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Objective: To investigate the distribution of blood pressure and analyze the associated factors of blood pressure of the elderly with type 2 diabetes in Jiangsu Province. Methods: The elderly over 60 years old participants with type 2 diabetes in the communities of Huai'an City and Changshu City, Jiangsu Province were selected in this study. They were divided into two groups: taking antihypertensive drugs and not taking antihypertensive drugs. The demographic characteristics, such as age and sex, and relevant factors were collected by questionnaire. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by physical examination. The percentile of SBP and DBP in each age group of men and women were described. The kernel density estimation curve was used to show the blood pressure distribution. The trend of blood pressure with age was fitted by locally weighted regression. The logistic regression model was used to analyze relevant factors of blood pressure. Results: A total of 12 949 participants were included in this study, including 7 775 patients in the antihypertensive drug group and 5 174 patients in the group without antihypertensive drugs. The SBP of participants was concentrated at 140-160 mmHg, and their DBP was concentrated at 75-85 mmHg. There were significant differences in the distribution of blood pressure among the subgroups of body mass index (BMI) and rural areas whether taking antihypertensive drugs and not. For participants aged under 80 years old, the SBP showed an increasing trend with age and the DBP showed a decreasing trend with age. Age, BMI ≥24 kg/m2, fasting blood glucose ≥7.0 mmol/L, living in rural areas and no smoking were influencing factors of the elevated SBP; BMI ≥24 kg/m2, male, living in rural areas, no smoking, drinking alcohol and not receiving drug hypoglycemic treatment were influencing factors of the elevated DBP. Conclusion: The SBP of older diabetic adults in Jiangsu Province is at a high level, and the distribution of blood pressure is significantly different between men and women in taking antihypertensive drugs group. The SBP presents a rising trend and the DBP is decreasing at the age of 60-80 years. The blood pressure level of this population are mainly affected by age, BMI, urban and rural areas, smoking.
Subject(s)
Adult , Aged , Humans , Male , Female , Middle Aged , Aged, 80 and over , Blood Pressure/physiology , Diabetes Mellitus, Type 2/epidemiology , Antihypertensive Agents/therapeutic use , Smoking , Body Mass Index , Hypertension/epidemiologyABSTRACT
Objective To explore the spatiotemporal distribution pattern, and identify risk cluster of esophageal cancer in Huai’an City so as to provide evidence for control and prevention of esophageal cancer. Methods Data of esophageal cancer incidence at township level in Huai’an City from 2011 to 2015 was collected. Spatial autocorrelation and local indications of spatial autocorrelation (LISA) were implemented to evaluate the spatial pattern of esophageal cancer incidence. Spatial scan statistics was used to examine spatio-temporal clustering of risk areas. Results The average incidence of esophageal cancer in Huai’an from 2011 to 2015 was 67.12/10 million, the incidence of male was significantly higher than that of female. The results of Moran’s I values implyed the spatial autocorrelation at township level. The results of LISA indicated that there were local hot spots and cold spots. The significant high-risk clusters included townships in Huai’an County, Huaiyin County and Jinhu County. The low-risk clusters were located in the main urban area and Xuyi County. Conclusions There are significant spatio-temporal aggregation for the distribution of incidence of esophageal cancer in Huai’an City and same spatiotemporal high-risk clusters between male and female. Our findings have a foundation to explore the multi-factorial etiology of esophageal cancer and have vital practical value for health services and policies implementation.
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Objective The aim is to investigate the association between body mass index (BMI) and risk of all-cause mortality among patients with type 2 diabetes. Methods A total of 17 638 patients with type 2 diabetes registered in the management of National Basic Public Health Services in two areas of southern and northern Jiangsu were recruited. Cox proportional risk regression model was used to calculate the hazard ratio(HR) value and 95% confidence interval (95% CI) of different BMI groups in the follow-up period. Results The subjects were followed up for a total of 77 451 person-years with an average duration of 4.39 years, and 1 274 patients died during the follow-up period. The number of death in low weight group (BMI<18.5 kg/m2), normal weight group (18.5 kg/m2≤BMI<24 kg/m2), overweight (24 kg/m2≤BMI<28 kg/m2) and obese group (BMI≥28 kg/m2) were 39, 575, 484 and 176 respectively.The corresponding mortalities were 15.6%, 9.5%, 6.2% and 5.1%, respectively. Compared to normal weight group, the adjusted HR of all-cause mortality in low weight, overweight and obese group were 1.66 (95% CI: 1.20-2.30), 0.68 (95% CI: 0.61-0.77), 0.58 (95% CI: 0.48-0.68), respectively. Conclusions Low-weight patients have the highest risk of all-cause mortality compared with normal counterparts, while both overweight and obese people have a lower risk of death. Overweight and obesity may reduce the risk of all-cause mortality in type 2 diabetic patients.
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<p><b>OBJECTIVE</b>To develop a risk model for predicting later development of diabetic nephropathy (DN) in Chinese people with type 2 diabetes mellitus (T2DM) and evaluate its performance with independent validation.</p><p><b>METHODS</b>We used data collected from the project 'Comprehensive Research on the Prevention and Control of Diabetes', which was a community-based study conducted by the Jiangsu Center for Disease Control and Prevention in 2013. A total of 11,771 eligible participants were included in our study. The endpoint was a clear diagnosis of DN. Data was divided into two components: a training set for model development and a test set for validation. The Cox proportional hazard regression was used for survival analysis in men and women. The model's performance was evaluated by discrimination and calibration.</p><p><b>RESULTS</b>The incidence (cases per 10,000 person-years) of DN was 9.95 (95% CI; 8.66-11.43) in women and 11.28 (95% CI; 9.77-13.03) in men. Factors including diagnosis age, location, body mass index, high-density-lipoprotein cholesterol, creatinine, hypertension, dyslipidemia, retinopathy, diet control, and physical activity were significant in the final model. The model showed high discrimination and good calibration.</p><p><b>CONCLUSION</b>The risk model for predicting DN in people with T2DM can be used in clinical practice for improving the quality of risk management and intervention.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Asian People , Diabetes Mellitus, Type 2 , Diabetic Nephropathies , Pathology , Models, Biological , Reproducibility of Results , Risk Factors , Urban PopulationABSTRACT
Objective To explore the association of body mass index (BMI),waist circumstance (WC)and the risk of hypertension among residents.Methods Multi -stage stratified random sampling was conducted to recruit the study objects in Huai'an City.The questionnaire investigation and body measurement were conducted to collect relevant data. Results The prevalence rates of hypertension in male and female residents of Huai'an City were 28.73% and 28.08%, respectively,with the standardized rates were 20.22% and 19.39%.Influencing factors of hypertension were gender (OR=0.88,95%CI :0.815 -0.952),age(OR =1.55,95%CI :1.503 -1.601),WC(OR =1.40,95%CI:1.294 -1.518),BMI (OR =1.50,95% CI:1.417 -1.578 ),respectively.Conclusion BMI and WC were related to hypertension.The control of BMI and WC can prevent hypertension effectively.
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Objective To explore the distribution of water with high level arsenic and prevalence of arsenism along Huai'he River and the surrounding area of Hong'ze lake in Huai'an of Jiangsu. Methods Wate rsamples were collected and tested in 2008 from 18 villages of 6 towns according to history data in 3 counties like Xuyi,Jinhu and Hongze. Samples having arsenic level higher than 0.05 mg/L were investigated by epidemiological method and the patients were diagnosed by Standard of Diagnosis for Endemic Arsenism. Results All 5199 water samples were determined,and 260 water samples were exceeding the national drinking water quality level (0.05 mg/L) in 3 counties,the rates of exceeding diagnosis were 5.6%(247/4454),0.7%(4/597),6.0%(9/148) respectively. Total detected rate of endemic arsenic disease was 5.94%(128/2155). The detected rates of age group of 0 ～ ,20 ～,30 ～ ,40 ～ ,50 ～ ,60 ～ ,70 ～ ,80 ～ were 2.86%(1/35),2.11%(2/95),1.26%(3/239),3.10%(16/516),5.53% (32/579),10.07%(41/407),11.84%(27/228),10.71%(6/56) respectively. The detected rate of male (9.10%,78/857) was higher than that of female(3.85%,50/1298,χ~2 = 25.46,P < 0.01). Conclusions Huai'he River and the surrounding areas of Hong'ze lake like Xuyi,Jinhu and Hongze are identified existing endemic arsenic disease area. The prevention of arsenism should be strengthened in these areas.