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Objective:To investigate the joint associations of smoking and insufficient physical activity with hypertension, diabetes and dyslipidemia in male adults.Methods:Based on the data from the 2017 Nanjing Chronic Diseases Risk Factors Surveillance Program, 61 098 Nanjing residents aged 18 and older was randomly recruited from 12 districts, using the multi-stage stratified cluster sampling method. Information about smoking behaviors, physical activity and chronic disease-related indicators within the first 12 months before the survey was obtained through questionnaires.Results:Among the 29 848 valid male samples, the proportions of non-smokers, current smokers and ex-smokers were 59.6%, 37.2% and 3.2%, and the proportions of those who had physically active<600 MET-min/w (insufficient physically active) and ≥600 MET-min/w (adequate physically active) were 18.8% and 82.2%, respectively. In non-smokers, current smokers and ex-smokers, the prevalence of hypertension was 24.7%, 34.0% and 43.8%, and the prevalence of diabetes was 8.8%, 12.3% and 16.5%, and the prevalence of dyslipidemia was 26.8%, 36.1% and 41.9%, respectively. Multivariate logistic regression analysis showed that current smokers had a higher risk of hypertension ( OR=1.164, 95% CI: 1.086-1.248), diabetes ( OR=1.324, 95% CI: 1.207-1.452), and dyslipidemia ( OR=1.291, 95% CI: 1.216-1.371) than non-smokers in male adults. Compared with people who had adequate physical activity, someone with insufficient physical activity had higher hypertension ( OR=1.452, 95% CI: 1.331-1.583), diabetes ( OR=1.170, 95% CI: 1.041-1.315) and dyslipidemia ( OR=1.245, 95% CI: 1.158-1.338). And current smokers with insufficient physical activity had the highest risk of hypertension ( OR=1.749, 95% CI: 1.550-1.974), diabetes ( OR=1.363, 95% CI: 1.165-1.595), and dyslipidemia ( OR=1.614, 95% CI: 1.461-1.782) in male adults. Conclusions:Smoking and insufficient physical activity are risk factors for hypertension, diabetes, and dyslipidemia. People who is characterized by smoking together with insufficient physical activity presents with increased risk on developing hypertension, diabetes, and dyslipidemia.
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Objective:To explore the association between different paths of diabetic progression and dyslipidemia in a Nanjing adult population.Methods:From January 2017 to June 2018, 61, 098 local residents aged ≥18 years were selected from the Chronic Disease and Risk Factor Surveillance database in Nanjing using a five-stage stratified cluster random sampling method. Data were collected through interview surveys, physical measurements, and laboratory examinations. The relationship between different rates of diabetic progression and dyslipidemia was analyzed using complex weighting and multilevel models.Results:In all, 60, 283 participants were finally enrolled in the study. The weighted proportions of normal glucose regulation, pre-diabetes, and diabetes were 71.2%, 17.9%, and 10.9%, respectively. The overall weighted prevalence, awareness, treatment, and control of dyslipidemia were 29.8%, 41.6%, 28.9%, and 22.9%, respectively. The weighted proportion of patients with dyslipidemia combined with diabetes was 52.9%. The weighted prevalence of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 24.0%, 38.8%, and 52.9%, respectively (all P<0.001). Compared to the normal glucose regulation group, subjects with pre-diabetes ( OR = 2.04, 95% CI: 1.95-2.13) or diabetes ( OR= 3.87, 95% CI: 3.66-4.10) had possibly gradually increased risks of dyslipidemia (all P<0.001). In addition, there was an increasing trend toward awareness, treatment, and control of dyslipidemia with increasing levels of glucose (all P<0.001). The weighted awareness of dyslipidemia in adults with normal glucose regulation, pre-diabetes, and diabetes was 36.3%, 42.8%, and 56.2%, respectively; the corresponding rates of treatment and control were 23.7%, 29.2%, and 43.7%, and 20.4%, 22.6%, and 30.1%, respectively. Conclusion:Diabetes and dyslipidemia have become the main chronic diseases in the Nanjing population.
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Objective:To investigate whether there is a correlation between right bundle branch block (RBBB) and nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus.Methods:A retrospective analysis of 226 patients with type 2 diabetes mellitus who were admitted to the Fifth Affiliated Hospital of Zhengzhou University from March 2018 to July 2019 was performed. According to the results of electrocardiogram examination, they were divided into RBBB group ( n=58 patients) and non-RBBB group ( n=168 patients). The general clinical data of the two groups of patients were collected, blood lipids, liver function, renal function, coagulation function and other related indicators were measured on the fasting of the next morning. The diagnosis of NAFLD is based on ultrasound. Logistic regression analysis was performed on factors that may affect RBBB. Results:Of the 226 patients with type 2 diabetes mellitus, 127 (56.2%) were male and 99 (43.8%) were female. The composition of male, age, diabetes duration, hypertension, fibrinogen (FIB), serum creatinine (SCr), alanine aminotransferase (ALT), and NAFLD in the RBBB group was higher than that in the non-RBBB group ( P<0.05). The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and albumin (ALB) in the RBBB group were lower than those in the non-RBBB group ( P<0.05). Logistic regression analysis showed that male ( OR=2.736, 95% CI: 1.075-5.251, P=0.032), advanced age ( OR=1.049, 95% CI: 1.009-1.090, P=0.016), higher serum creatinine levels ( OR=1.045, 95% CI: 1.021-1.070, P<0.001), and NAFLD ( OR=2.834, 95% CI: 1.166-6.891, P=0.022) were independent risk factors of RBBB in patients with type 2 diabetes mellitus. Conclusions:NAFLD may be associated with an increased risk of right bundle branch block in patients with type 2 diabetes.
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TBX20 gene encodes a T - box transcription factor,which plays an important role in cardiac deve-lopment and in maintaining the maturation of cardiac function. TBX20 mutations are related to a variety of human con-genital heart diseases (CHD)that include atrial septal defect,ventricular septal defect,tetralogy of Fallot,double outlet right ventricle,dilated cardiomyopathy and other valvular diseases. This review focuses on the relationship between TBX20 gene and the development of heart,the TBX20 gene mutations newly found in patients with various CHD in re-cent years and their relationship,which will provide guide for further clinical research and possible intervention.
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Objective To evaluate the effectiveness of a chronic disease self-management program (CDSMP) in the Nanjing community. Methods From April to June 2016, the volunteer patients with chronic diseases from National Basic Public Health Services Plan were recruited and agreed to enter the CDSMP. A total of 42 self-management groups were established. The Nanjing CDSMP was based on the model of the Shanghai CDSMP developed by Stanford University. Questionnaire surveys, anthropometric measurements, and laboratory examinations were collected at 3 measurement moments (baseline, after 6 months, and after 12 months). Qualitative data were obtained from 1-2 participants in each self-management group. Paired t-tests, paired Chi-square tests, generalized estimating equation, and content analysis were used to evaluate the effectiveness of the CDSMP. Results Among 562 eligible patients, 548 completed 3 questionnaire surveys, physical measurements, and laboratory examinations. Sixty-six interviewees completed qualitative evaluations. Compared with baseline, the time of stretching or strengthening exercise and aerobic exercise; the scores on communication with the medical doctor; self-efficacy to manage symptoms and manage disease in general; quality of life in physical component summary and mental component summary; and rate of glucose control were all higher after 6 months and after 12 months interventions, whereas the score of fatigue; pain, health distress; social/role activities limitation; and the value of body weight, systolic blood pressure, and triglyceride were all decreased (all P values<0.01). The satisfaction rate of CDSMP in general, and content were 87.9%, 90.9%, and 83.3%, respectively. Conclusion Overall, the Nanjing CDSMP was successful in improving knowledge and self-management skills, increasing self-management behaviors, self-efficacy, health status, and quality of life, and decreasing body weight, blood pressures, and lipids. It is suggested that CDSMP may be widely used in Nanjing communities.
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Objective To evaluate the diabetes self-management program based on Chinese local patients in Nanjing community. Methods From April 2014 to June 2014, diabetes patients were recruited through health records system screening in the community health service centers, letter invitation, poster announcements at communities, and telephone notification. A total of 53 self-management groups were established. Nanjing diabetes self-management program included six 1-1.5 hours sessions scheduled on consecutive weeks, based on the blueprint of Shanghai Chronic Disease Self-Management Program (CDSMP) developed at Stanford University. Baseline and three-month later interviews were conducted respectively. Results A total of 636 patients were recruited and agreed to enter CDSMP; 603 completed the 6-session activities, with the response rate being 94.8%. Compared to baseline, nine of the patients' the awareness rate of diabetes-related knowledge, six of self-management behaviors, the scores of quality of life in physical component summary [(47.51 ± 9.47) vs. (49.10 ± 8.27) points, t=6.170, P=0.000] and mental component summary [(47.09±11.95) vs. (49.13±10.74) points, t=5.157, P=0.000] were all higher after three months (all P values<0.05). Three months after implementation, the level of systolic blood pressure, diastolic blood pressure, fasting plasma glucose and total cholesterol decreased respectively by (1.42±0.52) mmHg (1 mmHg=0.133 kPa), (0.98 ± 0.34) mmHg, (0.66 ± 0.16) mmol/L, (0.15 ± 0.56) mmol/L,the differences were statistically significant (tpaired values were 3.935, 2.030, 4.889, 4.899, all P values<0.05). Conclusion The diabetes self-management program based on Chinese local patients for Nanjing may improve patients' awareness rate of diabetes-related knowledge, self-management behavior, the quality of life, and health status. CDSMP could be applied effectively in Nanjing.