General characteristics of studied sample.

To observe trends of diabetes and its associated risk factors from health surveys 2002–2017 in rural areas of Baluchistan-Pakistan and a secondary analysis based on community based health surveys of Baluchistan conducted between 2001–02, 2009–10, and 2016–17. A total of 4250 participants were included in this combined analysis, 2515 from 2001–2002, 1377 from 2009–2010 and 358 from 2016–2017 survey year. In each survey, detailed information of baseline parameters were noted on a predesigned questionnaire. Fasting plasma glucose (FPG) was used for diagnosis of diabetes for comparative purposes in this analysis. Cardiovascular (CVD) risk factors including hypertension, obesity, dyslipidaemia, tobacco use, alcohol consumption, and physical activity were compared. Most subjects were aged 30–50 years and males were found higher in 2016–17 compared to 2001–02 and 2009–10. Pronounced increases in BMI, waist circumference, blood pressure, and family history of diabetes were observed in 2016–17. Diabetes prevalence was 4.2 (3.4–4.9), 7.8 (6.6–9.2) and 31.9 (26.9–37.4), whilst pre-diabetes was 1.7 (1.3–2.2), 3.6 (2.8–4.6) and 10.7 (7.6–14.9) in years 2001–02, 2009–10, and 2016–17, respectively. Among those aged 20-39years, prevalence of diabetes was stable from 2001–10 yet increased considerably between the ages of 30-39years in 2016–17. Throughout the observed period, rapid increases were observed in hypertension, obesity, and dyslipidaemia, however, addiction to tobacco use and alcohol intake decreased. Adjusted odd ratios showed age, marital status, education, hypertension, and family history of diabetes as associated risk factors for glycaemic dysregulation. The rural Baluchistan population is confronted with increasing trends of early onset diabetes due to highly associated CVD risk factors, especially central obesity and dyslipidaemia, raising a major public health challenge.本研究以巴基斯坦俾路支省（Baluchistan）农村地区2002-2017年的健康调查数据为基础，同时基于该省2001-2002、2009-2010及2016-2017年开展的社区健康调查进行二次分析，旨在探讨糖尿病及其相关危险因素的流行趋势。本次合并分析共纳入4250名研究对象：2001-2002年调查纳入2515名，2009-2010年纳入1377名，2016-2017年纳入358名。各项调查均通过预先设计的问卷收集研究对象的基线特征详细信息。本次分析采用空腹血浆葡萄糖（Fasting Plasma Glucose, FPG）作为糖尿病的诊断指标，以保证不同调查间的可比性。本研究对心血管疾病（Cardiovascular Disease, CVD）危险因素进行了比较分析，包括高血压、肥胖、血脂异常、吸烟、饮酒及体力活动水平。研究对象以30-50岁人群为主，与2001-2002年及2009-2010年调查相比，2016-2017年调查的男性占比更高。2016-2017年调查中，研究对象的体重指数（Body Mass Index, BMI）、腰围、血压水平及糖尿病家族史阳性率均出现显著升高。2001-2002、2009-2010及2016-2017年的糖尿病患病率分别为4.2%（95%置信区间：3.4%~4.9%）、7.8%（6.6%~9.2%）及31.9%（26.9%~37.4%）；前驱糖尿病患病率则分别为1.7%（1.3%~2.2%）、3.6%（2.8%~4.6%）及10.7%（7.6%~14.9%）。在20-39岁人群中，2001-2010年的糖尿病患病率保持稳定，但2016-2017年调查中30-39岁人群的糖尿病患病率出现大幅上升。在整个观察周期内，高血压、肥胖及血脂异常的患病率快速上升，而吸烟及饮酒成瘾率则呈下降趋势。校正后的比值比（Odds Ratio, OR）分析显示，年龄、婚姻状况、受教育程度、高血压及糖尿病家族史均为血糖代谢异常的相关危险因素。由于存在大量与心血管疾病相关的危险因素（尤其是中心性肥胖与血脂异常），巴基斯坦俾路支省农村地区人群早发性糖尿病的患病率呈上升趋势，这已成为一项严峻的公共卫生挑战。