Sex differences in the associations between socioeconomic status and all-cause mortality in Chinese adults with abnormal glucose metabolism: a prospective study.

BACKGROUND: Abnormal glucose metabolism, including diabetes and prediabetes, significantly contributes to cardiovascular disease and mortality worldwide. Socioeconomic status (SES) has been identified as a critical determinant of health outcomes, but it remains unclear whether sex difference exists in the impact of SES on mortality among adults with abnormal glucose metabolism. METHODS: Data was used from the China Health and Retirement Longitudinal Study (CHARLS), involving participants aged 45 years or older with abnormal glucose metabolism at baseline (2011) and participated at least one subsequent survey (2013, 2015, and 2018). SES was categorized as low, medium, and high according to the educational level, rural-urban residence, and household income. Multivariate Cox proportional hazards regression models were used to evaluate the associations between SES and all-cause mortality among participants stratified by sex. RESULTS: A total of 5146 participants (60.06 ± 9.16 years old, females: 53.5%) were included in this study. The hazard ratio (HR) of mortality was 1.54 (95% CI: 1.20-1.98) for medium SES and 1.52 (95% CI: 1.18-1.96) for low SES compared to those with high SES. Stratified analyses revealed that the significant association was observed in Males, with HR of 1.69 (95% CI: 1.24-2.31) for medium SES and 1.63 (95% CI: 1.18-2.27) for low SES, while the associations were not statistically significant in females. CONCLUSIONS: Low SES was associated with higher all-cause mortality in Chinese adults with abnormal glucose metabolism, particularly among males. These findings underscore the need for targeted public health interventions addressing SES-related disparities to reduce mortality in this population.