Establishment and application of a new diagnostic definition of metabolic syndrome in the Shantou region of southern China

Estimation of salt intake assessed by 24-h urinary sodium level among adults speaking different dialects from the Chaoshan region of southern China

OBJECTIVE

Dietary salt intake may vary depending on different lifestyles. We aimed to estimate the different salt intakes and evaluate the knowledge and self-awareness about salt among people speaking the Teochew, Teochew-Hakka and Hakka dialects in the Chaoshan region of southern China.

DESIGN

The study followed a cluster sampling of residents in Chaoshan region. General characteristics, lifestyles, health status as well as knowledge and self-awareness related to salt intake were investigated using a questionnaire. Anthropometric variables as well as Na and K excretion in a 24-h urine collection were measured.

SETTING

Chaoshan region of China.

PARTICIPANTS

Four hundred fifteen adults who spoke only one of these three dialects.

RESULTS

The salt intake of adults who spoke the Teochew, Teochew-Hakka and Hakka dialects was 7·19 (interquartile range (IQR) 5·29-10·17), 9·03 (IQR 6·62-11·54) and 10·12 (IQR 7·61-12·82) g/d, respectively, with significant differences between Teochew and Teochew-Hakka speakers and between Teochew and Hakka speakers (both P < 0·05). The Na:K ratio for adults who spoke the three dialects was 3·00 (IQR 2·00-4·11), 3·50 (IQR 2·64-4·82) and 4·52 (IQR 3·35-5·97), respectively, and differed significantly among the groups (all P < 0·05). Multiple linear regression analysis showed increased Na:K ratio associated with hypertension (β = 0·71, P = 0·043) in Hakka speakers. Knowledge and self-awareness about salt intake were poor in this population.

CONCLUSIONS

Salt intake was closely related to lifestyles and was higher than the upper limit (5 g/d) recommended by the WHO in adults of Chaoshan, especially those speaking the Hakka dialect.

Comparison of the accuracy of three diagnostic criteria and estimating the prevalence of metabolic syndrome: A latent class analysis

Background:

Metabolic syndrome (MetS) is a growing public health problem with a worldwide distribution, and its prevalence is rapidly increasing worldwide. Hence, this study aimed to compare the prevalence of MetS based on the International Diabetes Federation (IDF), the National Cholesterol Education Program Expert Panel Adult Treatment Panel III (NCEP ATP III), and the American Association of Clinical Endocrinologists (AACE) diagnostic criteria.

Materials and Methods:

In this cross-sectional study, a total of 4737 people aged 45–69 years were enrolled in the 2^nd phase of Shahroud Eye Cohort Study. We evaluated the prevalence of MetS with 95% confidence intervals by age and sex groups and according to MetS components. The accuracy (sensitivity and specificity) of these three methods was compared using latent class analysis. Finally, kappa statistic was used to determine the agreement between the diagnostic methods.

Results:

The prevalence of MetS varied from a minimum of 47.2% (as defined by the AACE) to a maximum of 60.0% (as defined by the IDF). The sensitivity of the three diagnostic methods of IDF, NCEP ATP III, and AACE was 98.9%, 94.4%, and 91.1%, respectively, and the specificity of these three methods was 94.6%, 97.0%, and 98.4%, respectively. Moreover, the highest agreement was found between the definition of the IDF and the NCEP ATP III.

Conclusion:

The IDF diagnostic method has a higher sensitivity for the diagnosis of MetS in Iranian middle-aged people. It is recommended to use this method for identifying more people at risk of MetS.

Associations of blood levels of trace elements and heavy metals with metabolic syndrome in Chinese male adults with microRNA as mediators involved

Metabolic syndrome (MetS) is a global health problem with an increasing prevalence. However, effects of trace elements and heavy metals on MetS and the mechanism underlying this effect are poorly understood. A preliminary cross-sectional study was conducted in 2015. Significantly higher blood concentrations of lead (Pb), cadmium (Cd), copper (Cu), and selenium (Se) were observed in the MetS group. With a priori adjustment for age, the concentration of Cu and Se in the blood was associated with a 2.56 - fold [95% confidence interval (CI), 1.11, 5.92] and 3.31 - fold (95% CI, 1.4, 7.82) increased risk of MetS, respectively. Moreover, increased blood Se concentrations were associated with body mass index (BMI) [odds ratio (OR): 2.56; 95% CI, 1.11, 5.93], high blood pressure [for both systolic and diastolic blood pressures (SBP and DBP); OR: 3.82; 95% CI, 1.47, 7.31 for SBP and OR: 2.56; 95% CI, 1.18, 5.59 for DBP], and hypertriglyceridemia (OR: 3.3; 95% CI, 1.51, 7.2). In addition, the expression of miR-21-5p, miR-122-5p, and miR-146a-5p was significantly higher in subjects with MetS than those without MetS. Increased expression of miR-21-5p was significantly associated with increased SBP (β = 5.28; 95% CI, 0.63, 9.94) and DBP (β = 4.17; 95% CI, 0.68, 7.66). Moreover, Cu was positively associated with miR-21-5p (β = 3.02; 95% CI, 0.07, 5.95), whereas Se was positively associated with miR-122-5p (β = 2.7; 95% CI, 0.64, 4.76). The bootstrapping mediation models indicated that miR-21-5p partially mediated the relationships between Cu level and SBP/DBP. This study suggested that Cu and Se were both associated with MetS, and miR-21-5p participated in the development of MetS associated with Cu.

Sleep duration, daytime napping, markers of obstructive sleep apnea and stroke in a population of southern China

Sleep habits are associated with stroke in western populations, but this relation has been rarely investigated in China. Moreover, the differences among stroke subtypes remain unclear. This study aimed to explore the associations of total stroke, including ischemic and hemorrhagic type, with sleep habits of a population in southern China. We performed a case-control study in patients admitted to the hospital with first stroke and community control subjects. A total of 333 patients (n = 223, 67.0%, with ischemic stroke; n = 110, 23.0%, with hemorrhagic stroke) and 547 controls were enrolled in the study. Participants completed a structured questionnaire to identify sleep habits and other stroke risk factors. Least absolute shrinkage and selection operator (Lasso) and multiple logistic regression were performed to identify risk factors of disease. Incidence of stroke, and its subtypes, was significantly associated with snorting/gasping, snoring, sleep duration, and daytime napping. Snorting/gasping was identified as an important risk factor in the Lasso logistic regression model (Lasso' β = 0.84), and the result was proven to be robust. This study showed the association between stroke and sleep habits in the southern Chinese population and might help in better detecting important sleep-related factors for stroke risk.