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Zhang F, Chen Y, Wang S, Shi Z, Zhong Y, Zhu S, Wangmu C, Wu Y. Impact of altitude on the development of low bone mineral density and osteoporosis in individuals aged 50 years and older: protocol for a multicentre prospective cohort study. BMJ Open 2024; 14:e087142. [PMID: 39181552 DOI: 10.1136/bmjopen-2024-087142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION Osteoporotic fractures are a leading cause of disability and contribute significantly to medical care costs worldwide. Variations in bone mineral density and the risk of osteoporosis are notably influenced by altitude. This study aims to longitudinally examine individuals with osteoporosis and low bone mass at three different altitudes (low, high and very high) to understand the effects of high-altitude environments on bone density. METHODS AND ANALYSIS This multicentre, prospective cohort study will involve 893 participants divided into three groups based on altitude: low (500-1500 m), high (2500-4500 m) and very high (4500-5500 m). Participants will undergo comprehensive diagnostic assessments, including demographic data collection, structured questionnaires, medical examinations and clinical laboratory tests. Follow-up visits will occur annually for a minimum of 5 years. The primary outcome will be changes in bone mineral density values. Secondary outcomes will include the incidence of osteoporosis and osteoporotic fractures. Cox proportional hazard models will be used to calculate the risk associated with osteoporotic events and related fractures. ETHICS AND DISSEMINATION The study has been approved by the Institutional Review Board of the Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (No: 2024-70). The acquired insights will be disseminated via academic forums, scholarly articles and stakeholder engagement sessions. TRIAL REGISTRATIONNUMBER ChiCTR2300078872.
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Affiliation(s)
- Fengying Zhang
- Tibet Autonomous Region Clinical Research Center for High-altitude Stress, Endocrinology and Metabolism Disease, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | - Yanli Chen
- Xizang Minzu University, Xianyang, China
- Outpatient Department, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Suyuan Wang
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | | | - Yang Zhong
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
| | | | - Ciren Wangmu
- Department of Emergency, Shigatse People's Hospital, Lhasa, Tibet, China
| | - Yunhong Wu
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, Sichuan, China
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Dong W, Man Q, Zhang J, Liu Z, Gong W, Zhao L, Song P, Ding G. Geographic disparities of dietary inflammatory index and its association with hypertension in middle-aged and elders in China: results from a nationwide cross-sectional study. Front Nutr 2024; 11:1355091. [PMID: 38515520 PMCID: PMC10955052 DOI: 10.3389/fnut.2024.1355091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
Background Geographic distribution of dietary inflammatory index (DII) in China has not been thoroughly evaluated and evidence on the association between DII and hypertension among Chinese middle-aged and older population was inadequate. Objective To investigate the geographic disparities of DII and its association with hypertension among Chinese middle-aged and elders. Methods Data was from the China Adults Chronic Diseases and Nutrition Surveillance (CACDNS 2015) for middle-aged and older participants. The DII for each participant was determined through a combination of 3 days 24 h dietary recall interviews and a food frequency questionnaire. Spatial analysis was employed to investigate the geographic distribution of DII in China. Restricted cubic spline models and binary logistic regression analysis were used to assess the relationship between DII and hypertension. The least absolute shrinkage and selection operator (LASSO) regression was applied for identifying key hypertension-related factors, which was then included in the establishment of a risk prediction nomogram model, with the receiver operating characteristic (ROC) curve and decision curve analysis (DCA) being built to evaluate its discriminatory power for hypertension. Results A total of 52,087 middle-aged and older participants were included in the study, among whom 36.6% had hypertension. it revealed that a clear spatial correlation in the national distribution of DII scores (Moran I: 0.252, p = 0.001), with higher DII scores concentrated in the northwest region and lower DII scores concentrated in the southeast region. Hypertensive participants had higher DII scores compared to those without hypertension (OR: 1.507 vs. 1.447, p = 0.003). Restricted cubic spline models and binary logistic regression analysis demonstrated a positive association between DII and hypertension after adjusting for potential confounding factors. There was a significant increasing trend in the proportion of hypertensive individuals as DII scores increase (p for trend = 0.004). The nomogram model, constructed using key factors identified through LASSO regression, demonstrated a robust discriminative capacity, with an area under the curve (AUC) of 73.2% (95% CI, 72.4-74.0%). Decision curve analysis confirmed the reliability and effectiveness of the nomogram model. Sensitivity analysis conducted within the subpopulation aged under 45 years yielded results consistent with the primary analysis. Conclusion In Chinese adults middle-aged and older, geographic disparities in dietary inflammatory potential are notable, with lower levels observed in the southeastern coastal regions of China and higher levels in the northwestern regions. Meanwhile, there is a positive association between the inflammatory potential of the diet and hypertension. Additional research is needed to investigate regional disparities in dietary inflammatory potential and pinpoint specific dietary patterns associated with lower inflammation.
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Affiliation(s)
- Weihua Dong
- Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Qingqing Man
- Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Elements and Nutrition of National Health Commission, Beijing, China
| | - Jian Zhang
- Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Elements and Nutrition of National Health Commission, Beijing, China
| | - Zhen Liu
- Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Weiyi Gong
- Department of Nutrition Surveillance, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Liyun Zhao
- Department of Nutrition Surveillance, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Pengkun Song
- Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Key Laboratory of Trace Elements and Nutrition of National Health Commission, Beijing, China
| | - Gangqiang Ding
- Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, National Institute for Nutrition and Health, Beijing, China
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Wu Y, Wang Y, Dang Z, Zhang Y, Wang Y, Tong L, Peng W. Ethnic differences in eating patterns and their associations with obesity among adults in West China. Br J Nutr 2024; 131:321-332. [PMID: 37642161 DOI: 10.1017/s0007114523001745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Despite observed ethnic differences in eating patterns and obesity, evidence in China is limited. This study examined ethnic differences in eating patterns and their associations with weight outcomes among multi-ethnic adults in West China. A cross-sectional survey collected self-reported data on demographics, eating behaviours, weight and height in 2021. Principal component analysis and multivariate regression were conducted to identify eating patterns and examine their associations with weight outcomes. In total, 4407 subjects aged ≥ 18 years were recruited across seven provinces in West China. Four eating patterns were identified: 'meat-lover' - characterised by frequent consumption of meat and dairy products, 'indulgent' - by frequent intakes of added salt, sugar, alcohol and pickled food, 'diversified-eating' - by frequently consuming food with diversified cooking methods and eating out and 'nutri-health-concerned' - by good food hygiene behaviours and reading food labels. Ethnic differences in eating patterns were observed. Compared with Han, Hui were less likely to exhibit meat-lover or diversified-eating patterns; Tibetans were less likely to have meat-lover or nutri-health-concerned patterns; Mongolians were more likely to have indulgent pattern. BMI was positively associated with meat-lover pattern in both genders (exp(β): 1·029; 95 % CI: 1·001, 1·058 for men; 1·018; 1·000, 1·036 for women) and negatively associated with nutri-health-concerned pattern in women (0·983; 0·966, 1·000). Mongolians were two times more likely to be overweight/obese than Han (OR: 3·126; 1·688, 5·790). Considerable ethnic differences existed in eating patterns in West China. Mongolians were more likely to be overweight/obese, which was associated with their indulgent eating patterns. Ethnic-specific healthy eating intervention programs are needed.
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Affiliation(s)
- Yang Wu
- Department of Sociology, Jiangxi University of Finance and Economics, Nanchang, People's Republic of China
| | - Yanxiang Wang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
| | - Zhancui Dang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
| | - Yangrui Zhang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Li Tong
- Department of Traditional Chinese Medicine, Medical College, Qinghai University, Xining, People's Republic of China
- Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Xining, People's Republic of China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
- Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Xining, People's Republic of China
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Dong W, Li Y, Man Q, Zhang Y, Yu L, Zhao R, Zhang J, Song P, Ding G. Geographical Distribution of Dietary Patterns and Their Association with T2DM in Chinese Adults Aged 45 y and Above: A Nationwide Cross-Sectional Study. Nutrients 2023; 16:107. [PMID: 38201937 PMCID: PMC10780680 DOI: 10.3390/nu16010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/08/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND This study aimed to investigate the geographical distribution of dietary patterns and their association with T2DM among Chinese adults aged 45 years and above. METHODS Data was from the China Adults Chronic Diseases and Nutrition Surveillance (2015). Dietary intake for each participant was determined through a combination of 3-day 24-h dietary recall interviews and food frequency questionnaires. Principal component analysis was used to extract dietary patterns and spatial analysis was employed to investigate the geographic distribution of them. T2DM was diagnosed using criteria of ADA 2018, and binary logistic regression was employed to examine the relationship between dietary patterns and T2DM. RESULTS A total of 36,648 participants were included in the study; 10.9% of them were diagnosed as T2DM. Three dietary patterns were identified with the name of plant-based pattern, animal-based pattern, and oriental traditional pattern, which were represented located in northern, northwest, and southern regions, respectively. After adjusting for potential confounders, participants in the highest quartile of the plant-based pattern were associated with lower T2DM odds (OR = 0.82, 95% CI: 0.74, 0.90) when comparing with the lowest quartile. However, participants inclined to higher quartiles of animal-based pattern had a higher risk of T2DM (OR = 1.15, 95% CI: 1.04, 1.27) compared with those in the lower quartiles. No significant association was found between the oriental traditional pattern and T2DM (OR = 1.03, 95% CI: 0.93, 1.14). CONCLUSION Dietary patterns of Chinese population revealed geographical disparities, with plant-based dietary pattern showing protective effects and animal-based pattern carrying high risks for T2DM. Regional dietary variations and food environment are paramount in T2DM prevention and management.
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Affiliation(s)
- Weihua Dong
- National Institute for Nutrition and Health, Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, Beijing 100050, China; (W.D.); (Y.L.); (Q.M.); (J.Z.)
| | - Yuqian Li
- National Institute for Nutrition and Health, Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, Beijing 100050, China; (W.D.); (Y.L.); (Q.M.); (J.Z.)
| | - Qingqing Man
- National Institute for Nutrition and Health, Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, Beijing 100050, China; (W.D.); (Y.L.); (Q.M.); (J.Z.)
- Key Laboratory of Trace Elements and Nutrition of National Health Commission, Beijing 100050, China
| | - Yu Zhang
- Chinese Center for Diseases Control and Prevention, Beijing 100050, China;
| | - Lianlong Yu
- Shandong Center for Disease Control and Prevention, Jinan 250014, China;
| | - Rongping Zhao
- Department of Clinical Nutrition, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610056, China;
| | - Jian Zhang
- National Institute for Nutrition and Health, Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, Beijing 100050, China; (W.D.); (Y.L.); (Q.M.); (J.Z.)
- Key Laboratory of Trace Elements and Nutrition of National Health Commission, Beijing 100050, China
| | - Pengkun Song
- National Institute for Nutrition and Health, Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, Beijing 100050, China; (W.D.); (Y.L.); (Q.M.); (J.Z.)
- Key Laboratory of Trace Elements and Nutrition of National Health Commission, Beijing 100050, China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Department of Geriatric and Clinical Nutrition, Chinese Center for Diseases Control and Prevention, Beijing 100050, China; (W.D.); (Y.L.); (Q.M.); (J.Z.)
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Cui J, Nima O, Zhaxi D, Jin C, Wang R, Diao Y, Chen Y, Xu X, Li X. Health status of the population in Naqu, Tibet and its latent class analysis: a cross-sectional survey. Front Public Health 2023; 11:1223382. [PMID: 38026270 PMCID: PMC10654740 DOI: 10.3389/fpubh.2023.1223382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background Through a survey and analysis of the population's present state of health, it is possible to give data support for improving the health status of inhabitants in Naqu, Tibet. Additionally, it is possible to provide specific recommendations for the development of medical and healthcare facilities in Tibet. Methods The health scores of the participants were based on their responses to the four main sections of the questionnaire: dietary habits, living habits, health knowledge, and clinical disease history, and the variability of health status among groups with different characteristics was analyzed based on the scores. The four major sections were used to create classes of participants using latent class analysis (LCA). Using logistic regression, the factors influencing the classification of latent classes of health status were investigated. Results A total of 995 residents from 10 counties in Naqu were selected as the study subjects. And their demographic characteristics were described. The mean health score of residents after standardization was 81.59 ± 4.68. With the exception of gender, health scores differed between groups by age, education level, different occupations, marital status, and monthly income. The health status in Naqu, Tibet, was divided into two groups (entropy = 0.29, BLRT = 0.001, LMRT = 0.001) defined as the "good health group" and the "general health group." A monthly income of more than ¥5000 adverse to good health in Naqu, Tibet. Discussion Single, well-educated young adults in Naqu, Tibet, have outstanding health. The vast majority of people in Tibet's Naqu region were in good health. Furthermore, the population's latent health status was divided into two classes, each with good dietary and living habits choices, low health knowledge, and a history of several clinical diseases. Univariate and multivariate logistic regression analysis showed that monthly income more than ¥5000 was an independent risk factor for poor health status.
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Affiliation(s)
- Jiaxue Cui
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Ouzhu Nima
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
| | - Duoji Zhaxi
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
| | - Chenxin Jin
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Ruiqi Wang
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yizhuo Diao
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yongxing Chen
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaoguang Xu
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Neurosurgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
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Xiaoyue T, Qichuan Q, Jing G, Pengcuo S, Yu H, Tingxin L. Lipid levels in the Jiarong Tibetan's diet at high altitudes: a cross-sectional survey. Front Nutr 2023; 10:1207710. [PMID: 37435568 PMCID: PMC10330741 DOI: 10.3389/fnut.2023.1207710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Despite the ongoing debate on the inconsistent and controversial effects of Tibetan diet on blood lipid levels at high altitude, this cross-sectional study was conducted to analyze the relationship between dietary practices and blood lipid levels among Jiarong Tibetan population. A total of 476 Jiarong Tibetan residents were included, in which basic demographic data, physical activity records, simplified food frequency questionnaire, and biochemical data were collected. Using multivariate logistic regression analysis, the potential associations between the variables were examined, and it was found that fat energy supply ratio increased with the elevation of altitude, while the lipid level showed an inverted U-shaped variation. However, the findings suggested that a diet rich in unsaturated fatty acids might balance the effects of the Tibetan diet on the risk of lipid metabolism disorders. Therefore, it is crucial to concentrate on the fat composition rather than the amount of fat E% intake on the plateau. The results highlighted the importance of investigating the interaction between environment and genes in lipid levels among plateau Tibetan population. However, further large-scale prospective studies are required for better understanding of the complexities involved in dietary practices and their influences on blood lipid levels.
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Affiliation(s)
- Tang Xiaoyue
- Department of Health Management and Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Clinical Nutrition, Yizheng Hospital of Nanjing Drum Tower Hospital Group, Yizheng, Jiangsu, China
| | - Qiao Qichuan
- Department of Health Management and Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Guo Jing
- Physical Examination, Aba Prefecture People’s Hospital, Maerkang, China
| | - Sanlang Pengcuo
- Physical Examination, Aba Prefecture People’s Hospital, Maerkang, China
| | - Huang Yu
- Department of Health Management and Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Li Tingxin
- Department of Health Management and Physical Examination, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
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Wang Y, Chen Y, Gesang Y, Yang Z, Wang Y, Zhao K, Han M, Li C, Ouzhu L, Wang J, Wang H, Jiang Q. Exposure of Tibetan pregnant women to antibiotics in China: A biomonitoring-based study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 325:121439. [PMID: 36921657 DOI: 10.1016/j.envpol.2023.121439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Tibetan people are one Chinese ethnic minority living in Qinghai-Tibet Plateau with an average altitude of more than 4500 m. High altitude could cause a different antibiotic exposure, but relevant information is limited in Tibetan people. We investigated 476 Tibetan pregnant women in Lhasa, Tibet in 2021 and measured 30 antibiotics from five categories in urine, including 13 veterinary antibiotics (VAs), five human antibiotics (HAs), and 12 human/veterinary antibiotics (H/VAs). Food consumption was investigated by a brief food frequency questionnaire. Health risk was assessed by hazard quotient (HQ) and hazard index (HI) based on acceptable daily intakes (ADIs). All antibiotics were overall detected in 34.7% of urine samples with the 75th percentile concentration of 0.19 ng/mL (0.35 μg/g creatinine). HAs, VAs, and H/VAs were respectively detected in 5.3%, 13.0%, and 25.0% of urine samples, with the 95th percentiles of 0.01 ng/mL (0.01 μg/g creatinine), 0.50 ng/mL (0.99 μg/g creatinine), and 3.58 ng/mL (5.02 μg/g creatinine), respectively. Maternal age, smoking of family members, and housework time were associated with detection frequencies of HAs, VAs, or sum of all antibiotics. Pregnant women with a more frequent consumption of fresh milk, egg, yoghourt, poultry meat, and fish had a higher detection frequency of VAs or H/VAs. Only ciprofloxacin and tetracycline had a HQ of larger than one based on microbiological effect in 1.26% and 0.21% of pregnant women, respectively and a HI of larger than one was found in 1.47% of pregnant women. The findings suggested that there was an evident antibiotic exposure from various sources in Tibetan pregnant women with some basic characteristics of pregnant women as potential predictors and several animal-derived food items were important sources of exposure to antibiotic with a fraction of pregnant women in the health risk related to microbiological disruption of gut microbiota.
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Affiliation(s)
- Yuanping Wang
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, K1G5Z3, Canada
| | - Yangzong Gesang
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
| | - Zichen Yang
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
| | - Yi Wang
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ke Zhao
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
| | - Minghui Han
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
| | - Chunxia Li
- Obstetrics and Gynecology Department, Fukang Hospital, Affiliated Hospital of Tibet University, Lhasa, Tibet, 850000, China
| | - Luobu Ouzhu
- Administrative Department, Fukang Hospital, Affiliated Hospital of Tibet University, Lhasa, Tibet, 850000, China
| | - Jiwei Wang
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
| | - Hexing Wang
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China.
| | - Qingwu Jiang
- Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health, Fudan University, Shanghai, 200032, China
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Wang H, Wang Y, Shi Z, Zhao L, Jian W, Li K, Xu R, Wu Y, Xu F, Wang Y, Peng W. Association between Dietary Patterns and Metabolic Syndrome and Modification Effect of Altitude: A Cohort Study of Tibetan Adults in China. Nutrients 2023; 15:2226. [PMID: 37432367 DOI: 10.3390/nu15092226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 07/12/2023] Open
Abstract
Little is known about the longitudinal association between dietary patterns (DPs) and metabolic disorders in people living at high altitude areas, such as Tibetans. We constructed the first open cohort, with 1832 Tibetans, and collected data in 2018 and in 2022. The metabolic syndrome (MetS) prevalence was 30.1% (32.3% in men and 28.3% in women). Three different DPs were identified: modern DP (pulses, poultry, offal, and processed meat), urban DP (vegetables, refined grain, beef/mutton, and eggs), and pastoral DP (Tibetan cheese, tsamba, butter/milk tea, and desserts). Participants within the third tertile of the urban DP had a 3.42-fold (95% CI 1.65-7.10) higher risk of MetS than those with the first tertile. Modern DP was positively associated with elevated blood pressure (BP) and elevated triglycerides (TAG), while it was inversely associated with low HDL-C. The urban DP was associated with a higher risk of low HDL-C, but a lower risk of impaired fasting blood glucose (FBG). The pastoral DP was a risk factor for impaired FBG, but protective for central obesity and elevated BP. Associations of modern DP with elevated BP, and pastoral DP with low HDL-C, were modified by altitude. In conclusion, among Tibetan adults, DPs were associated with MetS and its components, and the associations were modified by altitude among Tibetans.
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Affiliation(s)
- Haijing Wang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining 810008, China
| | - Yanxiang Wang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining 810008, China
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
| | - Lei Zhao
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining 810008, China
| | - Wenxiu Jian
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining 810008, China
| | - Ke Li
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an 710061, China
| | - Ruihua Xu
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining 810008, China
| | - Yan Wu
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an 710061, China
| | - Fei Xu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
- Non-Communicable Disease Prevention and Control, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 211166, China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an 710061, China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining 810008, China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, Xining 810008, China
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Cui J, Zhaxi D, Sun X, Teng N, Wang R, Diao Y, Jin C, Chen Y, Xu X, Li X. Association of dietary pattern and Tibetan featured foods with high-altitude polycythemia in Naqu, Tibet: A 1:2 individual-matched case-control study. Front Nutr 2022; 9:946259. [PMID: 36211499 PMCID: PMC9538783 DOI: 10.3389/fnut.2022.946259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022] Open
Abstract
This study focused on the association of dietary patterns and Tibetan featured foods with high-altitude polycythemia (HAPC) in Naqu, Tibet, to explore the risk factors of HAPC in Naqu, Tibet, to raise awareness of the disease among the population and provide evidence for the development of prevention and treatment interventions. A 1:2 individual-matched case-control study design was used to select residents of three villages in the Naqu region of Tibet as the study population. During the health examination and questionnaire survey conducted from December 2020 to December 2021, a sample of 1,171 cases was collected. And after inclusion and exclusion criteria and energy intake correction, 100 patients diagnosed with HAPC using the “Qinghai criteria” were identified as the case group, while 1,059 patients without HAPC or HAPC -related diseases were identified as the control group. Individuals were matched by a 1:2 propensity score matching according to gender, age, body mass index (BMI), length of residence, working altitude, smoking status, and alcohol status. Dietary patterns were determined by a principal component analysis, and the scores of study subjects for each dietary pattern were calculated. The effect of dietary pattern scores and mean daily intake (g/day) of foods in the Tibetan specialty diet on the prevalence of HAPC was analyzed using conditional logistic regression. After propensity score matching, we found three main dietary patterns among residents in Naqu through principal component analysis, which were a “high protein pattern,” “snack food pattern,” and “vegetarian food pattern.” All three dietary patterns showed a high linear association with HAPC (p < 0.05) and were risk factors for HAPC. In the analysis of the relationship between Tibetan featured foods and the prevalence of HAPC, the results of the multifactorial analysis following adjustment for other featured foods showed that there was a positive correlation between the average daily intake of tsampa and the presence of HAPC, which was a risk factor. Additionally, there was an inverse correlation between the average daily intake of ghee tea and the presence of HAPC, which was a protective factor.
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Affiliation(s)
- Jiaxue Cui
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Duoji Zhaxi
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
| | - Xianzhi Sun
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Nan Teng
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Ruiqi Wang
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yizhuo Diao
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Chenxin Jin
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yongxing Chen
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaoguang Xu
- Institute of High Altitude Medicine, People’s Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Neurosurgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Xiaoguang Xu,
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
- Xiaofeng Li,
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Kong C, Yang L, Gong H, Wang L, Li H, Li Y, Wei B, Nima C, Deji Y, Zhao S, Guo M, Gu L, Yu J, Gesang Z, Li R. Dietary and Food Consumption Patterns and Their Associated Factors in the Tibetan Plateau Population: Results from 73 Counties with Agriculture and Animal Husbandry in Tibet, China. Nutrients 2022; 14:1955. [PMID: 35565921 PMCID: PMC9103862 DOI: 10.3390/nu14091955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
Dietary imbalances are an important cause of morbidity and mortality, both in China and globally. Abnormal element content in the natural environment and the unbalanced dietary structure of populations coexist in the Tibetan Plateau. This study analyzed the dietary and food consumption patterns of 617 Tibetan residents and their associated factors. Cluster analysis revealed three modes of dietary pattern; the food consumption scores (FCSs) of subjects in modes with relatively high consumption frequency of staple food and relatively singular dietary structure were the lowest. Although the FCSs of most subjects were acceptable (FCS > 35), subjects with relatively low FCSs were more dependent on locally cultivated highland barley that is probably low in selenium. Hierarchical linear models revealed both individual−family and regional factors were significantly related (p values < 0.05) with the food consumption of subjects as follows: age, travel time from township to county, and cultivation area of highland barley were negatively related; numbers of individuals aged 40−60 years and pork, beef, and mutton production were positively related. Individuals with secondary or higher education had higher FCSs. A single indicator may be incomprehensive in dietary and food consumption studies. For people with a relatively unbalanced diet, an analysis of the main foods they consume is critical. Dietary and food consumption patterns might have relatively large inter-regional and intra-regional variations; therefore, factors that influence it might be multi-level and multi-scale.
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Affiliation(s)
- Chang Kong
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
| | - Linsheng Yang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hongqiang Gong
- Tibet Center of Disease Control and Prevention, Lhasa 850030, China; (H.G.); (C.N.); (Y.D.); (S.Z.); (M.G.); (Z.G.); (R.L.)
| | - Li Wang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
| | - Hairong Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yonghua Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
| | - Binggan Wei
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
| | - Cangjue Nima
- Tibet Center of Disease Control and Prevention, Lhasa 850030, China; (H.G.); (C.N.); (Y.D.); (S.Z.); (M.G.); (Z.G.); (R.L.)
| | - Yangzong Deji
- Tibet Center of Disease Control and Prevention, Lhasa 850030, China; (H.G.); (C.N.); (Y.D.); (S.Z.); (M.G.); (Z.G.); (R.L.)
| | - Shengcheng Zhao
- Tibet Center of Disease Control and Prevention, Lhasa 850030, China; (H.G.); (C.N.); (Y.D.); (S.Z.); (M.G.); (Z.G.); (R.L.)
| | - Min Guo
- Tibet Center of Disease Control and Prevention, Lhasa 850030, China; (H.G.); (C.N.); (Y.D.); (S.Z.); (M.G.); (Z.G.); (R.L.)
| | - Lijuan Gu
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
| | - Jiangping Yu
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (C.K.); (L.Y.); (L.W.); (Y.L.); (B.W.); (L.G.); (J.Y.)
| | - Zongji Gesang
- Tibet Center of Disease Control and Prevention, Lhasa 850030, China; (H.G.); (C.N.); (Y.D.); (S.Z.); (M.G.); (Z.G.); (R.L.)
| | - Rujun Li
- Tibet Center of Disease Control and Prevention, Lhasa 850030, China; (H.G.); (C.N.); (Y.D.); (S.Z.); (M.G.); (Z.G.); (R.L.)
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