Association between cardiometabolic diseases and quality of life and the mediation effect of perceived stress / 中华心血管病杂志

Objective: To explore the association between cardiometabolic diseases (CMD) and quality of life, the association between CMD and perceived stress, and the mediation effect of perceived stress on the association between CMD and quality of life, and to provide evidence for the prevention and treatment of CMD and the improvement of quality of life in these patients. Methods: This is a cross-sectional study. Data were collected by the employees' physical examination of a company in Xi'an in 2021. Multiple linear regression models were used to analyze the association between the status of CMD (divided into three categories: no CMD, presence of one kind of CMD, and with≥2 kinds of CMD (≥2 kinds of CMD were defined as cardiometabolic multimorbidity (CMM)), quality of life, and perceived stress. Mediation analysis with a multi-categorical independent variable was conducted to determine the mediation effect of perceived stress on the association between CMD and quality of life. Results: Among all 4 272 participants, 1 457 (34.1%) participants had one kind of CMD and 677 (15.8%) participants had CMM. The average scores for quality of life and perceived stress were (57.5±15.7) and (16.9±7.9), respectively. Compared with participants without CMD, after adjusting for demographic and lifestyle factors, no statistically significant associations were observed between one kind of CMD and perceived stress or quality of life (both P>0.05). Perceived stress did not mediate the association between one kind of CMD and quality of life. However, participants with CMM had lower quality of life and higher perceived stress than participants without CMD. The relative total effect coefficient c (95%CI) and the relative direct effect coefficient c' (95%CI) between CMM and quality of life were -3.71 (-5.04--2.37) and -2.52 (-3.81--1.24) (both P<0.05), respectively. The relative indirect effect coefficient a2b (95%CI) of perceived stress on the association between CMM and quality of life was -1.18 (-1.62--0.77) (P<0.05). The mediation effect size was 31.8%. Conclusions: CMM is negatively associated with quality of life and positively associated with perceived stress. Perceived stress partially mediates the association between CMM and quality of life. Our results suggest that, in addition to preventing and treating CMM actively, efforts should be taken to relieve the perceived stress of people with CMM to improve their quality of life.

Inhibitors of JAK2/STAT Signaling Pathway and Hematologic Malignancies-Review / 中国实验血液学杂志

Jauns kinase (JAK)/transducer and activator of transcription（STAT） pathway is a classical approach to study the rapid changes of the gene expression in specific target cells by a variety of extracellular signals. The JAK and STAT transfer cytokine receptor signaling plays a unique role in multiple cellular and molecular biological changes.The abnormal signal of JAK/STAT pathway will lead to the hematopoietic abnormalities.Studies had shown that the abnormal activation of JAK2/STAT signaling pathway are in many kinds of malignant hematological diseases, such as in acute lymphoblastic/myeloid leukemia, chronic myeloid leukemia, lymphoma, myelodysplastic syndromes, myeloprofilerative neoplasm, especially in the patients of myeloproliferative neoplasm(MPN) with JAK gene mutation(JAK2V617F), this mutation has an important value for MPN diagnosis. At present, the effect of the specific inhibitors of JAK2 has showed good perspective, which had been applied to clinic treatment and achieved remarkable curative effect. In this review, the JAK2/STAT signaling transduction, the JAK2 signal and hematologic malignancies, the kagulation of signaling pathway and the inhibitors of JAK2/STAT signaling pathway are summarized.

Relationship between blood glucose concentrations of mothers without gestational diabetes mellitus during pregnancy and children's body mass index at 5 to 6 years old / 中华实用儿科临床杂志

Objective To investigate the relationship between children's body mass index (BMI)at 5 to 6 years old and glucose concentrations of mothers without pre-existing diabetes or a gestational diabetes mellitus(GDM) diagnosis during pregnancy.Methods A prospective observational study was performed in offspring whose mother had no pre-existing diabetes or a GDM diagnosis during pregnancy in the First Affiliated Hospital of Kunming Medical Uni versity from Jan.2006 to Dec.2007.The data of maternal glucose concentrations of oral glucose tolerance test(OGTT)were acquired through referring to clinical records.Weight and height at 5 to 6 years old were measured and used to calculate BMI.Multivariable linear regression models were used to examine the association between children's BMI and maternal glucose concentrations.The influence of maternal glucose concentrations on the risk of overweight of offspring was analyzed by Logistic regression.Results There were 860 cases of children were followed-up,including 459 male cases and 401 female cases.The average BMI of children was(15.6 ± 2.7) kg/m2.There were 78 cases of overweight (9.06％) and 50 cases of obesity(5.81％).The mean maternal fasting glucose level of the OGTT was (3.8 ± 0.6) mmol/L and 2 h glucose level of the OGTT was (6.0 ± 0.9) mmol/L.After adjusting for progestation BMI,maternal weight gain during pregnancy,sex,birth weight,age and paternal weight,at the 5 to 6 years old,BMI of offspring of mothers whose fasting glucose level of the OGTT≥5.51 mmol/L were significantly higher than those of mothers whose average blood glucose level ＜5.51 mmol/L(β =0.45,95％ CI:0.15-0.80).Maternal fasting glucose level of the OGTT≥5.51 mmoL/L was associated with an greater risk of children's overweight(OR =2.32,95％ CI:1.30-3.96).Conclusions Even though the mother was in the absence of pre-existing diabetes or GDM during pregnancy,fetal exposure to high maternal glucose concentration may also promote the development of overweight in the offspring at 5 to 6 years old.

Ethnic differences on nutritional status of children under 3 years old in poor counties of the western China / 中华流行病学杂志

Objective To explore the ethnic differences on nutritional status of children under three years old,in the western areas of China and to indentify the affecting factors.Methods 14 072children under the age of three years and their mothers were recruited,using the proportion population sampling method in 45 counties in the western areas of China.Height and weight were used as the measurement on nutrition of children.Results Height and weight of children with Han,Uyghur,Tibetan and Zhuang ethnicities were all lower than the WHO standards and with differences on height and weight among them.There were also ethnic differences on the status of malnutrition.Prevalence rates of stunting were 14.7％,20.3％,26.9％ and 26.5％ for Han,Uyghur,Tibetan and Zhuang ethnicities,respectively.Prevalence rates of underweight were 6.1％,10.7％,6.8％ and 15.5％ among the Han,Uyghur,Tibetan and Zhuang ethnicities,respectively.The prevalence rates of wasting were 4.2％,5.3％,2.9％,8.9％,and of under nutrition were 19.2％,25.5％,30.3％ and 36.5％ for the Han,the Uyghur,the Tibetan and the Zhuang ethnicities,respectively.When factors as family size,years of schooling of parents,family numbers,sex,age (months),mother' s height and weight,ways of feeding and sources of family income etc.were adjusted,children with Uyghur,Tibetan,Zhuang and other ethnicities were still presented more malnutrition than the children with Han ethnicity.Conclusion There were differences on malnutrition status of children under the age of three years among the studies on different ethnicities.Undemutrition was less than nutritional status,seen in children of the Han nationality than other minority ethnicites.Ethnicity seemed to be related to differences in the nutritional status of children in western China while children of the Han nationality would be better than other minorities on nutritional status if they were in same living conditionals.

Relationship between female menopause and hypertension/isolated systolic hypertension in rural districts of Hanzhong in Shaanxi province / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyze the associations between menopause and hypertension/isolated systolic hypertension (ISH) among rural females in Hanzhong, Shaanxi Province, China.</p><p><b>METHODS</b>In this cross-sectional study, 3030 residents were selected by stratified random sampling and investigated by questionnaire survey and physical examinations. Data of the females were analyzed to explore the impact of menopause on blood pressure by quantile regression and to investigate the associations between menopause and hypertension, ISH, and isolated distolic hypertension (IDH) by logistic regression.</p><p><b>RESULTS</b>The number of premenopausal and postmenopausal women was 965 and 998. The average age was (41.0 ± 8.07) years in the premenopausal group and (58.0±7.12) years in the postmenopausal group (P<0.001). The prevalence of hypertension among the premenopausal group and postmenopausal group was 21.9% and 49.3%, respectively. Quantiles regression analysis showed that the impact of menopause on systolic blood pressure increased as the percentile increased. The diastolic blood pressure (DBP) of the premenopausal group was significantly lower than that in the postmenopausal at q ≥ 0.40(DBP = 84 mmHg,1 mmHg = 0.133 kPa) percentile points (P<0.05), while the difference was not significant at q≤ 0.30 (DBP=80 mmHg) percentile points(P>0.05). After the potential confounders including age, education level, marriage, occupational, hyperlipidemia, family history, exercise, sleep, watching TV, smoking, passive smoking, alcohol consumption, body mass index, wealth index, waist circumference were controlled, positive associations were observed between menopause and hypertension/ISH in logistic regression models.</p><p><b>CONCLUSIONS</b>Menopause is positively related with hypertension/ISH. More effective interventions should be taken to prevent hypertension and ISH among rural women.</p>

Survey on the prevalences of overweight and obesity in 9 rural areas in Hanzhong, Shaanxi province / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the prevalences of overweight and obesity in the rural communities in Hanzhong, Shaanxi Province.</p><p><b>METHODS</b>A total of 3030 residents in the rural areas of Hanzhong city were selected by stratified random sampling method to take questionnaire-based survey and physical examinations.</p><p><b>RESULTS</b>The data of 3017 valid subjects (1048 men and 1969 women) entered the final analysis. The average body mass index was (22.9±4.2) kg/m(2) [(23.0±5.5) kg/m(2) in men and (22.9±3.2) kg/m(2) in women]. The prevalence rates of overweight and obesity were 27.9% and 5.9% respectively, and the standardized rates were 23.4% and 5.4%, respectively. More specifically, prevalence rates of overweight and obesity were 28.3% and 6.1% in men (standardized rates were 24.7% and 7.5%, respectively) and 27.6% and 5.8% (standardized rate were 22.8% and 4.5% respectively) in women. The overweight/obesity was more often in young and mid-aged married men with higher education and socioeconomic status and in middle-aged and older women with less education from wealthier households.</p><p><b>CONCLUSION</b>The prevalences of overweight and obesity are relatively high in the rural areas of Hanzhong, and therefore effective interventions are warranted.</p>

Study on the diet quality and its relative effect factors among rural residents, using the Chinese Diet Balance Index (CDBI) in Hanzhong, Shaanxi province / 中华流行病学杂志

Objective To evaluate the diet quality and the relative factors among rural residents in Hanzhong,Shaanxi province.Methods A cross-sectional survey on dietary status together with a semi-quantitative food frequency questionnaire were conducted on rural residents aged from 18 to 80 in Hanzhong of Shaanxi in 2010.Diet quality was evaluated by using the Chinese Diet Balance Index (CDBI) scoring and evaluating system.Linear regression models were developed to identify factors that influencing the status of under/over intake.Results 2748 rural residents were investigated with the average daily intake of grains,beans,heavily salted vegetables,plant oil,nuts and salt.Results showed that they were higher than average level of Chinese rural residents' (P＜0.01).80％ of the residents having their daily intake of grains,oil and salt exceeded,while animal food,diary food,egg,vegetable and firuits were lower (P＜0.01) than the RNIs.However,there was under intake noticed to some extent in some areas.The average values of DBI_LBS and DBI_HBS were 22.8 and 9.8.The proportions of moderate under intake (20＜DBI_LBS≤40) and moderate over intake (10＜DBI_HBS≤20) were 62.6％ and 48.0％.The main factors that influenced the dietary under-intake were education level,fortune index,hypertension,physical activity,and time to watch television.The main factors that affected the over-intake of diet were sex,age,number of family numbers,intensity of labor,time to sleep,smoking and drinking habits.Conclusion The main diet problem among the rural residents was under-dietary-intake,with over-intake to some extents,suggesting that it was necessary to strength the specific intervention program,to improve the diet quality in the residents of Hanzhong area.

Effect of breastfeeding on childhood overweight in the offspring of mothers with gestational diabetes mellitus / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate whether breastfeeding can reduce the risk of childhood overweight in the offspring of mothers with gestational diabetes mellitus (GDM).</p><p><b>METHODS</b>Follow-up was performed on 1189 offspring of mothers with GDM between January 2003 and December 2009. The influence of the manner and duration of breastfeeding between 0 to 3 months after birth on the risk of childhood overweight in the offspring of mothers with GDM was analyzed by logistic regression.</p><p><b>RESULTS</b>After correcting confounding factors such as pre-pregnancy BMI, gestational weight gain, gestational blood sugar, sex, birth weight, age and farther's body weight, it was found that the risk of childhood overweight in the offspring who received exclusive breastfeeding during the first 3 months after birth was lower than in the artificial feeding group (OR: 0.479, 95%CI: 0.256-0.897). Offspring who were breastfed for 0 to 3 months, 4 to 6 months and over 6 months had a lower risk of childhood overweight than the artificial feeding group (OR: 0.456, 95%CI: 0.233-0.827; OR: 0.29, 95%CI: 0.103-0.817; OR: 0.534, 95%CI: 0.280-0.970), offspring who were breastfed for 4 to 6 months had a lower risk of childhood overweight than those who were breastfed for 0 to 3 months (OR: 0.372, 95%CI: 0.129-0.874), and offspring who were breastfed for more than 6 months did not show significantly lower risk of overweight than those who were breastfed for less than 6 months (OR: 0.769, 95%CI: 0.470-1.258).</p><p><b>CONCLUSIONS</b>Within 3 months of birth, breastfeeding, especially exclusively, may reduce the risk of childhood overweight in the offspring of mothers with GDM. Within 6 months of birth, the risk of childhood overweight decreases as the duration of breastfeeding increases, but prolonging the duration of breastfeeding cannot necessarily reduce the risk of childhood overweight after postnatal six months.</p>

Dietary patterns and its relationship with hypertension among rural residents in Hanzhong,Shaanxi province / 中华流行病学杂志

Objective To investigate the relationship between dietary patterns and hypertension in Hanzhong city of Shaanxi province.Methods A cross-sectional survey on dietarypattern and hypertension together with a semi-quantitative food frequency questionnaire was conducted among rural residents aged from 18 to 80 in Hanzhong of Shaanxi province in 2010.Factor analysis by SPSS was used to identify food patterns based on the frequency of food.Logistic regression was used to analyze the relationship between dietary patterns and hypertension.Results 2929 rural residents were investigated with an average age as 50.0 years old and average schooling-years as 6.8.The prevalence rate of hypertension was 34.3％,with 35.4％ in males and 33.7％ in females.Among 29 kinds of food under investigation,only 11 kinds with the frequencies of consumption more than 1 time per week.Four main factors were derived as four dietary patterns by factor analysis and they were diversity dietary pattern,alcohol dietary pattern,beverage dietary pattern and simple dietary pattern.Among them,the balanced dietary pattern was significantly associated with hypertension.All the participants were categorized into 4 groups (Q1-Q4) according to their factor scores,quartile with Q1 as a reference.The residents who were more closer to having balance dietary pattern,were under less risk of suffering from hypertension after controlling for age,sex,BMI,education and income.Compared to Q1,the Q4 had lower risk of hypertension (OR=0.59,95％CI:0.44-0.77) for the balanced pattern.Conclusion Dietary pattern could be related to the prevalence of hypertension.A rational diet with diversity of foods should be suggested as one of the major measures for the prevention of hypertension.

Study on the prevalence rate of abdominal obesity in 9 rural communities from Hanzhong area of Shaanxi province / 中华流行病学杂志

Objective The objective of this study was to investigate the prevalence rate of abdominal obesity and to explore the associated risk factors in rural communities from Hanzhong area,Shaanxi province,and to providc baseline data for further targeted intervention programs.Methods A cross-sectional study was conducted among all the participants with questionnaires,interview and physical examination.Nine townships were selected in Hanzhong area,followed by one village randomly chosen from the selected township,using the stratified random sampling method.Results There were 3030 participants in this survey,among which 3021 samples were valid,including 1048 males and 1973 females.The overall prevalence rate of abdominal obesity was 38.9％(standardized rate as 33.4％ ) in rural communities of Hanzhong,and the prevalence rate on males abdominal obesity(35.0％ ) was significantly lower than that of females (40.9％).It was found that following factors as:being male,married,having more household wealth,frequent consumption of fried food,non-engagement of agricultural labor work,being nonsmoker or ex-smoker,spending longer time on watching-TV etc.were positively associated with the biggerr odds of having abdominal obesity when using the logistic regression analysis.Meanwhile,data from this study indicated that fctors as:at younger age,frequent participation in agricultural labor,under artificial feeding,with more years of education,less frequency of pregnancy etc.were negatively related to the prevalence of female abdominal obesity.Conclusion The prevalence rate of abdominal obesity in Hanzhong area,Shaanxi province was significantly higher than the national average level which called for the development of related intervention programs to prevent chronic diseases associated with gender related-obesity in Hanzhong.

Relationships between smoking behavior and obesity in men from 9 rural districts of Hanzhong in Shaanxi province / 中华流行病学杂志

Objectivc To examine the relationship between cigarette smoking and body mass index(BMI) as well as waist circumfcrcnce (WC) of men from 9 rural districts ofHanzhong,Shaanxi province.Methods Cross-sectional data was analyzed from Hanzhong Health Survey on rural residents in 2010.Quantile regression mode was used to compare the results using the BMI (WC) and smoking slatus (degree) as the dependent variables and independent variable and confounding factors were also controlled.Results 1039 rmale residents of rural areas of Hanzhong city were investigated.The prevalence rates on overweight and obesity among the males were 28.0％ and 5.9％,with central obesity as 35.0％ and the rate of currcnt cigarette smoking was 63.6％ in the areas.Results from the quantile regression showed that the relationship between smoking status and BMI beyond 80 percentile in men (BMI=24.4) which was not significantly different BMI among the heavy smokers,was much higher than those mild smokers beyond 90 percentile (BMI=24.9).WC of the current smokers was significantly higher than those ex-smokers beyond the 95 percentile (WC=96.7 cm).WCs of the moderate and heavy smokers had an increase along with the increase of WCs beyond the 85 percentiles (WC=89.9 cm).Conclusion The effect of smoking status and BMI (WC) were inconsistent,however,with BMI and WC increased among the subjects whose BMI or WC were at the high extreme end of the distribution.Thus,we should advise the obese subjects to quit smoking.