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Liu C, Liu R, Tian N, Fa W, Liu K, Wang N, Zhu M, Liang X, Ma Y, Ren Y, Wang Y, Cong L, Tang S, Vetrano DL, Ngandu T, Kivipelto M, Hou T, Du Y, Qiu C. Cardiometabolic multimorbidity, peripheral biomarkers, and dementia in rural older adults: The MIND-China study. Alzheimers Dement 2024. [PMID: 38982798 DOI: 10.1002/alz.14091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/20/2024] [Accepted: 06/01/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Evidence has emerged that cardiometabolic multimorbidity (CMM) is associated with dementia, but the underlying mechanisms are poorly understood. METHODS This population-based study included 5704 older adults. Of these, data were available in 1439 persons for plasma amyloid-β (Aβ), total tau, and neurofilament light chain (NfL) and in 1809 persons for serum cytokines. We defined CMM following two common definitions used in previous studies. Data were analyzed using general linear, logistic, and mediation models. RESULTS The presence of CMM was significantly associated with an increased likelihood of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) (p < 0.05). CMM was significantly associated with increased plasma Aβ40, Aβ42, and NfL, whereas CMM that included visceral obesity was associated with increased serum cytokines. The mediation analysis suggested that plasma NfL significantly mediated the association of CMM with AD. DISCUSSION CMM is associated with dementia, AD, and VaD in older adults. The neurodegenerative pathway is involved in the association of CMM with AD. HIGHLIGHTS The presence of CMM was associated with increased likelihoods of dementia, AD, and VaD in older adults. CMM was associated with increased AD-related plasma biomarkers and serum inflammatory cytokines. Neurodegenerative pathway was partly involved in the association of CMM with AD.
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Affiliation(s)
- Cuicui Liu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Rui Liu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Na Tian
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Wenxin Fa
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
| | - Keke Liu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Nan Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Min Zhu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Xiaoyan Liang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Yixun Ma
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
| | - Yongxiang Wang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Solna, Sweden
| | - Lin Cong
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Shi Tang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tingting Hou
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Yifeng Du
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P.R. China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, P.R. China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
| | - Chengxuan Qiu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P.R. China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, P.R. China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Solna, Sweden
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Chen Q, Deng Q, Liao Q, Liu Y, Zhang Z, Wu D, Lv Y, Qin J, Liu Q, Li S, Long Z, Xing X, Wang Q, Zeng X, Dong G, Hou M, Xiao Y. 8-OHdG mediates the association of co-exposure to fifty-five typical endocrine-disrupting chemicals with renal function: a cross-section investigation in Southern Chinese adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:30779-30792. [PMID: 38613763 DOI: 10.1007/s11356-024-33266-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/05/2024] [Indexed: 04/15/2024]
Abstract
Individual typical endocrine-disrupting chemicals (EDCs), including organophosphate triesters (OPEs), parabens, triclosan (TCS), bisphenols, benzophenones (BPs), phthalates (PAEs), and synthetic phenolic antioxidants (SPAs), are associated with renal dysfunction. However, the combined effects and underlying mechanisms of mixed EDC exposure on renal function remain unclear. Two hundred ninety-nine adult participants were enrolled in the cross-sectional survey conducted in Guangzhou, China. Urinary levels of 7 OPEs, 6 parabens, TCS, 14 bisphenols, 8 BPs, 15 PAEs, 4 SPAs, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were determined, and estimated glomerular filtration rate (eGFR) was served as the outcome index. We found elevated levels of diphenyl phosphate (DPP), bisphenol A (BPA), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-butyl phthalate (MBP) showed dose-responsive associations with eGFR decline, However, nonlinear associations were observed for bis(2-butoxyethyl) hydrogen phosphate (BBOEP), TCS, 4-hydroxybenzophenone (HBP), mono-n-pentyl phthalate (MnPP), and mono-benzyl phthalate (MBzP). The quantile-based g-computation model demonstrated that a quartile increase in the EDC mixture corresponded to a 0.383-SD decrease (95% CI - 0.658 ~ - 0.108, P = 0.007) in eGFR. Notably, BPA was identified as the primary contributor to this effect. Moreover, 8-OHdG mediated the eGFR decline associated with EDC mixtures with a mediation proportion of 25.49%. A sex-modified effect was also observed (P = 0.004), indicating that exposure to the mixture of EDC was linked to more pronounced renal dysfunction in females. Our novel findings suggest that exposure to a typical mixture of EDCs is associated with renal dysfunction in the general adult population of Southern China. Furthermore, 8-OHdG may play a role in the pathogenesis of EDC mixture-related renal dysfunction.
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Affiliation(s)
- Qingfei Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qifei Deng
- School of Public Health, Guangzhou Medical University, Xinzao Town, Panyu District, Guangzhou, 511436, Guangdong, China
| | - Qilong Liao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, 510530, People's Republic of China
| | - Yan Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Zhaorui Zhang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- School of Public Health, Guangzhou Medical University, Xinzao Town, Panyu District, Guangzhou, 511436, Guangdong, China
| | - Dehua Wu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Yanrong Lv
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Jingyao Qin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Qing Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Shuangqi Li
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Zihao Long
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
| | - Xiumei Xing
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qing Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Xiaowen Zeng
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Mengjun Hou
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Yongmei Xiao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong, China.
- Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China.
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Chen Q, Deng Q, Liu Y, Long Z, Li S, Liu Q, Lv Y, Qin J, Yang A, Huang Y, Tan Z, Wang D, Xing X, Xiao Y. Co-exposure of petrochemical workers to noise and mixture of benzene, toluene, ethylbenzene, xylene, and styrene: Impact on mild renal impairment and interaction. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 346:123628. [PMID: 38395129 DOI: 10.1016/j.envpol.2024.123628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
Epidemiological evidence concerning effects of simultaneous exposure to noise and benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS) on renal function remains uncertain. In 2020, a cross-sectional study was conducted among 1160 petrochemical workers in southern China to investigate effects of their co-exposure on estimated glomerular filtration rate (eGFR) and mild renal impairment (MRI). Noise levels were assessed using cumulative noise exposure (CNE). Urinary biomarkers for BTEXS were quantified. We found the majority of workers had exposure levels to noise and BTEXS below China's occupational exposure limits. CNE, trans, trans-muconic acid (tt-MA), and the sum of mandelic acid and phenylglyoxylic acid (PGMA) were linearly associated with decreased eGFR and increased MRI risk. We observed U-shaped associations for both N-acetyl-S-phenyl-L-cysteine (SPMA) and o-methylhippuric acid (2-MHA) with MRI. In further assessing the joint effect of BTEXS (β, -0.164 [95% CI, -0.296 to -0.033]) per quartile increase in all BTEXS metabolites on eGFR using quantile g-computation models, we found SPMA, tt-MA, 2-MHA, and PGMA played pivotal roles. Additionally, the risk of MRI associated with tt-MA was more pronounced in workers with lower CNE levels (P = 0.004). Multiplicative interaction analysis revealed antagonisms of CNE and PGMA on MRI risk (P = 0.034). Thus, our findings reveal negative dose-effect associations between noise and BTEXS mixture exposure and renal function in petrochemical workers. With the exception of toluene, benzene, xylene, ethylbenzene, and styrene are all concerning pollutants for renal dysfunction. Effects of benzene, ethylbenzene, and styrene exposure on renal dysfunction were more pronounced in workers with lower CNE.
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Affiliation(s)
- Qingfei Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China; Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qifei Deng
- School of Public Health, Guangzhou Medical University, Xinzao Town, Panyu District, Guangzhou, 511436, Guangdong, China
| | - Yan Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Zihao Long
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Shuangqi Li
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Qing Liu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Yanrong Lv
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Jingyao Qin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Aichu Yang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, No. 68 Haikang Street, Guangzhou, 510300, Guangdong, China
| | - Yongshun Huang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, No. 68 Haikang Street, Guangzhou, 510300, Guangdong, China
| | - Zhaoqing Tan
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Dongsheng Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Xiumei Xing
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China; Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China
| | - Yongmei Xiao
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China; Joint International Research Laboratory of Environment and Health, Ministry of Education, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China.
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Ren Y, Li Y, Tian N, Liu R, Dong Y, Hou T, Liu C, Han X, Han X, Wang L, Vetrano DL, Ngandu T, Marengoni A, Kivipelto M, Wang Y, Cong L, Du Y, Qiu C. Multimorbidity, cognitive phenotypes, and Alzheimer's disease plasma biomarkers in older adults: A population-based study. Alzheimers Dement 2024; 20:1550-1561. [PMID: 38041805 PMCID: PMC10984420 DOI: 10.1002/alz.13519] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/21/2023] [Accepted: 09/28/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION To examine the burden and clusters of multimorbidity in association with mild cognitive impairment (MCI), dementia, and Alzheimer's disease (AD)-related plasma biomarkers among older adults. METHODS This population-based study included 5432 participants (age ≥60 years); of these, plasma amyloid beta (Aβ), total tau, and neurofilament light chain (NfL) were measured in a subsample (n = 1412). We used hierarchical clustering to generate five multimorbidity clusters from 23 chronic diseases. We diagnosed dementia and MCI following international criteria. Data were analyzed using logistic and linear regression models. RESULTS The number of chronic diseases was associated with dementia (multivariable-adjusted odds ratio = 1.22; 95% confidence interval [CI] = 1.11 to 1.33), AD (1.13; 1.01 to 1.26), vascular dementia (VaD) (1.44; 1.25 to 1.64), and non-amnestic MCI (1.25; 1.13 to 1.37). Metabolic cluster was associated with VaD and non-amnestic MCI, whereas degenerative ocular cluster was associated with AD (p < 0.05). The number of chronic diseases was associated with increased plasma Aβ and NfL (p < 0.05). DISCUSSION Multimorbidity burden and clusters are differentially associated with subtypes of dementia and MCI and AD-related plasma biomarkers in older adults. HIGHLIGHTS We used hierarchical clustering to generate five clusters of multimorbidity. The presence and load of multimorbidity were associated with dementia and mild cognitive impairment. Multimorbidity clusters were differentially associated with subtypes of dementia and Alzheimer's disease plasma biomarkers.
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Liu S, Zhou X, Zhang M, Shi C, Ren R, Hou C, Di B. Estimating the prevalence of dyslipidemia by measuring fenofibrate in 33 cities in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169426. [PMID: 38128665 DOI: 10.1016/j.scitotenv.2023.169426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Dyslipidemia, recognized as a predominant risk factor for atherosclerotic cardiovascular disease (CVD), remains a pressing health concern worldwide, particularly in China with nearly 40 % of the population adversely suffering. Fenofibrate, as one of the most commonly used drugs for dyslipidemia therapy, excreted as the format of fenofibrate-acid, which showed considerable stability in sewage samples and could be detected as WBE-biomarkers to monitor the prevalence of dyslipidemia. In this work, we reported the first research on estimating the prevalence of dyslipidemia by WBE approach. 527 sewage samples from 33 cities in China were extracted by solid phase and analyzed by LC-MS/MS. The detected concentration of fenofibrate acid in sewage was on an average of 120.5 ± 59.9 ng/L, and the reverse-calculated consumption of fenofibrate based on fenofibrate acid was 77.8 ± 25.0 mg/day/1000inh. Detailed analysis unveiled an average prevalence of fenofibrate at 0.056 % ± 0.018 %, and the dyslipidemia prevalence among the population aged over 15 was ultimately estimated to be 37.9 % ± 9.3 % and was in accordance with the China Cardiovascular research result of 40.4 %, which proves that WBE is a substitutable approach of traditional epidemiological investigation methods due to its timeliness and cost-effectiveness. This study demonstrated that estimating dyslipidemia prevalence by WBE with metabolite fenofibrate acid as a biomarker is feasible in most Chinese cities.
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Affiliation(s)
- ShuCheng Liu
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - XinXin Zhou
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Manlei Zhang
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Chen Shi
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - Ren Ren
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China
| | - ChenZhi Hou
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China; Key Laboratory of Drug Quality Control and Pharmacovigilance, China Pharmaceutical University, Ministry of Education, No. 639 Longmian Avenue, Nanjing 211100, China.
| | - Bin Di
- School of Pharmacy, China Pharmaceutical University, No. 24 Tongjiaxiang Road, Nanjing 210009, China; China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, No. 24 Tongjiaxiang Road, Nanjing 210009, China; Key Laboratory of Drug Quality Control and Pharmacovigilance, China Pharmaceutical University, Ministry of Education, No. 639 Longmian Avenue, Nanjing 211100, China.
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Chen Y, Du J, Zhou N, Song Y, Wang W, Hong X. Prevalence, awareness, treatment and control of dyslipidaemia and their determinants: results from a population-based survey of 60 283 residents in eastern China. BMJ Open 2023; 13:e075860. [PMID: 38128931 DOI: 10.1136/bmjopen-2023-075860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES To investigate the prevalence, awareness, treatment and control of dyslipidaemia and its associated factors in eastern China. DESIGN Cross-sectional study. SETTING Data were collected from the 2017 Nanjing Chronic Disease and Risk Factor Surveillance. PARTICIPANTS This study included 60 283 participants aged ≥18 years. OUTCOME MEASURES Prevalence of dyslipidaemia was defined as self-reported history of dyslipidaemia and/or the use of lipid-lowering medication, and/or meeting at least one of the following during on-site investigation: total cholesterol ≥6.2 mmol/L, triglyceride ≥2.3 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L and high-density lipoprotein cholesterol <1.0 mmol/L. Dyslipidaemia awareness was defined as the proportion of patients with dyslipidaemia who explicitly indicate their awareness of having a diagnosis of dyslipidaemia. Treatment was based on medication use among individuals with dyslipidaemia. Control was defined as having dyslipidaemia, receiving treatment and achieving serum lipid control to the standard level. ANALYSIS Complex weighting was used to calculate weighted prevalence. A two-level logistic regression model determined the influencing factors for dyslipidaemia prevalence, awareness, treatment and control. RESULTS The crude prevalence rate of dyslipidaemia was 28.4% (17 093 of 60 283). Among 17 093 patients with dyslipidaemia, the crude rates of awareness, treatment and control were 40.0% (n=6830), 27.5% (n=4695) and 21.9% (n=3736), respectively. The corresponding weighted prevalence rates were 29.8%, 41.6%, 28.9% and 22.9%. Older age (OR 2.03, 95% CI 1.82 to 2.23), urban residence (1.24, 1.19 to 1.31), higher education level (1.31, 1.21 to 1.42), current smoking (1.22, 1.15 to 1.29), alcohol consumption (1.20, 1.14 to 1.26), obesity (2.13, 1.99 to 2.29), history of hypertension (1.64, 1.56 to 1.71) and diabetes (1.92, 1.80 to 2.04) were identified as independent risk factors for dyslipidaemia (all p<0.001). Participants who were older, female, living in urban areas, had higher education levels, did not smoke or drink alcohol, had central obesity, had hypertension or had diabetes were more likely to be aware of their dyslipidaemia conditions, receive treatment and achieve serum lipid control to a standard level than their comparators (all p<0.05). CONCLUSIONS The prevalence of dyslipidaemia is relatively high in eastern China; however, awareness, treatment and control levels are relatively low.
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Affiliation(s)
- Yijia Chen
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Jinling Du
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, Nanjing, China
- Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing, China
| | - Nan Zhou
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Yingqian Song
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, Nanjing, China
- Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing, China
| | - Weiwei Wang
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, Nanjing, China
| | - Xin Hong
- Department of Chronic and Noncommunicable Disease Prevention, Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, Nanjing, China
- Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing, China
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Xia Q, Chen Y, Yu Z, Huang Z, Yang Y, Mao A, Qiu W. Prevalence, awareness, treatment, and control of dyslipidemia in Chinese adults: a systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1186330. [PMID: 37476570 PMCID: PMC10354280 DOI: 10.3389/fcvm.2023.1186330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
Background Researchers have conducted a considerable number of epidemiological studies on dyslipidemia in China over recent years. Nevertheless, a representative study to comprehensively appraise for the epidemiological status of dyslipidemia is still lacked. This meta-analysis is intended to explore the pooled prevalence, rates of awareness, treatment, and control of dyslipidemia among adults in Chinese Mainland. Materials and methods A systematic review was performed on relevant cross-sectional studies published since January 2012 by searching six authoritative literature databases. Meta-analyses were conducted in included studies based on a random-effect model to summarize the epidemiological status of dyslipidemia in China. A potential source of heterogeneity was detected by subgroup analysis and meta-regression. Publication bias was assessed by Egger's test and funnel plots. A sensitivity analysis was conducted to examine the study quality's influence on the pooled estimate of prevalence and rates of awareness, treatment, and control. Results Forty-one original researches with a total of 1,310,402 Chinese participants were finally included in the meta-analysis. The prevalence, rates of awareness, treatment, and control of dyslipidemia were 42.1%, 18.2%, 11.6%, and 5.4%, respectively. With a pooled prevalence estimate at 24.5%, low HDL-C was the most prevalent among various dyslipidemia types, followed by hypertriglyceridemia (TG) (15.4%), hypercholesterolemia (TC) (8.3%), and high LDL-C (7.1%). The pooled prevalence of elevated serum lipoprotein(a) [Lp(a)] was 19.4%. By gender, the prevalence of dyslipidemia was 47.3% in males and 38.8% in females. Subgroup analyses revealed that the prevalence in southern and urban areas were higher than their counterparts. Females and population in urban areas tended to possess higher rates of awareness, treatment, and control. Meta-regression analyses suggested that the year of screening influenced prevalence estimates for dyslipidemia. The impact of the study's quality on the pooled estimates is insignificant. Conclusion Our study suggested a severe epidemic situation of dyslipidemia among adults in Chinese Mainland. More importantly, the awareness, treatment, and control rates were extremely low, revealing that dyslipidemia is a grave health issue. Consequently, we should attach more importance to the management of dyslipidemia, especially in economically underdeveloped areas. Systematic review registration PROSPERO [CRD42022366456].
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Affiliation(s)
- Qianhang Xia
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zijing Yu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zhongyue Huang
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yujie Yang
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Ayan Mao
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Wuqi Qiu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
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8
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Dou Y, Chen B, Yu X, Ma D. Effectiveness of Internet-based health management in patients with dyslipidemia: A four-year longitudinal study. Atherosclerosis 2023; 376:34-42. [PMID: 37279608 DOI: 10.1016/j.atherosclerosis.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND AIMS Dyslipidemia is an important risk factor for coronary artery disease and stroke, and it has emerged as a major public health issue worldwide. Internet-based health management and intervention may offer a new approach to health management. This study was conducted to provide health guidance and education to people with dyslipidemia using an Internet health management platform and to assess the effectiveness of Internet health management and intervention in improving health-related behaviors and controlling blood lipids. METHODS Starting in 2013 (Baseline, N = 56,542), a Western longitudinal study in China was performed, and all interventional objects were provided with Internet health management. Health checkups were conducted annually, and questionnaires were administered every two years to analyze changes in health behaviors two years (2015) and four years (2017) following the intervention. In addition, factors affecting behavioral changes and lipid control were analyzed in the dyslipidemic population to understand the effectiveness and influencing factors of Internet health management on lipid control. RESULTS By guiding interventional objects through the Internet health management platform, the awareness rate of dyslipidemia increased from 19.1% in 2013 to 34.4% in 2017; and the control rate of dyslipidemia increased from 9.1% at baseline to 18.5%. Certain health-related behaviors that are beneficial to health (tobacco use, physical activity, and partial dietary) were gradually improved over the intervention time. For patients with dyslipidemia, triglyceride decreased from 2.90 mmol/L (2013) to 2.77 mmol/L (2017) as the years went by. Analysis of factors affecting lipid control showed that non-compliance with health instructions affected lipid control; in addition to these, being female (0.722, 95% CI: 0.546,0.954) was found to be a protective factor for effective lipid control. CONCLUSIONS The basic Internet-based health management platform in this study appears to be moderately successful and is a valuable and feasible application. Tobacco, dietary, and physical activity interventions provided significant protection against dyslipidemia in patients.
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Affiliation(s)
- Yuqi Dou
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Botian Chen
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xue Yu
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Defu Ma
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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9
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Ye Y, Zhou Q, Dai W, Peng H, Zhou S, Tian H, Shen L, Han H. Gender differences in metabolic syndrome and its components in southern china using a healthy lifestyle index: a cross-sectional study. BMC Public Health 2023; 23:686. [PMID: 37046236 PMCID: PMC10091685 DOI: 10.1186/s12889-023-15584-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Lifestyle changes are important for the prevention and management of metabolic syndrome (MetS), but studies that focus on gender differences in the lifestyle risk factors of MetS are limited in China. This research aimed to generate a healthy lifestyle index (HLI) to assess the behavioral risk factors of MetS and its components, and to explore the gender differences in HLI score and other influencing factors of MetS. METHODS A convenience sample of 532 outpatients were recruited from a general hospital in Changsha, China. The general information and HLI scores [including physical activity (PA), diet, smoking, alcohol use, and body mass index (BMI)] of the subjects were collected through questionnaires, and each patient's height, weight, waist circumference, and other physical signs were measured. Logistic regression analysis was used to analyze the risk factors of MetS and its components. RESULTS The prevalence of MetS was 33.3% for the whole sample (46.3% in males and 23.3% in females). The risk of MetS increased with age, smoking, unhealthy diet, and BMI in males and with age and BMI in females. Our logistic regression analysis showed that lower HLI (male: OR = 0.838,95%CI = 0.757-0.929; female: OR = 0.752, 95%CI = 0.645-0.876) and older age (male: OR = 2.899, 95%CI = 1.446-5.812; female: OR = 4.430, 95%CI = 1.640-11.969) were independent risk factors of MetS, for both sexes. CONCLUSION Low levels of HLI and older ages were independent risk factors of MetS in both males and females. The association between aging and MetS risk was stronger in females, while the association between unhealthy lifestyles and MetS risk was stronger in males. Our findings reinforced the expected gender differences in MetS prevalence and its risk factors, which has implications for the future development of gender-specific MetS prevention and intervention programs.
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Affiliation(s)
- Ying Ye
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
- Xiangya School of Nursing, Central South University, Changsha, P.R. China
| | - Qiuhong Zhou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
- Xiangya School of Nursing, Central South University, Changsha, P.R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
| | - Weiwei Dai
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Hua Peng
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Shi Zhou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Huixia Tian
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Lu Shen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Huiwu Han
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China.
- Xiangya School of Nursing, Central South University, Changsha, P.R. China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China.
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10
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Yeh EJ, Grigolon RB, Rodrigues SR, A Bueno AP. Systematic literature review and meta-analysis of cardiovascular risk factor management in selected Asian countries. J Comp Eff Res 2023; 12:e220085. [PMID: 36861459 PMCID: PMC10402804 DOI: 10.57264/cer-2022-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 01/20/2023] [Indexed: 03/03/2023] Open
Abstract
Aim: There is a need to understand the management status of hypertension, dyslipidemia/hypercholesterolemia, and diabetes mellitus in the Asia-Pacific region (APAC). Methods: We conducted a systematic literature review and meta-analysis to summarize the awareness, treatment, and/or control rates of these risk factors in adults across 11 APAC countries/regions. Results: We included 138 studies. Individuals with dyslipidemia had the lowest pooled rates compared with those with other risk factors. Levels of awareness with diabetes mellitus, hypertension, and hypercholesterolemia were comparable. Individuals with hypercholesterolemia had a statistically lower pooled treatment rate but a higher pooled control rate than those with hypertension. Conclusion: The management of hypertension, dyslipidemia, and diabetes mellitus was suboptimal in these 11 countries/regions.
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11
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Lin Z, Fu M, Chen X. Self-perceived memory is negatively associated with chronic disease awareness: Evidence from blood biomarker data. SSM Popul Health 2023; 22:101361. [PMID: 36852376 PMCID: PMC9958050 DOI: 10.1016/j.ssmph.2023.101361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Background and objectives Cognitive misperception contributed to poor decision-making; yet their impact on health-related decisions is less known. We examined how self-perceived memory was associated with chronic disease awareness among older Chinese adults. Research design and methods Data were obtained from the China Health and Retirement Longitudinal Study. Nationally representative blood biomarkers were collected in 2015 to identify participants' dyslipidemia and diabetes status. Among participants with biomarker identified dyslipidemia or diabetes, disease awareness was defined as self-reported diagnosis of the conditions as of 2018. The association of self-perceived memory with chronic disease awareness was determined by weighted multivariate logistic regressions adjusting for cognitive ability and covariates. Results Among 4578 adults aged 60 and over, 1442 and 759 individuals were identified having dyslipidemia and diabetes, with proportions of disease awareness being 38.0% and 58.1%, respectively. The proportions were lower for individuals with better self-perceived memory and those with more impaired cognitive ability, showing opposite patterns. Adjusting for cognitive ability and covariates, self-perceived memory was negatively associated with the dyslipidemia (OR = 0.80, 95%CI: 0.63-1.02) and diabetes (OR = 0.71, 95%CI: 0.55-0.92) awareness. In particular, older adults with the highest level of self-perceived memory had significantly lower disease awareness as compared to those with the lowest level of self-perceived memory (OR = 0.51, 95%CI: 0.28-0.94 for dyslipidemia; and OR = 0.42, 95%CI: 0.21-0.84 for diabetes). The negative association was robust to adjusting for alternative cognitive measures, and was stronger for individuals with rural status, lower education, or living without children. Discussion and implications Cognitive misperception poses great challenges to chronic disease awareness. Targeted interventions and supports are needed, particularly for those more disadvantaged.
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Affiliation(s)
- Zhuoer Lin
- Department of Health Policy and Management, Yale School of Public Health, USA
| | - Mingqi Fu
- Center for Social Security Studies, Wuhan University, China
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, USA,Department of Economics, Yale University, USA,Yale Alzheimer's Disease Research Center, USA,Corresponding author. Department of Health Policy and Management, Yale School of Public Health, 60 College St, New Haven, CT, 06520, USA.
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12
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Liu C, Li Y, Li J, Jin C, Zhong D. The Effect of Psychological Burden on Dyslipidemia Moderated by Greenness: A Nationwide Study from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14287. [PMID: 36361165 PMCID: PMC9659001 DOI: 10.3390/ijerph192114287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Globally, dyslipidemia is now become a leading risk factor for many adverse health outcomes, especially in the middle-aged and elderly. Recent evidence suggests that exposure to greenness and the relief of a psychological burden may decrease the prevalence of dyslipidemia. The objective of our study was to examine whether a green space can moderate the association between mental health status and dyslipidemia. Our study selected the datasets of depression symptoms, dyslipidemia from the China Health and Retirement Longitudinal Study (CHARLS), and the satellite-based normalized difference vegetation index (NDVI) from the 30 m annual maximum NDVI dataset in China in 2018. Ultimately, a total of 10,022 middle-aged and elderly Chinese were involved in our study. Multilevel logistic regressions were performed to examine the association between symptoms of depression and dyslipidemia, as well as the moderate effect of greenness exposure on the association. Our research suggested that adults diagnosed with depression symptoms were more likely to suffer from dyslipidemia. In addition, the NDVI was shown to moderate the effect of depression on dyslipidemia significantly, though the effect was attenuated as depression increased. Regarding the moderate effect of the NDVI on the above association across age, gender, and residence, the findings presented that females, the elderly, and respondents living in urban areas were at a greater risk of having dyslipidemia, although the protective effect of the NDVI was considered. Likewise, the moderate effect of the NDVI gradually decreased as the level of depression increased in different groups. The current study conducted in China provides insights into the association between mental health, green space, and dyslipidemia. Hence, improving mental health and green spaces can be potential targets for medical interventions to decrease the prevalence of dyslipidemia.
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Affiliation(s)
- Chengcheng Liu
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Yao Li
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Jing Li
- Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
| | - Chenggang Jin
- School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China
| | - Deping Zhong
- National Institute of Natural Hazards, Ministry of Emergency Management of the People’s Republic of China, Beijing 100085, China
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13
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Fish Consumption and Risk of Stroke in Chinese Adults: A Prospective Cohort Study in Shanghai, China. Nutrients 2022; 14:nu14204239. [DOI: 10.3390/nu14204239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Present studies on the association of fish consumption with risk of stroke have shown controversial results, and this association within the Chinese population remains unknown. We aimed to investigate the association between fish consumption and incidence of total stroke, ischemic stroke and hemorrhagic stroke among adults in China. We analyzed the data of 57,701 adults aged 20–74 years, with no history of stroke, in a prospective cohort study in Shanghai. Fish consumption was calculated from a food frequency questionnaire at baseline and divided into four categories (less than 300, 300–450, 450–600 and more than 600 g/week). Participant information was linked to health information systems in which stroke event information was collected up until 31 December 2021. The hazard ratios (HR) and 95% confidence intervals (CI) of the associations of fish consumption with risk of total stroke, ischemic stroke and hemorrhagic stroke were estimated using cox proportional hazards regression models. Dose–response relationships were estimated using restricted cubic spline analyses. During a median follow-up of 4.56 years, 807 newly developed stroke events were ascertained, including 664 ischemic stroke events and 113 hemorrhagic stroke events. Fish consumption of 300–450 g/week was associated with a reduced risk of total stroke (HR: 0.78, 95% CI: 0.64–0.94) and ischemic stroke (0.70 (0.57–0.88)) compared with fish consumption of less than 300 g/week, after adjustment for comprehensive covariates including sociodemographic characteristics, lifestyle, dietary patterns and disease histories. No significant association was found between fish consumption and hemorrhagic stroke. The findings of our study support the consumption level of fish recommended in the dietary guidelines.
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Zhao Y, Anindya K, Atun R, Marthias T, Han C, McPake B, Duolikun N, Hulse E, Fang X, Ding Y, Oldenburg B, Lee JT. Provincial heterogeneity in the management of care cascade for hypertension, diabetes, and dyslipidaemia in China: Analysis of nationally representative population-based survey. Front Cardiovasc Med 2022; 9:923249. [PMID: 36093142 PMCID: PMC9458474 DOI: 10.3389/fcvm.2022.923249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background This study aims to examine (1) province-level variations in the levels of cardiovascular disease (CVD) risk and behavioral risk for CVDs, (2) province-level variations in the management of cascade of care for hypertension, diabetes, and dyslipidaemia, and (3) the association of province-level economic development and individual factors with the quality of care for hypertension, diabetes, and dyslipidaemia. Methods We used nationally representative data from the China Health and Retirement Longitudinal Study in 2015, which included 12,597 participants aged 45 years. Using a care cascade framework, we examined the quality of care provided to patients with three prevalent NCDs: hypertension, diabetes, and dyslipidaemia. The proportion of WHO CVD risk based on the World Health Organization CVD risk prediction charts, Cardiovascular Risk Score (CRS) and Behavior Risk Score (BRS) were calculated. We performed multivariable logistic regression models to determine the individual-level drivers of NCD risk variables and outcomes. To examine socio-demographic relationships with CVD risk, linear regression models were applied. Results In total, the average CRS was 4.98 (95% CI: 4.92, 5.05), while the average BRS was 3.10 (95% confidence interval: 3.04, 3.15). The weighted mean CRS (BRS) in Fujian province ranged from 4.36 to 5.72 (P < 0.05). Most of the provinces had a greater rate of hypertension than diabetes and dyslipidaemia awareness and treatment. Northern provinces had a higher rate of awareness and treatment of all three diseases. Similar patterns of regional disparity were seen in diabetes and dyslipidaemia care cascades. There was no evidence of a better care cascade for CVDs in patients who reside in more economically advanced provinces. Conclusion Our research found significant provincial heterogeneity in the CVD risk scores and the management of the cascade of care for hypertension, diabetes, and dyslipidaemia for persons aged 45 years or more. To improve the management of cascade of care and to eliminate regional and disparities in CVD care and risk factors in China, local and population-based focused interventions are necessary.
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Affiliation(s)
- Yang Zhao
- The George Institute for Global Health, Beijing, China
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- *Correspondence: Yang Zhao ;
| | - Kanya Anindya
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
- Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Tiara Marthias
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Department of Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Chunlei Han
- College of Public Health and Management, Binzhou Medical University, Yantai, China
| | - Barbara McPake
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Emily Hulse
- Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Xinyue Fang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yimin Ding
- School of Software, Tongji University, Shanghai, China
| | - Brian Oldenburg
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - John Tayu Lee
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Department of Health Service Research and Policy, Australian National University, Canberra, NSW, Australia
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15
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Qin Y, Liu R, Wang Y, Tang J, Cong L, Ren J, Tang S, Du Y. Self-Reported Sleep Characteristics Associated with Cardiovascular Disease Among Older Adults Living in Rural Eastern China: A Population-Based Study. Clin Interv Aging 2022; 17:811-824. [PMID: 35611325 PMCID: PMC9124474 DOI: 10.2147/cia.s361876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the cross-sectional associations of self-reported sleep characteristics with cardiovascular diseases (CVDs) and cardiovascular multimorbidity in older adults living in rural Eastern China. Patients and Methods This population-based study included 4618 participants (age ≥65 years; 56.5% women) living in rural Eastern China. In March–September 2018, data were collected through interviews, clinical examinations, neuropsychological testing, and laboratory tests. Sleep parameters were assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Score, and Berlin questionnaire. Coronary heart disease (CHD), heart failure (HF), and stroke were defined according to in-person interviews, clinical and neurological examinations, and electrocardiogram examination. Data were analyzed using logistic regression and restricted cubic spline regression. Results CHD was diagnosed in 991 participants, HF in 135 participants, and stroke in 696 participants. The multivariable-adjusted odds ratio (OR) of CHD was 1.27 (95% CI, 1.09–1.49) for sleep duration ≤6 hours/night (vs >6–8 hours/night), 1.40 (1.20–1.62) for poor sleep quality, and 1.22 (1.04–1.43) for high risk for obstructive sleep apnea (OSA). The OR of HF was 2.16 (1.38–3.39) for sleep duration >8 hours/night, and 1.76 (1.22–2.54) for high risk for OSA. In addition, the OR of stroke was 1.23 (1.04–1.46) for poor sleep quality, 1.32 (1.01–1.72) for excessive daytime sleepiness, and 1.42 (1.19–1.70) for high risk for OSA. The associations of poor sleep with cardiovascular multimorbidity (≥2 CVDs) were stronger than that of sleep problems with a single CVD. Conclusion Extreme sleep duration, high risk for OSA, and other sleep problems were associated with CVDs, especially cardiovascular multimorbidity.
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Affiliation(s)
- Yu Qin
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Rui Liu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Jiyou Tang
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People’s Republic of China
- Correspondence: Yifeng Du; Shi Tang, Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, Shandong, 250021, People’s Republic of China, Tel +86 531 68776354; +86-18678780912, Fax +86 531 68776354, Email ;
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16
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BMI, Blood Pressure, and Plasma Lipids among Centenarians and Their Offspring. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3836247. [PMID: 35096109 PMCID: PMC8794670 DOI: 10.1155/2022/3836247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/30/2021] [Indexed: 11/20/2022]
Abstract
Background The burden of cardiovascular diseases (CVDs) is increasing substantially due to population growth and aging. Determining effective prevention and understanding the underlying mechanisms remain desirable pursuits for increasing the quality of life. As centenarians and their offspring may have genetic advantages, they may present with healthier cardiovascular-related profiles. Methods We launched a cross-sectional household-based survey of centenarian families, including 253 centenarians, 217 centenarian offspring, and 116 offspring spouses without centenarian parents from county-level Chinese longevity city Rugao. Among offspring and offspring spouses were the following arrangements: 101 paired offspring and offspring spouses who lived together, 116 unpaired offspring, and 16 unpaired spouses. We investigated their cardiovascular-related health status including waist circumference, body mass index (BMI), blood pressure, and plasma lipids and compared results among centenarians, centenarian offspring, and offspring spouses. Results Centenarians ranged from 99 to 109 years with a median age of 100 years. Centenarian offspring, with a median age of 70 years, and offspring spouses, with a median age of 69 years, shared similar age. Results of blood pressure, plasma lipid levels, and BMI displayed no significant difference between centenarian offspring and offspring spouses. However, centenarians appeared to have lower waist circumference, BMI, TC, LDL-C, TG, and diastolic blood pressure but higher levels of systolic blood pressure (p < 0.05). Multivariate analysis showed the prevalence of obesity, hypertension, and dyslipidemia was similar between centenarian offspring and offspring spouses, while centenarians appeared to have a lower prevalence of obesity and a higher prevalence of hypertension (p < 0.05). Conclusions Centenarians and centenarian offspring did not present healthier BMI, blood pressure, or plasma lipids than offspring spouses. Further research on longevity and cardiovascular diseases are desirable.
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Lipid control in adult Chinese patients with type 2 diabetes: a retrospective analysis of time trends and geographic regional differences. Chin Med J (Engl) 2021; 135:356-358. [PMID: 34924502 PMCID: PMC8812612 DOI: 10.1097/cm9.0000000000001895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Wu Y, Cai F, Lu Y, Hu Y, Wang Q. lncRNA RP11-531A24.3 inhibits the migration and proliferation of vascular smooth muscle cells by downregulating ANXA2 expression. Exp Ther Med 2021; 22:1439. [PMID: 34721681 DOI: 10.3892/etm.2021.10874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 07/16/2021] [Indexed: 12/19/2022] Open
Abstract
A complete understanding of the behavioral influence and phenotypic transition of vascular smooth muscle cells, as well as the effects of the characteristics of these cells on the physiological and pathological processes of atherosclerosis, is crucial if new therapeutic targets for atherosclerosis are to be identified. In the present study, the long non-coding RNA RP11-531A24.3 was identified to be expressed at low levels in plaque tissues through screening a microarray for differentially expressed genes. The functional experimental results suggested that RP11-531A24.3 reduced the viability and inhibited the migration of human aortic vascular smooth muscle cells (HA-VSMCs). RNA antisense purification-mass spectrometry was used to identify the RNA-binding proteins (RBPs) for RP11-531A24.3. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis indicated that the pathway with the highest degree of association with RP11-531A24.3 RBPs was related to cell migration. The reduced migration and viability mediated by RP11-531A24.3 overexpression was more significantly suppressed after annexin 2 (ANXA2) depletion in RP11-531A24.3-overexpressing HA-VSMCs. Culture of HA-VSMCs under hypoxic conditions (1% O2) reduced the expression of RP11-531A24.3, and enhanced the protein expression of ANXA2 and HIF-1α, while knockdown of ANXA2 downregulated the protein expression of HIF-1α. These results suggested that RP11-531A24.3 regulated the proliferation and migration of HA-VSMCs through ANXA2 expression, and hypoxia may be an external factor in the regulation of RP11-531A24.3 and its downstream targets.
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Affiliation(s)
- Yilin Wu
- Department of Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Fen Cai
- Department of Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.,Department of Clinical Laboratory, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, Guangdong 510800, P.R. China
| | - Yuanbin Lu
- Department of Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Yanwei Hu
- Department of Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.,Department of Clinical Laboratory, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, P.R. China
| | - Qian Wang
- Department of Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
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19
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Abate TW, Zeleke B, Genanew A, Abate BW. The burden of stroke and modifiable risk factors in Ethiopia: A systemic review and meta-analysis. PLoS One 2021; 16:e0259244. [PMID: 34723996 PMCID: PMC8559958 DOI: 10.1371/journal.pone.0259244] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 10/16/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The burden and contribution of modifiable risk factors of stroke in Ethiopia are unclear. Knowledge about this burden and modifying risk factors is pivotal for establishing stroke prevention strategies. In recent decades, the issue of lifestyle and behavioral modification is a key to improve the quality of life. The modifiable risk factors are an importance as intervention strategies aimed at reducing these factors can subsequently reduce the risk of stroke. So far, many primary studies were conducted to estimate the burden of stroke and modifiable risk factors in Ethiopia. However, the lack of a nationwide study that determines the overall pooled estimation of burden and modifiable risk factors of stroke is a research gap. METHODS To conduct this systemic review and meta-analysis, we are following the PRISMA checklist. Three authors searched and extracted the data from the CINAHL (EBSCO), MEDLINE (via Ovid), PubMed, EMcare, African Journals Online (AJOL), and Google scholar. The quality of the primary study was assessed using the Newcastle-Ottawa Scale (NOS) by two independent reviewers. The primary studies with low and moderate risk of bias were included in the final analysis. The authors presented the pooled estimated burden of stroke and its modifiable risk factors. The registered protocol number in PROSPERO was CRD42020221906. RESULTS In this study, the pooled burden of hemorrhagic and ischemic stroke were 46.42% (95%CI: 41.82-51.53; I2 = 91.6%) and 51.40% (95%CI: 46.97-55.82; I2 = 85.5%) respectively. The overall magnitude of modifiable risk factor of hypertension, alcohol consumption and dyslipidemia among stroke patients were 49% (95%CI: 43.59, 54.41), 24.96% (95CI%:15.01, 34.90), and 20.99% (95%CI: 11.10, 30.88), respectively. The least proportion of stroke recovery was in the Oromia region (67.38 (95%CI: 41.60-93.17; I2 = 98.1%). Farther more, the proportion of stroke recovery was decreased after 2017 (70.50 (56.80-84.20). CONCLUSIONS In our study, more than 90% of stroke patients had one or more modifiable risk factors. All identified modifiable stroke risk factors are major public health issues in Ethiopia. Therefore, strategy is designed for stroke prevention to decrease stroke burden through targeted modification of a single risk factor, or a cluster of multiple risk factors, used on a population, community, or individual level.
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Affiliation(s)
- Teshager Weldegiorgis Abate
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Balew Zeleke
- Department of Pediatric and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashenafi Genanew
- Department of Pharmacology, School of Health Sciences, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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20
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Han KT, Choi DW, Kim S. Regional and income disparities in treatment and drug adherence of patients with dyslipidemia: a retrospective cohort study in South Korea, 2003-2015. BMC Geriatr 2021; 21:585. [PMID: 34674649 PMCID: PMC8529775 DOI: 10.1186/s12877-021-02510-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/01/2021] [Indexed: 11/25/2022] Open
Abstract
Backgrounds Health disparities represent a major public health problem that needs to be addressed, and a variety of factors, including geographical location and income, can contribute to these disparities. Although previous studies have suggested that health differs by region and income, evidence on the difference in treatment rate is relatively insufficient. To identify differences in prescription rates by region and income in patients with dyslipidemia. Methods Using data from the National Health Insurance Service senior cohort, we included older adults who were diagnosed with dyslipidemia in Korea from 2003 to 2015. Overall prescription rate was determined for patients with dyslipidemia. In addition, medication possession ratio and a defined daily dose were analyzed in patients who were prescribed statins. A generalized estimating equation Poisson model was used to assess differences in prescription rates. Results Patients living in rural areas (Chungcheong-do, Jeolla-do, and Gyeongsang-do) had a significantly higher prescription rate than those in metropolitan cities. Unlike the prescription rate, the drug adherence was significantly higher in Seoul, Gyeonggi-do, and Gangwon-do but lower in Jeolla-do and Gyeongsang-do than in metropolitan cities. Patients with low income had lower prescription rates than those with high income, but this difference was not statistically significant. Conclusion Our findings demonstrate differences in the treatment rates of patients with dyslipidemia by region and income. Appropriate interventions are needed in vulnerable regions and groups to increase the treatment rate for patients with dyslipidemia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02510-5.
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Affiliation(s)
- Kyu-Tae Han
- Division of Cancer Control and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, 10408, Republic of Korea
| | - Dong-Woo Choi
- Cancer Data Center, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, 10408, Republic of Korea
| | - Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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21
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Awareness, treatment, control, and determinants of dyslipidemia among adults in China. Sci Rep 2021; 11:10056. [PMID: 33980884 PMCID: PMC8115030 DOI: 10.1038/s41598-021-89401-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 04/26/2021] [Indexed: 11/20/2022] Open
Abstract
Effective management of dyslipidemia is important. This study aimed to determine the awareness, treatment, control, and determinants of dyslipidemia in middle-aged and older Chinese adults in China. Using data from the 2015 China National Stroke Screening and Prevention Project (CNSSPP), a nationally representative sample of 135,403 Chinese adults aged 40 years or more were included in this analysis. Dyslipidemia was defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults final report (NCEP-ATP III) and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Models were constructed to adjust for subjects’ characteristics with bivariate and multivariable logistic regression analyses. Overall, 51.1% of the subjects were women. Sixty-four percent were aware of their condition, of whom 18.9% received treatment, and of whom 7.2% had adequately controlled dyslipidemia. Dyslipidemia treatment was higher in men from rural areas than their urban counterparts. The multivariable logistic regression models revealed that women, urban residents, and general obesity were positively related to awareness. Women, married respondents, and current drinkers had higher odds of treatment. Age group, overweight, general obesity, urban residence, and women were independent determinants of control. Dyslipidemia awareness rate was moderately high, but treatment and control rates were low. Results can be used to develop policies and health promotion strategies with special focus on middle-aged and older adults.
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22
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Zhu X, Fan Y, Sheng J, Gu L, Tao Q, Huang R, Liu K, Yang L, Chen G, Cao H, Li K, Tao F, Wang S. Association Between Blood Heavy Metal Concentrations and Dyslipidemia in the Elderly. Biol Trace Elem Res 2021; 199:1280-1290. [PMID: 32651944 DOI: 10.1007/s12011-020-02270-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
Our objective was to evaluate the relationship of blood metal levels including strontium, cadmium, lead, vanadium, aluminum, cobalt, and manganese with dyslipidemia in the elderly Chinese population. In this study, stratified cluster sampling was adopted in the elderly in two communities of Lu'an City from June to September 2016, and 1013 participants were finally included. The inductively coupled plasma mass spectrometry (ICP-MS) was used to measure the metals' concentrations in whole blood. After multivariable adjustment, the odds ratios (95% confidence interval [CI]) of dyslipidemia associated with the highest quartile of metal concentrations were 1.32 (0.89 ~ 1.96), 1.28 (0.83 ~ 1.97), 1.86 (1.23 ~ 2.80), 0.80 (0.55 ~ 1.16), 0.76 (0.51 ~ 1.13), 0.76 (0.53 ~ 1.11), and 1.14 (0.78 ~ 1.67) for strontium, cadmium, lead, vanadium, aluminum, cobalt, and manganese, respectively, compared with the lowest quartile. After reducing the dimensionality of metal elements by principal component analysis, we found that the combined exposure of aluminum, cobalt, and vanadium was the protective factor of non-dyslipidemia, while the combined exposure of cadmium, strontium, and lead was the risk factor of dyslipidemia.
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Affiliation(s)
- Xingmeng Zhu
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Yong Fan
- Anhui Provincial Center for Disease Control and Prevention, Hefei, People's Republic of China
| | - Jie Sheng
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Ling Gu
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Qi Tao
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Rui Huang
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Guimei Chen
- School of Health Management, Anhui Medical University, Hefei, People's Republic of China
| | - Hongjuan Cao
- Lu'an Center for Disease Control and Prevention, Lu'an, People's Republic of China
| | - Kaichun Li
- Lu'an Center for Disease Control and Prevention, Lu'an, People's Republic of China
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
- School of Health Management, Anhui Medical University, Hefei, People's Republic of China
| | - Sufang Wang
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China.
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Han X, Jiang Z, Li Y, Wang Y, Liang Y, Dong Y, Tang S, Du Y, Qiu C. Sex disparities in cardiovascular health metrics among rural-dwelling older adults in China: a population-based study. BMC Geriatr 2021; 21:158. [PMID: 33663413 PMCID: PMC7934439 DOI: 10.1186/s12877-021-02116-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 02/24/2021] [Indexed: 02/06/2023] Open
Abstract
Background Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated sex disparities in CVH metrics and their management among rural-dwelling older adults in China. Methods This community-based study included 5026 participants (age ≥ 65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. In March–September 2018, data were collected through face-to-face interviews, clinical examinations, and laboratory tests. We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association’s recommendations. We performed descriptive analysis separately for men and women. Results Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global (9.7% vs. 7.8%) and behavioral (18.3% vs. 9.5%) CVH metrics (p < 0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% vs. 3.5%, p < 0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend< 0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p < 0.05). Conclusions The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct sex differences, alongside poor management of major biological risk factors. Trial registration ChiCTR1800017758 (Aug 13, 2018). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02116-x.
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Affiliation(s)
- Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China
| | - Ziying Jiang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China
| | - Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Yajun Liang
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China. .,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China.,Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Yang F, Ma Q, Ma B, Jing W, Liu J, Guo M, Li J, Wang Z, Liu M. Dyslipidemia prevalence and trends among adult mental disorder inpatients in Beijing, 2005-2018: A longitudinal observational study. Asian J Psychiatr 2021; 57:102583. [PMID: 33581368 DOI: 10.1016/j.ajp.2021.102583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/20/2021] [Accepted: 01/24/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate dyslipidemia prevalence and trends among adult mental disorder inpatients in Beijing from 2005 to 2018. METHODS This is a longitudinal observational study. Data of electronic health record of 19 psychiatry specialized hospitals in Beijing was obtained. The participants were adult inpatients who admitted in these hospitals between 2005 and 2018. Dyslipidemia was diagnosed according to ICD-10 code. Overall and annual prevalence of dyslipidemia was calculated. Dyslipidemia prevalence stratified by age group and mental disorder types was calculated. Univariate and multivariate logistic regressions were used to analyses the risk factors associated with dyslipidemia among mental disorder inpatients including demographic characteristics, comorbidities, schizophrenia and antipsychotics use. RESULTS 157,570 adult mental disorder inpatients were included in the study. Dyslipidemia prevalence increased over time from 4.88 % (4.33 %-5.43 %) in 2005 to 19.66 % (19.00 %-20.33 %) in 2018. The increased trends were similar in all age groups, with the highest prevalence observed in ≥60 years age group. Dyslipidemia prevalence was 18.36 % (18.06 %-18.67 %), 14.70 % (13.99 %-15.41 %), 11.63 % (11.26 %-12.01 %) among inpatients with schizophrenia, recurrent depressive disorder, bipolar disorder. Results from multivariate logistic regressions showed that dyslipidemia was related to male, increased age, divorced or widow (OR = 1.18, 95 %CI: 1.12-1.24), hypertension (OR = 1.63, 95 %CI: 1.57-1.70), diabetes (OR = 1.92, 95 %CI: 1.84-2.00), fatty liver (OR = 2.61, 95 %CI: 2.51-2.72), schizophrenia (OR = 1.66, 95 %CI: 1.61-1.72), antipsychotics use (OR = 1.71, 95 %CI: 1.65-1.77). CONCLUSIONS Dyslipidemia prevalence was high among adult mental disorder inpatients in Beijing, and increased between 2005 and 2018 in all age groups. The risk of dyslipidemia increased with age. Schizophrenia was associated with higher dyslipidemia prevalence. These finding highlight the urgent need for dyslipidemia prevention and control programs among mental disorder inpatients.
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Affiliation(s)
- Fude Yang
- Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, No.7, Huilongguan Nandian Road, Changping District, Beijing 100096, China.
| | - Qiuyue Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Botao Ma
- Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, No.7, Huilongguan Nandian Road, Changping District, Beijing 100096, China
| | - Wenzhan Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Moning Guo
- Beijing Municipal Commission of Health and Family Planning Information Center, Beijing Municipal Commission of Health and Family Planning Policy Research Center, No 277, Zhaodengyu Road, Xicheng District, Beijing 100034, China
| | - Juan Li
- Beijing Geriatric Hospital, No.118, Wenquan Road, Haidian District, Beijing 100095, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, No.7, Huilongguan Nandian Road, Changping District, Beijing 100096, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing 100191, China.
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Dutheil F, Baker JS, Mermillod M, De Cesare M, Vidal A, Moustafa F, Pereira B, Navel V. Shift work, and particularly permanent night shifts, promote dyslipidaemia: A systematic review and meta-analysis. Atherosclerosis 2020; 313:156-169. [PMID: 33069952 DOI: 10.1016/j.atherosclerosis.2020.08.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/15/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Shift work is common worldwide and linked to deleterious cardiovascular effects that might be underlined by dyslipidemia. The aim of this systematic review and meta-analysis is to determine the impact of shiftwork on dyslipidemia. METHODS Searching in PubMed, Cochrane Library, Science Direct and Embase databases without language restriction on 15 February 2020, included studies that describe blood lipids levels or a risk measure in shift workers compared with fixed-day workers (controls). Differences by study-level characteristics were estimated using stratified meta-analysis by type of shift work, and meta-regression to examine relations between dyslipidemia and demographic, lifestyle and work characteristics. Estimates were pooled using random-effect meta-analysis. RESULTS We included a total of 66 articles, representing 197,063 workers. Shift work globally increased the levels of triglycerides (overall SMD = 0.09; 95CI 0.05 to 0.13; p < 0.001), and globally decreased the levels of c-HDL (-0.08; 95CI -0.12 to -0.03; p = 0.001). Permanent night shift workers were an at-risk type of shift for dyslipidemia with significantly higher blood levels of total cholesterol (0.22; 95CI 0.01 to 0.42; p = 0.043) and triglycerides (0.18; 0.03 to 0.33; p = 0.017), and significantly lower blood levels of c-HDL (-0.16; 95CI -0.32 to 0.00; p = 0.05). Permanent night shift workers were more at-risk for total cholesterol than rotating 3 × 8 shift workers (Coefficient 0.22; 95CI 0.01 to 0.42; p = 0.038) and rotating 2 × 12 shift workers (0.24; 0.02 to 0.46; p = 0.037), and more at-risk for triglycerides than rotating day shift workers (0.21; 95CI 0.03 to 0.38; p = 0.023). Results were non-significant for c-LDL, nor depending on type of shifts. CONCLUSIONS Shift work, and particularly permanent night shift, is associated with dyslipidaemia via elevated total cholesterol and triglycerides, and reduced HDL-cholesterol. Our current study provides a practical and valuable strengthening of the evidence-base required for preventive health initiatives and workplace reform.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000, Clermont-Ferrand, France.
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France; Institut Universitaire de France, Paris, France
| | - Mélanie De Cesare
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Alexia Vidal
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Fares Moustafa
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Emergency Unit, F-63000, Clermont-Ferrand, France
| | - Bruno Pereira
- University Hospital of Clermont-Ferrand (CHU), Clinical Research and Innovation Direction, Clermont-Ferrand, France
| | - Valentin Navel
- Université Clermont Auvergne, CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France
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Xi Y, Niu L, Cao N, Bao H, Xu X, Zhu H, Yan T, Zhang N, Qiao L, Han K, Hang G, Wang W, Zhang X. Prevalence of dyslipidemia and associated risk factors among adults aged ≥35 years in northern China: a cross-sectional study. BMC Public Health 2020; 20:1068. [PMID: 32631296 PMCID: PMC7339536 DOI: 10.1186/s12889-020-09172-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/26/2020] [Indexed: 12/30/2022] Open
Abstract
Background Cardiovascular disease (CVD) prevalence has increased continuously over the last 30 years in China. Dyslipidemia is an important modifiable risk factor in CVD. We aimed to collect current data on the prevalence of dyslipidemia in northern China and explore potential influencing factors. Methods In this cross-sectional study, we selected a representative sample of 65,128 participants aged ≥35 years in Inner Mongolia during 2015–2017. All participants completed a questionnaire and were examined for risk factors. Dyslipidemia was defined according to 2016 Chinese guidelines for adults. The associated factors for dyslipidemia were estimated by multivariate logistic regression analysis. Results The age-standardized prevalence of dyslipidemia was 31.2% overall, with 4.3, 2.4, 14.7, and 17.4% for high total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C), respectively. The dyslipidemia prevalence was significantly higher in men than women (37.9% vs. 27.5%, P < 0.001), but postmenopausal women had a higher prevalence of dyslipidemia components (except low HDL-C). Compared with Han participants, Mongol participants had a lower prevalence of dyslipidemia (29.1% vs. 31.4%, P < 0.001). Male sex, living in urban areas, Han ethnicity, smoking, obesity, central obesity, hypertension, and diabetes were all positively correlated with dyslipidemia; alcohol consumption was linked to lower risk of dyslipidemia. Conclusions Our study revealed that dyslipidemia is a health problem in northern China. Greater efforts to prevent and manage dyslipidemia, especially in men under age 55 years, postmenopausal women, and people with unhealthy lifestyles or chronic diseases.
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Affiliation(s)
- Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Liwei Niu
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Ning Cao
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Han Bao
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Xiaoqian Xu
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Hao Zhu
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Tao Yan
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Nan Zhang
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China
| | - Liying Qiao
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Ke Han
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Gai Hang
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Wenrui Wang
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, 50 Ordos street, Hohhot, Inner Mongolia Province, 010000, P.R. China
| | - Xingguang Zhang
- Public Health College, Inner Mongolia Medical University, Hohhot, Inner Mongolia Province, PR China.
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Opoku S, Gan Y, Fu W, Chen D, Addo-Yobo E, Trofimovitch D, Yue W, Yan F, Wang Z, Lu Z. Prevalence and risk factors for dyslipidemia among adults in rural and urban China: findings from the China National Stroke Screening and prevention project (CNSSPP). BMC Public Health 2019; 19:1500. [PMID: 31711454 PMCID: PMC6849283 DOI: 10.1186/s12889-019-7827-5] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/21/2019] [Indexed: 12/27/2022] Open
Abstract
Background Dyslipidemia is a modifiable risk factor for cardiovascular disease (CVD). We investigated the prevalence and associated risk factors of dyslipidemia- raised total cholesterol (TC), raised triglycerides (TG), raised low-density lipoprotein (LDL-C), low high-density lipoprotein (HDL-C), and raised non-high-density lipoprotein (non-HDL-C) in rural and urban China. Methods We analyzed data from 136,945 participants aged 40–100 years of the CNSSPP project for 2014. Dyslipidemia was defined by the NCEP-ATP III and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Complete data on demographic, metabolic and lifestyle characteristics were used. Chi-square tests and multivariable logistic regression were used to obtain age- and sex-adjusted prevalence and risk factors for dyslipidemia among participants. Results A total of 53.1% participants lived in rural areas. The prevalence of dyslipidemia was similar among rural and urban participants (43.2% vs. 43.3%). Regarding the components of dyslipidemia: urban compared with rural participants had a higher prevalence of low HDL-C (20.8% vs. 19.2%), whereas the prevalence of raised LDL-C (7.8% vs. 8.3%), raised TC (10.9% vs.11.8%) and raised non-HDL-C (10.0% vs. 10.9%) were lower in urban residents, (all p < 0.001). Women were more likely to have raised TC than men (adjusted OR [AOR] =1.83, 95% confidence interval [CI]:1.75–1.91), raised LDL-C (AOR = 1.55, 95% CI: 1.47–1.63) and high non-HDL-C (AOR = 1.52 95% CI: 1.45–1.59) (all p < 0.001). Compared with rural, urban participants had higher odds of dyslipidemia: low HDL-C (AOR = 1.04, 95% CI: 1.01–1.07), and raised TG (AOR = 1.06, 95% CI: 1.04–1.09). Hypertension and current drinker were less likely to get low HDL-C with AOR 0.93 (95% CI: 0.90–0.96) and AOR 0.73 (95% CI: 0.70–75), respectively. Overweight, obesity, central obesity and diabetes had higher odds of all dyslipidemias (p < 0.001). Conclusions Low HDL-C was higher in urban areas, whereas the remaining dyslipidemia types were more common in rural areas. Dyslipidemia was more common in women in both areas of residence. Overweight, obesity, central obesity and diabetes were associated with dyslipidemias. The need to intensify intervention programs to manage dyslipidemia and risk factors should be prioritized.
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Affiliation(s)
- Sampson Opoku
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, China
| | - Wenning Fu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, China
| | - Dajie Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, China
| | - Emmanuel Addo-Yobo
- Department of Internal Medicine, SUNY Upstate Medical University, New York, USA
| | - Diana Trofimovitch
- Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA
| | - Wei Yue
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Feng Yan
- Department of Neurosurgery, Xuanwu Hospital, Capital medical University, Beijing, China
| | - Zhihong Wang
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, Guangdong, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, China.
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Huang Z, Tan R, Meng L, Yang H, Liang X, Qin Y, Luo Z. The Niemann-Pick C1-like 1 rs2073547 polymorphism is associated with type 2 diabetes mellitus in a Chinese population. J Int Med Res 2019; 47:4260-4271. [PMID: 31311377 PMCID: PMC6753537 DOI: 10.1177/0300060519862099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective To explore the association between Niemann–Pick C1-like 1 gene ( NPC1L1) single nucleotide polymorphisms and type 2 diabetes mellitus (T2DM) in a Chinese population. Methods Using propensity score matching, 490 T2DM patients and 490 matched controls were recruited from 13 communities in Guangxi, China. NPC1L1 rs217386 and rs2073547 genotyping was performed using a MassARRAY system. Results The rs2073547 genotype distribution differed significantly among patient groups. Low-density lipoprotein cholesterol levels were similar among different rs2073547 genotypes and alleles. The rs2073547 AG genotype was significantly more prevalent in patients with T2DM. After adjusting for risk or protective factors for diabetes, AG and GG+AG genotypes of rs2073547 were associated with significantly increased risks of T2DM. Compared with the AA genotype, the AG genotype was associated with a significantly higher risk of T2DM in participants with gamma-glutamyl transpeptidase (GGT) <45 U/L, systolic blood pressure (SBP) ≥140 mmHg, or triglyceride <1.70 mmol/L. In participants with GGT <45 U/L or SBP ≥140 mmHg, the GG+AG genotype was associated with a significantly higher T2DM risk versus the AA genotype. Conclusions The rs2073547 polymorphism of NPC1L1 may be related to T2DM susceptibility in the Chinese population.
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Affiliation(s)
- Zhenxing Huang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Ruyin Tan
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Liheng Meng
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Haiyan Yang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Xinghuan Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Yingfen Qin
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
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