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Hua J, Williams GJ, Barnett AL, Zhang J, Jin H, Xu M, Chen J, Zhou Y, Gu G, Du W. Association of the Onset of Self-Feeding With Subsequent Suspected Developmental Coordination Disorder: A Prospective Cohort Study in China. Front Psychiatry 2022; 13:818771. [PMID: 35599757 PMCID: PMC9120420 DOI: 10.3389/fpsyt.2022.818771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Successful self-feeding reflects the readiness of early motor development and environmental impacts, and the onset of self-feeding as a developmental milestone might be a predictor of subsequent motor development in children. In this study, we explored the association between the onset of self-feeding and childhood risk of Developmental Coordination Disorder in children from one-child and two-child families. METHODS We conducted a data-linkage prospective cohort study from 38 kindergartens in 6 cities in China. A total of 11,727 preschoolers aged 3-6 years old were included in the final analysis and were assessed with the Movement Assessment Battery for Children-second edition (MABC-2) Test. The information on early self-feeding onset was obtained from parents. The mixed and multi-level logistic models utilizing a random intercept were used to investigate the associations between the onset time of self-feeding and subsequent motor performance. RESULTS The results showed that, compared with those beginning self-feeding at or younger than 12 months of age, children starting self-feeding at 13-24, 25-36, and later than 36 months, showed a decrease in their total MABC-2 scores of 2.181, 3.026, and 3.874, respectively; and had an increased risk of suspected DCD by 36.0, 101.6, 102.6%, respectively; they also had 30.2, 46.6, 71.2% increased prevalence of at risk of suspected DCD, when adjusting for both child and family characteristics (each p < 0.05). Significant associations were observed in fine motor, gross motor, and balance subtests (each p < 0.05) in groups with a delayed onset of self-feeding. However, the strength of the associations was mitigated in the fine motor and balance subtests in children with a sibling. CONCLUSION The delayed onset time of self-feeding acts as an early behavioral marker for later childhood motor impairment. Moreover, children with a sibling may benefit from additional interaction and their motor developmental pattern may be affected by the presence of a sibling.
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Affiliation(s)
- Jing Hua
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Gareth J Williams
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Anna L Barnett
- Centre for Psychological Research, Oxford Brookes University, Oxford, United Kingdom
| | - Jiajia Zhang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hua Jin
- Health Care Department of Suzhou Ninth People's Hospital, Suzhou, China
| | - Manyun Xu
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Juan Chen
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Yingchun Zhou
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Guixiong Gu
- Pediatrics Research Institution of Suzhou University, Suzhou, China
| | - Wenchong Du
- NTU Psychology, Nottingham Trent University, Nottingham, United Kingdom
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Ren D, He L, Pang X. Association of CLTA-4 Gene Polymorphisms with Diabetes Mellitus: A Study Based on the Han Population of Northern China. Diabetes Metab Syndr Obes 2022; 15:2705-2712. [PMID: 36091483 PMCID: PMC9451031 DOI: 10.2147/dmso.s374451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the association of CLTA-4 gene polymorphism with Type 1 and 2 diabetes mellitus (DM) (T1DM and T2DM) in the Han population of northern China. METHODS A total of 234 Chinese Han DM patients and 187 non-diabetic subjects were included in the study. Two gene polymorphisms of the CLTA-4, including CTLA-4+49A/G (rs231775) and CTLA4-318C/T (rs5742909), were studied using polymerase chain reaction-restriction endonuclease fragment length polymorphism (PCR-RFLP) analysis. Chi-square analysis and Student's t-test were performed to determine the distribution of the gene polymorphism and alleles at the locus of CTLA4-318C/T and CTLA4+49A/G among T1DM and T2DM patients with or without diabetic ketosis (DK), diabetic nephropathy (DN) or autoantibodies (Ab). RESULTS Our results indicated that the distribution frequencies of genotypes and alleles at the CTLA-4+49A/G and CTLA4-318C/T loci of T1DM patients were not significantly different from those of the controls. However, the distribution frequencies of genotypes and alleles at the CTLA-4+49A/G loci of T2DM patients were significantly different from the controls (P=0.024 for genotypes and P=0.004 for A and G alleles). Besides, the A and G alleles at the CTLA4-318C/T loci of T2DM DK+ patients showed significantly different distribution frequencies compared to those of the T2DM DK patients (P=0.001). CONCLUSION Our data suggest that the gene polymorphisms of CTLA-4, including CTLA-4+49A/G and CTLA4-318C/T, are important predictors of DM. CTLA-4 may be a susceptibility gene for T2DM. Patients with T2DM carrying the T allele at the CTLA4-318 C/T locus are more predisposed to diabetic ketosis.
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Affiliation(s)
- Dongyue Ren
- Department of Emergency, the Fourth Affiliated Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Lin He
- Good Clinical Practice Institution, the Fourth Affiliated Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Xiaoling Pang
- Department of Emergency, the Fourth Affiliated Hospital of China Medical University, Shenyang, People’s Republic of China
- Correspondence: Xiaoling Pang, Department of Emergency, the Fourth Affiliated Hospital of China Medical University, No. 4 Chongshan East Road, Huanggu District, Shenyang, 110032, People’s Republic of China, Tel +86-18900913992, Email
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Yang T, Zhang J, Ke D, Yang W, Tang M, Jiang J, Cheng G, Li J, Cheng W, Wei Y, Li Q, Naismith JH, Zhu X. Hydrophobic recognition allows the glycosyltransferase UGT76G1 to catalyze its substrate in two orientations. Nat Commun 2019; 10:3214. [PMID: 31324778 PMCID: PMC6642264 DOI: 10.1038/s41467-019-11154-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 06/26/2019] [Indexed: 02/05/2023] Open
Abstract
Diets high in sugar are recognized as a serious health problem, and there is a drive to reduce their consumption. Steviol glycosides are natural zero-calorie sweeteners, but the most desirable ones are biosynthesized with low yields. UGT76G1 catalyzes the β (1-3) addition of glucose to steviol glycosides, which gives them the preferred taste. UGT76G1 is able to transfer glucose to multiple steviol substrates yet remains highly specific in the glycosidic linkage it creates. Here, we report multiple complex structures of the enzyme combined with biochemical data, which reveal that the enzyme utilizes hydrophobic interactions for substrate recognition. The lack of a strict three-dimensional recognition arrangement, typical of hydrogen bonds, permits two different orientations for β (1-3) sugar addition. The use of hydrophobic recognition is unusual in a regio- and stereo-specific catalysis. Harnessing such non-specific hydrophobic interactions could have wide applications in the synthesis of complex glycoconjugates.
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Affiliation(s)
- Ting Yang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University; State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610064, Chengdu, China
| | - Jinzhu Zhang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University; State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610064, Chengdu, China
| | - Dan Ke
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University; State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610064, Chengdu, China
| | - Wenxian Yang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University; State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610064, Chengdu, China
| | - Minghai Tang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Jian Jiang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University; State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610064, Chengdu, China
| | - Guo Cheng
- West China School of Public Health, Healthy Food Evaluation Research Center and State Key Laboratory of Biotherapy and Cancer Center, Sichuan University, 610041, Chengdu, China
| | - Jianshu Li
- Department of Biomedical Polymers and Artificial Organs, College of Polymer Science and Engineering and State Key Laboratory of Polymer Materials Engineering, Sichuan University, 610065, Chengdu, China
| | - Wei Cheng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Yuquan Wei
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Qintong Li
- Department of Pediatrics, Obstetrics and Gynecology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, 610041, Chengdu, China.
| | - James H Naismith
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610041, Chengdu, China.
- Division of Structural Biology, Wellcome Trust Centre of Human Genomics, Oxford, OX3 7BN, UK.
- Rosalind Franklin Institute, Harwell Campus, Didcot, OX11 0FA, UK.
| | - Xiaofeng Zhu
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University; State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, 610064, Chengdu, China.
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Ji L, Gao Z, Shi B, Bian R, Yin F, Pang W, Gao H, Cui N. Safety and Efficacy of High Versus Standard Starting Doses of Insulin Glargine in Overweight and Obese Chinese Individuals with Type 2 Diabetes Mellitus Inadequately Controlled on Oral Antidiabetic Medications (Beyond VII): Study Protocol for a Randomized Controlled Trial. Adv Ther 2018; 35:864-874. [PMID: 29873004 PMCID: PMC6015102 DOI: 10.1007/s12325-018-0717-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Treatment with basal insulin in Chinese populations is currently sub-optimal, with delayed initiation of insulin treatment and inadequate dose titration. Increasing the initial dose of insulin may be a practicable and effective solution to the problem of titration. A higher initial dose will be helpful for patients to achieve the blood glucose target and improve treatment satisfaction and compliance as well require fewer steps to titrate. Considering that overweight and obese patients usually require higher insulin doses because of insulin resistance, a higher initial dose of the basal insulin is feasible in overweight and obese patients with type 2 diabetes. However, safety is an important issue needing to be considered for higher initial dose treatment. The aim of this study is to assess the safety and efficacy of higher (0.3 U/kg) compared with standard (0.2 U/kg) starting doses of basal insulin in overweight and obese Chinese patients with type 2 diabetes who have failed to achieve glycaemic control using oral antidiabetic drugs (OADs). METHODS This is a phase IV, randomized, non-inferiority, open-label trial that will be conducted at approximately 50 centers in China. Eight hundred eighty overweight and obese adult Chinese patients with type 2 diabetes will be randomized to receive higher (0.3 U/kg) or standard (0.2 U/kg) starting doses of basal insulin glargine (100 U/ml) during a 16-week period. The primary endpoint is whether a higher initial dose of basal insulin (0.3 U/kg) is non-inferior to a standard initial dose (0.2 U/kg) based on the percentage of patients with at least one episode of hypoglycaemia (≤ 3.9 mmol/l or severe) over 16 weeks. Secondary endpoints include evaluation of glycosylated haemoglobin A1c (HbA1c), fasting blood glucose, postprandial blood glucose, insulin dose and safety. DISCUSSION This study is the first randomized-controlled study to evaluate the safety and efficacy of basal insulin treatment with a higher starting dose versus standard starting dose in overweight and obese Chinese patients with type 2 diabetes. Results of this study could generate evidence to support the feasibility of a higher starting dose of basal insulin in diabetes management of overweight and obese Chinese patients, therefore providing an easy approach to improve diabetes management. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT02836704. Registered on July 7th 2016. FUNDING Sanofi China.
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Affiliation(s)
- Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
| | - Zhengnan Gao
- Department of Endocrinology and Metabolism, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, 826 Xi'nan Road, Dalian, 116033, Liaoning, China
| | - Bimin Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China
| | - Rongwen Bian
- Department of Endocrinology and Metabolism, Jiangsu Province Institute of Geriatrics, 30 Luojia Road, Nanjing, 210024, Jiangsu, China
| | - Fuzai Yin
- Department of Endocrinology and Metabolism, The First Hospital of Qinhuangdao, 258 Wenhua Road, Qinhuangdao, 066000, Hebei, China
| | - Wuyan Pang
- Department of Endocrinology and Metabolism, Huaihe Hospital of Henan University, 115 Ximen Street, Kaifeng, 475000, Henan, China
| | - Hong Gao
- Sanofi China, 19 Floor, Tower III, Jing'An Kerry Centre, 1228 Middle Yan'an Road, Shanghai, 200040, China
| | - Nan Cui
- Sanofi China, 19 Floor, Tower III, Jing'An Kerry Centre, 1228 Middle Yan'an Road, Shanghai, 200040, China
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Ethnic Disparity in Annual Healthcare Expenditures for Type 2 Diabetes Mellitus in Ningxia, China. J Racial Ethn Health Disparities 2018; 5:1381-1388. [PMID: 29600352 DOI: 10.1007/s40615-018-0488-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/15/2018] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The incidence of type 2 diabetes mellitus (T2DM) and its complications has been increasing worldwide with an increasing provision of long-term medications and health services. This study aimed to assess the healthcare costs for T2DM patients for vulnerable ethnic minority. METHODS A cross-sectional study was conducted from October 13, 2016, to June 19, 2017, in two public hospitals in Ningxia, China. Eligible Hui and Han inpatients were recruited and interviewed. Ethnic disparities in annual healthcare expenditures for T2DM measured from a societal perspective and its associations of expenditures with other factors were analyzed by linear and quantile regressions. RESULTS Ethnic disparities in annual healthcare expenditures for T2DM were demonstrated, mainly reflecting differences in the cost of productivity loss. The quantile of annual healthcare expenditure showed significant ethnic disparities in T2DM patients with complications. At the 10th to 50th quantiles of healthcare expenditures, Hui patients had significantly lower expenditures than Han patients in both unadjusted and adjusted models. Non-significant difference in expenditures between Hui and Han patients was found at the 90th quantile of expenditure in the unadjusted model, but significantly higher expenditures for Hui patients were shown when adjusted for socioeconomic and clinical factors. CONCLUSION T2DM Hui patients faced significantly higher expenditures than Han patients when the costs of healthcare were high. Appropriate national policy considering the issue of ethnic minority should be further explored to improve health and subsidize economic burden for T2DM patients.
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Li J, Chattopadhyay K, Xu M, Chen Y, Hu F, Chu J, Li L. Glycaemic control in type 2 diabetes patients and its predictors: a retrospective database study at a tertiary care diabetes centre in Ningbo, China. BMJ Open 2018; 8:e019697. [PMID: 29581203 PMCID: PMC5875602 DOI: 10.1136/bmjopen-2017-019697] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The objectives of the study were to assess glycaemic control in patients with type 2 diabetes (T2DM) at a tertiary care diabetes centre in Ningbo, China and to determine factors that independently predict their glycaemic control. DESIGN Retrospective cross-sectional study using an existing database, the Diabetes Information Management System. SETTING Tertiary care diabetes centre in Ningbo, China. PARTICIPANTS The study included adult patients with T2DM, registered and received treatment at the diabetes centre for at least six consecutive months. The study inclusion criteria were satisfied by 1387 patients, from 1 July 2012 to 30 June 2017. PRIMARY OUTCOME MEASURE Glycaemic control (poor was defined as glycated haemoglobin (HbA1c)>=7% or fasting blood glucose (FBG)>7.0 mmol/L). RESULTS In terms of HbA1c and FBG, the 5-year period prevalence of poor glycaemic control was 50.3% and 57.3%, respectively. In terms of HbA1c and FBG, the odds of poor glycaemic control increased with the duration of T2DM (>1 to 2 years: OR 1.84, 95% CI 1.06 to 3.19; >2 to 4 years: 3.32, 1.88 to 5.85 and >4 years: 5.98, 4.09 to 8.75 and >1 to 2 years: 2.10, 1.22 to 3.62; >2 to 4 years: 2.48, 1.42 to 4.34 and >4 years: 3.34, 2.32 to 4.80) and were higher in patients residing in rural areas (1.68, 1.24 to 2.28 and 1.42, 1.06 to 1.91), with hyperlipidaemia (1.57, 1.12 to 2.19 and 1.68, 1.21 to 2.33), on diet, physical activity and oral hypoglycaemic drug (OHD) as part of their T2DM therapeutic regimen (1.80, 1.01 to 3.23 and 2.40, 1.36 to 4.26) and on diet, physical activity, OHD and insulin (2.47, 1.38 to 4.41 and 2.78, 1.58 to 4.92), respectively. CONCLUSIONS More than half of patients with T2DM at the diabetes centre in Ningbo, China have poor glycaemic control, and the predictors of glycaemic control were identified. The study findings could be taken into consideration in future interventional studies aimed at improving glycaemic control in these patients.
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Affiliation(s)
- Jialin Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Miao Xu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Yanshu Chen
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Fangfang Hu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Jianping Chu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
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Lin W, Chen C, Guan H, Du X, Li J. Hospitalization of elderly diabetic patients: characteristics, reasons for admission, and gender differences. BMC Geriatr 2016; 16:160. [PMID: 27595573 PMCID: PMC5011894 DOI: 10.1186/s12877-016-0333-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 08/27/2016] [Indexed: 12/24/2022] Open
Abstract
Background Understanding the differences in characteristics, gender, and common causes for admission in hospitalized elderly diabetic patients provides a theoretical basis for their successful management. This study explored the reasons and gender differences in hospitalizations of elderly patients with diabetes mellitus. Methods Patients aged ≥60 years who had received a diagnosis of diabetes by the time of discharge, from 1 January 2011 to 1 January 2014, were retrospectively enrolled. Hospitalization data of the patients were collected, and reasons for hospitalization were analyzed based on chief complaints and principle diagnosis. Results The most frequent reasons stated for admission were related to the chronic complications of diabetes (42.1 %), seconded by hyperglycemia (26.4 %) and infection (15.7 %). Ketonuria, ketonemia, or diabetic ketoacidosis was more commonly seen in women than men, whereas diabetic nephropathy and neoplasms were more frequently found in men than women. Regarding infection as a cause of hospitalization, the 4 main types were respiratory tract (44.5 %), urinary tract (20.3 %), gastrointestinal (14.8 %), and skin and soft tissue (10.9 %). Respiratory tract infection was significantly more common in men (61.4 %) than women (31 %, P = 0.001), whereas urinary tract infection was more frequent in women (29.6 %) than men (8.8 %, P = 0.004). Conclusion The most frequent reasons for hospital admission in elderly diabetic patients were chronic complications of diabetes, hyperglycemia, and infection. Men and women differed in reasons for hospital admission.
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Affiliation(s)
- Wei Lin
- Department of Geriatrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Science and Technology Information Center, Wenzhou Medical University Library, Wenzhou, China
| | - Chan Chen
- Department of Geriatrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huaqin Guan
- Department of Gastroenterology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaohong Du
- Department of Geriatrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Junjian Li
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Zhu M, Li J, Li Z, Luo W, Dai D, Weaver SR, Stauber C, Luo R, Fu H. Mortality rates and the causes of death related to diabetes mellitus in Shanghai Songjiang District: an 11-year retrospective analysis of death certificates. BMC Endocr Disord 2015; 15:45. [PMID: 26341126 PMCID: PMC4559917 DOI: 10.1186/s12902-015-0042-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 09/02/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND China is one of the countries with the highest prevalence of diabetes in the world. We analysed all the death certificates mentioning diabetes from 2002 to 2012 in Songjiang District of Shanghai to estimate morality rates and examine cause of death patterns. METHODS Mortality data of 2654 diabetics were collected from the database of local CDC. The data set comprises all causes of death, contributing causes and the underlying cause, thereby the mortality rates of diabetes and its specified complications were analysed. RESULTS The leading underlying causes of death were various cardiovascular diseases (CVD), which collectively accounted for about 30% of the collected death certificates. Diabetes was determined as the underlying cause of death on 28.7%. The trends in mortality showed that the diabetes related death rate increased about 1.78 fold in the total population during the 11-year period, and the death rate of diabetes and CVD comorbidity increased 2.66 fold. In all the diabetes related deaths, the proportion of people dying of ischaemic heart disease or cerebrovascular disease increased from 18.0% in 2002 to 30.5% in 2012. But the proportions attributed directly to diabetes showed a downtrend, from 46.7-22.0%. CONCLUSIONS The increasing diabetes related mortality could be chiefly due to the expanding prevalence of CVD, but has nothing to do with diabetes as the underlying cause. Policy makers should pay more attention to primary prevention of diabetes and on the prevention of cardiovascular complications to reduce the burden of diabetes on survival.
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Affiliation(s)
- Meiying Zhu
- Shanghai Songjiang Center for Disease Control and Prevention (CDC), North Xilin Road 1050, Songjiang District, Shanghai, 201620, China
| | - Jiang Li
- Department of Preventive Medicine, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Yixueyuan Road 138, PO Box 248, Shanghai, 200032, China.
| | - Zhiyuan Li
- Shanghai Songjiang Center for Disease Control and Prevention (CDC), North Xilin Road 1050, Songjiang District, Shanghai, 201620, China
| | - Wei Luo
- Shanghai Songjiang Center for Disease Control and Prevention (CDC), North Xilin Road 1050, Songjiang District, Shanghai, 201620, China
| | - Dajun Dai
- Department of Geosciences, Georgia State University, 24 Peachtree Center Avenue SE, Atlanta, GA, 30302, USA
| | - Scott R Weaver
- School of Public Health, Georgia State University, 140 Decatur Street, Atlanta, GA, 30302, USA
| | - Christine Stauber
- School of Public Health, Georgia State University, 140 Decatur Street, Atlanta, GA, 30302, USA
| | - Ruiyan Luo
- School of Public Health, Georgia State University, 140 Decatur Street, Atlanta, GA, 30302, USA
| | - Hua Fu
- Shanghai Songjiang Center for Disease Control and Prevention (CDC), North Xilin Road 1050, Songjiang District, Shanghai, 201620, China
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Zuo H, Shi Z, Hussain A. Prevalence, trends and risk factors for the diabetes epidemic in China: a systematic review and meta-analysis. Diabetes Res Clin Pract 2014; 104:63-72. [PMID: 24468097 DOI: 10.1016/j.diabres.2014.01.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 09/02/2013] [Accepted: 01/01/2014] [Indexed: 01/21/2023]
Abstract
AIMS To describe the prevalence and trends of diabetes and to quantitatively assess its risk factors in mainland China. METHODS Thirty-one epidemiological studies were identified by a systematic search of four databases. Prevalence estimates were mapped and summarized by meta-analysis in each region of China. The pooled ORs and 95% CIs of risk factors for diabetes were also calculated. RESULTS There was a large geographical imbalance with regard to the prevalence of diabetes. Region-pooled prevalence was highest in the eastern region (8.0%, 95% CI: 6.1-10.0%) and lowest in the western region (4.6%, 95% CI: 3.3-6.0%), which was consistent with regional levels of economic development. The overall prevalence of diabetes has been increasing since 1980. Traditional risk factors such as age, family history of diabetes, obesity, hypertension and elevated triglycerides were found to be associated with diabetes. In addition, urban residence and being from ethnic minorities were also significantly associated. CONCLUSION Based on the meta-analyses, we found that the prevalence of diabetes is different in different parts of China but it has been increasing sharply during the last three decades. Some risk factors were quantitatively derived in the study, which are free from the diversity of a single sample.
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Affiliation(s)
- Hui Zuo
- Department of Nutrition and Food Hygiene, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China; Section for International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Zumin Shi
- Department of Nutrition and Food Hygiene, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China; Discipline of Medicine, University of Adelaide, Adelaide, Australia.
| | - Akhtar Hussain
- Section for International Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Current practice on the management of acute coronary syndrome in China. Int J Cardiol 2013; 169:1-6. [DOI: 10.1016/j.ijcard.2013.08.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 08/29/2013] [Indexed: 11/18/2022]
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Cheng TO. China's little emperors: medical consequences of China's one-child policy. Int J Cardiol 2013; 168:5121-5. [PMID: 24071388 DOI: 10.1016/j.ijcard.2013.08.074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 08/23/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Tsung O Cheng
- Department of Medicine, The George Washington University Medical Center, 2150 Pennsylvania Avenue, N.W., Washington, DC 20037, United States.
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Cardiovascular health, risks and diseases in contemporary China. Int J Cardiol 2011; 152:285-94. [DOI: 10.1016/j.ijcard.2011.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 08/03/2011] [Indexed: 11/23/2022]
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