Effects of regular aerobic exercise on brachial ankle pulse wave velocity in middle-aged and elderly people / 中华老年医学杂志

Objective:To investigate the effects of regular aerobic exercise on brachial ankle pulse wave velocity(baPWV)in middle-aged and elderly people.Methods:This was a cross-sectional study.A total of 7993 subjects receiving health examination at the Taihu Sanatorium of Jiangsu Province were enrolled, including 4 371 males and 3 622 females, with an average age of 55.8 years(±7.9).Information on exercise, alcohol consumption, smoking, body mass index, baPWV, blood pressure, resting heart rate, fasting blood glucose, total cholesterol(TC), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C)and uric acid in all subjects were collected and recorded.Based on exercise habits, subjects were divided into the no exercise group(n=489), the occasional exercise group(n=3 222, exercise<3 times or<90 min per week)and regular exercise group(n=4 282, exercise 3-5 times or >90 min per week).Results:For male subjects, differences in baPWV between the no exercise group(1 747.37±346.07 cm/s), the occasional exercise group(1 486.77±195.15 cm/s)and the regular exercise group(1 449.77±219.50 cm/s)were statistically significant( P<0.05).For female subjects, difference in baPWV between the no exercise group(1865.05±120.19)cm/s, the occasional exercise group(1 593.18±332.51)cm/s and the regular exercise group(1 227.81±150.89)cm/s were also statistically significant( P<0.05).With increased time of exercise per week, the levels of systolic blood pressure, diastolic blood pressure, resting heart rate, fasting blood glucose, TG and uric acid in different exercise groups decreased gradually for both men and women.Multivariate linear regression analysis showed that exercise, alcohol consumption, systolic blood pressure, diastolic blood pressure and fasting blood glucose were independent risk factors for baPWV in men(all P<0.05)and that exercise, systolic blood pressure, diastolic blood pressure, resting heart rate and fasting blood glucose were the independent risk factors for baPWV in women(all P<0.05).Trend analysis showed that with increased time of exercise per week, the rate of abnormal baPWV decreased gradually in both men and women( χ2 values were 74.67 and 1545.54, respectively, P<0.01). Conclusions:Regular aerobic exercise can improve baPWV, systolic blood pressure, diastolic blood pressure, resting heart rate, fasting blood glucose, TG and uric acid in middle-aged and elderly people.Exercise is an independent influencing factor for baPWV in middle-aged and elderly people and exercise 3-5 times or more than 90 min per week is beneficial to cardiovascular health in middle-aged and elderly people.

Effects of cardiovascular health behaviors and factors on postmenopausal osteoporosis in Suxichang area of Jiangsu province / 中华老年医学杂志

Objective:To explore the relationship of cardiovascular health behavior and factors with development of bone mass loss and postmenopausal osteoporosis in Suxichang area of Jiangsu province.Methods:In the across sectional study, a total of 2 423 postmenopausal women receiving health check-up from March 2019 to June 2020 in our hospital were enrolled.The seven variable factors included cardiovascular health behavior(body mass index, exercise, healthy diet and smoking state)and cardiovascular health-influencing factors(blood pressure, fasting blood glucose and total cholesterol). The information of the seven factors and bone mineral density were recorded.The seven factors were classified as ideal, average and poor, according to the level of bone mineral density.All individuals were divided into three groups: normal bone mass(n=1 305), osteopenia(n=290)and osteoporosis(n=828).Results:There were statistically significant differences in age, fasting blood glucose, systolic blood pressure, diastolic blood pressure, total cholesterol and exercise between osteoporosis and normal bone mass group( P<0.05). As the number of ideal cardiovascular health behaviors and factors increased, the proportion of bone mass loss and osteoporosis gradually decreased( P<0.05). Multiple logistic regression analysis showed that ageing, increased total cholesterol and fasting blood glucose levels were the independent risk factors of osteoporosis.The exercise and normal body mass index were the protective factors for osteoporosis.For each 1 unit increment in age, total cholesterol, body mass index and fasting blood glucose, the OR values for bone mineral density decrement by 1 grade were 1.17, 1.25, 0.92 and 1.23, respectively(all P<0.05). The OR value for bone mineral density decrement by 1 grade was 0.58( P<0.05)when exercise decreased by 1 grade. Conclusions:Postmenopausal women should positively control the levels of total cholesterol and fasting blood glucose, maintain reasonable body weight and conduct regular exercise, which are conductive to the prevention and treatment of postmenopausal osteoporosis.

Impact of different lifestyle indexes on serum uric acid levels in young and middle-aged men / 中华内分泌代谢杂志

Objective:To investigate the impact of lifestyle index (LSI) on serum uric acid levels in young and middle-aged men.Methods:This was a cross sectional study. A total of 8 067 subjects underwent check-up in Taihu Sanatorium of Jiangsu Province from March 2020 to June 2021 were enrolled, average age were(46.46±8.81) years. According to age, subjects were divided into young male group (18-44 years old, n=3 269) and middle-aged male group (45-60 years old, n=4 798). Height, weight, body mass index, alcohol drinking, smoking, diet, exercise, fasting blood glucose, total cholesterol, triglycerides, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol(LDL-C), serum uric acid and other data in all cases were measured and recorded. Results:The serum uric acid level in allsubjects was (376.80±74.43)μmol/L and the prevalence of hyperuricemia was 25.7%.The serum uric acid level in the young male group was higher than that in the middle-aged male group [(381.86±74.32)μmol/L vs (373.34±74.32)μmol/L, P<0.001]. The prevalence of hyperuricemia in the young male group was higher than that in the middle-aged male group (27.4% vs 24.5%), and the difference was statistically significant ( P<0.001). With the improvement of LSI scores, the serum uric acid levels in young and middle-aged men showed a decreasing trend ( P<0.01). Logistic regression analysis showed that after adjusting for age, fasting blood glucose, total cholesterol, triglyceride, HDL-C, LDL-C, hypertension, and diabetes, LSI was an independent factor for serum uric acid levels in young and middle-aged men. The risk of hyperuricemia in young and middle-aged male decreased ( OR 0.83 and 0.84, respectively, P<0.01) for every 1-point increase in LSI. Exercise and body mass index were independently associated with hyperuricemia in the young male group ( OR 0.83 and 0.54, respectively, P<0.05). Exercise, body mass index, and alcohol drinking were independently associated with hyperuricemia in the middle-aged male group ( OR 0.85, 0.51 and 0.65, respectively, P<0.05). Conclusion:LSI is an independent factor associated with hyperuricemia in young and middle-aged men and a healthy lifestyle has a protective effect on serum uric acid levels in young and middle-aged men.

Correlation between serum uric acid level and impaired fasting glucose in adults / 中华健康管理学杂志

Objective:To investigate the correlation between different serum uric acid (SUA) levels and impaired fasting glucose (IFG) in adults.Methods:From March 2019 to February 2020, 5006 adults in Wuxi area of Taihu Sanatorium in Jiangsu Province were selected as subjects. Quintile method was divided into the following five groups: Q1: SUA<270 μmol/L, Q2: 270 μmol/L SUA 318 μmol/L or less, Q3: 319 μmol/L ≤SUA≤360 μmol/L, Q4: 361 μmol/L SUA 410 μmol/L or less, and Q5: SUA>410 μmol/L. Correlation was analyzed by logistic analysis, with IFG as the outcome index, five SUA groups as the observation index, and gender, age, body mass index (BMI), blood lipid, and blood pressure as confounding factors. Three logistic regression analysis models were constructed to explore the relationship between different SUA level groups and IFG risk, as well as the influence of BMI on the risk correlation between SUA and IFG.Results:The BMI, DBP, FPG, TC, TG, and LDL-C all increased with the increase in SUA level; however, HDL-C gradually decreased with the increase in SUA level (P<0.01). The SUA levels among the five groups were positively correlated with fasting blood glucose level in the IFG group ( r=0.589, P<0.001). After adjusting for age, sex, and BMI, SUA level was strongly associated with fasting glucose in the IFG group ( r=0.534, P<0.001). After further adjustment for blood lipid and blood pressure, the correlation persisted ( r=0.523, P<0.001). With Q1 as the control group, the calculated OR values of IFG risk were 1.199, 2.660, 2.784 and 3.629, respectively. After further adjustment for various confounding factors, the calculated OR values of each group were 1.130, 2.389, 2.350 and 2.895, respectively. The IFG risk in the group with SUA level in the corresponding Q2 and Q5 groups was 1.13 times and 2.90 times higher, respectively, than that in the normal group, indicating that with the increase in SUA level, the IFG risk in the population increased. With the increase in BMI and SUA levels after BMI stratification, the mean fasting glucose level increased ( P<0.001). Conclusion:The SUA level and IFG risk are closely related. Increased SUA level increases IFG risk, and SUA and IFG are associated with weight gain, which should be paid attention to.

The correlation between different smoking status and serum uric acid in a middle-aged male population / 中华老年医学杂志

Objective:To explore the correlation between different smoking status and serum uric acid(SUA)in a middle-aged male in health check-up population.Methods:In this cross-sectional study, a total of 26701 middle-aged men who underwent health check-up in Taihu Sanatorium of Jiangsu Province from January 2014 to June 2015 were studied.The correlation between smoking status and SUA was analyzed by questionnaires, physical examination and serum biochemical assay.Smoking state was divided into no smoking, a occasional smoking and smoking groups.Results:With the increase of age, there was a downward trend of SUA( F=7.38, P=0.000). Among the three smoking groups, the group with occasional smoking had the highest level of SUA.The smoking group had lower level of SUA than the non-smoking group and occasional smoking group( P=0.000 and 0.005). In the non-smoking group, the fourth quartile of SUA(41.5%)had a higher percentage than that in first quartile of SUA(38.4%)( χ2=12.266, P=0.000). In the smoking group, the fourth quartile of SUA(54.9%)had lower percentage than that in the first quartile of SUA(58.4%)( χ2=7.049, P=0.008). Compared with the non-smoking group, the prevalence of hyperuricemia(HUA)in smoking group was lower( OR=0.872, 95% CI: 0.821~0.927, P=0.000), the prevalence of HUA in occasional smoking group was higher( OR=1.194, 95% CI: 1.013~1.408, P=0.035). Conclusions:As compared with the non-smoking group, the prevalence of HUA is lower in smoking group and is higher in occasional smoking group.

Using essential health check-up items and follow-ups for malignant tumor screening / 中华老年医学杂志

Objective To explore cost effective means for early detection of malignant tumors in individuals undergoing health check-up.Methods This was a retrospective study involving 280,477 participants who had undergone health check-up including essential items from 2012 to 2016 at the Health Assessment and Intervention Research Center of Jiangsu Province.The protocol was composed of four steps.First,essential items were decided and conducted for all health examination participants.Second,cases with a high risk of malignant tumors were collected and additional tests were specified.Third,suspected malignant tumor cases were identified and recommendations for referrals and follow-up were made.Finally,physicians in charge of follow up would urge suspected cases to visit an oncologist,update case files,give regular instructions,and track recall results.Results There were 517 microscopically confirmed cases of malignant tumors,representing a detection rate of 184/100,000(1.84‰)in individuals seeking regular health check-up and of 2,023/100,000 (20.23‰)in those receiving follow ups.The five most prevalent malignant tumors were thyroid cancer (140 cases or 0.499‰),lung cancer(120 cases or 0.428‰),breast cancer(35 cases or 0.374‰),kidney cancer(55 cases or 0.196‰)and prostate cancer (33 cases or 0.177‰).Conclusions Essential examination items in combination with subsequent special tests,specialist referrals and follow ups are a cost effective way for early detection of malignant tumors in people seeking regular health examinations.

Using essential health check-up items and follow-ups for malignant tumor screening / 中华老年医学杂志

Objective To explore cost effective means for early detection of malignant tumors in individuals undergoing health check-up.Methods This was a retrospective study involving 280,477 participants who had undergone health check-up including essential items from 2012 to 2016 at the Health Assessment and Intervention Research Center of Jiangsu Province.The protocol was composed of four steps.First,essential items were decided and conducted for all health examination participants.Second,cases with a high risk of malignant tumors were collected and additional tests were specified.Third,suspected malignant tumor cases were identified and recommendations for referrals and follow-up were made.Finally,physicians in charge of follow up would urge suspected cases to visit an oncologist,update case files,give regular instructions,and track recall results.Results There were 517 microscopically confirmed cases of malignant tumors,representing a detection rate of 184/100,000(1.84‰)in individuals seeking regular health check-up and of 2,023/100,000 (20.23‰)in those receiving follow ups.The five most prevalent malignant tumors were thyroid cancer (140 cases or 0.499‰),lung cancer(120 cases or 0.428‰),breast cancer(35 cases or 0.374‰),kidney cancer(55 cases or 0.196‰)and prostate cancer (33 cases or 0.177‰).Conclusions Essential examination items in combination with subsequent special tests,specialist referrals and follow ups are a cost effective way for early detection of malignant tumors in people seeking regular health examinations.

Prevalence of ideal cardiovascular health in south Jiangsu adults / 中华健康管理学杂志

Objectives To estimate the prevalence of the cardiovascular health (CVH) status in south Jiangsu adults. Methods A cross-sectional study was conducted, a total of 11 996 participants that took health examination in hospitals from March 2013 to August 2013 and live in south Jiangsu were selected. Results Totally 136 participants (1.1%) met all 7 ideal CVH metrics;while 27.6%participants met 5 to 7 ideal CVH metrics, women had higher proportion (47.2%) than men (16.9%). The percentage of participants who met 5 to 7 ideal CVH metrics, whether male or female, decreased with increasing age. Ideal total cholesterol (TC) was the most prevalent (72.0%), whereas ideal salt intake was the least (19.9%). The mean (± SD) number of ideal CVH metrics for urban participants was (3.61 ± 1.46), higher than the rural participants (3.45±1.49). Old age, male and residence in rural area were risk factors for ideal CVH metrics≥5. Conclusions The prevalence of ideal CVH was extremely low in South Jiangsu adults, and there were differences in the distribution of ideal CVH metrics across gender and age. To improve CVH, specific promotion and interventions at the population and individual levels should be developed and implemented actively.

Association of overweight/obesity with arterial stiffness in females / 中华健康管理学杂志

Objective To evaluate the association of body weight with brachial-ankle pulse wave velocity (baPWV) in females.Methods A total of 2 921 residents (≥20 years old) were selected by the stratified cluster random sampling method from March to December 2011.Arterial stiffness was assessed by baPWV.Multivariate logistic regression analysis was used to evaluate the effect of body mass index (BMI) on arteriosclerosis.The predictive value of BMI to evaluate arteriosclerosis was analyzed by using receiver operation characteristic (ROC) curve.Results The prevalence of arteriosclerosis was significantly increased in overweight/obese residents (P＜0.01).BMI was positively correlated with baPWV (r=0.310,P＜0.01).The prevalence of increased arterial stiffness in individuals≥65 years older was higher than that in people of 20-40 or 41-64 years old (x2 values were 677.30 and 347.26,respectively; both P＜0.01).For females of 20-40 or 41-46 years old,the prevalences of increased arterial stiffness in overweight and obese groups were higher than those in normal body weight group (both P＜0.01).In univariate analysis,age,resting heart rate,systolic blood pressure (SBP) and diastolic blood pressure (DBP) were correlated with arteriosclerosis (all P＜0.01).The odds ratio for the prevalence of arteriosclerosis in overweight women was 2.017 (95％ confidence interval (CI):1.637-2.486,P＜0.01) and that in obese women was 2.759 (95％ CI:1.964-3.876,P＜0.01) after adjustment for age,resting heart rate and blood pressure.The area under the ROC curve was 0.693 (95％ CI:0.671-0.715,P＜0.01) to evaluate arteriosclerosis in females and the optimal cut-off point for BMI was 23.42 kg/m2.Conclusions For females,overweight and obesity may be risk factors of arteriosclerosis.The optimal cut-off point for BMI to evaluate arteriosclerosis in women could be 23.42 kg/m2.

Characteristics of neoplasma in 140 127 adults undergoing health check-up / 中华健康管理学杂志

ObjectiveRetrospectively investigate the characteristics of neoplasma of health checkup participants to find ways to improve cancer detection rate.Methods A total of 186 confirmed cancer patients were enrolled in this study.Personal information,including age,gender,andlocation were collected.The contribution of clinical symptoms,physical examination and laboratory test to cancer detection was investigated.ResultsBiopsy confirmed cancers accounted for 0.133％( 186/140 127 ).Lung (0.036％ ),liver ( 0.017％ ),kidney ( 0.014％ ),colorectal ( 0.013％ ) and gastric cancer ( 0.011％ )were the most commonly found neoplasma.Detection rate of liver cancer in male was significantly higher than that in female (x2 =6.181,P＜0.05 ).Asymptomatic cancer was found in 158 adults (84.9％ ).Ultrasound showed a significantly higher sensitivity to liver,kidney and thyroid cancer than tumor biomarkers.The detection of lung cancer was improved with the combination of X ray,tumor marker( TM ),clinical symptom and low-dose chest CT scan.In 2008,the detection rate for digest system carcinoma (0.083％ ) and lung cancer (x2 =8.538,P＜0.05) was significantly increased (x2 =11.792,P＜0.05).ConclusionsHealth check-up plays an important role in early detection of cancer.The combined use of physical examination,chest X ray,ultrasound test,TM and CT may improve the detection of cancer.

Effect of lifestyle intervention on index of early artery diseases in patients with metabolic syndrome / 中华健康管理学杂志

Objective To explore the effects of lifestyle intervention on index of early artery diseases in nondiabetic patients with metabolic syndrome (MS). Methods Eighty-seven nondiabetic patients with MS were randomly assigned to the intervention group ( n =47) and the control group ( n =40).The patients in the intervention group received health education,diet control,regular physical exercises,and unhealthy habit correction; however,the control group did not receive any intervention.All the patients were followed up for 9 months.Body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol ( HDL-C ),low-density lipoprotein cholesterol ( LDL-C ),fasting blood glucose (FBG),HbAlc,fasting insulin (FINS),HOMA-IR,high sensitivity C-reactive protein (hs-CRP),carotid intima-media thickness (IMT),brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index(ABI) were measured at baseline and at 9 months.ResultsAfter 6 or 9 months' intervention,BMI,WC,SBP,TG,HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were improved (all P ＜ 0.05). HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were further improved at 9 months when compared to 6 months ( all P ＜ 0.05 ). In comparison with the control group,BMI,WC,HDL-C,FPG,HbA1 c,FINS,HOMA-IR and hs-CRP were significantly improved in the intervention group at 9 months ( all P ＜ 0.05 ).After 6 or 9 months' intervention,baPWV and ABI were significantly changed ( both P ＜ 0.05 ) in the intervention group although IMT of the carotid did not changed (P ＞0.05). BaPWV and ABI were significantly changed in the intervention group when compared with those in the control group at 9 months ( both P ＜ 0.05).The abnormal rate of baPWV in the intervention group at 9 months was 44.68％. BaPWV and ABI were associated with hs-CRP and HOMA-IR.ConclusionsIn nondiabetic MS patients, health management could significantly improve insulin resistance,modify metabolic disorders,and prevent the development of atherosclerosis.

Association of education level with metabolic syndrome in Su-Xi-Chang area of Jiangsu Province / 中华健康管理学杂志

Objective To investigate the relationship between metabolic syndrome (MS) and education level in Su-Xi-Chang area to provide evidence for healthcare policy making. Methods A clustered sampling of 6798 subjects from Su-Xi-Chang areas of Jiangsu Province was included. Questionnaires and physical examinations were completed to collect clinical data. Logistic regression was used to analyze weather education level could be an independent risk factor of MS. Results Significant differences were found in waist circumstance (WC) ,systolic blood pressure (SBP) and fasting blood glucose (FBG) among participants with different education level. Significant differences were also existed in triglyceride and diastolic blood pressure (DBP) between subjects with higher and lower education level ( P＜0. 05 ). In single-factor or multivariate analysis, education level was negatively correlated with the prevalence of MS (P＜0. 05 ). Conclusions Education level may be an independent risk factor of MS. People with low and moderate education level have higher risk of MS. Therefore,it is recommended that health-related information should become an integral part of the compulsory education system.

Association between diet style and metabolic syndrome in old people / 中华老年医学杂志

Objective To investigate the relationship between metabolic syndrome (MS) and diet style in the elderly. Methods The 781 old people were consecutively selected. Related data were collected by means of questionnaires and physical examinations. And logistic regression was performed to analyze if moderate and high fat diet were risk factors of MS. Results The total prevalence rate of MS in old people was 40. 7%, with 36.7% in old males and 55.4% in old females,and the prevalence rate of MS was higher in old women than in old men (P=0. 000). The significant differences in waist circumferences among three groups of low, moderate and high-fat diet [(86.0±9.3) cm vs. (88.8±8.5) cm vs. (90. 0±7.9) cm, respectively (all P＜0.05)]were found. Fasting blood glucose showed a significant difference between two groups of low and high-fat diet, with the results of (5.78 ± 0.98) mmol/L and (6.27 ± 1.80) mmol/L, respectively ( P＜0. 05 ). The logistic regression analysis showed that odds ratio for people with moderate and high-fat diets were 1. 541 ( 1. 092-2. 174) and 2. 293 ( 1. 317-3. 994), respectively (P＜0.05), which indicated that moderate and high-fat diet was independent risk factors for MS in old people. Conclusions Both moderate and high-fat diets are risk factors of MS in old population, low fat diet with food balance is recommended to old population in order to decrease the prevalence of MS.

The effects of swimming on neurotrophin-3 levels in the skeletal muscles of diabetic rats / 中华物理医学与康复杂志

Objective To explore the effects of exercise on the levels of neurotrophin-3 (NT-3) in the skeletal muscles of streptozotocin-induced diabetic rats. Methods The rats were divided into an 8-week exercise group (A), a 4-week exercise group (B), a diabetes control group (C), an exercise group (D) in which no dia-betes was induced, and a control group (E). The rat model of diabetes was induced in the rats of groups A, B and C by intra-abdominal injection of streptozotocin (STZ) at 55 mg/kg. The exercising rats were forced to swim for 60 minutes once daily, 5 days a week. The levels of NT-3 in skeletal muscles were measured with an enzyme-linked immunosorbent assay. Cadual nerve conduction velocity (CNCV) in all of the rats was evaluated at the beginning, and after 4 and 8 weeks of swimming exercise. Results NT-3 levels in the skeletal muscles in group C were sig-nificantly lower than in groups A, D and E. There was no statistically significant difference in NT-3 levels between groups B and C. The NT-3 levels showed a significant positive correlation with CNCV at the 8th week. Conclu-sions The increase in NT-3 levels of skeletal muscles induced by exercise could contribute partially to the im-provement of diabetic neuropathy.