Dietary patterns and hyperglycemia in a follow-up study in Nanjing city / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the association between dietary patterns and the risk of developing hyperglycemia in Nanjing.</p><p><b>METHODS</b>Using multi-stage stratified random cluster sampling, the baseline survey was conducted on local residents older than 30 years in 7 communities from 2 urban districts from June to September 2007 in Nanjing. The total eligible subjects were 3376. Excluding the 476 previously diagnosed hyperglycemia patients, 2900 non-hyperglycemia subjects were used as the baseline sample for the follow-up survey from June to September 2010. Using specially designed food frequency questionnaire (FFQ), factor analysis was applied to identify food patterns. Multivariable linear and Cox regression models were used to analyze the association between different dietary patterns and risk of hyperglycemia.</p><p><b>RESULTS</b>The follow-up rate was 72.2%, with 2093 subjects participated the follow-up survey in 3 years. Three-year cumulative incidence of hyperglycemia was 7.5% (158/2093). The incidence rate was 7.1% (62/873) for males and 7.9% (96/1220) for females, but the differences were not statistically significant (χ(2) = 0.43, P = 0.513). Five dietary patterns were identified by factor analysis: condiment, animal and plant protein, traditional healthy, sweet food and alcohol drinking. By multivariable linear regression, on average, an increase in traditional healthy pattern and sweet food pattern of 1 unit was associated with a -0.054, 0.050 mmol/L increase in fasting blood glucose, respectively, and the differences were both statistically significant (t = -2.38, 2.27, respectively, P values were both less than 0.05). By multivariable Cox regression, the pattern sweet food was positively significantly associated with hyperglycemia risk in men. The incidence of hyperglycemia was 4.7% (14/295) for the lowest tertile of the factor score (T1), and 9.7% (26/269) for the highest tertile of the factor score (T3) (T3:T1: RR = 1.88, 95%CI: 1.04 - 3.54). The pattern traditional healthy was inversely associated with hyperglycemia risk in women. The incidence of hyperglycemia was 10.7% (45/421) for T1 and 6.3% (21/335) for T3 (T3:T1: RR = 0.59, 95% CI: 0.35 - 0.99). Conversely, a statistically significant positively association was observed for the pattern alcohol drinking in women. The incidence of hyperglycemia was 8.1% (38/472) for T1 and 11.1% (33/297) for T3 (T3:T1: RR = 1.35, 95%CI: 0.84 - 2.16).</p><p><b>CONCLUSION</b>Dietary patterns are associated with hyperglycemia. The sweet food pattern is a risk factor for hyperglycemia in men. In women, healthy dietary pattern is healthy and the alcohol drinking pattern is a risk factor for hyperglycemia.</p>

The relationship between body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio and hyperglycemia: a three-year follow-up study in Nanjing / 中华流行病学杂志

Objective To explore whether the increase of body mass index (BMI) , waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) can predict a higher risk of developing hyperglycemia. Methods A population-based cross-sectional study was conducted on local residents above 35 years of age in three urban districts and one rural county in July 2004. The subjects who were non-hyperglycemia in the baseline survey were selected to follow the survey in July 2007. Multivariable logistic regression analysis and area under curve (AUC) of receivcr-operating characteristics (ROC) were used to evaluate the predictive value of BMI, WC, WHR and WHtR. Results Of 3727 subjects without hyperglycemia who had completed in the baseline survey, 3031 of them participated in the follow-up survey, with a follow-up rate of 81.3%. The Three-year cumulative incidence of hyperglycemia was 6.7%,with male 6.3% and female 7.0%. By multiple linear regression, on average, an increase in BMI, WC, WHR, WHtR of 1 unit was associated with a 0.015 mmol/L, 0.023 mmol/L, 1.923 mmol/L, 2.382 mmol/L increase in fasting plasma glucose, respectively. The risk of developing hyperglycemia increased along with the increase of all the four indexes. When compared with other three indexes, the group which WHtR was more than 0.5, had the highest risk (male OR= 1.998, 95%CI:1.231-3.212, female OR= 1.832,95%CI: 1.157-2.902) of developing hyperglycemia. Data from ROC curve analysis showed that the AUC of WHtR was the highest in both males and females. Conclusion The increase of BMI, WC, WHR and WHtR could predict the higher risk causing the development of hyperglycemia. WHtR might serve as a simple but most effective index of hyperglycemia.

Study on the prevalence of depression and its risk factors among high school students in Nanjing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the prevalence of depression and its major risk factors among high school students in Nanjing, China.</p><p><b>METHODS</b>A population-based cross sectional study was conducted between October 2004 and December 2004. 168 classes from 56 schools were randomly selected in thirteen administrative districts/counties of Nanjing, China. Data from a total number of 7161 eligible students including 71.0% from junior high school and 29.0% from senior high school students with 49.4% boys and 50.6% girls. Among them 47.6% from urban and 52.4% from rural area. The response rate was 92.5%.</p><p><b>RESULTS</b>The overall prevalence of depression was 14.8% in this sample which was higher in boys (16.4%) than in girls (13.0%). There was no significant difference between junior and senior high school students (14.6% vs. 15.4%) or between age groups and urban rural residence. The identified major risk factors would include: lack of interest on learning, unmet academic achievements, lack of self-estimated capability of competence, too much burden on learning, lack of close friends, badving relation with friends/relatives, indifferent attitude towards friends/relatives, status of parents employment, and family structure.</p><p><b>CONCLUSION</b>The prevalence of depression was 14.8%, which was close to the figure in Asian-American high school students. More attention should be paid on the issue of mental health in high school students under the rapid transition of society, economy, life style and ideas in China.</p>