Classification of Type 2 Diabetes Incidence Risk and the Health Behavior of the 30–50-Year-Old Korean Adults: Latent Class Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Participants
- (1)
- Age: Individuals who were less than 30 years old and more than 60 years old;
- (2)
- Nonconforming data: Individuals who did not fast for 8 h prior to blood sampling;
- (3)
- Deficient data: Individuals whose fasting blood glucose and glycated hemoglobin test results were unavailable;
- (4)
- Missing data.
2.3. Observational Variable
2.4. Statistics
3. Results
3.1. Latent Class Analysis
3.1.1. Determining the Number of Latent Classes
3.1.2. Differential Classification and Naming of Latent Classes
3.1.3. Comparison of Characteristics by Classified Latent Classes
3.2. Multinomial Logistic Regression Analysis: Relationship between General Characteristics and Classified Latent Classes
3.3. Application and Evaluation of Diabetes Risk Prediction Tools
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Classes | AIC | BIC | Adjusted BIC | LMR | Entropy | Latent Class Prevalence (%) | ||||
---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | ||||||
2 | 84,395.078 | 84,516.808 | 84,462.785 | 0.0000 | 0.847 | 36.98 | 63.02 | |||
3 | 83,894.685 | 84,080.861 | 83,998.237 | 0.0000 | 0.689 | 26.76 | 31.57 | 41.67 | ||
4 | 83,700.155 | 83,950.776 | 83,839.552 | 0.0498 | 0.606 | 28.20 | 37.14 | 10.73 | 23.93 | |
5 | 83,618.400 | 83,933.467 | 83,793.642 | 0.2306 | 0.675 | 17.10 | 24.91 | 11.53 | 10.03 | 36.44 |
Characteristics | Classification | Class A (n = 2683) | Class B (n = 3534) | Class C (n = 1021) | Class D (n = 2277) |
---|---|---|---|---|---|
Current smoking | Yes | 37.3 | 0.0 | 78.8 | 0.6 |
No | 62.7 | 100 | 21.2 | 99.4 | |
Alcohol consumption (≥1 time per month) | Yes | 91.2 | 33.6 | 90.0 | 48.7 |
No | 8.8 | 66.4 | 10.0 | 51.3 | |
Physical activity | Yes | 45.5 | 44.8 | 32.2 | 50.9 |
No | 54.5 | 55.2 | 67.8 | 49.1 | |
Diet regularity | Yes | 28.1 | 64.9 | 28.9 | 59.4 |
No | 71.9 | 35.1 | 71.1 | 40.6 | |
Sleep time (h/day) | <7 | 45.6 | 46.4 | 49.8 | 52.8 |
≧7 | 54.4 | 53.6 | 50.2 | 47.2 | |
Abdominal obesity † | Yes | 0.5 | 0.7 | 83.6 | 74.4 |
No | 99.5 | 99.3 | 16.4 | 25.6 | |
Regular health examination | Yes | 71.8 | 74.6 | 67.9 | 72.6 |
No | 28.2 | 25.4 | 32.1 | 27.4 | |
Naming | Negative Abdominal Obesity and High-Risk Health Behavior | Negative Abdominal Obesity and Low-Risk Health Behavior | Positive Abdominal Obesity and High-Risk Health Behavior | Positive Abdominal Obesity and Low-Risk Health Behavior |
Characteristics | Classification | Class A | Class B | Class C | Class D | x2 | p |
---|---|---|---|---|---|---|---|
Age (year) | 30s | 972 (35.2) | 983 (27.8) | 369 (36.1) | 534 (23.5) | 196.477 | 0.000 |
40s | 998 (37.2) | 1231 (34.8) | 369 (36.1) | 788 (34.6) | |||
50s | 713 (26.6) | 1320 (37.4) | 283 (27.7) | 955 (41.9) | |||
Gender | Men | 1454 (54.2) | 643 (18.2) | 843 (82.6) | 928 (40.8) | 1686.131 | 0.000 |
Women | 1229 (45.8) | 2891 (81.8) | 178 (17.4) | 1349 (59.2) | |||
Current Spouse | Yes | 2158 (80.4) | 3029 (85.7) | 804 (78.7) | 1968 (86.4) | 62.081 | 0.000 |
No † | 525 (19.6) | 505 (14.3) | 217 (21.3) | 309 (13.6) | |||
Household income (quartile) | Low | 175 (6.5) | 224 (6.3) | 90 (8.8) | 161 (7.1) | ||
L-Medium | 571 (21.3) | 750 (21.2) | 229 (22.4) | 578 (25.4) | |||
M-High | 882 (32.9) | 1086 (30.7) | 364 (35.7) | 745 (32.7) | |||
High | 1055 (39.3) | 1474 (41.7) | 338 (33.1) | 793 (34.8) | |||
Education (school) | ≤Elementary | 98 (3.7) | 103 (2.9) | 32 (3.1) | 148 (6.5) | 102.358 | 0.000 |
Middle | 167 (6.2) | 184 (5.2) | 74 (7.2) | 172 (7.6) | |||
High | 924 (34.4) | 1177 (33.3) | 379 (37.1) | 864 (37.9) | |||
≥College | 1494 (55.7) | 2070 (58.6) | 536 (52.5) | 1093 (48.0) | |||
Occupation ‡ | Managers | 571 (21.3) | 787 (22.3) | 213 (20.9) | 426 (18.7) | 449.567 | 0.000 |
Office workers | 484 (18.0) | 577 (16.3) | 212 (20.8) | 308 (13.5) | |||
Service and sales worker | 417 (15.5) | 468 (13.2) | 157 (15.4) | 390 (17.1) | |||
Agriculture | 43 (1.6) | 55 (1.6) | 28 (2.7) | 74 (3.2) | |||
Functional | 452 (16.8) | 256 (7.2) | 229 (22.4) | 292 (12.8) | |||
Simple labor worker | 168 (6.3) | 222 (6.3) | 57 (5.6) | 175 (7.7) | |||
Unemployed | 548 (20.4) | 1169 (33.1) | 125 (12.2) | 612 (26.9) | |||
Current job state | Yes | 2135 (79.6) | 2365 (66.9) | 896 (87.8) | 1665 (73.1) | 237.754 | 0.000 |
No | 548 (20.4) | 1169 (33.1) | 125 (12.2) | 612 (26.9) | |||
Type of health insurance | Community | 730 (27.2) | 383 (23.7) | 312 (30.6) | 626 (27.5) | 38.540 | 0.000 |
Workplace | 1891 (70.5) | 2638 (74.6) | 676 (66.2) | 1608 (70.6) | |||
Medicare | 62 (2.3) | 58 (1.6) | 33 (3.2) | 43 (1.9) | |||
Private health state | Yes | 2500 (93.2) | 3297 (93.3) | 935 (91.6) | 2104 (92.4) | 4.672 | 0.197 |
No | 183 (6.8) | 237 (6.7) | 86 (8.4) | 173 (7.6) |
Characteristics | Classification | Class A | Class B | Class C | Class D | Statistics | p |
---|---|---|---|---|---|---|---|
Family history of diabetes | Yes | 685 (25.5) | 886 (25.1) | 313 (30.7) | 624 (27.4) | χ2 = 14.96 | 0.002 |
No | 1998 (74.5) | 2648 (74.9) | 708 (69.3) | 1653 (72.6) | |||
History of being diagnosed with hypertension | Yes | 397 (14.8) | 415 (11.7) | 356 (34.9) | 739 (32.5) | χ2 = 556.92 | <0.001 |
No | 2286 (85.2) | 3119 (88.3) | 665 (65.1) | 1538 (67.5) | |||
Blood pressure (≥130/85 mmHg) | Yes | 597 (22.3) | 566 (16.0) | 424 (41.5) | 862 (37.9) | χ2 = 499.60 | <0.001 |
No | 2085 (77.7) | 2967 (84.0) | 597 (58.5) | 1415 (62.1) | |||
HbA1c (%) | Mean ± SD | 113.54 ± 13.96 | 111.23 ± 14.17 | 120.99 ± 14.71 | 120.00 ± 14.7 | F = 246.00 | <0.001 |
76.37 ± 9.57 | 73.94 ± 9.13 | 82.31 ± 10.05 | 6 80.31 ± 9.91 | F = 321.02 | <0.001 | ||
<6.5 | 2583 (96.3) | 3418 (96.7) | 890 (87.2) | 2030 (89.2) | χ2 = 304.36 | <0.001 | |
≥6.5 | 100 (3.7) | 116 (3.3) | 131 (12.8) | 247 (10.8) | |||
Fasting glucose (mg/dl) | Mean ± SD | 5.51 ± 0.67 | 5.51 ± 0.57 | 5.84 ± 0.84 | 8.82 ± 0.89 | F = 157.18 | <0.001 |
<100 | 1923 (71.7) | 2851 (80.7) | 465 (45.5) | 1248 (54.8) | χ2 = 698.10 | <0.001 | |
≥100 | 760 (28.3) | 683 (19.3) | 556 (54.5) | 1029 (45.2) | |||
97.15 ± 20.27 | 94.36 ± 16.76 | 107.14 ± 25.03 | 104.67 ± 28.34 | F = 137.74 | <0.001 |
Variables | Class B (Reference) | |||
---|---|---|---|---|
Class A | Class C | Class D | ||
Gender | Men vs. women | 5.69 (5.03–6.44) | 23.32 (19.15–28.39) | 3.48 (3.06–3.95) |
Age | 30s vs. 50s | 2.63 (2.26–3.05) | 2.82 (2.28–3.49) | 1.04 (0.89–1.21) |
40s vs. 50s | 1.97 (1.71–2.26) | 1.92 (1.57–2.34) | 1.11 (0.98–1.27) | |
Household income quartile (ref. high) | Low | 1.02 (0.80–1.30) | 1.91 (1.38–2.65) | 1.19 (0.93–1.51) |
Low-medium | 0.97 (0.84–1.13) | 1.27 (1.03–1.57) | 1.38 (1.19–1.59) | |
Medium-high | 1.06 (0.93–1.21) | 1.41 (1.17–1.70) | 1.26 (1.11–1.44) | |
Education level (ref. college) | ≤Elementary school | 3.11 (2.27–4.27) | 3.29 (2.06–5.25) | 3.39 (2.55–4.52) |
Middle school | 2.36 (1.84–3.02) | 3.14 (2.24–4.38) | 2.00 (1.57–2.54) | |
High school | 1.61 (1.43–1.83) | 2.03 (1.71–2.42) | 1.56 (1.38–1.77) | |
Currently employed | Yes vs. no | 1.16 (1.02–1.32) | 1.32 (1.05–1.67) | 0.98 (0.87–1.12) |
Currently married | Yes vs. no | 1.10 (0.91–1.32) | 1.48 (1.23–1.75) | 1.19 (1.05–1.35) |
Family history | Yes vs. no | 1.10 (0.97–1.24) | 1.22 (0.95–1.55) | 1.35 (1.09–1.66) |
Variables | Classification | Total | Class A | Class B | Class C | Class D | Statistics | p |
---|---|---|---|---|---|---|---|---|
Score † | ≤4 | 6608 (69.4) | 1903 (70.9) | 3290 (93.1) | 117 (11.5) | 1298 (57.0) | χ2 = 3202.51 | <0.001 |
5–7 | 2474 (26.0) | 730 (27.2) | 241 (6.8) | 644 (63.1) | 859 (37.7) | |||
8–9 | 418 (4.4) | 50 (1.9) | 3 (0.1) | 245 (24.0) | 120 (5.3) | |||
≥10 | 15 (0.2) | 0 (0.0) | 0 (0.0) | 15 (1.5) | 0 (0.0) | |||
Mean ± SD (min–max) | 3.56 ± 2.09 (3.52–3.60) | 3.58 ± 1.71 | 2.16 ± 1.55 | 6.27 ± 1.59 | 4.50 ± 1.63 | F = 2097.58 | <0.001 | |
Probability of having diabetes | ≥6% | 2907 (30.6) | 780 (29.1) | 244 (6.9) | 904 (88.5) | 979 (43.0) | χ2 = 2718.48 | <0.001 |
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Seol, R.; Chun, J.-H. Classification of Type 2 Diabetes Incidence Risk and the Health Behavior of the 30–50-Year-Old Korean Adults: Latent Class Analysis. Int. J. Environ. Res. Public Health 2022, 19, 16600. https://doi.org/10.3390/ijerph192416600
Seol R, Chun J-H. Classification of Type 2 Diabetes Incidence Risk and the Health Behavior of the 30–50-Year-Old Korean Adults: Latent Class Analysis. International Journal of Environmental Research and Public Health. 2022; 19(24):16600. https://doi.org/10.3390/ijerph192416600
Chicago/Turabian StyleSeol, Roma, and Jin-Ho Chun. 2022. "Classification of Type 2 Diabetes Incidence Risk and the Health Behavior of the 30–50-Year-Old Korean Adults: Latent Class Analysis" International Journal of Environmental Research and Public Health 19, no. 24: 16600. https://doi.org/10.3390/ijerph192416600