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Zuo X, Zhang X, Ye R, Li X, Zhang Z, Shi R, Liao H, Liu L, Yang X, Jia S, Meng Q, Chen X. Hypertension status and its risk factors in highlanders living in Ganzi Tibetan Plateau: a cross-sectional study. BMC Cardiovasc Disord 2024; 24:449. [PMID: 39182052 PMCID: PMC11344291 DOI: 10.1186/s12872-024-04102-8] [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: 07/25/2023] [Accepted: 08/07/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND The updated status of hypertension and its risk factors are poorly evaluated in Tibetan highland areas. We initiated a large-scale cross-sectional survey to provide updated status of hypertension and its risk factors (especially salt intake) in the Ganzi Tibetan Plateau, China. METHODS Stratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents from 4 counties in the Ganzi Tibetan area. The whole survey population was used to present the epidemiology and risk factors of hypertension. The participants with blood and urine biochemistry data were used to analyze the relationship between salt intake parameters and hypertension. RESULTS Stratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents. The overall prevalence rate of hypertension was 33.5% (the age-adjusted prevalence rate was 28.9%). A total of 50.9% of the hypertensive patients knew their conditions; 30.1% of them received antihypertensive treatment; and 11.2% of them had their blood pressure controlled. Age, male sex, living altitude ≥ 3500 m, overweight and abdominal obesity were positively correlated with hypertension. In addition, the adjusted odds ratio (OR) for hypertension was 1.33 (95% CI: 1.01-1.74) for drinking tea with salt, and 1.51 (95% CI: 1.32-1.72) for per SD increase in the estimation of 24-hour urinary sodium excretion (e24hUSE). Furthermore, per 100mmol/day increase in e24hUSE was associated with elevation of blood pressure (+ 10.16, 95% CI: 8.45-11.87 mmHg for SBP; +3.83, 95% CI: 2.74-4.93 mmHg for DBP) in this population. CONCLUSIONS Our survey suggests a heavy disease burden of hypertension in the Ganzi Tibetan Plateau. Age, male sex, altitude of residence ≥ 3500 m, overweight, abdominal obesity, and excessive salt intake (shown as drinking tea with adding salt and a higher level of e24hUSE) all increased the risk of hypertension in this highland area.
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Affiliation(s)
- Xianghao Zuo
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xin Zhang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Runyu Ye
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xinran Li
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Zhipeng Zhang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Rufeng Shi
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Hang Liao
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Lu Liu
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xiangyu Yang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Shanshan Jia
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Qingtao Meng
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.
| | - Xiaoping Chen
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.
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Li F, Qi JJ, Li LX, Yan TF. Impact of insulin resistance on IVF/ICSI outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 299:54-61. [PMID: 38838387 DOI: 10.1016/j.ejogrb.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 05/22/2024] [Accepted: 05/31/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To evaluate the effect of insulin resistance (IR) on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes in patients with polycystic ovary syndrome (PCOS). STUDY DESIGN PubMed, Google Scholar,Web of Science, Embase, Scopus and the Cochrane Library were searched to identify relevant studies. A total of 6,137 PCOS women undergoing IVF/ICSI with or without IR were included in the systematic review and meta-analysis. RESULTS The systematic review and meta-analysis included twelve observational studies that were free from inherent bias. When comparing PCOS women undergoing IVF/ICSI, the IR and non-IR groups did not show significant differences in oocytes retrieved (WMD = -0.63, 95 % CI: -2.37 to 1.12, P = 0. 483), fertilization rate (WMD = 1.01, 95 % CI: -0.66 to 2.67, P = 0.236; OR = 0.97, 95 % CI: 0.79 to 1.19, P = 0.783), and live birth rate (OR = 1.02, 95 % CI: 0.78 to 1.33, P = 0.892). However, the group with IR had a lower number of MII oocytes (WMD = -1.07, 95 % CI: -1.54 to -0.59, P < 0.001), total embryos (WMD = -1.37, 95 % CI: -1. 78 to -0.95, P < 0.001), and clinical pregnancy rate (OR = 0.77, 95 % CI: 0.59 to 0.99, P = 0.042), as well as a higher miscarriage rate (OR = 1.11, 95 % CI: 1.02 to 1.22, P = 0.017) compared to the non-IR group. CONCLUSION In women with PCOS, IR had a negative impact on IVF/ICSI outcomes. To obtain more favourable empirical support, larger studies are necessary.
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Affiliation(s)
- Feng Li
- Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou 570311 Hainan Province, China
| | - Ju-Ju Qi
- The First Hospital of Shijiazhuang, Shijiazhuang 050011, Heibei Province, China
| | - Li-Xin Li
- The First Hospital of Shijiazhuang, Shijiazhuang 050011, Heibei Province, China
| | - Teng-Fei Yan
- Baoding No.1 Central Hospital, Baoding 071000, Hebei Province, China.
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Sun ZM, Du YZ, Wang SY, Sun SY, Ye Y, Sun XP, Li MX, He H, Long WC, Zhang CH, Yao XY, Fan WY, Wang L, Wu YH. Accuracy of FreeStyle Libre flash glucose monitoring in patients with type 2 diabetes who migrated from highlands to plains. World J Diabetes 2024; 15:1254-1262. [PMID: 38983810 PMCID: PMC11229966 DOI: 10.4239/wjd.v15.i6.1254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/02/2024] [Accepted: 03/19/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND The FreeStyle Libre flash glucose monitoring (FGM) system entered the Chinese market in 2017 to complement the self-monitoring of blood glucose. Due to its increased usage in clinics, the number of studies investigating its accuracy has increased. However, its accuracy has not been investigated in highland popu-lations in China. AIM To evaluate measurements recorded using the FreeStyle Libre FGM system compared with capillary blood glucose measured using the enzyme electrode method in patients with type 2 diabetes (T2D) who had migrated within 3 mo from highlands to plains. METHODS Overall, 68 patients with T2D, selected from those who had recently migrated from highlands to plains (within 3 mo), were hospitalized at the Department of Endocrinology from August to October 2017 and underwent continuous glucose monitoring (CGM) with the FreeStyle Libre FGM system for 14 d. Throughout the study period, fingertip capillary blood glucose was measured daily using the enzyme electrode method (Super GL, China), and blood glucose levels were read from the scanning probe during fasting and 2 h after all three meals. Moreover, the time interval between reading the data from the scanning probe and collecting fingertip capillary blood was controlled to < 5 min. The accuracy of the FGM system was evaluated according to the CGM guidelines. Subsequently, the factors influencing the mean absolute relative difference (MARD) of this system were analyzed by a multiple linear regression method. RESULTS Pearson's correlation analysis showed that the fingertip and scanned glucose levels were positively correlated (R = 0.86, P = 0.00). The aggregated MARD of scanned glucose was 14.28 ± 13.40%. Parker's error analysis showed that 99.30% of the data pairs were located in areas A and B. According to the probe wear time of the FreeStyle Libre FGM system, MARD1 d and MARD2-14 d were 16.55% and 14.35%, respectively (t = 1.23, P = 0.22). Multiple stepwise regression analysis showed that MARD did not correlate with blood glucose when the largest amplitude of glycemic excursion (LAGE) was < 5.80 mmol/L but negatively correlated with blood glucose when the LAGE was ≥ 5.80 mmol/L. CONCLUSION The FreeStyle Libre FGM system has good accuracy in patients with T2D who had recently migrated from highlands to plains. This system might be ideal for avoiding the effects of high hematocrit on blood glucose monitoring in populations that recently migrated to plains. MARD is mainly influenced by glucose levels and fluctuations, and the accuracy of the system is higher when the blood glucose fluctuation is small. In case of higher blood glucose level fluctuations, deviation in the scanned glucose levels is the highest at extremely low blood glucose levels.
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Affiliation(s)
- Zeng-Mei Sun
- Department of Endocrinology and Metabolism, Hospital of the People's Government of the Tibet Autonomous Region in Chengdu, Chengdu 614000, Sichuan Province, China
| | - Yuan-Ze Du
- Department of Nursing, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Su-Yuan Wang
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Shu-Yao Sun
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Yan Ye
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Xue-Ping Sun
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Ming-Xia Li
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Hua He
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Wun-Chun Long
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Cheng-Hui Zhang
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Xuan-Yu Yao
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Wu-Yi Fan
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Ling Wang
- Department of Endocrinology, Hospital of Chengdu Office of the People's Government of Tibet Autonomous Region, Chengdu 610041, Sichuan Province, China
| | - Yun-Hong Wu
- Department of Endocrinology and Metabolism, Hospital of the People's Government of the Tibet Autonomous Region in Chengdu, Chengdu 614000, Sichuan Province, China
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Yang S, Zhao H, Zhang H, Wang J, Jin H, Stirling K, Ge X, Ma L, Pu Z, Niu X, Yu D. Current status and continuing medical education need for general practitioners in Tibet, China: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:265. [PMID: 38459539 PMCID: PMC10924353 DOI: 10.1186/s12909-024-05143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/07/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND The Tibetan area is one of China's minority regions with a shortage of general practice personnel, which requires further training and staffing. This research helps to understand the current condition and demand for general practitioner (GP) training in Tibetan areas and to provide a reference for promoting GP education and training. METHODS We conducted a cross-sectional survey using stratified sampling targeting 854 GPs in seven cities within the Tibetan Autonomous Region, utilizing an online questionnaire. Achieving a high response rate of 95.1%, 812 GPs provided invaluable insights. Our meticulously developed self-designed questionnaire, available in both Chinese and Tibetan versions, aimed to capture a wide array of data encompassing basic demographics, clinical skills, and specific training needs of GPs in the Tibetan areas. Prior to deployment, the questionnaire underwent rigorous development and refinement processes, including expert consultation and pilot testing, to ensure its content validity and reliability. In our analysis, we employed descriptive statistics to present the characteristics and current training needs of GPs in the Tibetan areas. Additionally, chi-square tests were utilized to examine discrepancies in training needs across various demographic groups, such as age, job positions, and educational backgrounds of the participating GPs. RESULTS The study was completed by 812 (812/854, 95.1%) GPs, of whom 62.4% (507/812) were female. The top three training needs were hypertension (81.4%, 661/812), pregnancy management (80.7%, 655/812), and treatment of related patient conditions and events (80.5%, 654/812). Further research shows that the training required by GPs of different ages in "puncturing, catheterization, and indwelling gastric tube use" (64.6% vs. 54.8%, p = 9.5 × 10- 6) varies statistically. GPs in various positions have different training needs in "community-based chronic disease prevention and management" (76.6% vs. 63.9%, p = 0.009). The training needs of GPs with different educational backgrounds in "debridement, suturing, and fracture fixation" (65.6% vs. 73.2%, p = 0.027) were also statistically significant. CONCLUSIONS This study suggests the need for targeted continuing medical education activities and for updating training topics and content. Course developers must consider the needs of GPs, as well as the age, job positions, and educational backgrounds of GPs practicing in the Tibetan Plateau region. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Sen Yang
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
- Department of General Practice, Lazi County Health Service Center, Xigatse, Tibet, 858100, PR China
| | - Huaxin Zhao
- Department of Oncology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Hanzhi Zhang
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Junpeng Wang
- Medical Administration Affiliationision, Yangpu Hospital, Tongji University School of Medicine, Shanghai, 200090, PR China
| | - Hua Jin
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090, PR China
| | - Kyle Stirling
- Crisis Technologies Innovation Lab, Luddy School of Informatics, Computing and Engineering, Indiana University, Bloomington, IN, 47408, USA
| | - Xuhua Ge
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Le Ma
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Zhen Pu
- Department of General Practice, Lazi County Health Service Center, Xigatse, Tibet, 858100, PR China
| | - Xiaomin Niu
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai West Road, Shanghai, 200030, PR China.
| | - Dehua Yu
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China.
- Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090, PR 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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López-Bueno R, Núñez-Cortés R, Calatayud J, Salazar-Méndez J, Petermann-Rocha F, López-Gil JF, Del Pozo Cruz B. Global prevalence of cardiovascular risk factors based on the Life's Essential 8 score: an overview of systematic reviews and meta-analysis. Cardiovasc Res 2024; 120:13-33. [PMID: 38033266 DOI: 10.1093/cvr/cvad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/25/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Cardiovascular health (CVH) is a critical issue for global health. However, no previous study has determined the prevalence of cardiovascular risk factors based on the American Heart Association's (AHA) Life's Essential 8 (LE8). Therefore, we aimed to estimate the global prevalence of the eight cardiovascular risk factors identified in the LE8. A systematic search of systematic reviews with meta-analysis on cardiovascular risk factors covering data reported between 2000 and 2019 was conducted on PubMed, Epistemonikos, and the Cochrane Library until 1 May 2023. After applying exclusion criteria, 79 studies remained in the final selection for the narrative synthesis in the systematic review, of which 33 of them were used in the meta-analysis which included 2 555 639 participants from 104 countries. The overall pooled prevalence of cardiovascular risk factors was as follows: insufficient physical activity, 26.3% (95% CI 2.3%-63.4%), no adherence to a healthy diet, 34.1% (95% CI 5.8%-71.2%), nicotine exposure, 15.4% (95% CI 10.4%-21.2%), insufficient sleep quality, 38.5% (95% CI 14.0%-66.7%), obesity, 17.3% (95% CI 6.1%-32.6%), dyslipidemia, 34.1% (95% CI 33.8%-34.4%), diabetes, 12.0% (95% CI 7.0%-18.2%), and hypertension, 29.4% (95% CI 23.3%-35.8%). These results warrant prevention strategies aimed at reducing insufficient sleep quality, and no adherence to a healthy diet as leading cardiovascular risk factors worldwide. The high prevalence of hypertension among children and adults is concerning and should also be adequately addressed through global policies.
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Affiliation(s)
- Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | | | - Borja Del Pozo Cruz
- Faculty of Education, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Chan W, Li G, Zhou L, Wang J, Song L, Zhu L, Lin L, Wu B, Xiao J, Lian Y. Relationship between exposure to metalworking fluids and nonalcoholic fatty liver disease. Int Arch Occup Environ Health 2024; 97:57-64. [PMID: 38070038 DOI: 10.1007/s00420-023-02025-z] [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: 07/07/2023] [Accepted: 11/07/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE The relationship between metalworking fluids (MWFs) and nonalcoholic fatty liver disease (NAFLD) has not been previously explored. We aim to investigate the relationship between occupational exposure to MWFs and the prevalence of NAFLD and to determine the cumulative exposure threshold per day. METHODS In 2020, 2079 employees were selected randomly from one computer numerical control machining factory in Wuxi for a questionnaire survey, and occupational health examinations were conducted at the affiliated branch of Wuxi Eighth People's Hospital. MWF samples were collected within the factory using the National Institute for Occupational Safety and Health (NIOSH) 5524 method. NAFLD was defined as having a hepatic steatosis index (HSI) ≥ 36 without significant alcohol consumption. The relationship between NAFLD and MWFs was analyzed using logistic regression, and the daily exposure threshold was calculated using R software. RESULTS MWF exposure was found to be a risk factor for NAFLD in exposed workers compared to the non-exposed group. The OR for NAFLD in workers exposed to MWFs compared to controls was 1.42 (95% CI: 1.04-1.95). An increased risk of NAFLD was shown to be associated with an increasing dose. The daily exposure dose threshold to MWFs was found to be 6.54 mg/m3 (OR = 2.09, 95% CI: 1.24-3.52). CONCLUSION An association between occupational exposure to MWFs and NAFLD was found. As the concentration of exposure rose, the prevalence of NAFLD was also escalated.
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Affiliation(s)
- Weiling Chan
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Geyang Li
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Li Zhou
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Jin Wang
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Lin Song
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Lejia Zhu
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Lan Lin
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Beining Wu
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China
| | - Jing Xiao
- Department of Occupational Environmental Toxicology, School of Public Health, Nantong University, Nantong, 226001, Jiangsu, China
| | - Yulong Lian
- Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, 226001, Jiangsu, China.
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Zhang X, Zhou H, Chang X. Involvement of mitochondrial dynamics and mitophagy in diabetic endothelial dysfunction and cardiac microvascular injury. Arch Toxicol 2023; 97:3023-3035. [PMID: 37707623 DOI: 10.1007/s00204-023-03599-w] [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: 07/26/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
Endothelial cells (ECs), found in the innermost layer of blood vessels, are crucial for maintaining the structure and function of coronary microcirculation. Dysregulated coronary microcirculation poses a fundamental challenge in diabetes-related myocardial microvascular injury, impacting myocardial blood perfusion, thrombogenesis, and inflammation. Extensive research aims to understand the mechanistic connection and functional relationship between cardiac EC dysfunction and the development, diagnosis, and treatment of diabetes-related myocardial microvascular injury. Despite the low mitochondrial content in ECs, mitochondria act as sensors of environmental and cellular stress, influencing EC viability, structure, and function. Mitochondrial dynamics and mitophagy play a vital role in orchestrating mitochondrial responses to various stressors by regulating morphology, localization, and degradation. Impaired mitochondrial dynamics or reduced mitophagy is associated with EC dysfunction, serving as a potential molecular basis and promising therapeutic target for diabetes-related myocardial microvascular injury. This review introduces newly recognized mechanisms of damaged coronary microvasculature in diabetes-related microvascular injury and provides updated insights into the molecular aspects of mitochondrial dynamics and mitophagy. Additionally, novel targeted therapeutic approaches against diabetes-related microvascular injury or endothelial dysfunction, focusing on mitochondrial fission and mitophagy in endothelial cells, are summarized.
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Affiliation(s)
- Xiao Zhang
- Dermatology, Liaocheng Hospital of Traditional Chinese Medicine, Liaocheng, 252000, China
| | - Hao Zhou
- Department of Cardiology, The Sixth Medical Center of People's Liberation Army General Hospital, Beijing, 100048, China.
| | - Xing Chang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 5 Beixiagge, Xicheng District, Beijing, 100053, China.
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Xia Q, Chen Y, Yu Z, Huang Z, Yang Y, Mao A, Qiu W. Prevalence, awareness, treatment, and control of dyslipidemia in Chinese adults: a systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1186330. [PMID: 37476570 PMCID: PMC10354280 DOI: 10.3389/fcvm.2023.1186330] [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: 03/14/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
Background Researchers have conducted a considerable number of epidemiological studies on dyslipidemia in China over recent years. Nevertheless, a representative study to comprehensively appraise for the epidemiological status of dyslipidemia is still lacked. This meta-analysis is intended to explore the pooled prevalence, rates of awareness, treatment, and control of dyslipidemia among adults in Chinese Mainland. Materials and methods A systematic review was performed on relevant cross-sectional studies published since January 2012 by searching six authoritative literature databases. Meta-analyses were conducted in included studies based on a random-effect model to summarize the epidemiological status of dyslipidemia in China. A potential source of heterogeneity was detected by subgroup analysis and meta-regression. Publication bias was assessed by Egger's test and funnel plots. A sensitivity analysis was conducted to examine the study quality's influence on the pooled estimate of prevalence and rates of awareness, treatment, and control. Results Forty-one original researches with a total of 1,310,402 Chinese participants were finally included in the meta-analysis. The prevalence, rates of awareness, treatment, and control of dyslipidemia were 42.1%, 18.2%, 11.6%, and 5.4%, respectively. With a pooled prevalence estimate at 24.5%, low HDL-C was the most prevalent among various dyslipidemia types, followed by hypertriglyceridemia (TG) (15.4%), hypercholesterolemia (TC) (8.3%), and high LDL-C (7.1%). The pooled prevalence of elevated serum lipoprotein(a) [Lp(a)] was 19.4%. By gender, the prevalence of dyslipidemia was 47.3% in males and 38.8% in females. Subgroup analyses revealed that the prevalence in southern and urban areas were higher than their counterparts. Females and population in urban areas tended to possess higher rates of awareness, treatment, and control. Meta-regression analyses suggested that the year of screening influenced prevalence estimates for dyslipidemia. The impact of the study's quality on the pooled estimates is insignificant. Conclusion Our study suggested a severe epidemic situation of dyslipidemia among adults in Chinese Mainland. More importantly, the awareness, treatment, and control rates were extremely low, revealing that dyslipidemia is a grave health issue. Consequently, we should attach more importance to the management of dyslipidemia, especially in economically underdeveloped areas. Systematic review registration PROSPERO [CRD42022366456].
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Affiliation(s)
- Qianhang Xia
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zijing Yu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Zhongyue Huang
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yujie Yang
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Ayan Mao
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Wuqi Qiu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, 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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11
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Jiang B, Wang L, Zhang M, Zhao Z, Zhang X, Li C, Zhou M. The effect gap of hypertension health management services in poverty and non-poverty counties on the hypertension control: evidence from China Chronic Diseases Risk Factors Surveillance. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:38. [PMID: 37131251 PMCID: PMC10155340 DOI: 10.1186/s41043-023-00380-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/13/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND The Chinese government implemented the health poverty alleviation project (HPAP) since 2016 in poverty counties (PCs). To evaluate the effect of the HPAP on hypertension health management and control in PCs is vital for the policy improvement. METHODS China Chronic Disease and Risk Factors Surveillance programme were conducted from August 2018 to June 2019. A total of 95,414 participants aged 35 and above from 59 PCs and 129 non-poverty counties (NPCs) were involved in this study. Hypertension prevalence, hypertension control, treatment and health management prevalence, and physical examination proportion were calculated and compared by PCs and NPCs. Logistic regression was employed to explore the association between hypertension control and management services. RESULTS The hypertension prevalence in NPCs was significantly higher than that in PCs (NPCs 46.1% vs. PCs 41.2%, P < 0.001). The NPCs participants had a higher hypertension control prevalence (NPCs 32.7% vs. PCs 27.3%, P < 0.001) and treatment prevalence (NPCs 86.0% vs. PCs 80.0%, P < 0.001) than that in PCs. The proportion of physical examination in one year in NPCs was significantly higher than that in PCs (NPCs 37.0% vs. PCs 29.5%, P < 0.001). The proportion of diagnosed hypertension patients without hypertension health management in NPCs was significantly higher than that in PCs (NPCs 35.7% vs. PCs 38.4%, P < 0.001). Multivariable logistic regression showed that standardized and non-standardized hypertension health management were positively correlated with hypertension control in NPCs, and standardized hypertension health management was positively correlated with hypertension control in PCs. CONCLUSIONS These findings show the equity and accessibility gap of health resources still existed between PCs and NPCs under the influence of the HPAP. Hypertensive health management was effective for hypertension control in both PCs and NPCs. However, the quality of management services still needs to be improved.
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Affiliation(s)
- Bo Jiang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Limin Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenping Zhao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chun Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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12
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周 亚, 熊 海, 钟 怀, 万 洋, 廖 玉. [Effect of the Interaction Between Overweight/Obesity and Dyslipidemia on the Risk of Hypertension in Tibetan Population Living in Tibet]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:585-590. [PMID: 37248588 PMCID: PMC10475427 DOI: 10.12182/20230560504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Indexed: 05/31/2023]
Abstract
Objective To explore the possible interaction between overweight/obesity and dyslipidemia and to provide some evidence for the interaction of the risk of hypertension with overweight/obesity and dyslipidemia. Methods By using multi-stage stratified cluster random sampling method, the subjects of the study were randomly selected from Naqu city, Shannan city, and Ali prefecture, Tibet. A total of 4047 Tibetans with complete data were included. Investigators obtained relevant information on the subjects through questionnaire surveys, measured their height, body mass index, and blood pressure, and collected fasting venous blood samples. The multivariate logistic regression model was used to analyze the independent effects of overweight/obesity and dyslipidemia and hypertension. Stratified analysis and an additive interaction model were used to evaluate the effect of two-factor interaction on the risk of hypertension. Results The overall prevalence of hypertension, overweight/obesity, and dyslipidemia among Tibetans living in Tibet was 29.3%, 46.2%, and 40.9%, respectively. Overweight/obesity (odds ratio [ OR]=2.151) and dyslipidemia ( OR=1.240) were risk factors of hypertension. Evaluation results of the effect of additive interaction showed significant additive interaction of overweight/obesity and dyslipidemia on hypertension ( P=0.028), with the synergy index ( SI) being 1.318. Conclusion Overweight/obesity and dyslipidemia are risk factors for having hypertension and there is an additive interaction between dyslipidemia and overweight/obesity.
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Affiliation(s)
- 亚希 周
- 四川大学华西公共卫生学院/四川大学华西第四医院 老年医学/神经内科 (成都 610041)Department of Gerontology/Neurology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 海 熊
- 四川大学华西公共卫生学院/四川大学华西第四医院 老年医学/神经内科 (成都 610041)Department of Gerontology/Neurology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
- 西藏大学医学院 (拉萨 850000)School of Medicine, Tibet University, Lhasa 850000, China
| | - 怀昌 钟
- 四川大学华西公共卫生学院/四川大学华西第四医院 老年医学/神经内科 (成都 610041)Department of Gerontology/Neurology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 洋 万
- 四川大学华西公共卫生学院/四川大学华西第四医院 老年医学/神经内科 (成都 610041)Department of Gerontology/Neurology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - 玉琪 廖
- 四川大学华西公共卫生学院/四川大学华西第四医院 老年医学/神经内科 (成都 610041)Department of Gerontology/Neurology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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13
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Zhou E, Lei R, Tian X, Liu C, Guo J, Jin L, Jin H, Wang S, Cao L, Zhuoma C, Wang J, Luo B, Hu J. Association between salt sensitivity of blood pressure and the risk of hypertension in a Chinese Tibetan population. J Clin Hypertens (Greenwich) 2023; 25:453-462. [PMID: 37120829 PMCID: PMC10184482 DOI: 10.1111/jch.14663] [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: 02/06/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 05/02/2023]
Abstract
Epidemiological studies have confirmed salt sensitivity as a crucial risk factor for the development of hypertension. However, few studies have investigated the association between salt sensitivity of blood pressure (SSBP) and hypertension in Chinese Tibetan population. Therefore, we conducted a cross-sectional study based on a Tibetan population to evaluate the association between SSBP and the risk of hypertension. Seven hundred and eighty-four participants with hypertension and 645 participants without hypertension were included from five villages in Tibetan Autonomous Region of Gannan during 2013-2014. The assessment of salt sensitivity (SS) and non-salt sensitivity (NSS) was performed according to mean arterial pressure (MAP) changes by the modified Sullivan's acute oral saline load and diuresis shrinkage test (MSAOSL-DST). Logistic regression models and restricted cubic models were used to examine the association between SSBP and hypertension. There were 554 (70.5%) salt-sensitive participants with hypertension and 412 (63.9%) salt-sensitive participants without hypertension in this study. Compared with individuals with NSS, individuals with SS had a significantly increased risk of hypertension, and the multiple-adjusted odds ratios were 2.582 with 95% confidence interval of 1.357-4.912. Furthermore, a significant linear trend was found between MAP changes and hypertension. Subgroup analyses showed significant and stronger associations between SSBP and the risk of hypertension in the older (age ≥ 55 years old), males and participants who took exercise less than 1 time per week. Our results suggest that SS is associated with an increased risk of hypertension in Tibetan population, indicating a need for clinicians dealing with SSBP to decrease the risk of hypertension.
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Affiliation(s)
- Erkai Zhou
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoyu Tian
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jingzhe Guo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Limei Jin
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Hua Jin
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Shuxia Wang
- Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Liangjia Cao
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Cao Zhuoma
- People's Hospital of Xiahe County, Gannan Tibetan Autonomous Prefecture, Lanzhou, Gansu, China
| | - Jianzhong Wang
- School of Tibetan Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jihong Hu
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
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Sheng Z, Lou S, Cao J, Sun W, Shen Y, Xu Y, Ren Z, Liu W, Yi Q, Song P. The associations of obesity phenotypes with the risk of hypertension and its transitions among middle-aged and older Chinese adults. Epidemiol Health 2023; 45:e2023043. [PMID: 37054724 PMCID: PMC10593582 DOI: 10.4178/epih.e2023043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/14/2023] [Indexed: 04/15/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the associations of obesity phenotypes with hypertension stages, phenotypes, and transitions among middle-aged and older Chinese. METHODS Using the 2011-2015 waves of the China Health and Retirement Longitudinal Study, we conducted a cross-sectional analysis included 9,015 subjects and a longitudinal analysis included 4,961 subjects, with 4,872 having full data on the hypertension stage and 4,784 having full data on the hypertension phenotype. Based on body mass index and waist circumstance, subjects were categorized into 4 mutually exclusive obesity phenotypes: normal weight with no central obesity (NWNCO), abnormal weight with no central obesity (AWNCO), normal weight with central obesity (NWCO), and abnormal weight with central obesity (AWCO). Hypertension stages were classified into normotension, pre-hypertension, stage 1 hypertension, and stage 2 hypertension. Hypertension phenotypes were categorized as normotension, pre-hypertension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). The association between obesity phenotypes and hypertension was estimated by logistic regression. A comparison between different sexes was conducted by testing the interaction effect of sex. RESULTS NWCO was associated with normal→stage 2 (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.11 to 3.42), maintained stage 1 (OR, 1.62; 95% CI, 1.14 to 2.29), and normal→ISH (OR, 1.39; 95% CI, 1.05 to 1.85). AWCO was associated with normal→stage 1 (OR, 1.75; 95% CI, 1.40 to 2.19), maintained stage 1 (OR, 2.77; 95% CI, 2.06 to 3.72), maintained stage 2 (OR, 2.80; 95% CI, 1.50 to 5.25), normal→ISH (OR, 1.56; 95% CI, 1.20 to 2.02), and normal→SDH (OR, 2.54; 95% CI, 1.72 to 3.75). An interaction effect of sex existed in the association between obesity phenotypes and hypertension stages. CONCLUSIONS This study highlights the importance of various obesity phenotypes and sex differences in hypertension progression. Tailored interventions for different obesity phenotypes may be warranted in hypertension management, taking into account sex-specific differences to improve outcomes.
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Affiliation(s)
- Ziyue Sheng
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shang Lou
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Cao
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weidi Sun
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaojia Shen
- School of Public Health, Department of Maternal and Child Health, Health Science Centre, Peking University, Beijing, China
| | - Yunhan Xu
- School of Public Health, Department of Maternal and Child Health, Health Science Centre, Peking University, Beijing, China
| | - Ziyang Ren
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen Liu
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Behavioral and Metabolic Risk Factors for Noncommunicable Diseases among Population in the Republic of Srpska (Bosnia and Herzegovina). Healthcare (Basel) 2023; 11:healthcare11040483. [PMID: 36833017 PMCID: PMC9957477 DOI: 10.3390/healthcare11040483] [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: 12/04/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Noncommunicable diseases (NCDs) are the major cause of death worldwide, and they are attributable to genetic and physiological determinants, behavioral risk factors and environmental impacts. The aim of this study is to assess behavioral risk factors for metabolic disease using demographic and social-economic aspects of the population characterized by risk factors, and to investigate relations among lifestyle risk factors (alcohol consumption, tobacco use, physical inactivity, intake of vitamins, fruits and vegetables) that are responsible for the majority of NCD deaths in the Republic of Srpska's (RS's) population. This is a cross-sectional study based on the analysis of a survey conducted among 2311 adult (≥18 years) persons (54.0% women, and 46.0% men). The statistical analysis was carried out by using Cramer's V values, clustering, logistic regression (binomial, multinomial and ordinal), a chi-square test and odds ratios. In the case of logistic regression, we provide the prediction accuracy in percentages. A significant statistical correlation between demographic characteristics (gender and age) and risk factors was observed. The highest difference according to gender was observed in alcohol consumption (odds ratio (OR) = 2.705, confidence interval (95% CI) = 2.206-3.317), particularly in frequent consumption (OR = 3.164, 95% CI = 2.664-3.758). The highest prevalence of high blood pressure was registered in the elderly (66.5%); the same holds for hypertension (44.3%). Additionally, physical inactivity was one of the most common risk factors (33.4% physically inactive respondents). A significant presence of risk factors was confirmed among the RS population, with higher involvement of metabolic risk factors among the older population, while the prevalence of behavioral factors was related to younger age groups, particularly in the case of alcohol consumption and smoking. A low level of preventive awareness was observed among the younger population. Therefore, prevention is one of the most important instruments related to decreasing NCD risk factors in the RS population.
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Peng W, Jian W, Li T, Malowany M, Tang X, Huang M, Wang Y, Ren Y. Disparities of obesity and non-communicable disease burden between the Tibetan Plateau and developed megacities in China. Front Public Health 2023; 10:1070918. [PMID: 36703857 PMCID: PMC9873242 DOI: 10.3389/fpubh.2022.1070918] [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: 10/15/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023] Open
Abstract
Background Non-communicable diseases (NCDs) including risk factors, e.g., obesity, are the major causes of preventable deaths in China, yet NCD disparities in China remain under-studied. Objective This study aimed to compare the determinants and burden of NCDs within four selected provinces in mainland China: the least developed Qinghai-Tibet Plateau group (PG, Tibetan Autonomous Region [TAR] and Qinghai Province) and most developed megacity group (MCG, Shanghai, and Beijing). Methods Studies, reports, and other official sources with comparable data for NCD burden and related determinants for the four provinces were searched. Geographic, demographic, socioeconomic, and dietary characteristics and selected health indicators (e.g., life expectancy) were extracted from the China Statistical Yearbook and China Health Statistics Yearbook. Data on NCD burdens were extracted from the National Chronic Disease and Risk Factor Surveillance Study and other nationally representative studies. Results The overall NCD mortality rates and prevalence of metabolic risk factors including obesity, hypertension, and diabetes in mainland China have increased in the past 20 years, and this trend is expected to continue. The PG had the highest level of standardized mortality rates (SMRs) on NCDs (711.6-896.1/100,000, 6th/6-level); the MCG had the lowest (290.6-389.6/100,000, 1st/6-level) in mainland China. The gaps in SMRs were particularly high with regard to chronic respiratory diseases (PG 6th/6-level, MCG 1st/6-level) and cardiovascular diseases (6th/6 and 4th/6 in TAR and Qinghai; 1st/6-level and 2nd/6-level in Shanghai and Beijing). In contrast, the prevalence rates of obesity, hypertension, and diabetes were generally higher or comparable in MCG compared to PG. Diabetes prevalence was particularly high in MCG (5th/5-level, 13.36-14.35%) and low in PG (1st/5-level, 6.20-10.39%). However, awareness, treatment, and control of hypertension were poor in PG. Additionally, PG had much lower and severely inadequate intakes of vegetables, fruits, and dairy products, with additional indicators of lower socioeconomic status (education, income, etc.,) compared with MCG. Conclusion Evidence showed large disparities in NCD burden in China's provinces. Socioeconomic disparity and dietary determinants are probably the reasons. Integrated policies and actions are needed.
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Affiliation(s)
- Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, China,Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Xining, Qinghai, China,Wen Peng ✉
| | - Wenxiu Jian
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Tiemei Li
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Maureen Malowany
- Faculty of Medicine, Braun School of Public Health and Community Medicine, Hebrew University of Jerusalem—Hadassah Medical Organization, Jerusalem, Israel
| | - Xiao Tang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, China
| | - Mingyu Huang
- Medical College, Qinghai University, Xining, China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Yanming Ren
- Medical College, Qinghai University, Xining, China,*Correspondence: Yanming Ren ✉
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Ma X, Mao Y, Wang J, Zewangzhandui, Wang X. Anthropometric indices, body function, and physical fitness reference values for Tibetan ethnic children aged 6-17 residing at 3,650 meters above sea level. Front Nutr 2022; 9:1036470. [PMID: 36313099 PMCID: PMC9615562 DOI: 10.3389/fnut.2022.1036470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives It is known that high altitude influences the growth metrics of high-altitude residents. Using a WHO-recommended standard, the research aimed to establish growth and development reference values for children of Tibetan ethnicity between the ages of 6 and 17 years old. Methods The measurements took place in Jomda County, Tibet with an average altitude of 3,650 m above sea level. A total of 3,955 observations (1,932 boys and 2,023 girls) were utilized to model the centile estimations. Included in the measurements are height, weight, body mass index, heart rate, blood pressure, forced lung capacity, sit and reach, and standing long jump. The measurements were modeled using the generalized additive models for location, scale, and shape (GAMLSS). Models were fitted with suitable distributions and locally smoothed using the P-spline for each GAMLSS hyper-parameter. Using the smallest Schwarz Bayesian criterion, the optimal model for each measurement was selected. After model adjustment, centile estimations were calculated for each model. Results Compared to the height reference values at the 50th percentile for multi-ethnic Chinese children residing at low altitudes, Tibetan ethnic children exhibit apparent stunted growth. In terms of forced vital capacity, it is remarkable that Tibetan ethnic children lag behind multi-ethnic Chinese children residing at low altitudes. Heart rate and blood pressure regulation are generally normal. Centile estimations are provided in this article and tabulated centiles (1p, 3p, 5p, 15p, 25p, 50p, 75p, 85p, 95p, 97p, 99p) in Chinese, Tibetic, and English are openly available in FigShare (doi: 10.6084/m9.figshare.20898196.v1). Conclusion This study established the first GAMLSS based growth and development reference values for Tibetan ethnic children aged 6–17. These reference values have numerous clinical and scientific applications. We offer Chinese policymakers with practical initiatives to further enhance the health of Tibetan ethnic children.
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Affiliation(s)
- Xiaowei Ma
- College of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
| | - Yong Mao
- Education (Sports) Bureau of Jomda County, Chamdo, China
| | - Jian Wang
- College of Health and Exercise Science, Tianjin University of Sport, Tianjin, China,*Correspondence: Jian Wang,
| | - Zewangzhandui
- Education (Sports) Bureau of Jomda County, Chamdo, China
| | - Xiaomei Wang
- College of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
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