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Objective:To establish a more suitable and practicable criterion of metabolically healthy overweight/obesity (MHO/O) in Chinese, a comparison study on different criteria of MHO/O was conducted in subjects aged over 45-year-old in Shanghai Changfeng Community.Method:A total of 3 301 overweight/obese subjects over 45 years old (men 1 521, women 1 789) in Shanghai Changfeng Community was included in the study. According to the inclusion or exclusion of waist circumference (WC), homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.5, and numbers of abnormal metabolic components, the MHO/O criteria were divided into 7 types: Adult Treatment Panel Ⅲ (ATP-Ⅲ) (with WC)<1 component, ATP-Ⅲ (with WC)<2 components, ATP-Ⅲ (with WC)<3 components, ATP-Ⅲ (without WC)<1 component, ATP-Ⅲ (without WC)<2 components, adjusted metabolic associated fatty liver disease (MAFLD) criteria<1 component, and adjusted MAFLD criteria<2 components. The prevalence of MHO/O and its relationship with the changes of body mass index (BMI), and the differences of the characteristics of MHO/O among the 7 types of metabolic health standards were compared.Result:The prevalence of MHO/O according to the ATP-Ⅲ (with WC)<1, ATP-Ⅲ (with WC)<2, ATP-Ⅲ (with WC)<3, ATP-Ⅲ (without WC)<1, ATP-Ⅲ (without WC)<2, adjusted MAFLD criteria<1, and adjusted MAFLD criteria<2 was 2.85%, 15.48%, 39.87%, 8.00%, 33.66%, 2.33%, 12.24%, respectively. The prevalence of MHO/O decreased as BMI increased. When BMI ≥ 28 kg/m 2, the prevalence of MHO/O by ATP-Ⅲ (with WC)<1 and adjusted MAFLD criteria<1 dropped to 0. Conclusion:The adjusted MAFLD criterion without abnormal metabolic components is the most practicable definition of MHO/O.
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Objective To evaluate the diagnostic value of quantitative ultrasound test (QUS) in osteoporosis screening by comparing stiffness index (STI) calculated by QUS and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in Chinese community population.Methods A total of 6 105 residents aged 45 years and over from Shanghai Changfeng community were recruited.BMD of lumbar spine (L1-L4) and both femur measured by DXA and calcaneus STI calculated by QUS were observed simultaneously in the same day.The sensitivity,specificity and accuracy of QUS and DXA (gold standard) on the diagnosis of osteoporosis were compared.Results The prevalence of osteopenia or osteoporosis diagnosed by DXA and QUS was 38.82％,10.29％ and 64.50％,4.49％ respectively.STI was correlated with BMD of spine,left and right femur,respectively with the correlation coefficients of 0.536,0.574 and 0.570 (all P ＜ 0.001).The sensitivity and specificity of QUS for osteopenia was 86.16％ and 47.57％ and for osteoporosis was 23.57％ and 97.70％.Conclusion STI calculated by QUS had a good correlation with BMD measured by DXA.The high sensitivity and specificity of QUS made it as a diagnostic tool for osteopenia and osteoporosis screening in community health care center.
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Objective To explore the clinical performance and related factors of perimenopausal syndrome,cognition and demand for perimenopausal knowledge in community-dwelling women.Methods During June 2009 to December 2011,a cross-section survey of perimenopausal symptoms as well as cognition and demand for perimenopausal knowledge was conducted in 1546 women aged 45 to 65 years in Shanghai Changfeng Community.Results The average menopausal age of this population was (49.5 ±3.7) years.The total prevalence of perimenopausal syndrome was 75.7％ (n =1094) and 81.4％,76.5％,65.4％ in women with primary school,middle school and college education background respectively (P=0.007).Sexual disorders (80.8％),hot flushes & sweating (64.7％) and fatigue (55.8％) were the most common symptoms of perimenopause.The most serious symptoms affecting daily lives included urinary symptoms,unsatisfactory sexual life and hot flushes & sweating.And 391 (27.1％),238 (16.5％),285 (19.8％) and 296 (20.5％) women did not know the concept of perimenopausal syndrome,possible symptoms,health measures or symptoms requiring medical attention.The common methods of acquiring the knowledge of perimenopause were communicating with peers (458,31.7％),consulting professionals (364,25.2％) and searching health care information (225,17.6％).Conclusions In women,the prevalence of perimenopausal syndrome remains quite high.And a majority of them lack a sufficient knowledge of perimenopause and need professional guidance.
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ObjectiveTo explore the best measurement of waist circumference related with intra-abdominal fat volume evaluated by CT scan.MethodsHeight,weight,and hip circumference were measured among 147 subjects aged over 18 years old.Waist circumference was measured at 3 different levels:the upper brim of the iliac crest ( WC1 ),the midpoint between costal brim and iliac crest ( WC2 ),and the umbilicus ( WC3 ).The intra-abdominal fat volume was evaluated by CT scan.ResultsIntra-abdominal fat volume was significantly higher in men than in women [ ( 1 236.0±608.4 vs 931.0±665.0)cm3,P＜0.01 ].Correlation analysis showed that WC1 ( r =0.634),WC2( r=0.677),and WC3 (r =0.712)were positively correlated with intra-abdominal fat volume ( all P＜0.01 ).Partial correlation analysis adjusted by gender,weight,or body mass index showed that the correlation of intra-abdominal fat volume with WC3 ( r were 0.488 and 0.432) was better than that with WC1( r were 0.347 and 0.293 ) and WC2 ( r were 0.424 and 0.365 ).Multiple linear stepwise regression analysis demonstrated that WC2 and WC3 were independently associated with intra-abdominal fat volume and WC3 was the strongest impact factor (β =0.270,R2c =0.504,P＜0.01 ).ConclusionsWaist circumference is a simple anthropometric measurement parameter reflecting the degree of intraabdominal fat accumulation.All three different measurements of waist circumference may reflect intra-abdominal fat volume,while waist circumference at umbilical level is the best among them.
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<p><b>OBJECTIVE</b>To investigate the association of retinal vascular calibers with hyperuricemia in a middle-aged and elderly population.</p><p><b>METHODS</b>A cross-sectional design was applied in this study and 869 participants aged =40 years from a high-risk group for diabetes were recruited. All participants received the anthropometrical measurements and laboratory tests. Retinal arteriolar and venular caliber of the participants were measured with a semi-automated system. Hyperuricemia was defined as a serum uric acid level >420 μmol/L in men and >360 μmol/L in women. Linear regression models were used to assess the association of hyperuricemia with retinal vascular calibers. These models were additionally adjusted for age, central obesity, hypertension, dyslipidemia, weekly activity, smoking status, and education.</p><p><b>RESULTS</b>Among the 869 participants, 133 (15.3%) suffered from hyperuricemia. The crude mean serum uric acid level was 312.3 μmol/L (Standard Deviation 79.5); mean concentration was 355.0 μmol/L (SD 75.5) in male participants, and 288.0 μmol/L (SD 71.1) in female participants (age-adjusted difference 58.1 μmol/L, 95% Confidence Internal 48.5, 67.6). After adjusting for additional covariates, male participants with hyperuricemia had 3.77 μm (95% CI -0.46, 8.00) smaller arteriolar caliber and 6.20 μm (95% CI 0.36, 12.04) larger venule than those without hyperuricemia; the corresponding numbers among female participants were 1.57 μm (95% CI -1.07, 4.21) for retinal arteriolar caliber and 2.28 μm (95% CI -1.72, 6.27) for retinal venular caliber.</p><p><b>CONCLUSION</b>Hyperuricemia was associated with smaller retinal arteriolar caliber and larger venular caliber mainly in male participants in this study.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , China , Epidemiology , Diabetes Mellitus , Epidemiology , Hyperuricemia , Retinal Vessels , Pathology , Risk Factors , Sex CharacteristicsABSTRACT
Objective To study the association of liver fat content (LFC) with insulin resistance and β cell function. Methods One hundred and nine subjects including 31 cases with impaired glucose regulation (IGR), 31 newly diagnosed type 2 diabetes (NT2DM) and 47 normal controls (NC) with normal metabolic parameters were involved in the study. LFC was measured by 1H magnetic resonance spectroscopy (1H MRS) and the insulin resistance and β cell function were evaluated by oral 75 g glucose tolerance test. Results (1 ) LFCs were3.83% (2.35% ～7.59% ) ,12. 82% (8.10%～21.37%), and 21.99% (11.89%～34.43%), being progressively raised in the respective NC, IGR, NT2DM groups(P<0.01). (2) The subjects were divided into four subgroups according to LFC Quartile: Quartile 1 (LFC<4. 04% ) , Quartile 2(4. 04% ≤LFC<9. 77% ), Quartile 3 (9.77% ≤LFC<20.78% ) ,and Quartile 4( LFC≥20.78% ). Homeostasis model assessment of insulin resistance index (HOMA-IR) values were elevated significantly and progressively starting from Quartile 2(P<0. 01). (3) Insulin from 0 to 30 min ( △I30), the ratio of insulin from 0 to 30 min to glucose from 0 to 30 min ( △I30/ △G30) , C peptide from 0 to 30 min (△CP30) had a trend of increase in Quartile 2,then trended to decrease in Quartile 3. In Quartile 4, △CP30 and △I30/△G30 sharply decreased (P<0.05 or P<0.01). The ratio of C peptide from 0 to 30 min to glucose from 0 to 30 min ( △CP30/△G30) began to decrease from Quartile 3 (P<0. 05). The ratio of area under curve of C peptide to area under curve of glucose (CPAUC/GAUC) was significantly decreased from Quartile 3(P<0.05). From Quartile 3,glucose level became abnormally elevated to impaired fasting glucose and impaired glucose tolerance (P<0.01). (4) LFC was positively correlated with HOMA-IR (rs =0. 618 ,P<0.01), but was negatively correlated with △CP30(rs =-0.282), △CP30/△G30(rs = -0. 404), and CPAUC/GAUC(rs = -0. 308,all P<0.01). (5) Stepwise regression analysis demonstrated that LFC was the strongest predictor of HOMA-IR. Conclusions When LFC accumulated to 4% , insulin resistance occurred and the early phase of insulin secretion was compensatively increased. As the LFC further accumulated to 10% , both the early phase as well as β cell function in whole were deteriorated, and hyperglycemia developed.
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Objective To study the prevalence of metabolic syndrome (MS) in patients with type 2 diabetes according to three different diagnostic criteria and the effects of accumulation of MS components on blood lipid profile and to explore possible causes of their increased morbidity of cardiovascular diseases. Methods Components of MS and blood lipid profile were observed cross-sectionally in 157 patients with type 2 diabetes and analyzed using recommended diagnostic criteria by the World Health Organization (WHO, 1999), the National Cholesterol Education Program-Adult Treatment PanelⅢ( NCEP-ATPⅢ, 2001) and the Chinese Diabetes Society under Chinese Medical Association (CDS, 2004). Results Prevalence of MS was 73. 9% , 49. 7% and 52. 9% , and that of dyslipidemia was 54. 8% , 61. 2% and 54. 8% , with the criteria by WHO, NCEP-ATPⅢand CDS, respectively. Dyslipidemia was included in the most common combinations of MS. Blood level of triglycerides increased significantly, that of high density lipoprotein cholesterol ( HDL-C) decreased significantly, and size of low density lipoprotein cholesterol (LDL-C) particles decreased with the increase of the number of MS components, with a more significant coefficient of correlation by the criteria of CDS than that by the other two criteria. Conclusions In patients with type 2 diabetes, prevalence of MS could be more than 50% , most of them complicated with dyslipidemia, one of the most common components of MS, including elevated triglycerides, decreased HDL-C and decreased size of LDL-C particles, which could easily cause cardiovascular disease. The criteria by CDS could reflect the change in blood lipid profile in Chinese population more objectively.