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Objective To establish simple screening models for nonalcoholic fatty liver disease (NAFLD) in the adult Blang population. Methods Based on the survey data of metabolic diseases in the Blang people aged 18 years or above in 2017, 2993 respondents were stratified by sex and age (at an interval of 5 years) and then randomly divided into modeling group with 1497 respondents and validation group with 1496 respondents. Related information was collected, including demographic data, smoking, drinking, family history of diseases and personal medical history, body height, body weight, waist circumference, and blood pressure, and related markers were measured, including fasting plasma glucose, 2-hour postprandial plasma glucose or blood glucose at 2 hours after glucose loading, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase. The chi-square test was used for comparison of categorical data between two groups. Logistic regression analysis was used to establish the screening model. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value were used to evaluate the screening performance of established models versus existing models in the study population, and the DeLong method was used for comparison of AUC. Results Three screening models for NAFLD were established based on physical and biochemical measurements, i.e., simple noninvasive model 1 (age, body mass index, and waist circumference), noninvasive model 2 with the addition of blood pressure, and model 3 with the combination of hematological parameters (diabetes and ALT/AST). In the modeling group, the three models had an AUC of 0.881 (95% confidence interval [ CI ]: 0.864-0.897), 0.892 (95% CI : 0.875-0.907), and 0.894 (95% CI : 0.877-0.909), respectively, and there was a significant difference between model 1 and models 2/3 ( P =0.004 0 and P 0.05). Based on the overall consideration of screening performance, invasiveness, and cost, the simple noninvasive model 1 was considered the optimal screening model for NAFLD in this population. Model 1 had the highest Youden index at the cut-off value of 5 points, and when the score of ≥5 points was selected as the criteria for NAFLD, the model had a sensitivity of 86.5%, a specificity of 79.7%, a positive predictive value of 50.3%, and a negative predictive value of 96.1% in the modeling group and a sensitivity of 85.6%, a specificity of 80.6%, a positive predictive value of 51.7%, and a negative predictive value of 95.8% in the validation group. Conclusion The NAFLD screening models established for the adult Blang population based on age and obesity indicators have relatively higher sensitivity, specificity, and negative predictive value, and this tool is of important practical significance for the intervention of NAFLD and its closely related metabolic diseases in this population.
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Objective To investigate the prevalence and associated risk factors of diabetes and prediabetes in Blang ethnic adults in Menghai county. Methods A cross-sectional survey including 3 365 Blang ethnic adults (aged 18 and above from 5 administrative villages) was conducted from February 2017 to March 2017 in Menghai county. A questionnaire, physical examination, and blood assays were included in the survey. Finally,a total of 3 237 adults with complete data were selected into this analysis. Results The standardized prevalence of diabetes and prediabetes in Blang ethnic adults were estimated based on the sixth national census in 2010. According to the 1999 WHO criteria, the overall standardized prevalence of diabetes and prediabetes were 8.5% (men: 10.2%, women: 6.8%) and 16.1% (men: 18.0%, women: 14.1%), in which the standardized prevalence of newly diagnosed diabetes among the total population was 7.3% (men: 8.7%, women: 5.8%). Multivariable multinominal logistic regression analyses showed that age, hypertension, hypertriglyceridemia, and central obesity were significantly positively associated with both diabetes and prediabetes, with the corresponding odds ratios of 1.74 and 1.37, 2.39 and 2.02, 2.30 and 1.34, 2.55 and 1.73, respectively. Conclusion The prevalence of diabetes is relatively high in Blang ethnic adults in Menghai county. Improving knowledge of diabetes among the local population is one of key steps in the prevention of diabetes.
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Objective@#To investigate the prevalence of dyslipidemia among adults in the southern mountains of Ningxia Hui Aulonomous Region.@*Methods@#A cross-sectional study was conducted among a representative sample of 10 639 adults in the southern mountains using a population proportionate-sampling method in 2014. Questionnaires were completed and physical and laboratory examinations were performed. A total of 10 172 subjects were included in the analysis after excluding those with missing data. Dyslipidemia was diagnosed according to "Chinese guidelines for the prevention and treatment of dyslipidemia in adults" (2007).@*Results@#The prevalence of dyslipidemia, hypercholesterolemia, hypertriglyceridemia, decreased high-density lipoprotein cholesterol (HDL-C), and increased low-density lipoprotein cholesterol (LDL-C) was 33.90%, 0.30%, 12.52%, 28.53%, and 1.14%, and the age-specific prevalence was 32.42%, 0.29%, 10.97%, 27.70%, and 1.07%, respectively. Borderline high triglycerides and borderline increased LDL-C were found in 13.09% and 6.52% of the study population, respectively. The rates of hypertriglyceridemia, decreased HDL-C, and dyslipidemia were higher in males than in females (P<0.05). The prevalence of dyslipidemia was higher in the group characterized by the risk factors of obesity, hypertension, diabetes, hyperuricemia, smoking, and drinking, compared to those without these factors (P<0.05).@*Conclusion@#The prevalence of dyslipidemia was higher in men than in women, and the differences were statistically significant. Hypertriglyceridemia and decreased HDL-C were the two major types of dyslipidemia. Obesity, hypertension, diabetes, hyperuricemia, smoking, and drinking alcohol increased the risk of dyslipidemia.
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Objective To investigate the prevalence and risk factors of diabetes and prediabetes in Jingyuan County in Ningxia. Methods A cross-sectional survey including 10 639 participants (18-88 years of age) with a multistage sampling was conducted in Jingyuan County between January, 2014 and April, 2015. Questionnaires, physical examinations, and laboratory tests were included in the survey. Results Among all the subjects, 10 491 participants (men: 4 826, women: 5 665) with complete data were included in the analysis. The standardized prevalence of diabetes and prediabetes was 4.2% (men: 3.9%, women: 4.5%) and 8.8% (men: 7.6%, women 10.3%), respectively, in which the standardized prevalence of diabetes was higher in Hui (4.5%) than that in Han (3.5%) (P<0.05). Logistic regression analyses showed that age, family history of diabetes, overweight/obesity, hypertriglyceridemia and hypertension were positively associated with prediabetes and diabetes with the odds ratios being 1.60 and 2.14 (age, P<0.001), 1.40 and 3.32 (family history, P< 0.05), 1.47 and 1.57 (overweight/obesity, P< 0.001), 1.88 and 2.55 (hypertriglyceridemia, P<0.001), 1.44 and 1.89 (hypertension, P<0.001), respectively. Conclusions The prevalence of diabetes was relatively low in the rural area in Ningxia. However, it is still essential to take active interventions in people at high risk of diabetes in order to prevent the incident diabetes.
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Objective To investigate the prevalences of the obesity and hypertension in southern mountain regions of Ningxia. Methods A cross-sectional study was conducted among a representative sample of 10 639 adults using questionnaires, physical examinations, and blood pressure measurement in southern mountain areas with a population proportionate sampling method. Results The prevalences of overweight,obesity,central obesity,high percentage of body fat,and hypertension were 33.53%,10.71%,19.50%,27.69%,and 31.57% respectively, which were 30.31%,9.62%,16.70%,24.90%,and 27.61% after age-adjustment in rural areas of Ningxia,and increased with aging(Ptrend<0.05). The prevalences of overweight,obesity,and hypertension were higher in males than those in females(P<0.05),and that of central obesity was higher in females than in males(P=0.003).The prevalences of hypertension in subjects with overweight, obesity, central obesity, high percentage of body fat were 38. 14%, 53.75%,52.69%,and 48.90%,respectively. Body mass index,waist circumference,and percentage of body fat were positively correlated with systolic and diastolic blood pressure(P<0.05). The multivariable logistic model revealed that the risk of hypertension in different types of obesity increased about 1.5 times. Conclusion There is high prevalence of obesity and hypertension among the adults in southern mountain areas of Ningxia. The prevalence of hypertension in obesity,central obesity,and high percentage of body fat is closed to or more than half of the population investigated.
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Objective To investigate the prevalence of nonalcoholic fatty liver disease and the risk factors in Jingyuan county of Ningxia Autonomous Region.Methods The population proportionate sampling method was applied to enroll a representative sample of 10 639 adults in Jingyuan county and the study was conducted using questionnaires and physical examinations.A total of 10 553 people were included in the analysis after excluding those with missing data.High-resolution ultrasound was used to examine the liver and fasting blood was collected in the morning for measurement of blood glucose,blood lipid,and uric acid.The participants were divided into two groups of those with and without nonalcoholic fatty liver disease;the difference in blood biochemical indexes between fatty liver and non-fatty liver groups was compared,and the logistic regression model was used to explore the risk factors affecting the prevalence of fatty liver.Results The prevalence of nonalcoholic fatty liver disease was 7.60％.The prevalence of thyroid nodules was higher in men than in women (8.60％ vs.6.82％,x2=1 1.772,P=0.001).The prevalence rate of fatty liver increased with age (x2=57.336,P＜0.001),the prevalence rates among ≥18 years-＜29 years,≥30 years-＜39 years,≥40years-＜49 years,≥50 years-＜59 years,≥60 years-＜69 years,and above 70 years were 2.92％,6.50％,8.81％,9.59％,8.08％,and 4.77％ respectively.The detection rate of overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperuricemia,and dyslipidemia were higher in nonalcoholic fatty liver disease group than in the normal group (P＜0.05).Logistic regression analysis showed that nonalcoholic fatty liver disease group had a higher risk for overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperurcemia,and dyslipidemia (OR=5.41,12.45,2.99,1.85,2.05,3.30,1.41,2.23,and 1.98).Conclusion The incidence of nonalcoholic fatty liver in Jingyuan county of Ningxia Autonomous Region was higher.The groups of overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperuricemia,and dyslipidemia were high risk factors for nonalcoholic fatty liver disease.
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Objective To investigate the prevalence of metabolic syndrome (MS) among adults in rural areas of Ningxia Hui autonomous region.Methods A cross-sectional study was conducted in 10 639 adults enrolled with a multistage method from Jingyuan County.The MS was identified according to Chinese type 2 diabetes prevention guide (2013).Results Among all the subjects, 17.4% of them met the MS definition with the standardized prevalence of 14.7% after adjustment of sex and age.The prevalence and standardized rate of MS in men were 19.9% and 17.3%, and in women were 15.3% and 13.5%.The prevalence of MS in men was higher than that in women(P<0.001) and increased with aging in both genders.The prevalence and standardized rate of abdominal obesity,hyperglycemia,hypertension,high triglycerides,and low HDL-C were 19.5% and 16.7%, 15.0% and 12.9%, 42.0% and 37.1%, 25.8% and 23.1%, 28.5% and 27.7%,respectively.The rate of abdominal obesity was higher in women than in men (20.5% vs 18.2%, P=0.004), whereas the rate of hypertension, high triglycerides, and low HDL-C were higher in men than in women (all P<0.01).The prevalence of having one parameter of the MS was 68.4%.Conclusion The prevalence of MS is higher in rural areas of Ningxia Hui autonomous region, suggesting that a series of comprehensive prevention measures should be carried out to prevent and control the MS so as to improve the public health conditions in rural areas.
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Objective To investigate the prevalence of thyroid nodules and thyroid dysfunction in southern mountainouss areas of Ningxia.Methods A cross-sectional study was conducted among a representative sample of 10 639 adults in Jingyuan county with a population proportionate sampling method.High-resolution ultrasound was used to examine the thyroid and fasting blood specimens were collected in the morning for measurement of TSH,FT4,FT3.Chi-square test and spearman rank correlation analysis were used for statistical analysis.Results The prevalence of thyroid nodules was 29.08％,the sex-and age-adjusted rate was 27.17％.The prevalence of thyroid nodules was higher in women than in men (32.68％ vs.24.88％,x2=76.029 2,P＜0.001) and age was positively associated with thyroid nodules (r=0.272,P＜0.001).The rate of thyroid dysfunetion,subclinical hypothyroidism,subclinical hyperthyroidism,hypothyroidism,hyperthyroidism were 17.39％,13.00％,0.42％,0.96％,3.01％,respectively.The prevalence of thyroid nodules was higher in abnormal TSH group than in normal TSH group (39.44％ vs.27.24％,x2=95.624 0,P＜0.001).The level of THS,FT3,FT4 in thyroid nodules group differed fromn control group (Z=-9.144,P＜0.001;Z=-6.140,P＜0.001;Z=-1.997,P=0.046).Conclusion The prevalence of thyroid nodules and thyroid dysfunction were higher in southern mountainous areas of Ningxia.The relationship between thyroid nodules and thyroid function needs further research.We should pay attention to the early screening and diagnosis of thyroid nodules in mountainous areas.
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It is important to establish an appropriate obesity-cutoff method to identify people with diabetes or at high risk of the disease.Aside from restricted cubic splines and fractional polynomial model,the receiver operating characteristic curve is the most frequently one used to define these cutoffs.In this study,we explored the obesity cutoffs across different ethnic populations and evaluated the merits/demerits of different Methods by reviewing the currently used obesity cutoffs.
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Logistics supplies are essential for normal operations of hospitals,while effective management of hospital suppliers is key to optimizing the materials supplies.An evaluation system is built for both key suppliers and standby suppliers respectively.Based on such a system,a dynamic management mechanism is built to provide long-lasting supplier incentives,for competitive selection and elimination of the suppliers.These efforts enable the hospitals to pick the best suppliers by means of systems and regulations.
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<p><b>OBJECTIVE</b>To determine whether smoking increases the risk for developing metabolic syndrome (MetS) in Chinese men.</p><p><b>METHODS</b>A total of 693 men with no MetS at baseline were followed for 2.9-5.5 years. Subjects were divided into nonsmokers, ex-smokers, and current smokers according to baseline smoking status.</p><p><b>RESULTS</b>After adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR index, and BMI at baseline and weight change, current smokers were dose-dependently associated with increased risk for developing new MetS compared with nonsmokers. The odds ratio (OR) was 2.131 (95% CI, 1.264, 3.592; P<0.01) for the NCEPIII definition or 3.083 (95% CI, 1.807, 5.295; P<0.01) for the JCDCG definition of MetS. Ex-smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition. Compared with nonsmokers, current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL-C.</p><p><b>CONCLUSION</b>Smoking is a risk factor for developing MetS in Chinese men after adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR, BMI, and weight change. This could be due to an increased incidence of dyslipidemia. Smoking cessation for >13 years decreased the risk for developing MetS defined by the JCDCG definition.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Blood Glucose , Metabolism , Body Mass Index , China , Epidemiology , Cholesterol, HDL , Blood , Diabetes Mellitus , Blood , Epidemiology , Follow-Up Studies , Hypertriglyceridemia , Blood , Epidemiology , Metabolic Syndrome , Blood , Epidemiology , Odds Ratio , Risk Factors , Smoking , Blood , Epidemiology , Waist CircumferenceABSTRACT
Objective To study the relationship between plasma creatinine and lactic acid levels in type 2 diabetic patients with normal renal function, and the effect of mefformiu administration on plasma lactic acid. Methods Blood samples were collected from 723 type 2 diabetic inpatients(275 cases treated with mefformin as treatment group and 448 without mefformin as control group). Plasma lactic acid was measured with enzyme-electrode assay. The fasting plasma glucose, fasting insulin, creatinine (Cr) , alanine aminotransferase (ALT), and HbA1C levels were also determined. Results (1) The lactic acid level in treatment group was significantly higher than that in control group [(1.33±0.57 vs 1.17±0.47) mmol/L, P<0.01] and so was the incidence of hyperlactacidemia (9.45% vs 4.91%, P<0.01). No lactic acidosis was found in all patients. (2) The correlation analysis showed that Cr, blood urea nitrogen, ALT and body mass index (BMI) were positively correlated with lactic acid in control group, and the positive correlation between Cr and lactic acid still existed (r= 0.345, P<0.01) after adjustment for ALT and BMI. (3) After being divided by 20 μmol/L Cr in control group, lactic acid levels in subgroup increased with the Cr levels, especially when Cr was over 90 μmol/L. The Cr cutpoint for predicting lactatemia was 95.35 μmol/L. Conclusion It is safe to administrate metformin in type 2 diabetic patients with normal renal function, along with low risk of lactic acidemia. The incidence of lactic acidemia may increase when plasma Cr level reaches 95.35 μmol/L,
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This study was to assess the chronic morbidity and metabolic disordelters in 262 patients with type 2 diabetes.Of all participants,64(24.4%)coexisted with peripheral neuropathy,34(13.0%)combined with peripheral vascular disease.41(15.6%)were diagnosed as diabetic retinopathy,and 46 (17.6%)had concurrent diabetic nephropathy.In comparison with diabetic patients without these complications,those with the chronic conditions generally had higher plasma glucose,blood pressure or body mass index.
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<p><b>OBJECTIVE</b>To masess the role of hypertension and family history of hypertension in the development of nephropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM).</p><p><b>METHODS</b>A retrospective analysis was done on 2 groups of NIDDM patients, one group without proteinuria (urine protein < 300mg/24h, n = 106) and the other group with proteinuria (urine protein > or = 500mg/24h, n = 106). The 2 groups were matched by age (< or = +/- 3yrs), sex, ethnic and resident place. Some information of these subjects including demographic; history of disease, family history of diseases, lifestyle and behavior style variables was obtained by questionnaire; some variables were measured, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), quantity of protein in 24h urine. Then conditional logistic regression analysis was performed.</p><p><b>RESULTS</b>Some factors, including history of hypertension, longer duration of hypertension, higher levels of the past highest SBP and DBP, were independently associated with the occurrence risk of diabetic nephropathy (DN). Their corresponding odd ratios (OR) with 95% confidence intervals (CI) were 2.00(1.17 approximately 3.43), 1.25(1.08 approximately 1.46), 1.38(1.15 approximately 1.66), and 1.33(1.09 approximately 1.62) respectively, but family history of hypertension was not significantly associated with the development of DN. When/the above-mentioned relations were respectively adjusted by some possible confounding factors, they still existed.</p><p><b>CONCLUSIONS</b>History of hypertension, longer duration of hypertension, higher levels of the past highest SBP and DBP are independent risk factors for DN in Chinese NIDDM patients.</p>