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Objective To estimate the dose-response relationship between sedentary behavior with mortality in patients with type 2 diabetes. Methods A total of 17786 type 2 diabetic patients were recruited as participants, who were included in National Basic Public Health Service in Changshu County of Suzhou City, Qinghe District and Huai'an District in Huai'an City of Jiangsu Province. Cox proportional hazards regression model and restricted cubic spline model were employed to estimate the dose-response relationship between sedentary behavior with all-cause and cause specific mortality in patients with type 2 diabetes. Results Among 78114.34 person-years of the fo1low-up, the median of follow-up time was 4 years, and 1285 deaths occurred during that period. Compared to patients with sedentary behavior≤2 h/d, the multivariate adjusted hazard ratios of all-cause death associated with sedentary behavior levels of 3-4 h/d, 5-6 h/d, and≥7 h/d were 1.05(95％CI 0.92-1.20), 1.20(95％CI 1.03-1.42), and 1.39 (95％CI 1.16-1.65), respectively. Eevry increase of 1 h/d in sedentary behavior was associated with an increased hazard of death from cardiovascular disease(CVD) of 4％(HR=1.04, 95％CI 1.01-1.07) and from other causes of 6％( HR=1.06, 95％CI 1.03-1.09) . However, no significant association between sedentary behavior and malignant tumor death was found. The multivariable restrictive cubic spline regression indicated that the linear dose-response relationships were found between sedentary time with the all-cause, CVD cause, and other cause of mortality ( Non-linear test, P>0.05) . Conclusion Longer sedentary behavior could increase the risk of mortality in patients with type 2 diabetes.
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Objective@#To evaluate the risk of 10-year risk of ischemic cardiovascular disease (ICVD) in patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu province.@*Methods@#From December 2013 to January 2014, a total of 15 624 patients with type 2 diabetes aged 35 years old and above, who received national basic public health service in Changshu county of Suzhou city, Huai′an and Qinghe districts of Huai′an city, Jiangsu province, were recruited by cluster sampling method. Face-to-face questionnaire survey, anthropometric and laboratory measurements were conducted to collect exposures to ICVD risk factors. Improved Ten Year Risk Assessment Table of ICVD in Chinese was used to assess the risk score and the absolute risk of developing ICVD.@*Results@#The participants were (62.2±9.7) years old, of which 6 137 were men (39.3%). Among the participants, the highest rate of exposure to ICVD risk factors was high systolic blood pressure (74.8%, n=11 685), followed by high total cholesterol (70.7%, n= 11 051).The score of 10-year risk for ICVD was (10.4±3.3) and the median (P25-P75) value of absolute risk was 15.6% (6.8%-32.7%). 16.7% (n=2 602) participants were under extremely high risk of 10-year risk for ICVD, 23.8% (n=3 714) under high-risk and 24.0% (n=3 746) under middle-risk. Among the total risk score of ICVD, age (49.1%), hypertension (17.7%) and diabetes (15.5%) accounted for relatively high proportion, however, smoking (11.0%) was the most important risk factor except for age (47.4%) and systolic blood pressure (20.5%) in male participants.@*Conclusion@#Patients with type 2 diabetes aged 35 years old and above in two cities of Jiangsu Province have a high risk of developing ICVD for 10 years, especially in elderly, female, hypertension patients and male smokers.
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Objective@#To investigate the association between fresh fruit consumption and status of glycemic control, among patients with type 2 diabetes mellitus (T2DM).@*Methods@#Using the stratified cluster sampling method, a cross-sectional study was conducted among 19 473 diabetic patients who were under the Disease Management Program related to the National Basic Public Health Service in Changshu county, Huai’an and Qinghe districts of Huai’an city from December 2013 to January 2014, under the combination of fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) methods, the glycemic control status in T2DM patients was assessed. Multiple logistic regression method was used to explore the relationship between fresh fruit consumption and status of glycemic control among T2DM patients.@*Results@#62.4% of the T2DM patients reported their amount of fruits intake in the past year. Both the levels of FPG and HbA1c decreased in T2DM patients, when the frequency and amount of fresh fruit consumption were increasing. Compared with patients who did not take fresh fruits, the risk of poor glycemic control in patients with fresh fruit consumption of 1-4 times/week and ≥5 times/week decreased 20% (OR=0.80, 95%CI: 0.73-0.87) and 30% (OR=0.70, 95%CI: 0.62-0.80), respectively. Patients with fruit consumption of 50-99 g/day and ≥100 g/day had lower risk of poor glycemic control, with ORs (95%CI) as 0.71 (95%CI: 0.62-0.83) and 0.68 (95%CI: 0.59-0.78), respectively.@*Conclusions@#The association of fresh fruit intake and glycemic control was statistically significant in patients with type 2 diabetes. With the increase of frequencies and amounts of fresh fruit consumption, the levels of FPG and HbA1c showed a decreasing trend. Our findings suggested that fresh fruit intake seemed helpful for glycemic control.
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Objective@#To investigate the relationship between duration of sleep and all-cause mortality in patients with type 2 diabetes.@*Methods@#A total of 17 452 type 2 diabetic patients who were under the National Basic Public Health Service Project, in Changshu county, Qinghe district and Huai’an district in Huai’an city of Jiangsu province, were recruited as participants. Cox proportional hazards regression models were used to estimate the associations between different levels on the duration of sleep and all-cause mortality. Stratified analysis was performed according to factors as gender, age, and lifestyle.@*Results@#Among the 67 912 person-years of observation, from the fo1low- up program, the median time of follow-up was 4 years, with 1 057 deaths occurred during the follow-up period. Taking patients with duration of sleep as 7 h/d for reference, the multivariate adjusted hazard ratios (95%CI) of all-cause mortality appeared as ≤6, 8, 9 and ≥10 h/d were 1.14 (0.94-1.37), 1.10 (0.91-1.32), 1.33 (1.05-1.70), and 1.52 (1.24-1.87), respectively which were associated with the duration of sleep. Data from the subgroup analysis showed that this was consistent with the whole population. Longer duration of sleep was associated with the all-cause mortality but no significant association was found between shorter duration of sleep and the all-cause mortality.@*Conclusion@#Longer duration of sleep seemed to have increased the risk of all-cause mortality in type 2 diabetic patients.
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Objective To explore the control levels of blood glucose,blood lipid,blood pressure(BP),and body mass index(BMI)in the community-managed patients with type 2 diabetes in Jiangsu and to provide the basis for better management of type 2 diabetes in communities. Methods From December 2013 to January 2014,20 053 patients with type 2 diabetes and have received disease management according to the National Basic Public Health Service were recruited in Changshu County of Suzhou City, Huai'an and Qinghe Districts of Huai'an City. Questionnaire survey, anthropometric and laboratory measurements were conducted. According to the Chinese guidelines for type 2 diabetes prevention and treatment(2013),the control levels of blood glucose,blood lipid,BP, and BMI were assessed. Results Among 20 053 patients with type 2 diabetes,the proportions for controlled fasting plasma glucose(FPG) and HbA1Cwere 31.4% and 41.9% respectively,and 25.3% of the patients simultaneously achieved goals of FPG and HbA1Ccontrol. There were 23.9%,55.7%,75.5% and 24.2% of the patients met goals for total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol(LDL-C), respectively. Only 10. 3% of the patients achieved all the 4 targets of blood lipid. Furthermore,there were 25.4% and 35.9% patients achieved BP and BMI targets respectively,and the control rates for BP and BMI of females were higher than those of males(all P<0.05). Less than 1% of the patients had all eights indices controlled at target levels. Conclusions The achievement of comprehensive targets among community patients with type 2 diabetes remains poor in Jiangsu. Follow-up and management of type 2 diabetes should be strengthened in communities,health education and comprehensive intervention on disease complications should also be reinforced accordingly.
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Objective To explore the relation of sleep duration and control of HbA1Camong type 2 diabetes mellitus ( T2DM) under community management in Huai'an city. Methods There were 9 393 T2DM patients enrolled from Qinghe district and Huai'an district from Huai'an city using multi-stage cluster sampling method. The level of HbA1Cwas categorized as control group (＜7%) and uncontrolled group (≥7%), and sleeping duration was categorized as＜6 h, 6-8 h, and ＞8 h. Non-conditional logistic regression analysis was utilized to analyze the association between sleep duration and control of HbA1C. No confounders were adjusted in logistic regression model 1;and age, sex, and body mass index were adjusted in model 2 and furthermore, in model 3, smoking, drinking, education, duration of diabetes, familial history of diabetes, activity, and medication were adjusted plus variables in model 2. Stratified analyses were also used to explore the association above. Results Subjects with sleep duration＞8 h had a high risk of uncontrolled HbA1Cwhen compared with subjects for sleep duration of 6-8 h with OR＝1.188 ( P＝0.001) and the association were still existed with OR＝1.191 (P＝0.001) after Bonferroni adjusted and adjustment of age, sex, and body mass index. Whereas, with further adjustment of confounders in model 3, the association was vanished. Results of stratified analyses indicated that with Bonferroni adjustment, overweight patients with sleep duration of＜6 h had a lower risk of uncontrolled HbA1Cwith OR＝0.788 and 0.799, respectively, in model 1 and model 2 (both P＜0.05). Meanwhile, patients of female, or age≥60 years, or body mass index＜24 kg/m2, or disease duration≤3.58 years had high risk of uncontrolled HbA1Cwhen sleep duration＞8 h. Conclusion T2DM patients with sleep duration＞8 h were negative for HbA1Ccontrol, and this association was independent of age, sex, and body mass index, but was influenced by the duration of diabetes, activity, medication, familial history of diabetes, smoking, drinking, and education. Sleep duration in patients of female, age≥60 years, body mass index＜24 kg/m2, and short disease duration, should be appropriately adjusted.
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Objective To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods From December 2013 to January 2014, a total of 7763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results The prevalence of current smoking was 45.5%in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers (P<0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95%CI: 0.05%-0.49%) and 0.38% (95%CI: 0.23%-0.53%),respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers (P<0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.
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A total of 9 806 type 2 diabetics managed by the communities were selected by the stratified cluster random sampling.The characteristics, behavior and life style, history of diseases and treatments, and familial history were collected by a standard questionnaire.Their heights and weights were measured.Furthermore, their HbA1C was tested.Logistic regression was used to analyze the association between familial history of diabetes and glycemic control.The results showed that among the diabetics, patients with familial history accounted for 18.99%, and glycemic control rate was 42.72%.Compared with the diabetics without familial history, glycemic control rate in patients with parental history of diabetes and with many relatives decreased by 0.27 fold (OR=1.27, 95%CI 1.01-1.59) and 1.01 fold (OR=2.01, 95%CI 1.25-3.23), suggesting that family history of diabetes could reduce the glycemic control rate.
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Objective To understand the status of renal function abnormalities and explore its influencing factors in a community-based population with type 2 diabetes mellitus (T2DM).Methods Totally 9 413 patients with T2DM who have registered and received management of community public health service in 2014 were recruited in our study.All participants undertook questionnaire survey,physical examination and laboratory test.A simplified MDRD formula was used for estimating Glomerular Filtration Rate (eGFR),and Logistic Regression method was used to analyze the risk factors.Results The average eGFR was 91 ml/min · 1.73 m2 and the attack rate of people with eGFR ＜60 ml/min 1.73 m2 was 10.56％.The difference of renal function in participants with different age and gender was significant(x2 =6.306,P =0.012;x2 =269.293,P ＜ 0.001).Renal function in male patients and older patients was more worse.Multivariate analysis showed that long duration of diabetes,high levels of low density lipoprotein (LDL),total cholesterol (TC) and triglycerides (TG),uncontrolled blood glucose were independent risk factors for renal dysfunction.Conclusions Patients with T2DM are susceptible to renal function abnormalities.Comprehensively control of blood glucose,blood lipid and blood pressure should be performed to decrease the risk of the disease.
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Objective To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods From December 2013 to January 2014, a total of 7763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results The prevalence of current smoking was 45.5%in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers (P<0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95%CI: 0.05%-0.49%) and 0.38% (95%CI: 0.23%-0.53%),respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers (P<0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.
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Objective To explore the clinical features of type 2 diabetic patients with hypertension , and to analyze the influencing factors of glycemic control. Methods Using stratified cluster random sampling method, 5 communities were selected from urban areas of Huai'an in 2014. Type 2 diabetic patients managed by the communities were surveyed with questionnaire, physical and biochemical examinations. The related information and clinical features were compared between diabetic patients with and without hypertension. Logistic regression analysis was used to analyze the influencing factors of glycemic control. Results The number of well-controlled diabetic patients (HbA1c<7.0%) with and without hypertension (HbA1c<7.0%) were 419 (39.3%) and 480 (52.1%), respectively. Mean values of body mass index (BMI), diabetic duration and serum creatinine in diabetic patients with hypertension were significantly higher than those in diabetic patients without hypertension (P<0.05). The proportions of macrovascular complications and dyslipidemia in diabetic patients with hypertension were significantly higher than diabetic patients without hypertension (P<0.05). Multiple logistic regression analysis showed that high degree of education, high annual family income and high frequency of glucose monitoring were beneficial factors for glycemic control in diabetic patients with hypertension. Older age, hypertension, higher waist to hip ratio (WHR), the elevated triglyceride and serum creatinine were harmful factors for glycemic control. Conclusions The situation of glycemic control in diabetic patients with hypertension in urban areas of Huai'an is not optimistic. Therefore, community managements of risk factors such as central obesity and increased triglyceride in elder diabetic patients should be strengthened.
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Objective This study was to understand the status of pollution on drinking water, by volatile organic compounds(VOCs),among rural residents living in the basin of Huaihe River. Relationship between the morbidity,morbidity of cancers and VOCs were also explored. Methods 28 villages were chosen from Xuyi,Jinhu,Chuzhou along the Huaihe River,with water samples collected from ditch pond water,shallow wells,deep wells in November-December 2010. VOCs indicators were evaluated according to the Standard Quality GB 5749-2006 for Drinking Water. Results Methylene chloride,chloroform,benzene and carbon tetrachloride were all detected in 76 water samples. The rates of chloroform,benzene,carbon tetrachloride which exceeding the quality standards were 3.95%,21.05% and 22.37%,but no significant differences were found among these three water resources in chloroform,benzene or carbon tetrachloride. Results from the correlation analysis showed that benzene had positive correlation with tumor deaths(r=0.24,P<0.05). Results from the risk assessment on health showed that some chloroform,benzene,carbon tetrachloride products which were related to the risks of cancers were exceeding the acceptable ranges of risk,with the rates as 28.95%,22.37% and 64.47% but with no significant differences among the three water resources(P>0.05). Conclusion Drinking waters for rural residents along the Huaihe River were polluted while VOCs might have related to tumor incidence with potential impact and risk to the health of local residents.
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Objective This study was to understand the status of pollution on drinking water, by volatile organic compounds(VOCs),among rural residents living in the basin of Huaihe River. Relationship between the morbidity,morbidity of cancers and VOCs were also explored. Methods 28 villages were chosen from Xuyi,Jinhu,Chuzhou along the Huaihe River,with water samples collected from ditch pond water,shallow wells,deep wells in November-December 2010. VOCs indicators were evaluated according to the Standard Quality GB 5749-2006 for Drinking Water. Results Methylene chloride,chloroform,benzene and carbon tetrachloride were all detected in 76 water samples. The rates of chloroform,benzene,carbon tetrachloride which exceeding the quality standards were 3.95%,21.05% and 22.37%,but no significant differences were found among these three water resources in chloroform,benzene or carbon tetrachloride. Results from the correlation analysis showed that benzene had positive correlation with tumor deaths(r=0.24,P<0.05). Results from the risk assessment on health showed that some chloroform,benzene,carbon tetrachloride products which were related to the risks of cancers were exceeding the acceptable ranges of risk,with the rates as 28.95%,22.37% and 64.47% but with no significant differences among the three water resources(P>0.05). Conclusion Drinking waters for rural residents along the Huaihe River were polluted while VOCs might have related to tumor incidence with potential impact and risk to the health of local residents.
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<p><b>OBJECTIVE</b>This study was to understand the status of pollution on drinking water, by volatile organic compounds (VOCs), among rural residents living in the basin of Huaihe River. Relationship between the morbidity, morbidity of cancers and VOCs were also explored.</p><p><b>METHODS</b>28 villages were chosen from Xuyi,Jinhu, Chuzhou along the Huaihe River, with water samples collected from ditch pond water, shallow wells, deep wells in November-December 2010. VOCs indicators were evaluated according to the Standard Quality GB 5749-2006 for Drinking Water.</p><p><b>RESULTS</b>Methylene chloride, chloroform, benzene and carbon tetrachloride were all detected in 76 water samples. The rates of chloroform, benzene, carbon tetrachloride which exceeding the quality standards were 3.95% , 21.05% and 22.37% , but no significant differences were found among these three water resources in chloroform, benzene or carbon tetrachloride. Results from the correlation analysis showed that benzene had positive correlation with tumor deaths (r = 0.24, P < 0.05). Results from the risk assessment on health showed that some chloroform, benzene, carbon tetrachloride products which were related to the risks of cancers were exceeding the acceptable ranges of risk, with the rates as 28.95%, 22.37% and 64.47% but with no significant differences among the three water resources (P > 0.05).</p><p><b>CONCLUSION</b>Drinking waters for rural residents along the Huaihe River were polluted while VOCs might have related to tumor incidence with potential impact and risk to the health of local residents.</p>