Diabetes-related behaviours among elderly people with pre-diabetes in rural communities of Hunan, China: a cross-sectional study

Diet Quality Variation among Polish Older Adults: Association with Selected Metabolic Diseases, Demographic Characteristics and Socioeconomic Status

A lot of civilization diseases are related to a low-quality diet, which is often determined by environmental factors. The aim of the present study was to assess the relationship between the quality of diet and the selected metabolic diseases, as well as demographic characteristics and socioeconomic status among Polish seniors. The study was conducted on the basis of the KomPAN questionnaire (Questionnaire for Dietary Views and Habits). The research sample was chosen arbitrarily. In addition, in order to diversify the research sample, the use of the snowball method was used. The study was conducted from June to September 2019 in a group of 437 people aged 60 or more years in two regions of Poland. Two diet quality indices with a potentially beneficial (pHDI-10) and adverse impact on health (pHDI-14) were selected based on data on the frequency of consumption of 24 food groups using the KomPAN questionnaire data development procedure. Based on the intensities (low, moderate, high) and combinations of these indices, three diet quality index profiles were developed with potentially different influences on health: lower (lowest), middle (intermediate) and upper (highest). Logistic regression was used to evaluate the relationship between diet quality indices, some metabolic diseases (obesity, arterial hypertension, diabetes type 2), demographic characteristics (gender, age, place of residence), and socioeconomic status (low, moderate, high). It was shown that in the examined seniors with selected metabolic diseases, the higher quality diet was more common among women, urban inhabitants and subjects with higher socioeconomic status. In turn, among the elderly with obesity, a high-quality diet was observed more often in people aged 60-74 years and those with type II diabetes at ages 75 years or more. The relationships between diet quality, demographic characteristics and socioeconomic status were demonstrated, but it was not possible to obtain unambiguous results on the relationship of these variables with the occurrence of metabolic diseases. Further extended studies should assess the importance of diet quality in reducing the risk of metabolic diseases in the elderly, taking into account the variability resulting from the environmental characteristics of the study population.

Multiple chronic conditions among older adults in China: differences in socio-demographic characteristics

Objective

There are relatively few studies on multiple chronic conditions (MCC) among older adults in China. This study sought to assess the potential differences in the risk of MCC among different elderly populations, and thus to identify the most vulnerable populations at higher risk of developing the MCC.

Methods

A sample of 5320 adults aged 60 years or above from the China's Health-Related Quality of Life Survey for Older Adults 2018 (CHRQLS-OA 2018) were included in this study. Descriptive statistics frequencies and proportions were used to summarize the sample characteristics, and logistic regression models were conducted to identify the differences in the risk of having MCC among different populations.

Results

Overall, 52.6% of respondents had been clearly diagnosed with at least one chronic disease with 25.3% having MCC. The males ((adjusted odds ratio [AOR] = 0.84; 95% confidence interval [CI] = 0.73-0.98) were less likely to have MCC. This was also true among female elderly with a non-agricultural hukou (AOR = 0.75; 95% CI = 0.57-0.99). The elderly with a non-agricultural hukou aged 60-64 (AOR = 0.55; 95% CI = 0.34-0.88) had a lower risk of having MCC. Those whose average annual household income per capita were 15,000-30,000 RMB (AOR = 1.42; 95% CI = 1.03-1.96) were more likely to suffer from MCC. The odds ratios of having MCC were smaller as the personal savings increases in total samples (all P < 0.05).

Conclusions

The findings suggest that different policies or approaches should target these specific populations who are most in need and are most likely to suffer from MCC.

Clinical Characteristics and Prognosis of Young Patients with Coronary Heart Disease

Background

The objective of this study was to investigate the clinical characteristics and prognosis of coronary heart disease (CHD) in young patients.

Material/Methods

We included 972 CHD patients (≤50 years old) with coronary artery stenting who were prospectively enrolled and followed for 1 year. Clinical characteristics, risk factors, and predictors of outcomes were evaluated.

Results

The prevalence of current smoker, hypertension, diabetes mellitus, dyslipidemia and positive family history of CHD were 18.9%, 34.3%, 14.5%, 4.4%, and 44.2%, respectively. Most of the patients underwent coronary stenting due to stable angina (48.8%) and unstable angina (UA; 48.1%). After 1-year follow-up, 64 patients (6.6%) experienced clinical outcomes and the most common event was UA (n=56). Compared to patients without clinical outcomes, those with outcomes were more likely to be male, have higher systolic blood pressure, more likely to have hypertension and diabetes mellitus, and more likely to be presented as unstable angina. Multivariate regression analysis showed only age (hazard ratio [HR]: 1.12 and 95% confidence interval [CI]: 1.07–1.26), smoking (HR: 1.15 and 95% CI: 1.06–1.23), presence of hypertension (HR: 1.19 and 95% CI: 1.13–1.31), and diabetes mellitus (HR: 1.16 and 95% CI: 1.09–1.28), more vessels with stenosis (HR: 1.27 and 95% CI: 1.20–1.48) and presented with acute coronary syndrome (HR: 1.35 and 95% CI: 1.21–1.55) were independently associated with clinical outcomes.

Conclusions

Most of the young (≤50 years of age) CHD patients had poor management of risk factors and better controlling these risk factors would be helpful for the primary and secondary prevention of premature CHD in Guangdong province.

The Study of Clustering Effects of Behavior Risk Factors in Patients with Metabolic Syndrome in Southern China: A Cross-Sectional Study

OBJECTIVES

Metabolic syndrome (MetS) is now becoming a serious public health threat. Some behaviors risk factors were considered to be associated with MetS and interacted to adversely affect MetS. However, the clustering effects of behavior risk factors of MetS among Chinese population remain unclear. The aim of this study is to observe the behavior risk factors and their clustering effects of MetS in China.

METHODS

A cross-sectional study design was used. Subjects were recruited in the departments of Cardiology Clinic, Endocrine Clinic, and Health Management from March to December 2019. A demographic sheet was designed to collect the demographic and clinical characteristics of the subjects. International Physical Activity Questionnaire-Short was applied to evaluate the level of PA in this study. Other behavior risk factors were observed by the questionnaire. The stepwise logistic regression analysis was performed to identify the determinants of MetS. The multiple logistic regression analysis was used to analyze the clustering effects of behavior risk factors in MetS.

RESULTS

There are a total of 532 eligible subjects (56.6% females; mean age was 48.4 ± 15.3 years), and approximately 33.3% were diagnosed as MetS. The subjects with a smoking habit (heavy and long-time history) had a 1.833-fold higher risk for MetS than their counterparts (none and light smoking), and the subjects that preferred salty taste had a 1.626-fold higher risk for MetS than the comparison cohort. Smoking and alcohol drinking had the highest clustering effect on MetS among the behavior risk factors.

CONCLUSIONS

The main finding of this study was that smoking and salty taste preference were the independent determinants of MetS. Smoking and alcohol consumption had the highest clustering effect on southern Chinese MetS.

Correlates, Facilitators and Barriers of Healthy Eating Among Primary Care Patients with Prediabetes in Singapore-A Mixed Methods Approach

Healthy diet remains the primary means to prevent chronic diseases among those with prediabetes. We conducted a mixed methods study, consisting of a cross-sectional survey and in-depth interviews to assess factors associated with fulfilling the healthy plate recommendation, and to explore reasons for the behaviour among primary care patients with prediabetes in Singapore. The prevalence of meeting the recommendation was 57.3%. This was positively associated with being married and negatively associated with being Malay, frequency of eating out weekly and frequency of deep-fried food consumption weekly. The recurrent themes for not meeting the recommendation included family influence, perception of healthy food being not tasty, lack of skills to prepare or choose healthy food, difficulty in finding healthier options when eating out, and healthy food being costly. The recurrent themes for meeting the recommendation included family influence, self-discipline, fear of disease complications, education by healthcare professionals, mass media influence and health promotion campaigns. Much more remains to be done to promote healthy eating among these patients. There were different levels of facilitators and barriers to healthy eating. Apart from the individual and interpersonal levels, practitioners and policy makers need to work together to address the organisational, community and policy barriers to healthy eating.

Diabetes care in figures: current pitfalls and future scenario

Diabetes mellitus (DM) epidemic-on a global scale-is a major and snowballing threat to public health, healthcare systems and economy, due to the cascade of pathologies triggered in a long-term manner after the DM manifestation. There are remarkable differences in the geographic disease spread and acceleration of an increasing DM prevalence recorded. Specifically, the highest initial prevalence of DM was recorded in the Eastern-Mediterranean region in 1980 followed by the highest acceleration of the epidemic characterised by 0.23% of an annual increase resulted in 2.3 times higher prevalence in the year 2014. In contrast, while the European region in 1980 demonstrated the second highest prevalence, the DM epidemic developments were kept much better under control compared to all other regions in the world. Although both non-modifiable and modifiable risk factors play a role in DM predisposition, cross-sectional investigations recently conducted amongst elderly individuals demonstrate that ageing as a non-modifiable risk factor is directly linked to unhealthy lifestyle as a well-acknowledged modifiable risk factor which, in turn, may strongly promote ageing process related to DM even in young populations. Consequently, specifically modifiable risk factors should receive a particular attention in the context of currently observed DM epidemic prognosed to expand significantly over 600 million of diabetes-diseased people by the year 2045. The article analyses demographic profiles of DM patient cohorts as well as the economic component of the DM-related crisis and provides prognosis for future scenarios on a global scale. The innovative approach by predictive diagnostics, targeted prevention and treatments tailored to the person in a suboptimal health condition (before clinical onset of the disease), as the medicine of the future is the most prominent option to reverse currently persisting disastrous trends in diabetes care. The key role of biomedical sciences in the future developments of diabetes care is discussed.