Association of Visit-to-Visit Variabilities in Metabolic Factors with Chronic Kidney Disease in Chinese Adults Living in Shanghai / 生物医学与环境科学（英文）

Objective@#This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease (CKD) in Shanghai community residents.@*Methods@#We used data from a cohort study of community residents who participated in three examinations in 2008, 2009, and 2013, respectively. Fasting plasma glucose (FPG) level, blood pressure (BP), and lipid levels were determined in 2,109 participants at all three visits, and CKD was evaluated between the second and the third visits. Visit-to-visit variabilities in metabolic factors were described by coefficients of variation (CV) at three visits. A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV. CKD was defined as the estimated glomerular filtration rate < 60 mL/min per 1.73 m @*Results@#A total of 200 (9.5%) participants had CKD at the third visit. Compared with the lowest quartile of CV, the highest quartile was associated with a 70% increased risk of CKD for FPG [odds ratio, @*Conclusion@#The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.

Analysis on cardio-metabolic related risk factors in farmers of 15 provinces in China / 中华流行病学杂志

Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.

Analysis on cardio-metabolic related risk factors in farmers of 15 provinces in China / 中华流行病学杂志

Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.

The serum vitamin D level is inversely correlated with nonalcoholic fatty liver disease

BACKGROUND/AIMS: A low vitamin D level has been associated with metabolic syndrome and diabetes. However, an association between a low vitamin D level and nonalcoholic fatty liver disease (NAFLD) has not yet been definitively established. This study aimed to characterize the relationship between a vitamin D level and NAFLD in Korea. METHODS: A cross-sectional study involving 6,055 health check-up subjects was conducted. NAFLD was diagnosed on the basis of typical ultrasonographic findings and a history of alcohol consumption. RESULTS: The subjects were aged 51.7±10.3 years (mean±SD) and 54.7% were female. NAFLD showed a significant inverse correlation with the vitamin D level after adjusting for age and sex [odds ratio (OR)=0.85, 95% confidence interval (CI)=0.75-0.96]. The age- and sex-adjusted prevalence of NAFLD decreased steadily with increasing vitamin D level [OR=0.74, 95% CI=0.60-0.90, lowest quintile (≤14.4 ng/mL) vs highest quintile (≥28.9 ng/mL), p for trend 20 ng/mL) [OR=0.86, 95% CI=0.75-0.99] and the quintiles of the vitamin D level in a dose-dependent manner (p for trend=0.001). CONCLUSIONS: The serum level of vitamin D, even when within the normal range, was found to be inversely correlated with NAFLD in a dose-dependent manner. Vitamin D was found to be inversely correlated with NAFLD independent of known metabolic risk factors. These findings suggest that vitamin D exerts protective effects against NAFLD.

Prevalence and metabolic risk factors of nonalcoholic fatty liver disease in a middle-aged and elderly population in Guangzhou / 中华流行病学杂志

Objective To investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and understand the relationship between NAFLD and metabolic risk factors in middle-aged and elderly adults.Methods This cross-sectional study recruited 2 935 subjects in Guangzhou,Guangdong province.Face-to-face interviews and laboratory analyses were conducted to collect general information and other covariates.Analysis of covariance and logistic regression analysis were performed to investigate the relationship between metabolic factors and the prevalence of NAFLD.NAFLD was diagnosed based on standard criteria recommend by the Fatty Liver Disease and Alcoholic Liver Disease Branch of Chinese Hepatology Society,and the degree of steatosis was assessed (mild,moderate or severe).Results Compared with normal subjects,those with NAFLD had higher levels of WC,BMI,FPG,TG,SBP,DBP and greater prevalence of metabolic syndrome,but lower levels of physical activity and HDL-C.After adjusted for covariates,the OR for each standard deviation change was 2.70(95％CI:2.45-2.98) for WC,1.47(95％ CI:1.35-1.59) for SBP,1.48 (95％CI:1.37-1.60) for DBP,1.88 (95％CI:1.66-2.12) for TG,1.25 (95％ CI:1.15-1.36) for FPG and 0.51 (95％CI:0.47-0.56) for HDL-C (all P＜0.001).Higher levels of WC,BMI,TG,SBP,DBP and FPG were significantly related with the increase in degree of NAFLD (P-trend＜0.001).Conclusion There is a relatively high prevalence of NAFLD in middle-aged and elderly adults in China.NAFLD is closely related with the different forms of metabolic syndrome,and WC is the leading risk factor for NAFLD.

Elevated alanine aminotransferase activity is not associated with dyslipidemias, but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

<p><b>OBJECTIVE</b>To explore demographic and metabolic factors associated with increased alanine aminotransferase (ALT) activity in non-diabetic non-alcoholic fatty liver disease (NAFLD) patients.</p><p><b>METHODS</b>Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences, Tehran, Iran awere diagnosed as NAFLD entered into analysis. Exclusion criteria were having diabetes mellitus and fasting blood glucose over 126 mg/dL, active hepatitis B virus infection, having hepatitis C virus positive serology, and to be under corticosteroid therapy. ALT levels were considered pathologically high when it was over 30 IU/L for men and over 19 IU/L for women.</p><p><b>RESULTS</b>Bivariate analyses using t test and chi-square test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations (P=0.003). Moreover, these patients represented significantly higher homeostatic model assessment levels (P=0.003), levels of serum insulin (P=0.002), fasting blood glucose (P<0.001), and uric acid (P=0.02). The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations. Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD (P=0.027) and insulin resistance (P=0.013) were the only variables significantly associated with abnormal ALT levels.</p><p><b>CONCLUSIONS</b>This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before. By excluding diabetic patients from our population, we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations. Further studies are needed to confirm our results.</p>

Assessments of nutrient intake and metabolic profiles in Korean adolescents according to exercise regularity using data from the 2008 Korean National Health and Nutrition Examination Survey

The purpose of this study was to assess the metabolic profile and nutrient intake data in Korean adolescents according to exercise regularity using the forth Korean National Health and Nutrition Examination Survey from 2008 data. A total of 834 Korean adolescents (440 boys, 394 girls) aged 12 to 18 years were classified into exercising male (EM), non-exercising male (NM), exercising female (EF), and non-exercising female (NF) groups. EM exhibited significantly higher weight (P < 0.001), waist circumference (WC) (P < 0.01) and body mass index (BMI) (P < 0.001) than NM. EF showed significantly greater height (P < 0.01), weight (P<0.001), WC (P < 0.001), and BMI (P < 0.001) than NF. Although ratios of macronutrient intake were within the appropriate range in all groups, energy, riboflavin, vitamin C and calcium were assessed as in adequate by the nutritional adequacy ratio (NAR) in all groups. Moreover, EF and NF had inadequate intake of vitamin A and iron according to NAR, respectively. There were significant correlations between height and NAR protein (r = 0.249, P < 0.001), and mean adequacy ratio (MAR) (r = 0.177, P < 0.01), and between weight and NAR protein (r = 0.180, P < 0.01), and MAR(r = 0.136, P < 0.05) in EM. On the other hand, there were significant correlations between weight and NAR protein (r = 0.270, P < 0.01), WC and NAR protein (r = 0.271, P < 0.01), and BMI and NAR protein (r = 0.326, P < 0.01) in NM. There were significant correlations height and NAR Fe (r = 0.153, P < 0.05) in EF. However, there were no significant correlations between metabolic factors and nutritional adequacy in NF. Although we noted no significant differences in MAR between the groups, the exercising groups showed higher MAR values than the non-exercising groups. Therefore, practicing of ideal dietary behaviors appears to be induced through physical activity and regular exercise in Korean adolescents.

Cardiovascular and Renal Damage in Hypertensives Complicated with Metabolic Disorders / 中华高血压杂志

Objective To study the target organ damage in patients of hypertension with metabolic disorder. Methods 1033 patients were divided into five groups: hypertension without complications(102 cases), hypertension with dyslipidemia (117 cases), hypertension with abdominal obesity(119 cases), hypertension with type 2 diabetes mellitus(135 cases), hypertension with metabolic syndrome (560 cases). The structure and the function of heart and blood vessel were examined by color Doppler. Urinary microalbuminuria was determined. Results (1)Only 9.9% patients of hypertension were without metabolic disorder, 90.1% hypertensives complicated with the metabolic disorder; (2)Compared with hypertension with dyslipidemia, hypertension with type 2 diabetes mellitus (P90%) complicated with the metabolic disturbance. Hypertension complicated with abdominal obesity accentuate left ventricular hypertrophy. Hypertension with diabetes mellitus and metabolic syndrome accentuated the vascular and renal lesion.