Extreme Temperature and Incident Diabetes Risk Among Middle-Aged and Older Adults in China: A National Longitudinal Cohort Study.

Yizhan Wu; Han Shi; Li Zhang; Wenhui Shi; Laiyang Song; Jiangwei Liu

doi:10.1177/15578518261470093

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Extreme Temperature and Incident Diabetes Risk Among Middle-Aged and Older Adults in China: A National Longitudinal Cohort Study.

Yizhan Wu·Han Shi·Li Zhang·Wenhui Shi·Laiyang Song·Jiangwei Liu

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Abstract

BACKGROUND AND AIMS: The metabolic consequences of extreme temperature exposure in nondiabetic populations remain poorly understood. This study aimed to examine associations between heatwave and coldwave exposure and incident diabetes mellitus (DM) and impaired glucose tolerance (IGT) in middle-aged and older Chinese adults. METHODS: A total of 1803 China Health and Retirement Longitudinal Study participants aged ≥45 years with normoglycemia at baseline were followed from Wave 1 (2011) to Wave 3 (2015). Eighteen extreme-temperature indicators were derived from city-level fifth-generation European Centre for Medium-Range Weather Forecasts atmospheric reanalysis data. Outcomes were classified according to American Diabetes Association criteria. Generalized linear mixed-effects models (GLMMs) were pooled across five imputed datasets, with Bonferroni correction for multiple comparisons (α = 0.0028) and sensitivity analysis adjusting for individual follow-up duration. RESULTS: All nine heatwave indicators showed odds ratios (ORs) < 1.0 for DM and IGT. HT9 (≥97.5th percentile, ≥4 consecutive days) was the sole Bonferroni-significant result: OR = 0.845 (95% confidence interval [CI]: 0.802-0.890). Coldwave indicators showed no consistent associations. Age significantly modified the HT9 effect (P-interaction = 0.004): adults aged 65-84 showed a stronger inverse association (OR = 0.616) than those aged < 65 (OR = 0.921). CONCLUSION: Prolonged heatwave exposure was consistently associated with reduced diabetes risk, with pronounced age heterogeneity. Replication in larger prospective studies is warranted.

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Humans Middle Aged China Longitudinal Studies Aged Female Incidence Male Risk Factors Diabetes Mellitus Extreme Heat Glucose Intolerance CHARLS cohort study coldwave diabetes heatwave Journal Article

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Yizhan Wu, Han Shi, Li Zhang, Wenhui Shi, Laiyang Song, Jiangwei Liu. 2026-07-22. Extreme Temperature and Incident Diabetes Risk Among Middle-Aged and Older Adults in China: A National Longitudinal Cohort Study.. https://doi.org/10.1177/15578518261470093

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Journal Article resource Aged subject China subject Diabetes subject Diabetes Mellitus subject Female subject Humans subject Incidence subject Journal Article subject Longitudinal Studies subject Male subject Middle Aged subject

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