Prevalence and Correlation of Metabolic Syndrome: A Cross-Sectional Study of Nearly 10 Million Multi-Ethnic Chinese Adults

Association of subclinical hypothyroidism with metabolic syndrome and its components among outpatients with first-episode drug-naïve major depressive disorder: a large-scale cross-sectional study

Both metabolic syndrome (MetS) and subclinical hypothyroidism (SCH) are prevalent in major depressive disorder (MDD) patients. However, their relationship in this population remains unknown. The study assessed the association between SCH and MetS in 1706 first-episode drug-naïve (FEDN) MDD patients. We also compared the relationship between MetS and clinical symptoms in patients with and without comorbid SCH. The Positive and Negative Syndrome Scale positive subscale, the Hamilton Anxiety Rating Scale, and the Hamilton Depression Rating Scale were used to detect clinical symptoms. Serum levels of free triiodothyronine, free thyroxine, thyroid stimulating hormone (TSH), anti-thyroglobulin, thyroid peroxidases antibody, cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fasting glucose were measured. The Area Under the Curve (AUC) was used to test the performance of serum TSH in identifying MetS patients. The prevalence of MetS and SCH was 34.5% (n = 585) and 61% (n = 1034), respectively. The presence of SCH increased the risk of MetS, hyperglycemia, hypertension, obesity, and low HDL-C by 4.91, 3.51, 3.54, 2.02, and 2.34 times, respectively. Serum TSH had a nice ability to distinguish MetS patients from non-MetS patients (AUC value = 0.77). MetS and its components exhibited a positive association with clinical profiles only in SCH patients, but not in non-SCH patients. Taken together, our study suggested SCH was closely related to MetS and might play a vital role in the relationship between MetS and clinical symptoms. Regular thyroid function checks might help early detect MetS.

A Qualitative Study on Postpartum Women Experienced Various Pain Throughout the Perinatal Period Based on the Thrive Model

Aim

This study aims to thoroughly explore to comprehensively examine the diverse types and subjective experiences of pain in postpartum women throughout perinatal period, aiming to deepen understanding and support the development of precise pain management strategies in nursing care.

Design

A descriptive qualitative study.

Methods

Between August and November 2022, postpartum women attending outpatient clinics at a tertiary level A hospital were selected as participants. The study followed the framework of the THRIVE model and utilized a phenomenological method for qualitative research. In-depth semi-structured interviews were conducted with 21 postpartum women, and the data were analyzed using the Colaizzi 7-step analysis method.

Results

Thematic analysis revealed that different postpartum women exhibited diverse perceptions of their own pain experiences. Three themes were identified to describe the pain encountered by postpartum women: (1) Experiencing pain is complex (including experiencing multiple kinds of pain, individual differences in pain, and pain is variable), (2) Double perceptions of pain (negative effects of pain and positive energy for perceiving pain), and (3) Fighting pain requires active support (active outside support and construct a positive self-coping style).

Conclusion

This study provides a comprehensive overview of perinatal pain management in postpartum women, offering recommendations for accurate pain understanding and management. Healthcare professionals should be vigilant about maternal pain changes and individual experiences, implement targeted measures and support, aid in alleviating psychological burdens, boost maternal confidence in childbirth, and enhance postpartum quality of life.

Patient or Public Contribution

In this study, interviews were conducted in the hospital outpatient department, and the participants included in this study participated in the interviews to provide support for the implementation of this subject.

Association of body mass index with COVID-19 outcome in a pediatric tertiary referral hospital in Iran

BACKGROUND

One of the challenging risk factors for severe COVID-19 infection is obesity and high body mass index (BMI). In this study we assessed the association between BMI and outcomes of hospitalized pediatric patients with COVID-19 in Iran.

METHOD

This retrospective cross-sectional study was performed in the biggest referral pediatric hospital in Tehran from March 7 to August 17, 2020. All hospitalized children ≺18 years of age with laboratory-confirmed COVID-19 were included in the study. We evaluated the association of BMI with COVID-19 outcomes (death, severity of clinical course, oxygen therapy, intensive care unit [ICU] admission, ventilator requirement). The secondary objectives were investigating the association of gender, underlying comorbidity, and patient age with COVID-19 outcomes. The limits for obesity, overweight, and underweight were set at BMI >95 percentile, 85≤ BMI ≤ 95, and BMI<5 percentile, respectively.

RESULTS

In total, 189 confirmed pediatric cases of COVID-19 (0.1-17 years) with a mean age of 6.4 ± 4.7 years were included. Overall, 18.5% of the patients were obese and 33% were underweight. We found that BMI had no significant relation with COVID outcomes in pediatric cases but after subgrouping the participants, underlying comorbidities and lower BMI in previously ill children were independently associated with a poor clinical outcome of COVID-19. In addition, the previously ill children with higher BMI percentiles were at a relatively lower risk of ICU admission (95% CI: 0.971-0.998, OR: 0.98, p = 0.025) and better clinical course of COVID-19 (95% CI: 0.970-0.996, OR: 0.98, p = 0.009). The BMI percentile had a statistically significant direct relationship with age (Spearman correlation coefficient= 0.26, p<0.001). When we separated the children with underlying comorbidity, the BMI percentile was significantly lower (p<0.001) in comparison to the previously healthy children.

CONCLUSION

Based on our results, obesity is not related to COVID-19 outcomes in pediatric patients, but after controlling for confounding effects, underweight in children with underlying comorbidities was more likely to be associated with a poor prognosis of COVID-19.

Prevalence of Metabolic Syndrome and Risk Factors Among Chinese Adults: Results from a Population-Based Study - Beijing, China, 2017-2018

What is already known about this topic?

Metabolic syndrome (MetS) is one of the most easily available health indicative markers for cardiovascular diseases, and it has become a major public health problem worldwide due to increasing urbanization and aging populations. The prevalence of MetS increased dramatically in China, however, there are no records of MetS defined by the 2017 Chinese Diabetes Society for Beijing by far.

What is added by this report?

In this study, the data of 24,412 participants aged 18-74 years from a large population-based study in Beijing was collected. The overall prevalence of MetS among Beijing residents was 24.5%. The prevalence was 35.2% in males and 15.4% in females.

What are the implications for public health practice?

Effective public health strategies should target males, people with older age, lower education, higher body mass index, smokers, those who drink alcohol, those who are unemployed or retired, and those who live in rural areas on MetS prevention and control.

Effect of BMI on Central Arterial Reflected Wave Augmentation Index, Toe-Brachial Index, Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index in Chinese Elderly Hypertensive Patients with Hemorrhagic Stroke

BACKGROUND

Hypertensive cerebral hemorrhage seriously endangers the health of the elderly. However, the relationship between obesity and arterial elasticity in hypertensive cerebral hemorrhage remains to be clarified. The purpose of our study is to explore the associations between body mass index (BMI) and central arterial reflected wave augmentation index (cAIx), toe-brachial index (TBI), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) in the elderly hypertensive patients with hemorrhagic stroke.

MATERIALS AND METHODS

A total of 502 elderly hypertensive patients with hemorrhagic stroke and 100 healthy controls were collected. According to the BMI, patients were divided into normal BMI, overweight, obesity, and obese groups. The multivariate logistic regression model was used to establish a risk model for elderly hypertensive hemorrhagic stroke.

RESULTS

Compared with the normal BMI group, systolic blood pressure (SBP), diastolic blood pressure (DBP), cAIx, and baPWV in the abnormal BMI group were significantly increased (P < 0.05), while TBI and ABI were significantly decreased (P < 0.05). Logistic regression showed that BMI (OR = 1.031, 95%CI: 1.009-1.262), cAIx (OR = 1.214, 95%CI: 1.105-1.964), TBI (OR = 0.913, 95%CI: 0.885-0.967), baPWV (OR = 1.344, 95%CI: 1.142-2.147), and ABI (OR = 0.896, 95%CI: 0.811-0.989) are important factors for the occurrence of hemorrhagic stroke in the elderly hypertensive patients. ROC curve analysis showed that the AUC of cAIx, TBI, baPWV, ABI, and BMI were 0.914, 0.797, 0.934, 0.833, and 0.608, respectively. The final prediction model of hemorrhagic stroke elderly hypertensive patients was Y_(P)= 65.424 + 0.307(cAIx) - 13.831(TBI) + 0.012(baPWV) - 0.110(ABI) + 0.339(BMI).

CONCLUSIONS

Obesity is associated with decreased arterial elasticity. Therefore, reasonable weight management of the elderly may be of great significance for reducing the risk of hemorrhagic stroke in patients with hypertension.