significant overall trend test was obtained, yet the exposure\u2013response relationship across distance strata was non-monotonic (\n                      <jats:italic>P<\/jats:italic>\n                      for trend\u2009&lt;\u20090.05). A borderline interaction existed between roadway proximity and smoking (\n                      <jats:italic>P<\/jats:italic>\n                      for interaction\u2009=\u20090.044). Stratification showed a positive association among non-smokers (OR\u2009=\u20091.29, 95% CI:1.06\u20131.56) but no significant link in smokers (OR\u2009=\u20090.82, 95% CI:0.48\u20131.42). Given the marginal\n                      <jats:italic>P<\/jats:italic>\n                      -value and small smoking subgroup sample (wide CIs), this interaction needs cautious interpretation and verification in larger cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This cross-sectional study found a significant association between proximity to major roadways and prevalent diabetes in Chinese older adults. Roadway proximity acts as a composite surrogate marker of traffic hazards, neighborhood socioeconomic deprivation and built environments, rather than merely traffic pollution or noise. These findings guide future environmental and health equity research on seniors. Longitudinal studies with objective exposure measurements are required to confirm our results and inform age-friendly urban design and geriatric health policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-026-08060-y","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T03:27:06Z","timestamp":1785209226000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Residential proximity to major roadways and prevalent diabetes in older adults: a cross-sectional study based on CLHLS"],"prefix":"10.1186","volume":"26","author":[{"given":"Yong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiying","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinzhu","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"issue":"2","key":"8060_CR1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S2213-8587(25)00299-2","volume":"14","author":"I Genitsaridi","year":"2026","unstructured":"Genitsaridi I, Salpea P, Salim A, Sajjadi SF, Tomic D, James S, et al. 11th edition of the IDF Diabetes Atlas: global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050. 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