Socioeconomic and lifestyle determinants of the prevalence of hypertension among elderly individuals in rural southwest China: a structural equation modelling approach

Influence of metabolic syndrome and lifestyle factors on thyroid nodules in Chinese adult men: a cross-sectional study

Introduction

Given the high prevalence of thyroid nodules and the potential for malignancy, it is imperative to understand the various factors that contribute to their development. This study aimed to explore the relationship between metabolic syndrome, lifestyle, and thyroid nodules in adult men in southern China.

Methods

This study enrolled a total of 183,990 subjects at a medical examination center in a general hospital in southern China between January 1, 2015, and December 31, 2020. Multivariate logistic regression analysis was utilized to evaluate the relationship between metabolic syndrome, lifestyle factors, and thyroid nodules. Furthermore, structural equation modeling elucidated the intricate relationships among these variables.

Results

The prevalence of thyroid nodules among Chinese adult males was 14.9%. Several factors were identified as risk factors for thyroid nodules, including advanced age, irregular meal time, smoking or quitting smoking, quitting drinking, heavy manual labor, hypertension, diabetes, dyslipidemia and centripetal obesity, and those belonging to ethnic minorities and drinking alcohol were found to be protective factors against thyroid nodules. Structural equation modeling highlighted metabolic syndrome's mediating role amidst lifestyle influences on thyroid nodules.

Conclusion

The prevalence of thyroid nodules in Chinese adult males is relatively moderate to low. The factors identified in this study can help clinicians identify high-risk patients and develop targeted screening strategies for the timely detection of thyroid nodules. However, further mechanistic research and longitudinal studies are necessary to explore the underlying causes and establish causal relationships.

Bariatric Surgery and Vitamin D: Trends in Older Women and Association with Clinical Features and VDR Gene Polymorphisms

(1) Background: Obesity and its comorbidities can cause burdens and limitations. Bariatric surgery (BS) is indicated as a safe procedure to reduce body mass and improve present comorbidities. However, several complications were reported, such as vitamin D [25(OH)D] deficiency. We evaluated if 25(OH)D serum levels relate to clinical characteristics, symptoms, or habits in women after their BS, and whether the vitamin D receptor (VDR) gene's TaqI and FokI polymorphisms affected 25(OH)D levels and the total body bone mineral density (TBBMD). (2) Methods: This cohort cross-sectional comparative analytical prospective study consisted of 27 women, 61.6 ± 5.0 years, submitted to BS one year prior at a public reference hospital, DF-Brazil. All participants were asked to follow the physical and dietary activity recommendations and received vitamin D3 supplements. Their anthropometric, biochemical, and immunological measurements and blood samples were obtained. (3) Results: 73.3% of participants had low 25(OH)D levels, and their levels correlated positively with TBBMD and negatively with systolic pressure. VDR TaqI did not affect 25(OH)D levels, whereas VDR FokI's allele f presence correlated to a median rise in 25(OH)D levels. Neither polymorphism correlated to TBBMD. (4) Conclusions: 25(OH)D levels were positively correlated with TBBMD, negatively with systolic blood pressure, and were higher in those with the VDR FokI allele f.

Spatial patterns in sociodemographic factors explain to a large extent the prevalence of hypertension and diabetes in Aragon (Spain)

Introduction

The global burden of multi-morbidity has become a major public health challenge due to the multi stakeholder action required to its prevention and control. The Social Determinants of Health approach is the basis for the establishment of health as a cross-cutting element of public policies toward enhanced and more efficient decision making for prevention and management.

Objective

To identify spatially varying relationships between the multi-morbidity of hypertension and diabetes and the sociodemographic settings (2015-2019) in Aragon (a mediterranean region of Northeastern Spain) from an ecological perspective.

Materials and methods

First, we compiled data on the prevalence of hypertension, diabetes, and sociodemographic variables to build a spatial geodatabase. Then, a Principal Component Analysis (PCA) was performed to derive regression variables, i.e., aggregating prevalence rates into a multi-morbidity component (stratified by sex) and sociodemographic covariate into a reduced but meaningful number of factors. Finally, we applied Geographically Weighted Regression (GWR) and cartographic design techniques to investigate the spatial variability of the relationships between multi-morbidity and sociodemographic variables.

Results

The GWR models revealed spatial explicit relationships with large heterogeneity. The sociodemographic environment participates in the explanation of the spatial behavior of multi-morbidity, reaching maximum local explained variance (R2) of 0.76 in men and 0.91 in women. The spatial gradient in the strength of the observed relationships was sharper in models addressing men's prevalence, while women's models attained more consistent and higher explanatory performance.

Conclusion

Modeling the prevalence of chronic diseases using GWR enables to identify specific areas in which the sociodemographic environment is explicitly manifested as a driving factor of multi-morbidity. This is step forward in supporting decision making as it highlights multi-scale contexts of vulnerability, hence allowing specific action suitable to the setting to be taken.

Identifying factors associated with of blood pressure using Structural Equation Modeling: evidence from a large Kurdish cohort study in Iran

BACKGROUND

Identifying the risk factors leading to hypertension can help explain why some populations are at a greater risk for developing hypertension than others. The present study seeks to identify the association between the risk factors of hypertension in 35- to 65-year-old participants in western Iran.

METHODS

This cross-sectional study was conducted on 9705 adults from baseline data of Ravansar Non-Communicable Disease (RaNCD) cohort study, in the west region of Iran. Each of the latent variables were confirmed by confirmatory factor analysis. Using Structural Equation Modeling (SEM), we assessed the direct and indirect effects of factors associated with blood pressure.

RESULTS

Socioeconomic status (SES), physical activity, mean of serum lipids, obesity, diabetes and family history of hypertension had a diverse impact on the blood pressure, directly and (or) indirectly. The standardized total effect of SES, physical activity, mean of serum lipids, and obesity were -0.09 vs. -0.14, -0.04 vs. -0.04, 0.13 vs. 0.13 and 0.24 vs. 0.15 in men and women, respectively. Diabetes had a direct relationship with the blood pressure in women (0.03).

CONCLUSION

With regard to control of high blood pressure, public health interventions must target obesity, lifestyle and other risk related to nutritional status such as hyperlipidemia and hyperglycemia in Iranian population and among those with higher SES.

Prevalence of diabetes mellitus according to associated factors in rural traditional populations in Goiás, Brazil: a cross-sectional study

OBJECTIVE

To identify the prevalence of and factors associated with diabetes mellitus in rural traditional communities.

METHODS

Cross-sectional study carried out in 115 rural communities distributed in 45 municipalities in the state of Goiás, including: 13 river communities, 51 quilombolas and 63 agrarian reform settlements. Probabilistic sampling was performed, and participants were selected at random. The outcome variable was self-reported diabetes mellitus, while exposure variables were sociodemographic, lifestyle, health conditions and access to health services. Multiple regression was used to determine the association between study variables.

RESULTS

Among the 2,537 participants, the overall prevalence of diabetes was 9.8%, with 13.5% in river dwellers, 10.0% in quilombolas and 9.3% in settlers. Factors associated with diabetes were negative self-perception of health, being a former smoker, high blood pressure, hypercholesterolemia, and living in a river community.

CONCLUSION

The results reinforce the need to strengthen strategies for the prevention and control of diabetes and its complications in rural populations, especially among river dwellers.

Delving the Role of Caralluma fimbriata: An Edible Wild Plant to Mitigate the Biomarkers of Metabolic Syndrome

Metabolic syndrome (MS), commonly known as syndrome X or insulin resistance syndrome, is a collection of risk factors for cardiovascular diseases and type II diabetes. MS is believed to impact over a billion individuals worldwide. It is a medical condition defined by visceral obesity, insulin resistance, high blood pressure, and abnormal cholesterol levels, according to the World Health Organization. The current dietary trends are more focused on the use of functional foods and nutraceuticals that are well known for their preventive and curative role against such pathological disorders. Caralluma fimbriata is one such medicinal plant that is gaining popularity. It is a wild, edible, succulent roadside shrub with cactus-like leaves. Besides its main nutrient contents, various bioactive constituents have been identified and linked with positive health outcomes of appetite-suppressing, hypolipidemic, antioxidant, hepatoprotective, and anticancer potentials. Hence, such properties make C. fimbriata an invaluable plant against MS. The current review compiles recent available literature on C. fimbriata's nutritional composition, safety parameters, and therapeutic potential for MS. Summarized data in this review reveals that C. fimbriata remains a neglected plant with limited food and therapeutic applications. Yet various studies explored here do prove its positive health-ameliorating outcomes.

Prevalência de diabetes mellitus autorreferido e fatores associados em população rural e tradicional de Goiás: estudo transversal

RESUMO: Objetivo: Identificar a prevalência e os fatores associados ao diabetes mellitus em comunidades rurais. Métodos: Estudo transversal desenvolvido em 115 comunidades rurais distribuídas em 45 municípios do Estado de Goiás, sendo: 13 ribeirinhas, 51 quilombolas e 63 assentamentos de reforma agrária. Realizou-se amostragem probabilística, e os participantes foram selecionados de forma aleatória. A variável desfecho foi diabetes mellitus autorreferido, enquanto as de exposição foram sociodemográficas, estilo de vida, condições de saúde e acesso a serviços de saúde. Utilizou-se regressão múltipla para verificar a associação entre variáveis de estudo. Resultados: Entre os 2.537 participantes, a prevalência geral de diabetes foi de 9,8%, sendo 13,5% nos ribeirinhos, 10,0% nos quilombolas e 9,3% nos assentados. Os fatores associados ao diabetes foram a autopercepção negativa de saúde, ser ex-fumante, hipertensão arterial, hipercolesterolemia e residir em comunidade ribeirinha. Conclusão: Os resultados reforçam a necessidade de fortalecer estratégias para prevenção e controle da diabetes e suas complicações em populações rurais, especialmente entre os ribeirinhos.

Prevalence and Factors Associated with Hypertension

Aims: hypertension (HTN) is rapidly emerging as a public health problem among elderly in developing countries. The objective of this study was to assess the prevalence of hypertension and its associated factors among the elderly in Pokhara Metropolitan, Nepal.Methods: a cross-sectional analytical study was carried out to assess hypertension among 323 community dwelling elderly in Pokhara Metropolitan from October 2019 to March 2020. Quota sampling was used to collect the samples. Elderly those who were attending hospitals or with any serious medical conditions were excluded from the study. Face to face interview was done for data collection and anthropometric measurements, and semi structured standard STEPS questionnaires were used as data collection tools. Data were entered in Epi DATA [Version 3.1] and analyzed using SPSS [Version 20] as per data analysis plan. Bivariate logistic regression analysis were conducted and statistical significance was declared at a p-value ≤ 0.05.Results: prevalence of hypertension was reported among 34.4 percent (Male: 39.3%, Female 29%) elderly in Pokhara Metropolitan. The higher proportion of hypertensive cases were in age group 60-69 years (36%). The prevalence of hypertension was significantly associated with ethnicity (OR= 1.74, CI: 1.07-2.83), current alcohol intake (OR= 2.56, CI: 1.30-5.05) and mental stress (OR= 2.25, CI: 1.19-4.28).Conclusion: more than one third of the elderly had hypertension. Ethnicity, current alcohol intake and mental stress are found to be factors associated with hypertension. Periodic screening for early detection of hypertension and implementing health promotion interventions to encourage behavior change among elderly may promote healthy ageing.