Predicting Metabolic Syndrome Using Anthropometric Indices among Chinese Adolescents with Different Nutritional Status: A Multicenter Cross-sectional Study / 生物医学与环境科学（英文）

Objective@#To evaluate the predictive performance of anthropometric indices for metabolic syndrome (MetS) among Chinese adolescents with different nutritional status.@*Methods@#We recruited 9,513 adolescents aged 10-18 years from seven provinces in China during September 2014. Anthropometric indices and blood pressure were measured at recruitment, and blood samples were collected for determining fasting plasma glucose and lipid profile. Receiver operating characteristic (ROC) analyses were used to assess the predictive performance of anthropometric indices, including body mass index (BMI) percentile, waist circumference percentile, waist-height ratio, and waist-hip ratio.@*Results@#Overall, the four anthropometric indices showed good accuracy for predicting MetS with areas under ROC curves (AUCs) ranging from 0.86 to 0.94; similar AUCs ranging from 0.73 to 0.99 were observed for participants with normal weight. The performance of all four indices was poor in overweight and obese participants, with AUCs ranging from 0.66 to 0.77 and from 0.60 to 0.67, respectively. Waist circumference showed relatively better performance in all the subgroup analyses.@*Conclusions@#We suggest using anthropometric indices with the cutoff values presented here for predicting MetS in the overall and normal-weight adolescent population, but not in the overweight and obese adolescent population where more specific screening tests are required.

Impact of early health status on the risk of developing child overweight and obesity / 上海预防医学

Objective To investigate the impact of early health status on the risk of developing child overweight and obesity so as to provide evidences for preventive measures against child overweight and obesity.Methods Three schools were randomly selected from primary schools in Shanghai, and another three schools were randomly selected from 9-year schools in Shanghai.Retrospective surveys were conducted for 1 511 pupils selected from all the Grade One and Grade Two students of the above selected schools, the univariate and multivariate logistic regression analyses were used to analyze the early risk factors for child overweight and obesity.Results The results of univariate logistic regression analyses showed that for the children with relatively high birth weights, asthma, allergic constitution, histories of chronic diseases, relatively good appetite, relatively high ages that had been notified of their overweight and obesity, the detection rate of overweight and obesity was higher (P<0.05).The results of multivariate logistic regression analyses showed that birth weights(OR=2.699, 95%CI=1.097~6.644), allergic constitution(OR=1.498, 95%CI=1.044~2.149), histories of chronic diseases(OR=2.486, 95%CI=1.327~4.659) and appetite(OR=22.011, 95%CI=8.861~54.673) were the risk factors influencing child overweight and obesity (P<0.05).Conclusion Attention still needs to be paid to the body mass control of the children with relatively high birth weights, allergic constitution and histories of chronic diseases.Scientific and reasonable feeding at early stages as well as cultivating good eating and drinking habits may help prevent and control child overweight and obesity.

Study on the sleep duration and the related dangerous self-injurious behaviors of junior school students in Shanghai / 上海预防医学

Objective To understand the correlation between the sleep duration and the dangerous self-injurious behaviors of junior school students in Shanghai.Methods By using systematic sampling methods, 21 junior schools were randomly selected from 17 districts in Shanghai.By using simple random sampling methods, 2 classes were randomly selected from each grade of students from each of the selected junior schools.By using the Survey Questionnaire for Health-related Behaviors of Teenagers in Shanghai(junior school students'edition), questionnaire surveys were performed to investigate the sleep duration and the related dangerous self-injurious behaviors of junior school students.Results A total of 6 414 students (of which male students occupied 49.1% and female students occupied 50.9%) were surveyed and the pass rate of questionnaires was 99.55%.The average age of the students surveyed was 13.28±1.84.21.1% of the students surveyed slept less than 7 hours every day, 69.6% thereof slept 7-8 hours every day and 9.3% thereof slept 9 hours or more every day.In the past 12 months, 47.2% of the students surveyed often felt lonely,71.3% thereof felt unhappy because of study stress or unsatisfactory school records and 9.3% thereof cancelled their daily activities for 2 weeks or more because of feeling sad and desperate.11.7% of the students surveyed conducted self-injurious behaviors, 11.9% thereof contemplated suicide, 6.9% thereof made plans for suicide.The sleep duration of the students surveyed was negatively correlated with the rate of psychological depression related to self-injuries as well as the self-injurious behaviors thereof.Conclusion Lack of sleep is common among junior school students in Shanghai, and sleep insufficiency is correlated with self-injurious psychology and behaviors.which suggests that it is very much necessary to provide junior school students with education that improves sleep.

Discussion on the relationship between central obesity and asthma of pupils / 上海预防医学

Objective To explore the relationship between central obesity and asthma of 7-to 9-year-old pupils, and to make clear the direction of research for the next stage.Methods By cluster sampling, 6 primary schools in Shanghai were randomly selected;the parents of all the Grade One and Grade Two pupils thereof were surveyed, and physical examinations were made for these pupils.Rates were compared using the chi-square test, and the numerous factors for the central obesity and asthma of school-age children were analyzed by using the logistic regression analysis model.Results The obesity rate of these pupils was 9.40%, the rate of central obesity thereof was 16.41%, and the rate of pupils who had suffered asthma was 4.37%.The body mass index (BMI) was used in the univariate analysis to assess the nutritional status of pupils.The difference in terms of the rate of asthma between the obesity group and the non-obesity group had no statistic significance.However, the assessment based on waist circumferences showed that excess waist circumferences were related to asthma.However, multivariate regression analyses showed that masculinity, aging, little weekend sleep, good appetite, having no preference for foods, big appetite and fast eating were the risk factors for central obesity.In the model, a history of asthma was an risk factor for central obesity.Conclusion Central obesity is related to asthma for 7-to 9-year-old pupils.It is necessary to continue the follow-up study for factors influencing obesity, and to probe into the relationship between obesity and asthma, thereby providing more evidences for public health practices.

Relationships of Inflammatory Factors and Risk Factors with Different Target Organ Damage in Essential Hypertension Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Atherosclerosis (AS) is an inflammatory disease. Inflammation was considered to play a role in the whole process of AS. This study aimed to analyze the relationships of inflammatory factors and risk factors with different target organ damages (TOD) in essential hypertension (EH) patients and to explore its clinical significance.</p><p><b>METHODS</b>A total of 294 EH patients were selected and divided into four groups according to their conditions of TOD. Forty-eight healthy subjects were selected as control. The clinical biochemical parameters, serum amyloid A, serum tryptase, and lipoprotein-associated phospholipase A2 (Lp-PLA2) in each group were detected, and the related risk factors were also statistically analyzed.</p><p><b>RESULTS</b>Fibrinogen (Fbg) was the most significant independent risk factor in acute coronary syndrome (ACS) group (odds ratio [OR]: 22.242, 95% confidence interval [CI]: 6.458-76.609, P< 0.001) with the largest absolute value of the standardized partial regression coefficient B' (b': 1.079). Lp-PLA2 was the most significant independent risk factor in stroke group (OR: 13.699, 95% CI: 5.236-35.837, P< 0.001) with b' = 0.708. Uric acid (UA) was the most significant independent risk factor in renal damage group (OR: 15.307, 95% CI: 4.022-58.250, P< 0.001) with b' = 1.026.</p><p><b>CONCLUSIONS</b>Fbg, Lp-PLA2, and UA are the strongest independent risk factors toward the occurrence of ACS, ischemic stroke, and renal damage in EH patients, thus exhibiting the greatest impacts on the occurrence of ACS, ischemic stroke, and renal damage in EH patients, respectively.</p>

Adolescents'static behaviors and related factors in Shanghai / 上海预防医学

[Objective] To investigate and analyse the related factors of static behavior among ado-lescents , such as screen time , mild physical activity , moderate and vigorous physical activity , and nutri-tional status. [ Methods] In 2011, multistage sampling was done from 10 classes of three middle schools in three districts in Shanghai;the students filled the questionnaire on their own which recorded all of the activities of one school day and one weekend day .The data was analyzed by general describing analysis , correlation analysis, and Kruskal-Wallis test. [Results] The static time in weekend was 389.19 mi-nutes per day , the screen time was 122 .93 minutes per day , and both were over three times those on one school day .The static time was not related to moderate and vigorous physical activity , but was related to mild physical activity .The difference in mean time before the screen at weekend was statistically significant between obesity group , overweight group , normal group , low weight group and malnutrition group . [ Con-clusion] Adolescents lacked adequate physical activities in their spare time , and behavior before the screen might be related to their poor nutrition status .