1
|
Yang Y, Lee H, Shirai K, Liu K, Iso H, Kim HC. Sex-specific associations between socioeconomic status and ideal cardiovascular health among Korean adults: The Korea National Health and Nutrition Examination Survey, 2007-2017. PLoS One 2024; 19:e0307040. [PMID: 39146358 PMCID: PMC11326625 DOI: 10.1371/journal.pone.0307040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/27/2024] [Indexed: 08/17/2024] Open
Abstract
Socioeconomic status (SES) has a considerable impact on cardiovascular health (CVH), which may differ by sex. We aimed to investigate sex-specific socioeconomic disparities in CVH among 31,141 individuals aged 25-64 years who participated in the cross-sectional 2007-2017 Korea National Health and Nutrition Survey (KNHANES) and the Life's Simple 7 metrics were used to define ideal CVH. Latent class analysis was used to estimate overall SES patterns. Logistic regression models were used to estimate sex-specific odds ratios (ORs) and 95% confidence interval (95% CI) for the likelihood of ideal CVH across SES classes, with the highest SES as the reference group. Four SES classes were identified: (1) low class with low education and material property (2.4%), (2) lower-medium class (10.1%) and (3) higher-medium class (43.7%) with increasing material affluence, and (4) high class with highest education and income (43.8%). Lower SES was associated with decreased ideal CVH among women; compared to their high SES counterparts, women with lowest SES were least likely to achieve ideal overall CVH (OR: 0.55, 95%CI: 0.43-0.71). Similar SES gradients in ideal overall CVH for men were also observed but it was less clear (OR (95%CI) for lowest SES: 0.83, 0.51-1.34). Low SES was associated with poorer achievement of ideal CVH with some sex-heterogeneities. Interventions that equalize the distribution of power and resources and targeted sex-specific approaches to empower low socioeconomic subgroups are warranted to prevent the transition from ideal to suboptimal cardiovascular health and to close socioeconomic disparities in CVH among Korean adults.
Collapse
Affiliation(s)
- Yiyi Yang
- Department of Public Health, Yonsei University Graduate School, Seoul, South Korea
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University, Osaka, Japan
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kokoro Shirai
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University, Osaka, Japan
| | - Keyang Liu
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University, Osaka, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research (iGHP), Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, South Korea
| |
Collapse
|
2
|
Duan Y, Li S, Su Q, Xu S, Lu G. Influence of exercise prescription intervention based on WeChat on glycolipid metabolism and fitness of suboptimal-health teachers. Medicine (Baltimore) 2024; 103:e38167. [PMID: 38788028 PMCID: PMC11124765 DOI: 10.1097/md.0000000000038167] [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: 03/03/2024] [Accepted: 04/17/2024] [Indexed: 05/26/2024] Open
Abstract
Exercise is an effective means to promote health, but adherence is low. Due to the advantages of immediacy, economy and effectiveness, the use of WeChat social software has permeated into every aspect in daily life in China. To explore the influence of WeChat-based exercise prescription intervention mode on glycolipid metabolism and fitness of suboptimal-health teachers. 293 suboptimal-health teachers with senior professional titles were randomized to a control group (CG) or an experimental group (e.g.). The CG exercised on its own, while the e.g. adopted the exercise prescription intervention based on WeChat. The intervention period was 6 months. Finally, 264 cases were adhered to and completed, including 132 cases in the CG and 132 cases in the e.g.. The Suboptimal-Health Status Questionnaires-25 scores (SHSQ-25 scores), exercise adherence, subjective feelings, physical fitness, blood glucose and blood lipids were detected before and after intervention and compared between 2 groups. After the intervention, the SHSQ-25 scores in the e.g. was significantly decreased than those in the CG (P < .01). The complete exercise adherence in the e.g. was significantly higher than those in the CG (P < .01). After intervention, the subjective feelings of e.g. were significantly improved compared to CG (P < .05). The body shape, body function and physical quality in the e.g. was higher than those in the CG (P < .05). Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) decreased significantly in the e.g. but not in the CG (P < .05). Fasting blood glucose (FBG) decreased significantly in the e.g. but not in the CG, with a significant difference between groups (P < .05). The subjects in the e.g. were very satisfied with WeChat management. WeChat-based exercise prescription intervention could improve SHS, exercise adherence, subjective feelings, physical fitness and glycolipid metabolism.
Collapse
Affiliation(s)
- Yimei Duan
- Institute of Sports Medicine and Health, Chengdu Sports University, Chengdu, Sichuan, China
- College of Physical Education, Sichuan Normal University, Chengdu, Sichuan, China
| | - Shunchang Li
- Institute of Sports Medicine and Health, Chengdu Sports University, Chengdu, Sichuan, China
| | - Quansheng Su
- Institute of Sports Medicine and Health, Chengdu Sports University, Chengdu, Sichuan, China
| | - Simao Xu
- College of Physical Education, Guangxi Normal University, Guilin, Guangxi, China
| | - Guotian Lu
- College of Physical Education, Sichuan Normal University, Chengdu, Sichuan, China
| |
Collapse
|
3
|
Guan Q, Dong H, Zhang Z, Guo Z, Lin Z, Niu H, Wu Y, Hou H. The mediating effect of perceived stress on the relationship between big five personality traits and suboptimal health status in Chinese population: a nationwide survey in the framework of predictive, preventive, and personalized medicine. EPMA J 2024; 15:25-38. [PMID: 38463623 PMCID: PMC10923761 DOI: 10.1007/s13167-023-00349-x] [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: 09/02/2023] [Accepted: 11/22/2023] [Indexed: 03/12/2024]
Abstract
Background The effects of psychological factors on suboptimal health status (SHS) have been widely described; however, mechanisms behind the complex relationships among the Big Five personality traits and SHS are unclear. Identifying people with specific traits who are susceptible to SHS will help improve life quality and reduce the chronic disease burden under the framework of predictive, preventive, and personalized medicine (PPPM / 3PM). This study investigated the relationships among personality traits and SHS. It also explored whether perceived stress plays a mediating role in SHS development. Method A nationwide cross-sectional survey based on multistage random sampling was conducted in 148 cities in China between June 20 and August 31, 2022. Personality traits, perceived stress, and SHS were evaluated using the Big Five Inventory-10 (BFI-10), the 4-item Perceived Stress Scale (PSS-4), and the Short-Form Suboptimal Health Status Questionnaire (SHSQ-SF), respectively. Pearson's correlation analysis was employed to examine the associations between personality traits, perceived stress, and SHS. Structural equation modeling (SEM) was used to discern the mediating role of perceived stress in the relationships among personality traits and SHS. Result A total of 22,897 participants were enrolled in this study, among whom the prevalence of SHS was 52.9%. SHS was negatively correlated with three trait dimensions (i.e., extraversion, agreeableness, and conscientiousness) but positively correlated with neuroticism. Meanwhile, stress was negatively correlated with extraversion, agreeableness, conscientiousness, and openness, whereas it was positively correlated with neuroticism. The SEM results showed that, when adjusting for covariates (i.e., gender, age, BMI, educational level, current residence, marital status, and occupational status), higher agreeableness (β = - 0.049, P < 0.001) and conscientiousness (β = - 0.103, P < 0.001) led to lower SHS prevalence, higher neuroticism (β = 0.130, P < 0.001), and openness (β = 0.026, P < 0.001) caused SHS to be more prevalent. Perceived stress played a partial mediating role in the relationships among personality traits and SHS, respectively, contributing 41.3%, 35.9%, and 32.5% to the total effects of agreeableness, conscientiousness, and neuroticism on SHS. Additionally, the mediating impact of stress was significant even though extraversion had no direct effect on SHS. Conclusion This study revealed a high prevalence of SHS in Chinese residents. Personality traits significantly influenced SHS rates, which perceived stress tended to mediate. From a PPPM perspective, early screening and targeted intervention for people with neuroticism (as well as stress alleviation) might contribute to health enhancement and chronic disease prevention. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-023-00349-x.
Collapse
Affiliation(s)
- Qihua Guan
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Hualei Dong
- Department of Sanatorium, Shandong Provincial Taishan Hospital, Taian, China
| | - Zhihui Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Zheng Guo
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN USA
- School of Public Health, Edith Cowan University, Perth, Australia
| | - Zi Lin
- Department of Pediatrics, Taian Maternity and Child Health Hospital, Taian, China
| | - Hui Niu
- Department of Pediatrics, Taian Maternity and Child Health Hospital, Taian, China
| | - Yibo Wu
- School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191 China
| | - Haifeng Hou
- School of Public Health and The Second Affiliated Hospital of Shandong First Medical University, 6699 Qingdao Road, Jinan, 250117 Taian China
| |
Collapse
|
4
|
Alzain MA, Asweto CO, Hassan SUN, Saeed ME, Kassar A, Ali KEM, Ghorbel M, Zrieq R, Alsaif B, Wang W. Assessing suboptimal health status in the Saudi population: Translation and validation of the SHSQ-25 questionnaire. J Glob Health 2024; 14:04030. [PMID: 38305242 PMCID: PMC10836270 DOI: 10.7189/jogh.14.04030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
Background Suboptimal Health Status (SHS) is realised as a vital feature for improving global health. However, the Arabian world does not have a validated instrument for screening SHS in their population. Therefore, the study aimed to evaluate the psychometric properties of Arabic-translated SHS (ASHSQ-25) in the Saudi Arabian population. Methods We conducted a cross-sectional study among the conveniently sampled 1590 participants from the Saudi population (with a 97.4% response rate). The data was gathered through an online survey and then exported into SPSS and AMOS version 26.0 for analysis. Mann-Whitney and Kruskal-Wallis tests were used to identify the median difference between demographic groups. The one-tailed 90% upper limit of SHS scores was chosen as the cut-off criteria for SHS. Reliability and confirmatory analysis were performed for the psychometric evaluation of ASHSQ-25 in the Saudi Arabian context. Results This study demonstrates that the ASHSQ-25 has good internal consistency, interclass correlation coefficient (ICC) = 0.92; 95% confidence interval (CI) = 0.91-0.93) and reliability (Cronbach's α = 0.92). The confirmatory factor analysis (CFA) results indicated a good fit of the databased on the CMIN/degrees of freedom (df) = 4.461, comparative fit index (CFI) = 0.94, Tucker Lewis index (TLI) = 0.93, and Root Mean Square Error of Approximation (RMSEA) = 0.05. The result factor loadings for each item were high (≥ 0.55), except for one item from the immune system subscale. The SHS cut-off point for ASHSQ-25 was 33, leading to a 23.7% prevalence of SHS. Conclusions This study reveals that ASHSQ-25 has appropriate internal consistency and structural validity to assess SHS in an Arabic-speaking population; therefore, it is recommended.
Collapse
Affiliation(s)
- Mohamed Ali Alzain
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il City, Saudi Arabia
- Department of Community Medicine, Faculty of Medicine and Health Sciences, University of Dongola, Dongola, Sudan
| | | | - Sehar-Un-Nisa Hassan
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il City, Saudi Arabia
| | - Mohammed Elshiekh Saeed
- Faculty of Medicine, National University-Sudan, Khartoum, Sudan
- Department of Physiology, Faculty of Medicine, University of Dongola, Dongola, Sudan
| | - Ahmed Kassar
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il City, Saudi Arabia
| | - Kamal Elbssir Mohammed Ali
- Department of Community Health, Occupation Health and Safety Program, Northern Boarder University, Arar, Saudi Arabia
| | - Mouna Ghorbel
- Department of Biology, College of Sciences, University of Hail, P.O., Ha'il City, Saudi Arabia
| | - Rafat Zrieq
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il City, Saudi Arabia
- Applied Science Research Centre, Applied Science Private University, Amman, Jordan
| | - Bandar Alsaif
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il City, Saudi Arabia
| | - Wei Wang
- Clinical Research Center, First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- On behalf of Global Health Epidemiology Research Group (GHERG) & Global Suboptimal Health Consortium (GSHC)
| |
Collapse
|
5
|
Choi HR, Chang Y, Kim Y, Cho Y, Kwon MJ, Kang J, Kwon R, Lim GY, Kim KH, Kim H, Hong YS, Park J, Zhao D, Cho J, Guallar E, Park HY, Ryu S. Vasomotor and other menopause symptoms and the prevalence of ideal cardiovascular health metrics among premenopausal stage women. Menopause 2023; 30:750-757. [PMID: 37279516 PMCID: PMC10309111 DOI: 10.1097/gme.0000000000002203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 04/05/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVE We examined the association between menopause symptoms and the prevalence of ideal cardiovascular health (CVH) metrics among premenopausal women. METHODS This cross-sectional study comprised 4,611 premenopausal women aged 42 to 52 years. Data for CVH metrics were collected during health screening examinations. Menopause symptoms were measured using the Korean version of the Menopause-Specific Quality of Life questionnaire. For vasomotor, psychosocial, physical, and sexual symptoms, participants were divided into absent or symptomatic groups, further divided into tertiles (range, 0-7; 7 being the most bothersome). Ideal CVH metrics were defined according to the American Heart Association Life Simple 7 metrics, except dietary component. Cardiovascular health metrics were scored from 0 (unhealthy) to 6 (healthy) and classified as poor (0-2), intermediate (3-4), and ideal (5-6). Multinomial logistic regression models were used to estimate the prevalence ratios for intermediate and poor CVH metrics using ideal CVH as the reference. RESULTS The overall and 4 menopause-specific quality of life domain scores were significantly associated with poorer CVH metrics scores in a dose-response manner ( P < 0.05). After adjusting for age, parity, education level, anti-Mullerian hormone levels, and alcohol intake, women with the most bothersome degree for vasomotor, psychosocial, physical, and sexual symptoms had significantly higher prevalence of poor CVH metrics, with corresponding prevalence ratios (95% confidence interval) of 2.90 (1.95-4.31), 2.07 (1.36-3.15), 3.01 (1.19-7.65), and 1.66 (1.15-2.39), respectively, compared with those without each vasomotor, psychosocial, physical, and sexual symptom. CONCLUSIONS Premenopausal stage women with either vasomotor or nonvasomotor menopausal symptoms have significantly higher prevalence of poor CVH metrics, compared with those without any menopausal symptoms.
Collapse
Affiliation(s)
- Hye Rin Choi
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Yoosoo Chang
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Yejin Kim
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoosun Cho
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min-Jung Kwon
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeonggyu Kang
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ria Kwon
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Ga-Young Lim
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Kye-Hyun Kim
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yun Soo Hong
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jihwan Park
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Di Zhao
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Juhee Cho
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Eliseo Guallar
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Hyun-Young Park
- Department of Precision Medicine, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Seungho Ryu
- From the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| |
Collapse
|
6
|
Liu Y, Wan C, Xi X. Measurement properties of the EQ-5D-5L in sub-health: evidence based on primary health care workers in China. Health Qual Life Outcomes 2023; 21:22. [PMID: 36890491 PMCID: PMC9996950 DOI: 10.1186/s12955-023-02105-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/21/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Sub-health which is the state between health and disease is a major global public health challenge. As a reversible stage, sub-health can work as a effective tool for the early detection or prevention of chronic disease. The EQ-5D-5L (5L) is a widely used, generic preference-based instrument while its validity in measuring sub-health is not clear. The aim of the study was thus to assess its measurement properties in individuals with sub-health in China. METHODS The data used were from a nationwide cross-sectional survey conducted among primary health care workers who were selected on the basis of convenience and voluntariness. The questionnaire was composited of 5L, Sub-Health Measurement Scale V1.0 (SHMS V1.0), social-demographic characteristics and a question assessing the presence of disease. Missing values and ceiling effects of 5L were calculated. The convergent validity of 5L utility and VAS scores was tested by assessing their correlations with SHMS V1.0 using Spearman's correlation coefficient. The known-groups validity of 5L utility and VAS scores was assessed by comparing their values between subgroups defined by SHMS V1.0 scores using the Kruskal-Wallis test. We also did an analysis in subgroups according to different regions of China. RESULTS A total of 2063 respondents were included in the analysis. No missing data were observed for the 5L dimensions and only one missing value was for the VAS score. 5L showed strong overall ceiling effects (71.1%). The ceiling effects were slightly weaker on the "pain/discomfort" (82.3%) and "anxiety/depression" (79.5%) dimensions compared with the other three dimensions (nearly 100%). The 5L weakly correlated with SHMS V1.0: the correlation coefficients were mainly between 0.2 and 0.3 for the two scores. 5L was yet not sensitive in distinguishing subgroups of respondents with different levels of sub-health, especially the subgroups with adjacent health status (p > 0.05). The results of subgroup analysis were generally consistent with those of the full sample. CONCLUSIONS It appears that the measurement properties of EQ-5D-5L in individuals with sub-health are not satisfactory in China. We thus should be cautious to use it in the population.
Collapse
Affiliation(s)
- Yueyue Liu
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, China
| | - Chuchuan Wan
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, China
| | - Xiaoyu Xi
- The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, China.
| |
Collapse
|
7
|
Meng X, Wang F, Gao X, Wang B, Xu X, Wang Y, Wang W, Zeng Q. Association of IgG N-glycomics with prevalent and incident type 2 diabetes mellitus from the paradigm of predictive, preventive, and personalized medicine standpoint. EPMA J 2023; 14:1-20. [PMID: 36866157 PMCID: PMC9971369 DOI: 10.1007/s13167-022-00311-3] [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: 10/31/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022]
Abstract
Objectives Type 2 diabetes mellitus (T2DM), a major metabolic disorder, is expanding at a rapidly rising worldwide prevalence and has emerged as one of the most common chronic diseases. Suboptimal health status (SHS) is considered a reversible intermediate state between health and diagnosable disease. We hypothesized that the time frame between the onset of SHS and the clinical manifestation of T2DM is the operational area for the application of reliable risk assessment tools, such as immunoglobulin G (IgG) N-glycans. From the viewpoint of predictive, preventive, and personalized medicine (PPPM/3PM), the early detection of SHS and dynamic monitoring by glycan biomarkers could provide a window of opportunity for targeted prevention and personalized treatment of T2DM. Methods Case-control and nested case-control studies were performed and consisted of 138 and 308 participants, respectively. The IgG N-glycan profiles of all plasma samples were detected by an ultra-performance liquid chromatography instrument. Results After adjustment for confounders, 22, five, and three IgG N-glycan traits were significantly associated with T2DM in the case-control setting, baseline SHS, and baseline optimal health participants from the nested case-control setting, respectively. Adding the IgG N-glycans to the clinical trait models, the average area under the receiver operating characteristic curves (AUCs) of the combined models based on repeated 400 times fivefold cross-validation differentiating T2DM from healthy individuals were 0.807 in the case-control setting and 0.563, 0.645, and 0.604 in the pooled samples, baseline SHS, and baseline optimal health samples of nested case-control setting, respectively, which presented moderate discriminative ability and were generally better than models with either glycans or clinical features alone. Conclusions This study comprehensively illustrated that the observed altered IgG N-glycosylation, i.e., decreased galactosylation and fucosylation/sialylation without bisecting GlcNAc, as well as increased galactosylation and fucosylation/sialylation with bisecting GlcNAc, reflects a pro-inflammatory state of T2DM. SHS is an important window period of early intervention for individuals at risk for T2DM; glycomic biosignatures as dynamic biomarkers have the ability to identify populations at risk for T2DM early, and the combination of evidence could provide suggestive ideas and valuable insight for the PPPM of T2DM. Supplementary information The online version contains supplementary material available at 10.1007/s13167-022-00311-3.
Collapse
Affiliation(s)
- Xiaoni Meng
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen, Fengtai District, Beijing, 100069 China
| | - Fei Wang
- Health Management Institute, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853 China
| | - Xiangyang Gao
- Health Management Institute, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853 China
| | - Biyan Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen, Fengtai District, Beijing, 100069 China
| | - Xizhu Xu
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117 China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen, Fengtai District, Beijing, 100069 China
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen, Fengtai District, Beijing, 100069 China
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117 China
- Centre for Precision Health, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA 6027 Australia
| | - Qiang Zeng
- Health Management Institute, Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853 China
| |
Collapse
|
8
|
Psychometric Properties of Suboptimal Health Status Instruments: A Systematic Review. J Pers Med 2023; 13:jpm13020299. [PMID: 36836533 PMCID: PMC9967625 DOI: 10.3390/jpm13020299] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Suboptimal health status (SHS) measurement has now been recognized as an essential construct in predictive, preventive, and personalized medicine. Currently, there are limited tools, and an ongoing debate about appropriate tools. Therefore, it is crucial to evaluate and generate conclusive evidence about the psychometric properties of available SHS tools. OBJECTIVE This research aimed to identify and critically assess the psychometric properties of available SHS instruments and provide recommendations for their future use. METHODS Articles were retrieved by following the guidelines of the PRISMA checklist, and the robustness of methods and evidence about the measurement properties was assessed using the adapted COSMIN checklist. The review was registered in PROSPERO. RESULTS The systematic review identified 14 publications describing four subjective SHS measures with established psychometric properties; these included the Suboptimal Health Status Questionnaire-25 (SHSQ-25), Sub-health Measurement Scale Version 1.0 (SHMS V1.0), Multidimensional Sub-health Questionnaire of Adolescents (MSQA), and the Sub-Health Self-Rating Scale (SSS). Most studies were conducted in China and reported three reliability indices: (1) the internal consistency measured by Cronbach's α value ranged between 0.70 and 0.96; (2) the test-retest reliability; and (3) the split-half reliability coefficient values ranged between 0.64 and 0.98, and between 0.83 and 0.96, respectively. For the values of validity coefficients in the case of SHSQ-25 > 0.71, the SHMS-1.0 ranged from 0.64 to 0.87, and the SSS ranged from 0.74 to 0.96. Using these existing and well-characterized tools rather than constructing original tools is beneficial, given that the existing choice demonstrated sound psychometric properties and established norms. CONCLUSIONS The SHSQ-25 stood out as being more suitable for the general population and routine health surveys, because it is short and easy to complete. Therefore, there is a need to adapt this tool by translating it into other languages, including Arabic, and establishing norms based on populations from other regions of the world.
Collapse
|
9
|
Zhen H, Liu J, Xiong K, Zheng L, Hu Y, Li M, Jin W. Engineering a carboxypeptidase from Aspergillus oryzae M30011 to improve the terminal-specific enzymatic hydrolysis of aromatic amino acids. Process Biochem 2023. [DOI: 10.1016/j.procbio.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
10
|
Guo Z, Meng R, Zheng Y, Li X, Zhou Z, Yu L, Tang Q, Zhao Y, Garcia M, Yan Y, Song M, Balmer L, Wen J, Hou H, Tan X, Wang W. Translation and cross-cultural validation of a precision health tool, the Suboptimal Health Status Questionnaire-25, in Korean. J Glob Health 2022; 12:04077. [PMID: 36181723 PMCID: PMC9526479 DOI: 10.7189/jogh.12.04077] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Suboptimal health status (SHS) is a reversible stage between health and illness that is characterized by health complaints, low energy, general weakness, and chronic fatigue. The Suboptimal Health Status Questionnaire-25 (SHSQ-25) has been validated in three major populations (African, Asian, and Caucasian) and is internationally recognized as a reliable and robust tool for health estimation in general populations. This study focused on the development of K-SHSQ-25, a Korean version of the SHSQ-25, from its English version. METHODS The SHSQ-25 was translated from English to Korean according to international guidelines set forth by the World Health Organization (WHO) for health instrument translation between different languages. A subsequent cross-sectional survey involved 460 healthy South Korean participants (aged 18-83 years; 65.4% females) to answer the 25 questions focusing on the health perspectives of 5 domains, 1) fatigue, 2) cardiovascular health, 3) digestive tract, 4) immune system and 5) mental health. The K-SHSQ-25 was further validated using tests for reliability, internal consistency, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS The version of K-SHSQ-25 achieved linguistic, cultural, and conceptual equivalence to the English version. The intraclass correlation coefficient (ICC) of test-retest reliability for individual items ranged from 0.88 to 0.99. Reliability estimates based on internal consistency reached a Cronbach's α of 0.953; the Cronbach's α for each domain ranged from 0.76 to 0.94. Regarding construct validity, the EFA of the K-SHSQ-25 generally replicated the multidimensional structure (fatigue, cardiovascular, digestive, immune system, and mental health) and 25 questions. The CFA revealed that the root mean square error of approximation (RMSEA), goodness-of-fit index (GFI) and adjusted goodness of fit index (AGFI) were excellent (RMSEA = 0.069<0.08, GFI = 0.929>0.90, AGFI = 0.907>0.90). The five domains of the K-SHSQ-25 showed significant correlations with each other (r = 0.59-0.81, P<0.001). The cut-off point of K-SHSQ-25 for SHS was determined as an SHS score of 25. The prevalence of SHS in this study was 60.0% (276/460), with 47.8% (76/159) for males and 58.5% for females (176/301). CONCLUSIONS Our results indicate that the Korean version of SHSQ-25, K-SHSQ-25, is a transcultural equivalent, robust, valid, and reliable assessment tool for evaluating SHS in the Korean-speaking population.
Collapse
Affiliation(s)
- Zheng Guo
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- The Nathan Centre, Joondalup, Western Australia, Australia
| | - Ruoyu Meng
- Department of Physiology, Institute of Medical Science, Jeonbuk National University Medical School, Jeonju, Korea
| | - Yulu Zheng
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- The Nathan Centre, Joondalup, Western Australia, Australia
| | - Xingang Li
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- The Nathan Centre, Joondalup, Western Australia, Australia
| | - Ziqi Zhou
- Department of Herbology, School of Korean Medicine, Wonkwang University, Jeonbuk, Korea
| | - Leilei Yu
- Department of Endocrinology, Taian City Central Hospital, Taian, China
| | - Qian Tang
- Department of Obstetrics, Tengzhou People's Central Hospital, Tengzhou, China
| | - Ying Zhao
- School of Foreign Languages, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Monique Garcia
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- The Nathan Centre, Joondalup, Western Australia, Australia
| | - Yuxiang Yan
- School of Foreign Languages, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Manshu Song
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lois Balmer
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Department of Physiology, Institute of Medical Science, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jun Wen
- School of Business and Law, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Haifeng Hou
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Public Health, Shandong First Medical University &
- Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Xuerui Tan
- The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Wei Wang
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- The Nathan Centre, Joondalup, Western Australia, Australia
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
- The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | | |
Collapse
|
11
|
Meng X, Wang B, Xu X, Song M, Hou H, Wang W, Wang Y. Glycomic biomarkers are instrumental for suboptimal health status management in the context of predictive, preventive, and personalized medicine. EPMA J 2022; 13:195-207. [DOI: 10.1007/s13167-022-00278-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/29/2022] [Indexed: 12/08/2022]
|
12
|
Placental lesions and differential expression of pro-and anti-angiogenic growth mediators and oxidative DNA damage marker in placentae of Ghanaian suboptimal and optimal health status pregnant women who later developed preeclampsia. PLoS One 2022; 17:e0265717. [PMID: 35312727 PMCID: PMC8936490 DOI: 10.1371/journal.pone.0265717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Angiogenic growth mediators (AGMs) and oxidative stress (OS) both play essential roles in normal placental vascular development and as such, placental alterations in these factors contribute to pre-eclampsia (PE). Suboptimal health status (SHS), an intermediate between health and disease, has been associated with imbalanced AGMs and OS biomarkers. Thus, SHS pregnant women may be at increased risk of developing PE and may present abnormal placental alteration and expression of AGMs and OS compared to optimal health status (OHS) pregnant women. We examined the histopathological morphology, immunohistochemical expression of AGMs antibodies and oxidative DNA damage marker in the placentae of SHS and OHS pregnant women who developed early-onset PE (EO-PE) and late-onset (LO-PE) compared to normotensive pregnancy (NTN-P). Methods This nested case-control study recruited 593 singleton normotensive pregnant women at baseline (10–20 weeks gestation) from the Ghanaian Suboptimal Health Status Cohort Study (GHOACS) undertaken at the Komfo Anokye Teaching Hospital, Ghana. Socio-demographic, clinical and obstetrics data were collected, and a validated SHS questionnaire-25 (SHSQ-25) was used in classifying participants into SHS (n = 297) and OHS (n = 296). Participants were followed until the time of PE diagnosis and delivery (32–42 weeks gestation). Blood samples were collected at the two-time points and were assayed for AGMs; soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PIGF), vascular endothelial growth factor-A (VEGF-A), and soluble endoglin (sEng), and OS biomarkers; 8-hydroxydeoxyguanosine (8-OHdG), 8-epiprostaglandinF2-alpha (8- epi-PGF2α) and total antioxidant capacity (TAC) using ELISA. Placental samples were collected for histopathological and immunohistochemical analysis. Results Of the 593 pregnant women, 498 comprising 248 SHS and 250 OHS women returned for delivery and were included in the final analysis. Of the 248 SHS women, 56, 97 and 95 developed EO-PE, LO-PE and NTN-P, respectively, whereas 14, 30 and 206 of the 250 OHS mothers developed EO-PE, LO-PE and NTN-P, respectively. At baseline, SHS_NTN pregnant women had a significant imbalance in AGMs and OS biomarkers compared to OHS_NTN pregnant women (p<0.0001). At the time of PE diagnosis, SHS_NTN-P women who developed EO-PE, LO-PE, and NTN-P had lower serum levels of P1GF, VEGF-A and TAC and correspondingly higher levels of sEng, sFlt-1, 8-epiPGF2α, and 8-OHdG than OHS-NTN-P women who developed EO-PE and LO-PE, NTN-P (p<0.0001). A reduced placental size, increased foetal/placental weight ratio, and a significantly higher proportion of fibrinoid necrosis, infarction, villous fibrin, syncytial knots, calcification, chorangiosis, tunica media/vascular wall hypertrophy and chorioamnionitis was associated with the SHS group who developed PE (EO-PE>LO-PE) more than OHS groups who developed PE (EO-PE>LO-PE) when all were compared to NTN-P (p<0.0001). The intensity of antibody expression of PIGF and VEGF-A were significantly reduced, whereas Flt-1, Eng and 8-OHdG were significantly increased in placentae from SHS-pregnant women who developed EO-PE>LO-PE more than OHS- pregnant women who developed EO-PE>LO-PE when all were compared to NTN-P (p<0.0001). Conclusion Increased lesions, oxidative DNA damage, and imbalanced expression between pro-and anti-AGMs are associated more with SHS-embodied PE placentae rather than OHS-embodied PE subtypes, thus potentially allowing differential evaluation of PE.
Collapse
|
13
|
Zhang J, Zheng YY, Wu TT, Ma X, Ma YT, Xie X, Tang BP. Blood Routine Test Parameters Score, a Novel Predictor of Adverse Outcomes of Coronary Artery Disease Patients with or without Diabetes Who Underwent Percutaneous Coronary Intervention: A Retrospective Cohort Study. ACS OMEGA 2021; 6:32508-32516. [PMID: 34901600 PMCID: PMC8655762 DOI: 10.1021/acsomega.1c03990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND In this study, we developed a novel risk score named the blood routine test parameters (BRTP) score to predict the clinical outcomes in coronary artery disease (CAD) patients who had undergone percutaneous coronary intervention (PCI). METHODS There were 6049 patients with CAD after PCI enrolled in CORFCHD-PCI from January 2008 to December 2016. We divided these patients into two groups according to diabetes (diabetic group, n = 3809, and nondiabetic group, n = 2240). During a follow-up time of 35.9 ± 22.6 months, we compared the incidences of all-cause mortality (ACM) and cardiac mortality (CM), which were assigned as the primary outcomes between patients with a high BRTP score (≥5 points) and those with a low BRTP score (<5 points). RESULTS We found that the BRTP score independently predicted the risk for ACM and CM in both diabetic patients [ACM, hazard risk (HR) = 1.748 (95% confidence interval (CI): 1.186-2.575), P = 0.005; CM, HR = 1.728 (95% CI: 1.120-2.667), P = 0.014] and nondiabetic patients [ACM, HR = 1.682 (95% CI: 1.208-2.340), P = 0.002; CM, HR = 1.718 (95% CI: 1.188-2.484), P = 0.004]. However, the BRTP score was found to be an independent predictor for major adverse cardiovascular event (MACE) and major adverse cardiovascular and cerebrovascular event (MACCE) in diabetic patients [MACE, HR = 1.366 (95% CI: 1.076-1.734), P = 0.010; MACCE, HR = 1.330 (95% CI: 1.035-1.710), P = 0.026] but not in nondiabetic patients [MACE, HR = 1.241 (95% CI: 0.994-1.549), P = 0.056; MACCE, HR = 1.238 (95% CI: 0.981-1.562), P = 0.072]. CONCLUSIONS This study suggests that the BRTP score is an independent and novel predictor of mortality in CAD patients who had undergone PCI, especially in patients with comorbidity of diabetes. TRIAL REGISTRATION ChiCTR-ROC-16010153. Registered 14, December, 2016.
Collapse
Affiliation(s)
- Jian Zhang
- Department
of Cardiology, First Affiliated Hospital
of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi
District, Urumqi 830011 P. R. China
| | - Ying-Ying Zheng
- Department
of Cardiology, First Affiliated Hospital
of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi
District, Urumqi 830011 P. R. China
- Department
of Cardiology, First Affiliated Hospital
of Zhengzhou University, Zhengzhou 450052 P. R. China
- Key
Laboratory of Cardiac Injury and Repair of Henan Province, No. 1, Jianshe East Road, Erqi District, Zhengzhou 450052, Henan, P. R. China
| | - Ting-Ting Wu
- Department
of Cardiology, First Affiliated Hospital
of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi
District, Urumqi 830011 P. R. China
| | - Xiang Ma
- Department
of Cardiology, First Affiliated Hospital
of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi
District, Urumqi 830011 P. R. China
| | - Yi-Tong Ma
- Department
of Cardiology, First Affiliated Hospital
of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi
District, Urumqi 830011 P. R. China
| | - Xiang Xie
- Department
of Cardiology, First Affiliated Hospital
of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi
District, Urumqi 830011 P. R. China
| | - Bao-Peng Tang
- Department
of Cardiology, First Affiliated Hospital
of Xinjiang Medical University, No. 137, Liyushan Road, Xinshi
District, Urumqi 830011 P. R. China
| |
Collapse
|
14
|
Wang W, Yan Y, Guo Z, Hou H, Garcia M, Tan X, Anto EO, Mahara G, Zheng Y, Li B, Kang T, Zhong Z, Wang Y, Guo X, Golubnitschaja O. All around suboptimal health - a joint position paper of the Suboptimal Health Study Consortium and European Association for Predictive, Preventive and Personalised Medicine. EPMA J 2021; 12:403-433. [PMID: 34539937 PMCID: PMC8435766 DOI: 10.1007/s13167-021-00253-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023]
Abstract
First two decades of the twenty-first century are characterised by epidemics of non-communicable diseases such as many hundreds of millions of patients diagnosed with cardiovascular diseases and the type 2 diabetes mellitus, breast, lung, liver and prostate malignancies, neurological, sleep, mood and eye disorders, amongst others. Consequent socio-economic burden is tremendous. Unprecedented decrease in age of maladaptive individuals has been reported. The absolute majority of expanding non-communicable disorders carry a chronic character, over a couple of years progressing from reversible suboptimal health conditions to irreversible severe pathologies and cascading collateral complications. The time-frame between onset of SHS and clinical manifestation of associated disorders is the operational area for an application of reliable risk assessment tools and predictive diagnostics followed by the cost-effective targeted prevention and treatments tailored to the person. This article demonstrates advanced strategies in bio/medical sciences and healthcare focused on suboptimal health conditions in the frame-work of Predictive, Preventive and Personalised Medicine (3PM/PPPM). Potential benefits in healthcare systems and for society at large include but are not restricted to an improved life-quality of major populations and socio-economical groups, advanced professionalism of healthcare-givers and sustainable healthcare economy. Amongst others, following medical areas are proposed to strongly benefit from PPPM strategies applied to the identification and treatment of suboptimal health conditions:Stress overload associated pathologiesMale and female healthPlanned pregnanciesPeriodontal healthEye disordersInflammatory disorders, wound healing and pain management with associated complicationsMetabolic disorders and suboptimal body weightCardiovascular pathologiesCancersStroke, particularly of unknown aetiology and in young individualsSleep medicineSports medicineImproved individual outcomes under pandemic conditions such as COVID-19.
Collapse
Affiliation(s)
- Wei Wang
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai’an, China
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Yuxiang Yan
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Zheng Guo
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Haifeng Hou
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai’an, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Monique Garcia
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Xuerui Tan
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Enoch Odame Anto
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Department of Medical Diagnostics, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gehendra Mahara
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Yulu Zheng
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Bo Li
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Timothy Kang
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Institute of Chinese Acuology, Perth, Australia
| | - Zhaohua Zhong
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- School of Basic Medicine, Harbin Medical University, Harbin, China
| | - Youxin Wang
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- Department of Medical Diagnostics, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Xiuhua Guo
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Olga Golubnitschaja
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - On Behalf of Suboptimal Health Study Consortium and European Association for Predictive, Preventive and Personalised Medicine
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai’an, China
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Department of Medical Diagnostics, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Nursing and Health, Henan University, Kaifeng, China
- Institute of Chinese Acuology, Perth, Australia
- School of Basic Medicine, Harbin Medical University, Harbin, China
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| |
Collapse
|
15
|
Adua E, Afrifa-Yamoah E, Frimpong K, Adama E, Karthigesu SP, Anto EO, Aboagye E, Yan Y, Wang Y, Tan X, Wang W. Construct validity of the Suboptimal Health Status Questionnaire-25 in a Ghanaian population. Health Qual Life Outcomes 2021; 19:180. [PMID: 34281537 PMCID: PMC8287694 DOI: 10.1186/s12955-021-01810-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/24/2021] [Indexed: 12/13/2022] Open
Abstract
Background The Suboptimal Health Status Questionnaire-25 (SHS-Q-25) developed to measure Suboptimal Health Status has been used worldwide, but its construct validity has only been tested in the Chinese population. Applying Structural Equation Modelling, we investigate aspects of the construct validity of the SHS-Q-25 to determine the interactions between SHS subscales in a Ghanaian population.
Methods The study involved healthy Ghanaian participants (n = 263; aged 20–80 years; 63% female), who responded to the SHSQ-25. In an exploratory factor and parallel analysis, the study extracted a new domain structure and compared to the established five-domain structure of SHSQ-25. A confirmatory factor analysis (CFA) was conducted and the fit of the model further discussed. Invariance analysis was carried out to establish the consistency of the instrument across multi-groups.
Results The extracted domains were reliable with Cronbach’s \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\alpha$$\end{document}α of 0.846, 0.820 and 0.864 respectively, for fatigue, immune-cardiovascular and cognitive. The CFA revealed that the model fit indices were excellent \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\left( {{\text{RMSEA}} = 0.049~ < ~0.08,\,{\text{CFI}} = 0.903 > 0.9,\,{\text{GFI}} = 0.880 < 0.9,\,{\text{TLI}} = 0.907 > 0.9} \right)$$\end{document}RMSEA=0.049<0.08,CFI=0.903>0.9,GFI=0.880<0.9,TLI=0.907>0.9. The fit indices for the three-domain model were statistically superior to the five-domain model. There were, however, issues of insufficient discriminant validity as some average variance extracts were smaller than the corresponding maximum shared variance. The three-domain model was invariant for all constrained aspects of the structural model across age, which is an important risk factor for most chronic diseases.
Conclusion The validity tests suggest that the SHS-Q25 can measure SHS in a Ghanaian population. It can be recommended as a screening tool to early detect chronic diseases especially in developing countries where access to facilities is diminished.
Collapse
Affiliation(s)
- Eric Adua
- Center for Precision Health, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia.,Shantou University of Medical College, Shantou, China.,Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ebenezer Afrifa-Yamoah
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia
| | - Kwasi Frimpong
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia.,Ghana Institute of Management and Public Administration, Accra, Ghana
| | - Esther Adama
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia
| | - Shantha P Karthigesu
- Center for Precision Health, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia
| | - Enoch Odame Anto
- Center for Precision Health, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia.,Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Aboagye
- Institute of Environmental Medicine, Karolinska Institute, Nobels Väg 13, 17177, Stockholm, Sweden
| | - Yuxiang Yan
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Xuerui Tan
- Shantou University of Medical College, Shantou, China
| | - Wei Wang
- Center for Precision Health, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia. .,Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, 100069, China.
| |
Collapse
|
16
|
Wang H, Tian Q, Zhang J, Liu H, Zhang J, Cao W, Zhang X, Li X, Wu L, Song M, Kong Y, Wang W, Wang Y. Blood transcriptome profiling as potential biomarkers of suboptimal health status: potential utility of novel biomarkers for predictive, preventive, and personalized medicine strategy. EPMA J 2021; 12:103-115. [PMID: 34194583 PMCID: PMC8192624 DOI: 10.1007/s13167-021-00238-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/01/2021] [Indexed: 02/06/2023]
Abstract
The early identification of Suboptimal Health Status (SHS) creates a window opportunity for the predictive, preventive, and personalized medicine (PPPM) in chronic diseases. Previous studies have observed the alterations in several mRNA levels in SHS individuals. As a promising "omics" technology offering comprehension of genome structure and function at RNA level, transcriptome profiling can provide innovative molecular biomarkers for the predictive identification and targeted prevention of SHS. To explore the potential biomarkers, biological functions, and signalling pathways involved in SHS, an RNA sequencing (RNA-Seq)-based transcriptome analysis was firstly conducted on buffy coat samples collected from 30 participants with SHS and 30 age- and sex-matched healthy controls. Transcriptome analysis identified a total of 46 differentially expressed genes (DEGs), in which 22 transcripts were significantly increased and 24 transcripts were decreased in the SHS group. A total of 23 transcripts were selected as candidate predictive biomarkers for SHS. Gene Ontology (GO) annotations and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis revealed that several biological processes were related to SHS, such as ATP-binding cassette (ABC) transporter and neurodegeneration. Protein-protein interaction (PPI) network analysis identified 10 hub genes related to SHS, including GJA1, TWIST2, KRT1, TUBB3, AMHR2, BMP10, MT3, BMPER, NTM, and TMEM98. A transcriptome predictive model can distinguish SHS individuals from the healthy controls with a sensitivity of 83.3% (95% confidence interval (CI): 73.9-92.7%), a specificity of 90.0% (95% CI: 82.4-97.6%), and an area under the receiver operating characteristic curve of 0.938 (95% CI: 0.882-0.994). In the present study, we demonstrated that blood (buffy coat) samples appear to be a very promising and easily accessible biological material for the transcriptomic analyses focused on the objective identification of SHS by using our transcriptome predictive model. The pattern of particularly determined DEGs can be used as predictive transcriptomic biomarkers for the identification of SHS in an individual who may, subjectively, feel healthy, but at the level of subcellular mechanisms, the changes can provide early information about potential health problems in this person. Our findings also indicate the potential therapeutic targets in dealing with chronic diseases related to SHS, such as T2DM and CVD, and an early onset of neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases, as well as the findings suggest the targets for personalized interventions as promoted in PPPM. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13167-021-00238-1.
Collapse
Affiliation(s)
- Hao Wang
- Department of Clinical Epidemiology and Evidence-Based Medicine, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- Center for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Jie Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Hongqi Liu
- Student Healthcare Center, Weifang University, Weifang, China
| | - Jinxia Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Weijie Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- Center for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Xiaoyu Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Xingang Li
- Center for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Manshu Song
- Center for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Yuanyuan Kong
- Department of Clinical Epidemiology and Evidence-Based Medicine, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Center for Precision Health, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| |
Collapse
|
17
|
Does Genetic Predisposition Contribute to the Exacerbation of COVID-19 Symptoms in Individuals with Comorbidities and Explain the Huge Mortality Disparity between the East and the West? Int J Mol Sci 2021; 22:ijms22095000. [PMID: 34066804 PMCID: PMC8125927 DOI: 10.3390/ijms22095000] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/25/2021] [Accepted: 05/06/2021] [Indexed: 12/15/2022] Open
Abstract
The elderly and patients with several comorbidities experience more severe cases of coronavirus disease 2019 (COVID-19) than healthy patients without underlying medical conditions. However, it is unclear why these people are prone to developing alveolar pneumonia, rapid exacerbations, and death. Therefore, we hypothesized that people with comorbidities may have a genetic predisposition that makes them more vulnerable to various factors; for example, they are likely to become more severely ill when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To test this hypothesis, we searched the literature extensively. Polymorphisms of genes, such as those that encode angiotensin-converting enzyme 1 (ACE1), have been associated with numerous comorbidities, such as cardiovascular disease, hypertension, diabetes, chronic kidney disease, and obesity, and there are potential mechanisms to explain these associations (e.g., DD-type carriers have greater ACE1 activity, and patients with a genetic alpha-1 anti-trypsin (AAT) deficiency lack control over inflammatory mediators). Since comorbidities are associated with chronic inflammation and are closely related to the renin–angiotensin–aldosterone system (RAAS), these individuals may already have a mild ACE1/ACE2 imbalance before viral infection, which increases their risk for developing severe cases of COVID-19. However, there is still much debate about the association between ACE1 D/I polymorphism and comorbidities. The best explanation for this discrepancy could be that the D allele and DD subtypes are associated with comorbidities, but the DD genotype alone does not have an exceptionally large effect. This is also expected since the ACE1 D/I polymorphism is only an intron marker. We also discuss how polymorphisms of AAT and other genes are involved in comorbidities and the severity of SARS-CoV-2 infection. Presumably, a combination of multiple genes and non-genetic factors is involved in the establishment of comorbidities and aggravation of COVID-19.
Collapse
|
18
|
Mahara G, Liang J, Zhang Z, Ge Q, Zhang J. Associated Factors of Suboptimal Health Status Among Adolescents in China: A Cross-Sectional Study. J Multidiscip Healthc 2021; 14:1063-1071. [PMID: 33994792 PMCID: PMC8114174 DOI: 10.2147/jmdh.s302826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/01/2021] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Suboptimal health status (SHS) is a state between health and disease, has several adverse effects, although, its main underlying mechanism is still unclear. This study aimed to investigate SHS and its associated factors of adolescents. METHODS A community-based cross-sectional study was conducted in the three different geographic locations of China (Shanxi, Guangzhou, and Tibet). A multidimensional sub-health questionnaire of adolescent (MSQA) is used to evaluate SHS. Independent two-sample K-S test was performed for the quantitative data as the non-parametric test, whereas Chi-square test method was applied to explore the difference of discrete variables data between groups. Then finally, multiple logistic regression analysis was applied to analyze the influential factors of SHS. RESULTS Among 1461 respondents (between 15 and 18 years old), females proportion (56.47%) was higher than males (43.53%) where SHS was higher in Shanxi followed by Tibet and then Guangdong. The rural area, grade, lack of sleep time, home visit in a week, lack of exercise, a heavy burden of study, smoking, drinking, and fewer friends were the risk factors of SHS, while families living status, seeking help and extroversion were the protective factors. CONCLUSION SHS is significantly associated with behavior and lifestyle-related factors. For comprehensively prevention and control of the SHS, it is urgently needed to reduce the risk factors and enhance the protective factors among adolescents.
Collapse
Affiliation(s)
- Gehendra Mahara
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China
| | - Jiazhi Liang
- Center for Disease Control and Prevention at Haizhu, Guangzhou, Guangdong, 510288, People’s Republic of China
| | - Zhirong Zhang
- Nanhai District People’s Hospital of Foshan City, Foshan, Guangdong, People’s Republic of China
| | - Qi Ge
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China
| | - Jinxin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China
| |
Collapse
|
19
|
Wang X, Zhong Z, Balmer L, Wang W. Glycosylation Profiling as a Biomarker of Suboptimal Health Status for Chronic Disease Stratification. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1325:321-339. [PMID: 34495543 DOI: 10.1007/978-3-030-70115-4_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
WHO defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." We coined and defined suboptimal health status (SHS) as a subclinical, reversible stage of the pre-chronic disease. SHS is a physical state between health and disease, characterized by health complaints, general weakness, chronic fatigue, and low energy levels. We have developed an instrument to measure SHS, Suboptimal Health Status Questionnaire-25 (SHSQ-25), a self-reported survey assessing five health components that has been validated in various ethnical populations. Our studies suggest that SHS is associated with the major components of cardiovascular health and the early onset of metabolic diseases. Besides subjective measure of health (SHS), glycans are conceived as objective biomarkers of SHS. Glycans are complex and branching carbohydrate moieties attached to proteins, participating in inflammatory regulation and chronic disease pathogenesis. We have been investigating the role of glycans and SHS in multiple cardiometabolic diseases in different ethnical populations (African, Chinese, and Caucasian). Here we present case studies to prove that a combination of subjective health measure (SHS) with objective health measure (glycans) represents a window of opportunity to halt or reverse the progression of chronic diseases.
Collapse
Affiliation(s)
- Xueqing Wang
- School of Health and Medical Sciences, Edith Cowan University, Perth, Australia
- College of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Zhaohua Zhong
- College of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Lois Balmer
- School of Health and Medical Sciences, Edith Cowan University, Perth, Australia
| | - Wei Wang
- School of Health and Medical Sciences, Edith Cowan University, Perth, Australia.
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China.
- First Affiliated Hospital, Shantou University Medical College, Shantou, China.
| |
Collapse
|
20
|
Xue Y, Huang Z, Liu G, Feng Y, Xu M, Jiang L, Xu J. Association analysis of Suboptimal health Status: a cross-sectional study in China. PeerJ 2020; 8:e10508. [PMID: 33365207 PMCID: PMC7735074 DOI: 10.7717/peerj.10508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/16/2020] [Indexed: 12/15/2022] Open
Abstract
Background Suboptimal health status (SHS) among urban residents is commonplace in China. However, factors influencing SHS have not been thoroughly explored, especially with regard to the effects of internal factors (e.g., personality and health awareness) on SHS. Methods A cross-sectional study was conducted with a nationally representative sample of 5460 Chinese urban residents..SHS was measured using the Suboptimal Health Mesurement Scale Version 1.0. Demographic information, and information pertaining to lifestyle behaviors, environmental factors, and internal factors were abtained through a questionnaire. The associations between demographic information, lifestyle behaviors, environmental factors, internal factors and SHS were assessed using logistic regression. Results Of the 5460 participants (with a mean age of 41.56 ± 16.14 years), 2640 (48.4 %) were men. Out of 36 variables, 23 were significantly associated with SHS: age (odds ratio [OR]: 1.014), an education level of high school/junior college (OR: 1.443) , marital status (OR: 1.899), area of registered permanent residence (OR: 0.767), monthly household income (p < 0.001) , exposure to second-hand smoke (p = 0.001), alcohol drinking (OR: 1.284), bad eating habits (OR: 1.717), not sleeping before 11 p.m. every day (p = 0.002), spending time online more than five hours a day (OR: 1.526), having a good relationship with parents during one’s growth period (OR: 0.602), living with good quality air (OR:0.817), living in not crowded conditions (OR:0.636), having a harmonious neighborhood (OR:0.775), having adequate fitness facilities (OR:0.783), one’s health being affected by two-child policy (OR: 1.468) and medical policies (OR: 1.265) , high adverse quotient (OR: 0.488), many (≥3 kinds) interests and hobbies (OR: 0.617), mature and steady personality traits (OR: 0.469) , a high attention to one’s health (OR: 0.833), and effective health promotion induced by leading a leisurely lifestyle (OR: 0.466) were significantly associated with SHS. Conclusions All these variables were included demographic information, lifestyle behaviors, environmental factors and internal factors. Our study supports the benefits of controlling both internal and external factors in preventing suboptimal health.
Collapse
Affiliation(s)
- Yunlian Xue
- Department of Sanitation Economy Administration, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.,Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong Province, China.,School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhuomin Huang
- Department of Sanitation Economy Administration, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.,School of Health Services Management, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Guihao Liu
- Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong Province, China
| | - Yefang Feng
- Department of Sanitation Economy Administration, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.,School of Health Services Management, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Mengyao Xu
- Department of Sanitation Economy Administration, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.,School of Health Services Management, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Lijie Jiang
- Department of Sanitation Economy Administration, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.,School of Health Services Management, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jun Xu
- Department of Sanitation Economy Administration, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| |
Collapse
|
21
|
Zhu J, Ying W, Zhang L, Peng G, Chen W, Anto EO, Wang X, Lu N, Gao S, Wu G, Yan J, Ye J, Wu S, Yu C, Yue M, Huang X, Xu N, Ying P, Chen Y, Tan X, Wang W. Psychological symptoms in Chinese nurses may be associated with predisposition to chronic disease: a cross-sectional study of suboptimal health status. EPMA J 2020; 11:551-563. [PMID: 33078069 PMCID: PMC7556591 DOI: 10.1007/s13167-020-00225-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Suboptimal health status (SHS) is a reversible state between ideal health and illness and it can be effectively reversed by risk prediction, disease prevention, and personalized medicine under the global background of predictive, preventive, and personalized medicine (PPPM) concepts. More and more Chinese nurses have been troubled by psychological symptoms (PS). The correlation between PS and SHS is unclear in nurses. The purpose of current study is to investigate the prevalence of SHS and PS in Chinese nurses and the relationship between SHS and PS along with predisposing factors as well as to discuss the feasibility of improving health status and preventing diseases according to PPPM concepts in Chinese nurses. METHODS A cross-sectional study was conducted with the cluster sampling method among 9793 registered nurses in Foshan city, China. SHS was evaluated with the Suboptimal Health Status Questionnaire-25 (SHSQ-25). Meanwhile, the PS of depression and anxiety were evaluated with Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) self-assessment questionnaires. The relationship between PS and SHS in Chinese nurses was subsequently analyzed. RESULTS Among the 9793 participants, 6107 nurses were included in the final analysis. The prevalence of SHS in the participants was 74.21% (4532/6107) while the symptoms of depression and anxiety were 47.62% (2908/6107) and 24.59% (1502/6107) respectively. The prevalence of SHS in the participants with depression and anxiety was significantly higher than those without the symptoms of depression (83.3% vs 16.7%, P < 0.001) and anxiety (94.2% vs 5.8%, P < 0.0001). The ratio of exercise habit was significantly lower than that of non-exercise habit (68.8% vs 78.4%, P < 0.001) in SHS group. CONCLUSIONS There is a high prevalence of SHS and PS in Chinese nurses. PS in Chinese nurses are associated with SHS. Physical exercise is a protective factor for SHS and PS so that the exercise should be strongly recommended as a valuable preventive measure well in the agreement with PPPM philosophy. Along with SDS and SAS, SHSQ-25 should also be highly recommended and applied as a novel predictive/preventive tool for the health measures from the perspectives of PPPM in view of susceptible population and individual screening, the predisposition to chronic disease preventing, personalization of intervention, and the ideal health state restoring.
Collapse
Affiliation(s)
- Jinxiu Zhu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
- Institute of Clinical Electrocardiography, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Wenjuan Ying
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Li Zhang
- Nursing Department, Foshan First People’s Hospital, Foshan, 528000 Guangdong China
| | - Gangyi Peng
- Division of Medical Administration, Health commission of Guangdong Province, Guangzhou, 510060 China
| | - Weiju Chen
- Nursing Department, The First Affiliated Hospital, Ji’nan University, Guangzhou, 510630 China
| | - Enoch Odame Anto
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Xueqing Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Nan Lu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Shanshan Gao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Guihai Wu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Jingyi Yan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Jianfeng Ye
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Shenglin Wu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Chengzhi Yu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Minghui Yue
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xiru Huang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Nuo Xu
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Pengxiang Ying
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Yanhong Chen
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xuerui Tan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Wei Wang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| |
Collapse
|
22
|
Wang W. Cardiovascular health in China: Low level vs high diversity. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2020; 3:100038. [PMID: 34327386 PMCID: PMC8315433 DOI: 10.1016/j.lanwpc.2020.100038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Wei Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
| |
Collapse
|
23
|
Zhang M, Shi Y, Shi O, Zhao Z, Zhang X, Li C, Huang Z, Zhao L, Wang L, Li Y, Li X. Geographical variations in cardiovascular health in China: A nationwide population-based survey of 74,726 adults. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2020; 3:100033. [PMID: 34327384 PMCID: PMC8315622 DOI: 10.1016/j.lanwpc.2020.100033] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/26/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022]
Abstract
Background Cardiovascular disease is the leading cause of death in China. The aim of this study was to evaluate the levels of cardiovascular health among Chinese adults and to understand the geographic pattern of cardiovascular health. Methods In 2015, a total of 74,726 respondents aged ≥ 20 years with no history of cardiovascular disease were randomly sampled from 298 counties/districts of 31 provinces in mainland China and were interviewed. Seven metrics, including smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting glucose, were determined. Ideal cardiovascular health was defined as the simultaneous presence of all metrics at the ideal level. A score ranging from 0 to 14 was calculated as the sum of all seven metrics for each province. Scores for cardiovascular health behaviors (smoking, body mass index, physical activity and diet) and those for cardiovascular health factors (smoking, total cholesterol, blood pressure, and fasting glucose) were also calculated. Findings The mean age was 44.4 ± 15.9 years, and 49.3% were women. The age-sex-standardized prevalence of ideal cardiovascular health was universally poor, ranging from 0.02% [95% confidence interval (CI): 0%, 0.05%] in Tibet to 2.76% (95% CI: 0.45%, 5.07%) in Heilongjiang. Ideal diet (7.1%) was the least common factor of the seven metrics in each province and varied considerably across provinces. Other component metrics of ideal cardiovascular health were also spatially patterned. In all provinces, women had higher scores than men for cardiovascular health, health behaviors and health factors. Differences in cardiovascular health and health behavior scores between urban and rural areas were associated with levels of socio-economic development. Interpretation Strategies for addressing poor cardiovascular health require geographic targeting and localized consideration. Funding This research was supported by National Key R&D Program, the Shenzhen Strategic Emerging Industry Development Special Fund, and the Fund of "Sanming" Project of Medicine in Shenzhen.
Collapse
Affiliation(s)
- Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Yu Shi
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China.,Department of Clinical Research and Epidemiology, Shenzhen Institute for Cardiovascular Disease, Shenzhen 518057, Guangdong Province, China
| | - Oumin Shi
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China
| | - Zhenping Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Chun Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Liyun Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Yichong Li
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China.,Department of Clinical Research and Epidemiology, Shenzhen Institute for Cardiovascular Disease, Shenzhen 518057, Guangdong Province, China
| | - Xinhua Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| |
Collapse
|
24
|
Wang H, Tian Q, Zhang J, Liu H, Zhang X, Cao W, Zhang J, Anto EO, Li X, Wang X, Liu D, Zheng Y, Guo Z, Wu L, Song M, Wang Y, Wang W. Population-based case-control study revealed metabolomic biomarkers of suboptimal health status in Chinese population-potential utility for innovative approach by predictive, preventive, and personalized medicine. EPMA J 2020; 11:147-160. [PMID: 32549914 DOI: 10.1007/s13167-020-00200-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/06/2020] [Indexed: 12/18/2022]
Abstract
Background Suboptimal health status (SHS) is a subclinical stage of chronic diseases, and the identification of SHS provides an opportunity for the predictive, preventive, and personalized medicine (PPPM) of chronic diseases. Previous studies have reported the associations between metabolic signatures and early signs of chronic diseases. Methods This study aimed to detect the metabolic biomarkers for the identification of SHS in a case-control study. SHS questionnaire-25 (SHSQ-25) was used in a population-based health survey to measure the SHS levels of participants. The liquid chromatography-mass spectrometry-based untargeted metabolomics analysis was conducted on plasma samples collected from 50 SHS participants and 50 age- and sex-matched healthy controls. Results After adjusting for the confounders, 24 significantly differential metabolites, such as sphingomyelin, sphingosine, sphinganine, progesterone, pregnanolone, and bilirubin, were identified as the candidate biomarkers for SHS. Pathway analysis revealed that sphingolipid metabolism, taurine metabolism, and steroid hormone biosynthesis are the disturbed metabolic pathways related to SHS. A combination of four metabolic biomarkers (sphingosine, pregnanolone, taurolithocholate sulfate, cervonyl carnitine) can distinguish SHS individuals from the controls with a sensitivity of 94.0%, a specificity of 90.0%, and an area under the receiver operating characteristic curve of 0.977. Conclusion Plasma metabolites are valuable biomarkers for SHS identification, and meanwhile, SHSQ-25 can be used as an alternative health screening tool in the population-based health survey. SHS-related metabolic disturbances could be detected at the early onset of SHS, and SHS-related metabolites could create a window opportunity for PPPM of chronic diseases.
Collapse
Affiliation(s)
- Hao Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Jie Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Hongqi Liu
- Student Health Center, Weifang University, Weifang, China
| | - Xiaoyu Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Weijie Cao
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Jinxia Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Enoch Odame Anto
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Xingang Li
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Xueqing Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Di Liu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Yulu Zheng
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Zheng Guo
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Manshu Song
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
- School of Public Health, Shandong First Medical University, Taian, China
| |
Collapse
|
25
|
Anto EO, Owiredu WKBA, Adua E, Obirikorang C, Fondjo LA, Annani-Akollor ME, Acheampong E, Asamoah EA, Roberts P, Wang W, Donkor S. Prevalence and lifestyle-related risk factors of obesity and unrecognized hypertension among bus drivers in Ghana. Heliyon 2020; 6:e03147. [PMID: 32042945 PMCID: PMC7002790 DOI: 10.1016/j.heliyon.2019.e03147] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/11/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022] Open
Abstract
Obesity and hypertension are public health problems associated with cardiovascular events worldwide. Bus drivers, whose lifestyle is primarily sedentary and characterized by poor eating habits are at increased risk. This study determined the prevalence and lifestyle-related risk factors of obesity and hypertension among Inter-Regional Metromass Bus Drivers (IRMBDs) in Ghana. This cross-sectional study recruited 527 professional drivers from Metromass Bus stations in Accra and Kumasi Metropolis, Ghana. Structured questionnaires were administered to obtain socio-demographic and lifestyle characteristics from all participants. Anthropometric measurements including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and blood pressure (BP) were determined. The prevalence of unrecognized hypertension was 38.7%. The prevalence of obesity using BMI, WC, and WHR as obesity indices were 19.0%, 19.9%, and 19.4%, respectively. Use of sleep inhibitors, long-duration sitting and eating late at night were independent risk factors for obesity, regardless of the obesity index used (p < 0.05). Physical inactivity, high caloric intake and eating at stressful periods were independent risk factors for obesity based on WC and WHR measurements (p < 0.05). Ageing, smoking history, alcoholic beverage intake, sleep inhibitor drug use, high calorie intake, long-duration sitting, eating late and under stressful conditions were independent risk factors for hypertension (p < 0.05). There is a high prevalence of unrecognized hypertension and obesity among IRMBDs which were associated with individual lifestyle and behaviours. Increased awareness through educational and screening programs will trigger lifestyle modifications that will reduce cardio-metabolic disease onset and offer clues for better disease predictive, preventive and personalized medicine.
Collapse
Affiliation(s)
- Enoch Odame Anto
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Perth, WA, 6027, Australia
| | - W K B A Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Adua
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Perth, WA, 6027, Australia
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Perth, WA, 6027, Australia
| | - Evans Adu Asamoah
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Roberts
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wei Wang
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Perth, WA, 6027, Australia.,School of Public Health, Taishan Medical University, Taian, Shandong, 271000, China
| | - Sampson Donkor
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
26
|
Sun Q, Xu X, Zhang J, Sun M, Tian Q, Li Q, Cao W, Zhang X, Wang H, Liu J, Zhang J, Meng X, Wu L, Song M, Liu H, Wang W, Wang Y. Association of suboptimal health status with intestinal microbiota in Chinese youths. J Cell Mol Med 2020; 24:1837-1847. [PMID: 31808612 PMCID: PMC6991644 DOI: 10.1111/jcmm.14880] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/21/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023] Open
Abstract
Suboptimal health status (SHS), a physical state between health and disease, is a subclinical and reversible stage of chronic disease. Previous studies have shown alterations in the intestinal microbiota in patients with some chronic diseases. This study aimed to investigate the association between SHS and intestinal microbiota in a case-control study with 50 SHS individuals and 50 matched healthy controls. Intestinal microbiota was analysed by MiSeq 250PE. Alpha diversity of intestinal microbiota in SHS individuals was higher compared with that of healthy controls (Simpson index, W = 2238, P = .048). Beta diversity was different between SHS and healthy controls (P = .018). At the phylum level, the relative abundance of Verrucomicrobia was higher in the SHS group than that in the controls (W = 2201, P = .049). Compared with that of the control group, nine genera were significantly higher and five genera were lower in abundance in the SHS group (all P < .05). The intestinal microbiota, analysed by a random forest model, was able to distinguish individuals with SHS from the controls, with an area under the curve of 0.79 (95% confidence interval: 0.77-0.81). We demonstrated that the alteration of intestinal microbiota occurs with SHS, an early stage of disease, which might shed light on the importance of intestinal microbiota in the primary prevention of noncommunicable chronic diseases.
Collapse
Affiliation(s)
- Qi Sun
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
- National Research Institute for Family PlanningBeijingChina
- Graduate School of Peking Union Medical CollegeBeijingChina
| | - Xizhu Xu
- School of Public HealthShandong First Medical University & Shandong Academy of Medical SciencesTaianChina
| | - Jie Zhang
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Ming Sun
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Qihuan Li
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Weijie Cao
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiaoyu Zhang
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Hao Wang
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Jiaonan Liu
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Jinxia Zhang
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiaoni Meng
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Lijuan Wu
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Manshu Song
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| | - Hongqi Liu
- University HospitalWeifang UniversityWeifangChina
| | - Wei Wang
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
- School of Public HealthShandong First Medical University & Shandong Academy of Medical SciencesTaianChina
- School of Medical and Health SciencesEdith Cowan UniversityPerthWAAustralia
| | - Youxin Wang
- Beijing Key Laboratory of Clinical EpidemiologySchool of Public HealthCapital Medical UniversityBeijingChina
| |
Collapse
|
27
|
Anto EO, Roberts P, Coall DA, Adua E, Turpin CA, Tawiah A, Wang Y, Wang W. Suboptimal health pregnant women are associated with increased oxidative stress and unbalanced pro- and antiangiogenic growth mediators: a cross-sectional study in a Ghanaian population. Free Radic Res 2019; 54:27-42. [PMID: 31814473 DOI: 10.1080/10715762.2019.1685668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Optimal oxidative stress (OS) is important throughout pregnancy; however, an increased OS may alter placental angiogenesis culminating in an imbalanced of angiogenic growth mediators (AGMs). Suboptimal Health Status (SHS), a physical state between health and disease, may be associated with increased OS and unbalanced AGMs. In this study, we explored the association between SHS, biomarkers of OS (BOS) and AGMs among normotensive pregnant women (NTN-PW) in a Ghanaian Suboptimal Health Cohort Study (GHOACS). This comparative GHOACS recruited 593 NTN-PW from the Komfo Anokye Teaching Hospital, Ghana. SHS was measured using a Suboptimal Health Status Questionnaire-25 (SHSQ-25). Along with the subjective SHS measure, objective BOS: 8-hydroxy-2-deoxyguanosine (8-OHdG), 8-epiprostaglandinF2 alpha (8-epi-PGF2α), total antioxidant capacity (TAC), and AGMs: vascular endothelial growth factor-A (VEGF-A), soluble fms-like tyrosine kinase receptor 1 (sFlt-1), placental growth factor (PIGF) and soluble endoglin (sEng) were evaluated. Compared to optimal health NTN-PW, levels of PlGF, VEGF-A and TAC were significantly (p < 0.05) reduced and negatively associated with SHS whilst sEng, sFlt-1, 8-epiPGF2α, 8-OHdG, and combined ratios of sFlt-1/PlGF, 8-epiPGF2α/PlGF, 8-OHdG/PlGF, and sEng/PlGF were significantly increased and positively associated with SHS. The first quartile for PIGF (2.79-fold) and VEGF-A (5.35-fold), and the fourth quartile for sEng (4.31-fold), sFlt-1 (1.84-fold), 8-epiPGF2α (2.23-fold), 8-OHdG (1.90-fold) and urinary 8-OHdG (1.95-fold) were independently associated with SHS (p < 0.05). SHS is associated with increased OS and unbalanced AGMs. Early identification of SHS-related OS and unbalanced AGMs may inform clinicians of the need for therapeutic options.
Collapse
Affiliation(s)
- Enoch Odame Anto
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Roberts
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - David Antony Coall
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Eric Adua
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | | | - Augustine Tawiah
- Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.,School of Public Health, Taishan Medical University, Taian, China
| |
Collapse
|
28
|
Association between Serum Uric Acid and Non-Alcoholic Fatty Liver Disease according to Different Menstrual Status Groups. Can J Gastroenterol Hepatol 2019; 2019:2763093. [PMID: 31871925 PMCID: PMC6906828 DOI: 10.1155/2019/2763093] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/22/2019] [Accepted: 10/28/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The present study aimed to explore the association between SUA and NAFLD in women with different menstrual statuses. METHODS A total of 6043 women were selected from the Jidong and Kailuan communities for inclusion in the present study. The SUA levels of participants were divided into quartiles. NAFLD was determined by abdominal ultrasonography. Data from laboratory tests and clinical examination were collected, and basic information was obtained from standardized questionnaires. The menstrual status was stratified into menstrual period, menopause transition period, and postmenopause. Multivariate logistic regression models were used to determine the relationship between menstrual status, SUA, and NAFLD. RESULTS The levels of SUA in subjects with NAFLD in the menstrual period, menopause transition period, and postmenopause were 268.0 ± 71.1, 265.6 ± 67.8, and 286.7 ± 75.8 (mmol/L), respectively, and were higher than those in subjects without NAFLD. The adjusted odds ratios (ORs) with 95% confidence interval (CI) for NAFLD among participants in the menopause transition period and postmenopausal period were 1.10 (0.89-1.37) and 1.28 (1.04-1.58), respectively, compared with the menstrual period women. Compared to the lowest quartile of SUA, the adjusted ORs with 95% CI of the highest quartile for NAFLD were 2.24 (1.69-2.99) for females in the menstrual period, 1.92 (1.10-3.37) for females in the menopause transition period, and 1.47 (1.06-2.03) for females in postmenopause. CONCLUSIONS Menstrual status was significantly correlated with NAFLD. High levels of SUA were associated with NAFLD in females during the three menstrual periods.
Collapse
|
29
|
Zhang L, Li Y, Zhou W, Wang C, Dong X, Mao Z, Huo W, Tian Z, Fan M, Yang X, Li L. Mediation effect of BMI on the relationship between age at menarche and hypertension: The Henan Rural Cohort Study. J Hum Hypertens 2019; 34:448-456. [DOI: 10.1038/s41371-019-0247-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/20/2019] [Accepted: 08/01/2019] [Indexed: 12/18/2022]
|
30
|
Anto EO, Roberts P, Coall D, Turpin CA, Adua E, Wang Y, Wang W. Integration of suboptimal health status evaluation as a criterion for prediction of preeclampsia is strongly recommended for healthcare management in pregnancy: a prospective cohort study in a Ghanaian population. EPMA J 2019; 10:211-226. [PMID: 31462939 DOI: 10.1007/s13167-019-00183-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/18/2019] [Indexed: 12/14/2022]
Abstract
Background Normotensive pregnancy may develop into preeclampsia (PE) and other adverse pregnancy complications (APCs), for which the causes are still unknown. Suboptimal health status (SHS), a physical state between health and disease, might contribute to the development and progression of PE. By integration of a routine health measure in this Ghanaian Suboptimal Health Cohort Study, we explored the usefulness of a 25-question item SHS questionnaire (SHSQ-25) for early screening and prediction of normotensive pregnant women (NTN-PW) likely to develop PE. Methods We assessed the overall health status among a cohort of 593 NTN-PW at baseline (10-20 weeks gestation) and followed them at 21-31 weeks until 32-42 weeks. After an average of 20 weeks follow-up, 498 participants returned and were included in the final analysis. Hematobiochemical, clinical and sociodemographic data were obtained. Results Of the 498 participants, 49.8% (248/498) had 'high SHS' at baseline (61.7% (153/248) later developed PE) and 38.3% (95/248) were NTN-PW, whereas 50.2% (250/498) had 'optimal health' (17.6% (44/250) later developed PE) and 82.4% (206/250) were NTN-PW. At baseline, high SHS score yielded a significantly (p < 0.05) increased adjusted odds ratio, a wider area under the curve (AUC) and a higher sensitivity and specificity for the prediction of PE (3.67; 0.898; 91.9% and 87.8%), PE coexisting with intrauterine growth restriction (2.86, 0.838; 91.5% and 75.9%), stillbirth (2.52; 0.783; 96.6% and 60.0%), hemolysis elevated liver enzymes and low platelet count (HELLP) syndrome (2.08; 0.800; 97.2% and 63.8%), acute kidney injury (2.20; 0.825; 95.3% and 70.0%) and dyslipidaemia (2.80; 0.8205; 95.7% and 68.4%) at 32-42 weeks gestation. Conclusions High SHS score is associated with increased incidence of PE; hence, SHSQ-25 can be used independently as a risk stratification tool for adverse pregnancy outcomes thereby creating an opportunity for predictive, preventive and personalized medicine.
Collapse
Affiliation(s)
- Enoch Odame Anto
- 1School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia.,2Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Roberts
- 1School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - David Coall
- 1School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | | | - Eric Adua
- 1School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Youxin Wang
- 4Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wei Wang
- 1School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia.,4Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.,5School of Public Health, Taishan Medical University, Taian, China
| |
Collapse
|
31
|
Tian JS, Meng Y, Wu YF, Zhao L, Xiang H, Jia JP, Qin XM. A novel insight into the underlying mechanism of Baihe Dihuang Tang improving the state of psychological suboptimal health subjects obtained from plasma metabolic profiles and network analysis. J Pharm Biomed Anal 2019; 169:99-110. [DOI: 10.1016/j.jpba.2019.02.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 01/25/2019] [Accepted: 02/25/2019] [Indexed: 02/08/2023]
|
32
|
Liu H, Yao Y, Wang Y, Ma L, Liu X, Guo S, Feng X, Chen Y, Chen X, Liu Z, Ji L, Li D, Zhou Y. Ideal cardiovascular health metrics and the risk of non-alcoholic fatty liver disease: A cross-sectional study in northern China. Liver Int 2019; 39:950-955. [PMID: 30712318 DOI: 10.1111/liv.14060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/10/2019] [Accepted: 01/21/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE The components of ideal cardiovascular health (CVH) metrics have been shown to be associated with non-alcoholic fatty liver disease (NAFLD). The present study aimed to determine the association between ideal CVH metrics and NAFLD. METHODS A total of 10,511 participants (47.26% men) aged 18 to 92 years were selected from the Jidong and Kailuan communities. Ideal CVH was based on 7 ideal CVH metrics: smoking, body mass index (BMI), physical activity, diet, total cholesterol, blood pressure and fasting blood glucose. NAFLD was determined by abdominal ultrasonography. All participants underwent questionnaire assessments and clinical and laboratory examinations. Logistic regression models were used to analyse the relationship of CVH metrics and the number of ideal CVH metrics with NAFLD. RESULTS The prevalence rates of NAFLD by CVH summary score quartiles were 64.38% (2,015/3,130), 50.16% (786/1,567), 33.28% (1,194/3,588) and 20.89% (465/2,226). Participants in the highest quartile showed a lower odds ratio (OR) than those in the lowest quartile (fully adjusted OR: 0.17, 95% CI: 0.17-0.20, P < 0.001). Similar results were observed in subjects stratified by sex and age (45 years). The ORs were progressively decreased with an increased number of ideal CVH metrics (all P < 0.001). CONCLUSIONS NAFLD was significantly associated with both the summary score of CVH metrics and the number of ideal CVH metrics. The combined evaluation of ideal CVH may contribute to the prevention of NAFLD.
Collapse
Affiliation(s)
- Huamin Liu
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Yan Yao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Likun Ma
- Department of Cardiology, Anhui Provincial Hospital, Hefei, China
| | - Xuezhen Liu
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Shasha Guo
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Xia Feng
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Yanru Chen
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Xueyu Chen
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Zhongni Liu
- Department of Pathophysiology, Key Laboratory of Cardiovascular Pathophysiology, Harbin Medical University, Harbin, China
| | - Long Ji
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Dong Li
- School of Public Health, Taishan Medical University, Tai'an, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
33
|
Ge S, Xu X, Zhang J, Hou H, Wang H, Liu D, Zhang X, Song M, Li D, Zhou Y, Wang Y, Wang W. Suboptimal health status as an independent risk factor for type 2 diabetes mellitus in a community-based cohort: the China suboptimal health cohort study. EPMA J 2019; 10:65-72. [PMID: 30984315 DOI: 10.1007/s13167-019-0159-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/11/2019] [Indexed: 12/17/2022]
Abstract
Background The prevalence of diabetes, constituted chiefly by type 2 diabetes mellitus (T2DM), is a global public health threat. Suboptimal health status (SHS), a physical state between health and disease, might contribute to the progression or development of T2DM. Methods We conducted a prospective cohort study, based on the China Suboptimal Health Cohort Study (COACS), to understand the impact of SHS on the progress of T2DM. We examined associations between SHS and T2DM outcomes using multivariable logistic regression models and constructed predictive models for T2DM onset based on SHS. Results A total of 61 participants developed T2DM after an average of 3.1 years of follow-up. Participants with higher SHS scores had more T2DM outcomes (p = 0.036). Moreover, compared with the lowest quartile of SHS scores, participants with fourth, third, and second quartile SHS scores were found to be associated with a 1.7-fold, 1.6-fold, and 1.5-fold risk of developing T2DM, respectively. The predictive model constructed with SHS had higher discriminatory power (AUC = 0.848) than the model without SHS (AUC = 0.795). Conclusions The present study suggests that a higher SHS score is associated with a higher incidence of T2DM. SHS is a new independent risk factor for T2DM and has the capability to act as a predictive tool for T2DM onset. The evaluation of SHS combined with the analysis of modifiable risk factors for SHS allows the risk stratification of T2DM, which may consequently contribute to the prevention of T2DM development. These findings might require further validation in a longer-term follow-up study.
Collapse
Affiliation(s)
- Siqi Ge
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China.,2Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Xizhu Xu
- 3School of Public Health, Taishan Medical University, Taian, 271000 China
| | - Jie Zhang
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China
| | - Haifeng Hou
- 3School of Public Health, Taishan Medical University, Taian, 271000 China
| | - Hao Wang
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China.,4School of Medical and Health Sciences, Edith Cowan University, Perth, WA6027 Australia
| | - Di Liu
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China
| | - Xiaoyu Zhang
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China
| | - Manshu Song
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China.,4School of Medical and Health Sciences, Edith Cowan University, Perth, WA6027 Australia
| | - Dong Li
- 3School of Public Health, Taishan Medical University, Taian, 271000 China
| | - Yong Zhou
- 5Department of Neurology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093 China
| | - Youxin Wang
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China.,4School of Medical and Health Sciences, Edith Cowan University, Perth, WA6027 Australia
| | - Wei Wang
- 1Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, 10 Youanmen Xitoutiao, Beijing, 100069 China.,3School of Public Health, Taishan Medical University, Taian, 271000 China.,4School of Medical and Health Sciences, Edith Cowan University, Perth, WA6027 Australia
| |
Collapse
|
34
|
Peng Y, Cao S, Yao Z, Wang Z. Prevalence of the cardiovascular health status in adults: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2018; 28:1197-1207. [PMID: 30360955 DOI: 10.1016/j.numecd.2018.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The American Heart Association has outlined seven cardiovascular health (CVH) metrics, including smoking, body mass index, physical activity, dietary pattern, total cholesterol, and fasting plasma glucose, to define and monitor CVH status. Our study was to evaluate the global CVH in adults. METHODS AND RESULTS We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and reference lists of relevant articles for studies published between 1 January 2010 and 30 June 2018. Included studies should report the proportions of ideal status for the seven CVH metrics and/or provide the prevalence of overall poor (having 0-2 ideal metrics) or ideal (having 5-7 ideal metrics) CVH status in adults. 88 articles were identified: 75 for the prevalence of ideal CVH metrics, 58 for the proportion of overall poor CVH status, and 55 for the proportion of overall ideal CVH status. Smoking had the highest prevalence of ideal status (69.1%) while dietary pattern has the lowest (12.1%). 32.2% and 19.6% of participants had overall poor and ideal CVH, respectively. Females and young adults had better CVH status when compared to males and older adults. There existed regional variations in ideal CVH metrics and overall CVH status. The overall CVH status had improved over study time. CONCLUSION The prevalence of ideal status was low for some metrics, such as dietary pattern, and the overall CVH status was still unsatisfactory. We should continue to measure the CVH status and carry out lifestyle interventions to improve the CVH status in the whole population.
Collapse
Affiliation(s)
- Y Peng
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia.
| | - S Cao
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Australia
| | - Z Yao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Z Wang
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia
| |
Collapse
|
35
|
Hou H, Feng X, Li Y, Meng Z, Guo D, Wang F, Guo Z, Zheng Y, Peng Z, Zhang W, Li D, Ding G, Wang W. Suboptimal health status and psychological symptoms among Chinese college students: a perspective of predictive, preventive and personalised health. EPMA J 2018; 9:367-377. [PMID: 30538788 DOI: 10.1007/s13167-018-0148-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/13/2018] [Indexed: 12/08/2022]
Abstract
Background Suboptimal health status (SHS) is an intermediate health status between health and illness, a syndrome characterised by the perception of health complaints, general weakness and low energy. This study aimed to investigate the prevalence of SHS and the correlation between SHS and psychological symptoms among Chinese college students and to identify the SHS-related risk factors from the perspective of predictive, preventive and personalised medicine (PPPM). Methods A cross-sectional study was conducted among 4119 college students who were enrolled from Taishan Medical University and Baoji Vocational and Technical College in the eastern and western areas of China. SHS levels of the participants were measured by an established self-reporting Suboptimal Health Status Questionnaire-25 (SHSQ-25). Psychosomatic conditions were estimated by the self-rating Symptom Checklist-90 (SCL-90) scale. Spearman correlation analysis was applied to analyse the relationship between SHSQ-25 scores and SCL-90 estimates. Logistic regression analysis was applied for multivariate analysis. Results The prevalence of SHS was 21.0% (864/4119), with 23.3% (701/3005) for female students and 14.6% (163/1114) for male students. The prevalence of general positive psychological symptom was 14.2% (586/4119), with 15.6% (470/3005) for female students and 10.4% (116/1114) for male students. A strong correlation was identified between SHS score and SCL-90 estimates, with the correlation coefficient (r) of 0.719. Logistic regression showed that variables significantly associated with SHS were somatisation (adjusted odds ratio (aOR) = 3.185, 95% confidence interval [CI] = 2.048-4.953), obsessive-compulsive (aOR = 3.518, 95% CI = 2.834-4.368), interpersonal sensitivity (aOR = 1.883, 95% CI = 1.439-2.463) and depression (aOR = 1.847, 95% CI = 1.335-2.554). Conclusions Our findings confirm that there is a high prevalence of SHS among college students and there is a strong association between SHS and psychological symptoms among Chinese college students. High susceptibility of SHS occurs particularly in vulnerable groups: female students, sophomore students, medical students and students from rural area. Identification of SHS and prompt application of personalised psychological health-supporting activities will promote college students' health status.
Collapse
Affiliation(s)
- Haifeng Hou
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China.,2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Xia Feng
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China
| | - Yuejin Li
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China
| | - Zixiu Meng
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China
| | - Dongmei Guo
- Baoji Vocational and Technical College, Baoji, People's Republic of China
| | - Fang Wang
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China
| | - Zheng Guo
- 2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Yulu Zheng
- 2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| | - Zhiqi Peng
- Baoji Vocational and Technical College, Baoji, People's Republic of China
| | - Wangxin Zhang
- 4School of Basic Medical Science, Taishan Medical University, Taian, People's Republic of China
| | - Dong Li
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China
| | - Guoyong Ding
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China
| | - Wei Wang
- 1School of Public Health, Taishan Medical University, 619 Changcheng Road, Taian, 271016 People's Republic of China.,2School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027 Australia
| |
Collapse
|
36
|
Ideal Cardiovascular Health Metrics Associated with Reductions in the Risk of Extracranial Carotid Artery Stenosis: a Population-based Cohort Study. Sci Rep 2018; 8:12277. [PMID: 30115933 PMCID: PMC6095842 DOI: 10.1038/s41598-018-29754-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 07/17/2018] [Indexed: 01/08/2023] Open
Abstract
The cardiovascular health (CVH) metrics are closely related to the risk of stroke. Extracranial carotid artery stenosis (ECAS) represents an important risk factor for ischemic stroke. The present study aims to explore the longitudinal effect of the baseline CVH metrics on the development of ECAS. Totally 5,440 participants were randomly enrolled in the Asymptomatic Polyvascular Abnormalities Community study from 2010 to 2011. Information regarding the seven CVH metrics was collected at baseline. ECAS was assessed by performing carotid duplex sonography at baseline (2010-2011) and during the follow-up (2012-2013). Finally 3,487 subjects were included, and 976 participants developed ECAS during the 2-year follow-up. The optimum CVH status was associated with a 42% (95% confidence interval: 0.40-0.85) decreased risk of the incidence of ECAS after adjusting for age, sex, weight, education, income, alcohol use, waist-hip ratio, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, homocysteine, and C-reactive protein. Ideal physical activity, total cholesterol and fasting blood glucose were independent protective factors of ECAS. In this cohort study, the ideal baseline CVH status was negatively associated with the occurrence of ECAS during the follow-up. This study provides practical insight for further developing effective screening strategies or implementing the best medical treatment.
Collapse
|
37
|
Latent class analysis to evaluate performance of plasma cortisol, plasma catecholamines, and SHSQ-25 for early recognition of suboptimal health status. EPMA J 2018; 9:299-305. [PMID: 30174765 DOI: 10.1007/s13167-018-0144-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
Abstract
Background Chronic stress is associated with suboptimal health status (SHS) which is a new public health challenge in China and worldwide. Plasma stress hormones may act as potential objective biomarkers for SHS measure. This study was aimed to evaluate the diagnostic performance of plasma cortisol, catecholamine adrenaline/noradrenaline, and SHS questionnaires (SHSQ) for SHS using latent class analysis (LCA) in the absence of a gold standard. Methods A cross-sectional study was conducted among 868 employees in Beijing. The SHS questionnaires-25 (SHSQ-25) was distributed, and plasma cortisol, adrenaline, and noradrenaline were measured in the survey. LCA was used to assess the performance of both subjective and objective measures for SHS recognition. Results Akaike information criterion (AIC) and consistent AIC (CAIC) was 14.11 and 54.48 respectively, indicating that the model was well fitted. The sensitivity and specificity of plasma cortisol were 0.836 (95% CI 0.811-0.861) and 0.840 (95% CI 0.816-0.864), respectively. The area under curve (AUC) of receiver operating characteristic (ROC) of SHSQ-25 was 0.743 (95% CI 0.709-777), while the AUC of plasma adrenaline was 0.688 (95% CI 0.651-0.725). The prevalence of SHS in the investigated population was 34.78%. Conclusion Plasma cortisol is a valuable biomarker for SHS detection, whereas SHSQ-25 is more suitable for SHS screening in the population-based health survey. The accuracy and applicability of plasma adrenaline are inferior to cortisol and SHSQ-25, respectively. LCA has merit to evaluate performance of plasma cortisol, catecholamines, and SHSQ-25 for recognition of SHS in the absence of a gold standard test.
Collapse
|