Overweight and Obesity Difference of Chinese Population Between Different Urbanization Levels

Re-examining the reversal hypothesis: A nationwide population-based study of the association between socioeconomic status, and NCDs and risk factors in China

Background

According to the reversal hypothesis, as a country's economic and social development progresses, the burden of NCDs and risk factors shifts from rich to poor. The aim of this research is to examine the reversal hypothesis in the Chinese setting.

Methods

Using data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, we explored whether the reversal hypothesis applies at the subnational level. Participants aged 45 years and older in 2015 were included. We examined five risk factors (smoking, heavy drinking, physical inactivity, overweight, and obesity) and three objectively measured NCDs (diabetes, hypertension, dyslipidemia). Binary logistic regressions were performed to examine outcomes across people of differing SES in provincial level, in urban and rural areas, and across generations.

Results

Nationally, SES is positively associated with heavy drinking, obesity, diabetes and dyslipidemia, whereas it is negatively associated with physical inactivity. The association between SES and smoking and hypertension was not statistically significant. Except in the cases of diabetes and dyslipidemia, we found that risk factors of all kinds were more concentrated among richer people in rural than in urban areas. Across provinces with increasing GDP per capita, a downward trend in risk factors among those with high SES compared to those with low SES could be interpreted, while the opposite trend could be interpreted with respect to the metabolic syndrome conditions. Obesity and overweight exhibited slight downward trends (in line with those for risk factors) and upward trends (in line with those for metabolic syndrome conditions), respectively.

Conclusion

We conclude that China is at a relatively early stage of 'reversal', visible with respect to risk factors. If these patterns persist over time, the trend will likely feed through to metabolic disorders which will increasingly become diseases of the poor.

The Influence of Socio-Demographic Factors on Preference and Park Usage in Guangzhou, China

Urban green space (UGS) provides a range of services to visitors and is particularly important for recreation and well-being. There are a number of approaches to research visitor accessibility, but implications for demographic differences of users are typically ignored. In order to more precisely model usage of UGS regarding visitor preference, this study used Guangzhou (China) as a case study, concentrating on residents’ visitation to parks and their factors across different groups (for example, by gender, education level, age and visiting frequency). Online questionnaires from 2360 adults were collected on visiting preferences, such as traveling time, visiting frequency, visit duration within parks, visiting reasons and barriers. Results indicate that women were less likely than men to undertake longer walking trips to access parks (over 40 min). Elderly people tended to have longer visit durations, and lower-educated people tended to have shorter visiting times (particularly less than 15 min) in parks. Visit duration in parks had a positive association with walking time and a negative association with visiting frequency. Furthermore, the proportion of people visiting parks to relieve stress declined with increasing age. Infrequent park users (visiting parks less than once a month) rarely visited to gain inspiration or to socialize with strangers. Barriers to use of parks were correlated with socio-demographic factors, highlighting that older people identified poor quality of parks and long walking times as critical barriers. This study provides evidence that there is no one-size-fits-all modeling approach for UGS usage; instead, it demonstrates the importance of considering the socio-demographic characteristics of users.

Double Burden of Malnutrition among Chinese Women of Reproductive Age and Their Social Determinants

This study aimed to examine the impact of a wide range of demographic, socioeconomic, and community factors on the double burden of malnutrition among women of reproductive age using longitudinal data. We used data about 11,348 women of reproductive age who participated in the China Health and Nutrition Survey (CHNS), a longitudinal survey, between 1989 and 2015. Nutritional outcomes were categorized into four groups, namely underweight, normal weight, overweight, and obesity, with normal weight as reference. A multinomial logit model was fitted due to geographic clustering and repeated observations of individuals. The prevalence of underweight decreased over time from 1991 but has tended to rise again since 2004, while the prevalence of overweight/obesity continued to rise between 1991 and 2015. Improved individual factors, socioeconomic status, and community urbanization reduced the risk of underweight but elevated the risk of overweight and obesity. The medium levels, rather than the highest levels, of household income and community urbanization are associated with a higher risk of overweight and obesity. The notable increase in underweight prevalence is a cause for concern to be addressed along with efforts to curb the rising tide of overweight. In order to enhance the nutritional status of women of reproductive age, it is essential to improving the community environment, levels of education, and living environment from a wider context. Long-term and targeted plans are urgently needed for nutrition improvements among the different populations.

Body Mass Index and Major Adverse Cardiovascular Events: A Secondary Analysis Based on a Retrospective Cohort Study

Background

The association between body mass index (BMI) and major adverse cardiovascular events (MACE) has not been clarified and is controversial. Therefore, the purpose of present study is to explore the association between BMI and MACE.

Material/Methods

This was a secondary analysis of a retrospective cohort study in which 204 participants who were diagnosed with stable coronary artery disease (CAD) and received elective percutaneous coronary intervention (PCI) were recruited. According to the BMI, patients were divided into 3 categories – underweight (BMI <18.5 kg/m²), normal BMI (18.5 ≤BMI <25 kg/m²), and overweight (BMI ≥25 kg/m²)], and the patients were followed up. The primary endpoint was MACE.

Results

After a median follow-up of 783 days, MACE events had occurred in 18 participants. After controlling for potential confounding factors, no difference was observed in MACE between the underweight group and the normal BMI group (OR=1.73, 95% CI 0.42 to 7.17); but there were significantly fewer MACE in the overweight group than in the normal BMI group (OR=0.17; 95% CI: 0.03 to 0.84). Pearson correlation analysis showed that BMI was positively correlated with hemoglobin (r=0.2102) and albumin (r=0.2780), but negatively correlated with high-density lipoprotein cholesterol (r=−0.2052). The receiver operating characteristic curve (ROC) showed that the best threshold for BMI to predict MACE was 24.23, the area under the curve was 0.729, sensitivity was 0.893, and the specificity was 0.460.

Conclusions

Our study shows that overweight patient with stable CAD have lower risk of MACE after PCI, and the optimal threshold for predicting MACE is 24.23.

Estimated global overweight and obesity burden in pregnant women based on panel data model

Objective

To estimate the global and country-level burden of overweight and obesity among pregnant women from 2005 to 2014.

Methods

Publicly accessible country-level data were collected from the World Health Organization, the World Bank and the Food and Agricultural Organization. We estimated the number of overweight and obese pregnant women among 184 countries and determined the time-related trend from 2005 to 2014. Based on panel data model, we determined the effects of food energy supply, urbanization, gross national income and female employment on the number of overweight and obese pregnant women.

Results

We estimated that 38.9 million overweight and obese pregnant women and 14.6 million obese pregnant women existed globally in 2014. In upper middle income countries and lower middle income countries, there were sharp increases in the number of overweight and obese pregnant women. In 2014, the percentage of female with overweight and obesity in India was 21.7%, and India had the largest number of overweight and obese pregnant women (4.3 million), which accounted for 11.1% in the world. In the United States of America, a third of women were obese, and the number of obese pregnant women was 1.1 million. In high income countries, caloric supply and urbanization were positively associated with the number of overweight and obese pregnant women. The percentage of employment in agriculture was inversely associated with the number of overweight and obese pregnant women, but only in upper middle income countries and lower middle income countries.

Conclusion

The number of overweight and obese pregnant women has increased in high income and middle income countries. Environmental changes could lead to increased caloric supply and decreased energy expenditure among women. National and local governments should work together to create a healthy food environment.

Clustering of unhealthy lifestyle behaviours and associations with perceived and actual weight status among primary school children in China: A nationally representative cross-sectional study

Few studies have focused on clustering of unhealthy lifestyle behaviours among primary school children and potential associations with perceived and actual weight status. An index was constructed from adding up 13 unhealthy behaviours measured by survey responses. Multilevel linear regressions were used to analyse associations between child personal characteristics, perceived and actual weight status with the unhealthy lifestyle index among 11,157 children in primary schools across China. Parental and area factors were also taken into account, including education, weight status, physical activity, urban/rural and area socioeconomic circumstances. The unhealthy lifestyle index normally distributed, with 84.5% of children reporting between 2 and 6 unhealthy behaviours. Boys reported more unhealthy behaviours compared with girls (coefficient 0.32, 95%CI 0.26 to 0.37) and children in urban areas had fewer unhealthy behaviours than their rural counterparts (-0.29, 95%CI -0.56 to -0.03). An interaction revealed stronger 'protective' effects of living in cities for girls than boys, which were not explained by differences in child overweight/obesity. More unhealthy behaviours were characteristic of children in more affluent areas, and of those born to mothers and/or fathers with lower educational attainment. Children who perceived themselves as overweight or underweight both scored higher on the unhealthy lifestyle index. Unhealthy behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. There was no effect of actual weight status on number of unhealthy behaviours. Perceived, but not actual weight status, was also a significant correlate of unhealthy behaviours. Clustering of unhealthy lifestyle behaviours that could increase the risk of childhood obesity are common among Chinese primary school children, particularly among boys in cities, those in more affluent areas and with parents with lower education. Perceived, but not actual weight status, was also a significant correlate of unhealthy lifestyle. This has important implications for public health because understanding clustering of unhealthy lifestyle behaviours can be used to assist in the development of targeted obesity prevention initiatives.

Neck circumference may be a valuable tool for screening individuals with obesity: findings from a young Chinese population and a meta-analysis

BACKGROUND

Central obesity and overweight/obesity can result in various chronic non-communicable diseases, such as cardiovascular disease, metabolic syndrome, and diabetes mellitus. Waist circumference (WC) and body mass index (BMI) are widely used to measure obesity despite their limitations. For example, WC and BMI cannot be measured in pregnant women and subjects with abdominal ascites or masses. Therefore, this study aims to determine the efficacy of neck circumference (NC) as a tool for screening central obesity and overweight/obesity.

METHODS

A total of 1169 undergraduates aged 18-25 years were studied by a cross-sectional survey in China, 2016. Questionnaires and physical examinations were used to collect data. Receiver operator characteristic (ROC) curve was performed to determine the best threshold of NC for screening central obesity and overweight/obesity. Meanwhile, a meta-analysis was conducted to estimate the efficacy of NC for screening central obesity and overweight/obesity synthetically.

RESULTS

NC was moderately correlated with WC and BMI. The ROC analysis showed that 37.1 cm for male and 32.6 cm for female were the best thresholds for central obesity, and 37.4 cm and 32.2 cm for overweight/obesity, respectively. The sensitivity, specificity, area under receiver operating curve (AUC) of central obesity and overweight/obesity were higher. In the meta-analysis, the pooled sensitivity, specificity, AUC and their 95%CI of NC for screening central obesity were 0.72 (0.68~ 0.75), 0.87 (0.74~ 0.94), 0.77 (0.73~ 0.80) for male and 0.73 (0.65~ 0.80), 0.80 (0.71~ 0.86), 0.82 (0.79~ 0.86) for female. For overweight/obesity, the pooled sensitivity, specificity, AUC and corresponding 95%CI were 0.83 (0.70~ 0.91), 0.77 (0.66~ 0.85), 0.86 (0.83~ 0.89) for male and 0.82 (0.71~ 0.90), 0.84 (0.61~ 0.95), 0.89 (0.86~ 0.92) for female.

CONCLUSION

NC may not be a good tool for screening individuals with central obesity. But it may be a simple and valuable tool for screening individuals with overweight/obesity, especially in females.

Evaluation of a multi-layered health promotion approach in rural China

BACKGROUND

To explore the effectiveness of a multi-layered health promotion approach in rural China.

METHODS

A two-year intervention was applied to the 18 intervention rural villages while the 18 controls received standard health communication materials. Data were collected at baseline and post-intervention respectively to evaluate the effectiveness.

RESULTS

All intervention villages had developed healthy policies addressing prioritized health issues such as livestock captivity, garbage disposal, etc.; however, no healthy policies had been developed in the controls. The two-week morbidity rate and incidence of diarrhea of the intervention villages decreased to 13.4% from 18.5% (p = 0.009), and to 9.5% from 13.0% (p = 0.038), respectively, whereas no statistically significant change was found in the controls. The knowledge about hepatitis B and rabies transmission had increased significantly among the intervention villagers (hepatitis B from 27.5% to 34.4%, p = 0.005; rabies from 12.0% to 24.6%, p < 0.001) but not in the control for rabies (p > 0.05). Among both intervention and control groups, the proportion of proper hand-washing and chopping board use increased significantly (all p < 0.01). Greater changes had been found in physical inactivity and alcohol drinking among the intervention group than the control. No change was found in smoking rate among both groups. Score values (mean ± SD) for environmental quality, livestock captivity, and vector density (e.g., mosquitoes, flies, rats, and cockroaches) increased significantly from 2.8 ± 0.9 to 3.4 ± 0.7, from 1.9 ± 0.9 to 2.5 ± 0.9, and from 0.6 ± 0.9 to 1.8 ± 0.4, respectively (p < 0.05) in the intervention villages.

CONCLUSIONS

The two-year multi-layered health promotion approach shows real promise in empowering the rural communities to take control over, and protect their own health.

Associations between behavioural risk factors and overweight and obesity among adults in population-based samples from 31 countries

OBJECTIVE

Concern about overweight and obesity is growing worldwide, and more research to examine behaviours associated with the risk for increased weight in adult populations is needed. The aim of this study was to estimate associations between behavioural risk factors and overweight and obesity among adults in nationally representative population samples from 20 countries in Europe, 8 countries in Asia, Australia, Chile and USA.

METHODS

This secondary analysis is based on the International Social Survey Program (ISSP), 2011-2013, Health and Health Care Module. In a cross-sectional population-based survey (N=48,741) (mean age 46.6 years, SD=17.4, age range 15-102 years) simple or multi-stage stratified random sampling was used, yielding representative samples of the adult population of respective countries. Body Mass Index was assessed by self-reported height and weight. Correlates were risk behaviours for chronic disease (smoking status, alcohol intake, consumption of fruits and vegetable (=FV), and physical activity).

RESULTS

Overall, for all 31 countries the prevalence of overweight or obesity was 44.1%, 31.7% overweight and 12.4% obese. In adjusted logistic regression models, among men and among women ex-smoking was positively associated with both overweight and obesity, while light or moderate smoking overall and among men were inversely related with obesity. Moderate alcohol use was positively associated with both overweight and obesity, while heavy alcohol use was negatively associated with overweight. The daily consumption of FV was found to be protective from both overweight and obesity, overall and for men but not for women. Physical activity was positively associated with overweight but not obesity.

CONCLUSIONS

Some risk behaviours for chronic disease appear to be associated with overweight and obesity among adults. Interventions targeting these risk behaviours may have the potential to reduce weight.

Do different parenting patterns impact the health and physical growth of 'left-behind' preschool-aged children? A cross-sectional study in rural China

BACKGROUND

Many migrants from rural China seek work in urban areas and leave their children in their home villages to be raised by relatives. These children are often referred to as 'left-behind children'. Parental migration tends to have a profound impact on a child's growth. This study sought to assess the prevalence of illness and malnutrition among children in rural areas raised with different parenting patterns and to explore factors affecting their health and development.

METHOD

A cross-sectional survey was conducted to examine the physical health of children raised with different parenting patterns and to explore associated risk factors. In total, this study examined 735 children ages 3-6 years in eight rural villages in two counties of Shandong Province. Their primary caregivers were interviewed with a semi-structured questionnaire. Anthropometric measurements of the children were taken and their nutritional status was determined according to WHO Child Growth Standards.

RESULTS

This study found a relatively high prevalence of wasting, overweight and obesity among left-behind children. After potential confounders were controlled for, the parenting pattern, annual household income and health literacy of the primary caregiver significantly influenced the health and developmental indicators of children.

CONCLUSIONS

This study highlighted the impact of the characteristics of the primary caregiver on a child's health and development and the importance of practical interventions for preschool-aged children who are left behind and raised with different parenting patterns.

Anti-obesity effect of total phenylpropanoid glycosides from Ligustrum robustum Blume in fatty diet-fed mice via up-regulating leptin

ETHNOPHARMACOLOGICAL RELEVANCE

In Chinese folk medicine, the leaves of Ligustrum robustum Blume (LR) were commonly used in the treatment of obesity and hyperlipidemia. This study aimed to evaluate the anti-obesity effect and mechanisms of total phenylpropanoid glycosides from Ligustrum robustum Blume (LRTPG) in fatty diet-fed C57BL/6J mice.

MATERIALS AND METHODS

C57BL/6J mice were divided randomly into 6 groups, i.e., control, model, positive (Orlistat 0.12g/kg), and LRTPG at three dosages (0.3, 0.6 or 1.2g/kg), respectively. Control mice were fed with standard diet; the others were fed with fatty diet. After 4 weeks׳ modeling, therapy mice were intragastrically administrated with positive drug or LRTPG for 5 weeks, respectively. Pharmacodynamic effects including body weight, fat weight, Lee׳s index, serum lipid levels, morphological changes and adipocyte area ratio were evaluated. The mechanisms were explored as the factors related to lipids metabolism in gene expressions by real-time PCR, and assured as the protein level of differential gene by Western blotting.

RESULTS

The anti-obesity effects of LRTPG in all treated mice were shown as decreased body weight, fat mass, Lee׳s index, total cholesterol (TC) level, and adipocyte area. The mechanisms were demonstrated as elevated mRNA and protein levels of adipose leptin, and consequently decreasing mRNA of adipose acyl coenzyme A: diacylglycerol acyltransferase (DGAT) with increasing mRNA of hepatic cholesterol 7α-hydroxylase (CYP7A1), which led to inhibition of triglyceride (TG) synthesis and promotion of cholesterol catabolism.

CONCLUSIONS

The anti-obesity effect of LRTPG in fatty diet-fed mice was related to the up-regulation of leptin, which may provide scientific evidence supporting the traditional usage of LR on obesity in China.

Comparison of obesity among Chinese and U.S. Special Olympic athletes with intellectual disabilities

BACKGROUND/OBJECTIVES

Obesity is a health problem in China, but there are no reports on the obesity status of Chinese citizens with intellectual disabilities (ID). Research has shown that adults with ID have higher body mass index (BMI) than adults without ID, but this information is primarily based on populations residing in North American and European countries. The purpose of this study was to compare BMI and obesity status of Chinese and U.S. Special Olympic athletes with ID.

SUBJECTS/METHODS

Height, weight, BMI and self-reported physical activity (SRPA) data from the Special Olympics 2006 U.S. National Games and 2007 Shanghai World Games databases were analyzed. Linear and logistic analyses were conducted for continuous data and dichotomous variables, respectively. Predictor variables were age, gender, country, SRPA, and obesity status according to country specific criteria. Significance was set at p < 0.05.

RESULTS

The U.S. group had significantly higher BMI values than their Chinese counterparts. Age (p = 0.001) and country (p = <0.001) were the main predictors of BMI and obesity status, even when country-specific standards of obesity classifications were used. Holding all other factors constant, each unit increase of age was associated with increased odds for obesity by a factor of 1.04 and the odds of obesity occurring in U.S. athletes was 2.47 times greater than in Chinese athletes.

CONCLUSION

Obesity is an emerging health problem for Chinese adults with ID. Participation in Special Olympics does not offset obesity in people with ID and other methods of intervention are needed to address obesity in this population segment. This is a global health concern that requires immediate attention.

Increasing body mass index identifies Chinese patients with type 2 diabetes mellitus at risk of poor outcomes

AIMS

Association between body mass index (BMI) and glycemic control, comorbidities/complications, and health-related quality of life (HRQoL) was assessed in Chinese patients with type 2 diabetes mellitus (T2DM) enrolled in the Diabetes Disease Specific Programme.

METHODS

Surveys of 200 physicians and 2052 patients with T2DM captured demographic, clinical, and HRQoL information. Adjusted and unadjusted analyses were conducted across 3 BMI groups; normal (18.5-<24.0, n=998), overweight (24.0-<28.0, n=822), and obese (≥28.0, n=212).

RESULTS

There were no between group differences in the achievement of glycated hemoglobin (HbA1c) <7.0% (48mmol/mol); however, compared with the normal BMI group, more obese patients had an HbA1c >9.0% (75mmol/mol; 4.3% vs 10.2%, P=0.002). More obese patients compared with normal BMI patients had hypertension (48.6% vs 35.3%, P<0.001), dyslipidemia (35.4% vs 18.8%, P<0.001), or both hypertension and dyslipidemia (24.1% vs 13.9%, P<0.001). Patients in the obese group reported worse HRQoL and greater effects of diabetes on their daily living.

CONCLUSIONS

Obesity in Chinese patients with T2DM results in poor glycemic control, more comorbidities, and worse HRQoL. Management of these patients should include efforts to reduce weight. Selection of weight-neutral or weight-reducing anti-diabetic medications maybe useful in these patients.

Do older Chinese people's diets meet the Chinese Food Pagoda guidelines? Results from the China Health and Nutrition Survey 2009

OBJECTIVE

To evaluate dietary intake based on the Chinese Food Pagoda (CFP) and to determine what factors may be associated with adherence to CFP guidelines for older Chinese.

DESIGN

This cross-sectional population-based study used 24 h recall over three consecutive days to assess dietary intake and adherence to CFP among older Chinese participating in the China Health and Nutrition Survey 2009.

SETTING

Nine provinces across four diverse regions (Northeast, East Coast, Central and West).

SUBJECTS

A total of 2745 older Chinese, aged 60-69 years (n 1563) and ≥70 years (n 1182), with dietary data.

RESULTS

None of the participants reached all ten food group recommendations. More than half of the participants exceeded the recommended amount for grains (63%), oil (62·8%) and salt (55·7%). Ten per cent of the participants consumed dairy, while merely 0·5% met the recommended amount. Average Chinese Food Pagoda Score (CFPS) was 3·3 in men and 3·5 in women, far below the maximum possible score of 10. Women had 0·26 higher CFPS than men (P<0·001; 95% CI 0·16, 0·36). People living in medium and high urbanicity areas had significantly higher scores than those living in low urbanicity areas (P<0·001). Also, there were significant differences in CFPS according to gender, BMI, work status, education level and region.

CONCLUSIONS

Few older Chinese are meeting the intake of the various food groups based on the recommendations in the CFP guidelines, thus increasing the risk of malnutrition and non-communicable diseases. Action is needed to increase dissemination and uptake of nutrition education, with interventions targeted at socio-economic regions. Moreover, specific dietary guidelines for older Chinese people should be developed.

Left Ventricular Hypertrophy and Asymptomatic Cardiac Function Impairment in Chinese Patients with Simple Obesity using Echocardiography

BACKGROUND

Simple obesity in China is rising rapidly and causing increasing concern. The objectives of our study are to investigate cardiac structure and function in individuals with simple obesity and to analyze the effect of BMI on left ventricular structure and function.

METHODS

Between January 2012 and July 2014, echocardiography was performed in 361 consecutive patients visiting the outpatient echocardiography center for a health examination or cardiac evaluation before a weight loss operation in our hospital. Echocardiographic indices, waist-to-hip ratios, BMI, and metabolic markers were evaluated. We analyzed these data using Student's t test (normally distributed) or a nonparametric test (not normally distributed) for continuous variables and chi-square test for categorical variables. Multivariate correlation and regression analysis were conducted for comparisons.

RESULTS

The study sample was divided into three groups: a normal/overweight group (BMI < 28.0 kg/m(2)), a mildly/moderately obese group (BMI 28-39.9 kg/m(2)), and a severely obese group (BMI ≥ 40 kg/m(2)). There were no significant differences in clinical and laboratory characteristics among the groups, except for BMI and waist-to-hip ratio. The severely obese group had a higher left ventricular end diastolic diameter (LVEDD; p < 0.01) and lower left ventricular ejection fraction (LVEF; p < 0.01) than the mildly/moderately obese group, which had a higher LVEDD and LV mass index (LVMI) than the normal/overweight group. BMI correlated well with LVEDD, left ventricular posterior wall thickness at end-diastole (LVPW), LV mass, LVMI, and E/e'. In addition, age was significantly associated with some echocardiographic parameters, including left atrial dimension (r = 0.366, p < 0.01), LVPW (r = 0.347, p < 0.01), interventricular septal thickness at end- diastole (r = 0.351, p< 0.01), and E/A (r = -0.47, p < 0.01).

CONCLUSIONS

Simple obesity caused cardiac structural changes, including LV hypertrophy and LV enlargement, and severe obesity resulted in asymptomatic LV systolic and diastolic function impairment.

Can China diminish its burden of non-communicable diseases and injuries by promoting health in its policies, practices, and incentives?

China has rapidly progressed through epidemiological and demographic transitions and is now confronting an increasing burden from non-communicable diseases and injuries. China could take advantage of what has been learnt about prevention and control of non-communicable diseases and injuries, which is well summarised in the WHO best buys (a set of affordable, feasible, and cost-effective intervention strategies in any resource setting), to improve individual and population health. Implementation of these strategies could allow China to exceed the incremental gains in decreasing non-communicable diseases and injury burdens of high-income countries, and greatly shorten the interval needed to achieve decreased morbidity and mortality in its population. With the lessons learnt from other countries and its own programmes and policies, China could provide a health model for the world.

JAK-STAT in lipid metabolism of adipocytes

JAK-STAT signaling pathway plays an important role in the cells' development and homeostasis. Over the past decades, the studies have identified the role of the JAK-STAT pathway in cell proliferation and apoptosis. Here, we want to discuss that whether and how the JAK-STAT pathway affects the lipid metabolism of adipose tissue. A host of cytokines and hormones can regulate lipid metabolism through activating the JAK-STAT signaling pathway. Activated STATs can regulate lipid metabolism directly by influencing the expression of enzymes. We have summarized the relevant research and articles of JAK-STAT during the recent years. Within this review, we will introduce you the recent research and highlight the unresolved problems in understanding how JAK-STAT signaling pathway contribute to the lipid metabolism in mature adipocytes and preadipocytes. Dysregulation of the JAK-STAT pathway would lead to a multiple metabolism disorders and medicines for this signaling pathway maybe become a new idea for diseases such as metabolic syndrome, especially in children.