Effect of community management based on Roy′s adaptation model in patients with chronic obstructive pulmonary disease / 中华健康管理学杂志

Objective:To determine the effect of community management based on the Roy′s adaptation model (RAM) in patients with chronic obstructive pulmonary disease (COPD).Methods:This study was a cluster randomized controlled study, with the community as the cluster unit, and selected 805 COPD patients from 8 communities in Xuzhou City who had completed community registration before June 2019. A total of 735 patients actually completed follow-up and participated in intervention evaluation. They were randomly divided into control group (362 cases) and intervention group (373 cases) by random number table method. The control group received routine follow-up, while the intervention group received RAM intervention for 6 months. The forced expiratory volume in 1 second (FEV1)/forced volume vital capacity (FVC) ratio (FEV 1/FVC) and the modified British medical research council (mMRC) were used to assess the pulmonary function. The hospital anxiety and depression scales (HADS) were used to evaluate the mental health. The Chinese version of the Short Form Coping and Adaption Processing Scale (CAP-15) was used to assess the adaptive capacity. And the St. George′s Respiratory Questionnaire (SGRQ) was used to evaluate the quality of life in COPD patients. The t test or χ 2 test was used for pre-intervention comparisons between groups, and the repetitive measure analysis of variance (ANOVA) was used for post-intervention comparisons between groups. Results:After 6 months intervention, there were no significant differences in FEV 1/FVC radio between the two groups [(0.61±0.11) vs (0.62±0.12)] ( P=0.172). The scores of mMRC [(2.04±0.33) vs (2.77±0.31) points], HAD-A [(5.28±4.28) vs (6.99±4.41) points], HAD-D [(5.82±5.12) vs (7.27±4.93) points] and SGRQ [(40.17±9.30) vs (53.69±9.77) points] were all lower in the intervention group than those in the control group (all P<0.001). The CAPS-15 score was higher in the intervention group than that in the control group [(35.87±3.62) vs (26.1±3.47)] ( P<0.001). Conclusion:RAM could be used in community management of COPD patients, which could improve their dyspnea symptoms and psychological and physiological functions, also improve their adaptability and quality of life.

Effect of group cognitive behavioral therapy on anxiety, depression and quality of life in patients with chronic obstructive pulmonary disease in community / 中华行为医学与脑科学杂志

Objective:To explore the effect of group cognitive behavior therapy (GCBT) on anxiety, depression and quality of life in patients with chronic obstructive pulmonary disease (COPD) in community.Methods:From August to November 2019, patients with moderate COPD in 18 communities in Xuzhou City were randomly divided into the intervention group ( n=240) and the control group ( n=223). The control group received routine management and the intervention group received group cognitive behavioral therapy intervention for 8 weeks on the basis of routine management.Before and after the intervention, FEV 1% predicted value and FEV 1/FVC were measured by pulmonary function tester.Hospital Anxiety and Depression Scale (HADS) was used to evaluate the anxiety and depression of patients.St.George's respiratory questionnaire (SGRQ), COPD assessment test (CAT) and modified medical research council dyspnea (mMRC) were used to evaluate the quality of life of patients.SPSS 20.0 software was used for analysis.The χ 2 test, independent sample t-test, paired sample t-test were used for statistical analysis. Results:After 8 weeks of intervention, the anxiety and depression scores of the intervention group were lower than those of the control group (anxiety: (8.23±4.02) vs (10.71±3.60); depression: (7.87±3.73) vs (10.20±3.72)( t=6.415, 6.185, both P<0.01). After the intervention, there was no significant difference in FEV 1%((51.7±12.3)% vs (52.0±12.6)%) predicted value and FEV 1/FVC((57.3±10.8)% vs (56.9±10.7)%) between the two groups( t=-0.259, 0.400, both P>0.05). The scores of CAT, mMRC and SGRQ in the intervention group were lower than those in the control group((17.35±5.78) vs (20.90±8.00), (1.55±0.82) vs (2.30±1.21), (41.78±21.56) vs (57.08±24.46))( t=-5.061, -7.227, -6.580, all P<0.01). Conclusion:Group cognitive behavioral therapy can relieve the anxiety and depression and improve the quality of life of patients with COPD.

Effect of cognitive-behavioral therapy on psychological stress and quality of life in patients with pulmonary tuberculosis / 中华全科医师杂志

Objective:To explore the effect of cognitive-behavioral therapy on psychological stress and quality of life in patients with pulmonary tuberculosis.Methods:According to two-level cluster random design 461 patients with tuberculosis from 20 communities in Pizhou county of Jiangsu province were selected in the study from September 2018 to November 2018. The intervention group received cognitive-behavioral therapy for two months, while control group received routine follow-up. Anxiety, depression and quality of life were assessed by GAD-7, PHQ-9 and SF-36 scales, respectively. At the same time, the comparison between the two groups was conducted by independent sample t test, and the difference between the two groups before and after treatment was analyzed by paired sample ttest. Results:A total of 454 participants were finally included in this analysis; there were 230 cases in the intervention group and 224 cases in the control group. In the intervention group the scores of anxiety and depression after intervention were significantly lower than the baseline scores [(7.57±5.27) vs. (5.93±2.56), t=-4.245, P<0.01; (8.13±6.01) vs. (6.02±2.67); t=-4.866, P<0.01], and the quality of life score was significantly higher than the baseline score [(58.46±12.71) vs. (74.31±13.22); t=13.108, P<0.01]; while in the control group there were no significant differences in the scores of anxiety, depression and quality of life after intervention, compared with those at baseline [(7.62±5.41) vs.(7.65±5.38); (8.00±5.84) vs. (8.07±5.91); (59.11±13.25) vs. (60.51±13.76); t=0.059, t=0.126, t=1.104, all P>0.05]. However, only for patients with mild and moderate anxiety and depression symptoms in the intervention group, the anxiety and depression scores were decreased after intervention [(7.29±1.21) vs. (5.54±1.71), (11.99±1.31) vs. (9.17±1.55); (7.01±1.47) vs. (4.42±1.22), (11.88±1.12) vs. (8.39±2.33); t=8.056, t=10.020, t=13.558, t=8.852,all P<0.01]. Conclusion:Cognitive-behavioral therapy can relieve the psychological pressure and improve the quality of life in pulmonary tuberculosis patients with mild or moderate anxiety/depression symptoms.

Prevalence and risk factors of stroke among residents in Xuzhou city / 中华健康管理学杂志

Objective:To investigate the prevalence and risk factors of stroke in Xuzhou city.Methods:A total of 41 932 residents aged 18 years and above were selected using the multi-stage stratified cluster sampling method. A questionnaire survey was conducted to investigate the rate of stroke, and a physical examination was performed to investigate height, weight, blood pressure, etc. Univariate analyses of stroke were performed using the Chi square test and trend chi-square test. Logistic regression analysis was performed for multi-factor analysis.Results:A total of 39 854 participants (19 222 males, 10 323 from urban areas) from 41 932 eligible participants were included in the statistical analysis, and their average age was (52.1±16.8). In this study, 885 stroke patients (464 males, 302 from urban areas) were found among 39 854 participants. The prevalence of stroke was 2 220.61/100 000, which was separately 2 413.90/100 000 and 2 040.52/100 000 among males and females. The difference between males and females was significant (χ2=6.22, P=0.013). The prevalence of stroke in urban areas (2 925.51/100 000) was higher than in rural areas (1 974.20/100 000) (χ2 =31.45, P<0.001). The results of univariate analysis revealed that the risk factors for stroke were [ OR(95% CI)] smoking [1.82(1.53-2.08)], drinking [1.22(1.08-1.81)], sleep quality [1.42(1.13-1.96)], physical activities [1.44(1.11-2.14)], hypertension [3.53(2.44-6.02)], heart disease [1.23(1.11-1.75)], diabetes [1.42(1.31-2.05)], family history of hypertension [1.43(1.30-2.37)], family history of diabetes [1.22(1.10-1.65)], and family history of stroke [1.57(1.46-2.06)]. Logistic regression analysis showed that age [3.02(2.14-4.96)], smoking [1.59(1.12-3.85)], poor sleep quality [1.15(1.03-3.23)], lack of physical activity [1.22(1.08-3.38)], hypertension [4.53(3.07-7.36)], diabetes [1.08(1.02-3.23)], and family history of stroke [1.15(1.08-3.31)] were related to stroke. Conclusion:The epidemic of stroke in Xuzhou city was relatively high, and prevention and control measures of stroke should be taken according to the risk factors of stroke in the population distribution.

Differential expression of long non-coding RNAs in peripheral blood of type 2 diabetic patients / 中华内分泌代谢杂志

Objective@#To screen and verify the differential expression profiles of long non-coding RNAs(LncRNAs) in peripheral blood of patients with type 2 diabetes mellitus(T2DM), to identify the potential molecular specific markers of early T2DM.@*Methods@#The blood samples of 4 type 2 diabetic patients and 4 normal control subjects were collected for microarray analysis. Then six candidate markers of LncRNAs screened from the differential expression profile were tested by qRT-PCR among the subjects (80 cases in the T2DM group and 50 cases in the control group). The possibility of these LncRNAs as molecular diagnostic markers was analyzed, and finally two of them were carried out by receiver operating characteristic (ROC) analysis.@*Results@#Compared with control subjects, there were differentially expressed 133 LncRNAs in type 2 diabetic patients, among which 5 were up-regulated with the maximum up-regulated fold 3.29 and 128 were down-regulated with the maximum down-regulated fold 8.99. Six down-regulated LncRNAs were selected for validation and revealed a similar result to that of microarray.The expressions of two LncRNAs(NONHSAT160746 and NONHSAT140069) in peripheral blood of diabetic patients were significantly lower than those of control subjects (P<0.01). The areas under the ROC curve of the two LncRNAs were 0.734 and 0.703, respectively(P<0.01).@*Conclusion@#LncRNAs NONHSAT160746 and LncRNAs NONHSAT140069 are the potential molecular specific markers for the diagnosis of diabetes mellitus.

Differential expression of long non-coding RNAs in peripheral blood of type 2 diabetic patients / 中华内分泌代谢杂志

Objective To screen and verify the differential expression profiles of long non-coding RNAs (LncRNAs) in peripheral blood of patients with type 2 diabetes mellitus(T2DM), to identify the potential molecular specific markers of early T2DM. Methods The vein blood samples of 4 type 2 diabetic patients and 4 normal control subjects were collected for microarray analysis. Then six candidate markers of LncRNAs screened from the differential expression profile were tested by qRT-PCR among the subjects ( 80 cases in the T2DM group and 50 cases in the control group). The possibility of these LncRNAs as molecular diagnostic markers was analyzed, and finally two of them were carried out by receiver operating characteristic (ROC) analysis. Results Compared with control subjects, there were differentially expressed 133 LncRNAs in type 2 diabetic patients, among which 5 were up-regulated with the maximum up-regulated fold 3.29 and 128 were down-regulated with the maximum down-regulated fold 8.99. Six down-regulated LncRNAs were selected for validation and revealed a similar result to that of microarray.The expressions of two LncRNAs(NONHSAT160746 and NONHSAT140069) in peripheral blood of diabetic patients were significantly lower than those of control subjects (P＜0.01). The areas under the ROC curve of the two LncRNAs were 0.734 and 0.703, respectively(P＜0.01). Conclusion LncRNAs NONHSAT160746 and LncRNAs NONHSAT140069 are the potential molecular specific markers for the diagnosis of diabetes mellitus.

Study on the relationship between poor sleep quality and stoke / 中华老年医学杂志

Objective To explore the relationship between poor sleep quality and stoke.Methods A total of 738 stroke patients in Xuzhou city in 2013 were selected as the case group and age-and sex-matched healthy non-stroke subjects (n =738)as control group.The writer-designed general situation questionnaire and the Pittsburgh Sleep Quality Index(PSQI)analyses were conducted for a face-to-face investigation.Results No significant difference in mean age(66.1±10.9 and 65.8 ± 10.6,t =0.60,P =0.58)and in sex (50％ vs.50 ％) was found between two groups.There were statistically significant differences between case and control groups in baseline values of BMI(t=2.40,P =0.02),histories of hypertension(x2 =174.30,P =0.00),diabetes mellitus (x2 =27.20,P =0.00),coronary heart disease(x2 =115.60,P =0.00),smoking(x2 =6.10,P =0.01),drinking (x2 =7.30,P =0.01)and living stress(x2 =11.40,P =0.01).The PSQI sub-scores and PSQI total scores were higher in case group than in control group.The rate of poor sleep quality was higher in case group(279 cases,37.8 ％) than in control group(136 cases,18.4 ％) (x2 =6.10,P =0.01).Multivariate logistic analysis showed that,after adjusting for confounding factors of BMI,histories of hypertension,diabetes,coronary heart disease.smoking,drinking and living stress,the poor sleep quality in total male plus female was independent predictor variables for stroke[odds ratio(95 ％ CI) of 2.3 (1.8-3.0)],no matter their sex,with odds ratio (95 ％ CI) in male (2.5,1.7-3.7) or in female (2.2,1.5-3.2),respectively,but there was no significance difference in the odds ratio between male and female in case group(x2 =0.04,P=0.85).The risk stroke was 2.3 folds higher in poor sleep quality versus control in male plus female,with pure male or female of 2.5 or 2.2 folds.There was no significance difference between male and female in case group versus.the control(x2 =0.04,P=0.85).Conclusions Poor sleep quality is associated with the occurrence of stroke and may be a risk factor for stroke.

Joint effect of smoking and diabetes on stroke / 中华流行病学杂志

Objective To explore the interaction of smoking and diabetes on stroke.Methods In this case-control study,a face to face questionnaire survey was conducted.Logistic regression models were used to analyze the relationship between smoking or diabetes and stroke.The indicators of interaction were calculated according to the Bootstrap method in this study.Results A total of 918 cases and 918 healthy controls,who participated in the chronic disease risk factor survey in Xuzhou in 2013,were included in this study.Logistic regression analysis found that cigarette smoking was associated with stroke (OR=1.63,95％ CI:1.33-2.00),and diabetes was also associated with stroke (OR=2.75,95％CI:2.03-3.73) after adjusting confounders.Compared with those without diabetes and smoking habit,the odds ratio of stroke in those with diabetes and smoking habits was 8.94 (95％CI:3.77-21.19).Diabetes and smoking combined interaction index was 3.65 (95％CI:1.68-7.94),the relative excess risk was 5.77 (95％ CI:0.49-11.04),the attributable proportion was 0.65 (95％ CI:0.42-0.87).Conclusion The results suggest that there are additive interactions between smoking and diabetes on stroke.

Joint effect of smoking and diabetes on stroke / 中华流行病学杂志

Objective To explore the interaction of smoking and diabetes on stroke.Methods In this case-control study,a face to face questionnaire survey was conducted.Logistic regression models were used to analyze the relationship between smoking or diabetes and stroke.The indicators of interaction were calculated according to the Bootstrap method in this study.Results A total of 918 cases and 918 healthy controls,who participated in the chronic disease risk factor survey in Xuzhou in 2013,were included in this study.Logistic regression analysis found that cigarette smoking was associated with stroke (OR=1.63,95％ CI:1.33-2.00),and diabetes was also associated with stroke (OR=2.75,95％CI:2.03-3.73) after adjusting confounders.Compared with those without diabetes and smoking habit,the odds ratio of stroke in those with diabetes and smoking habits was 8.94 (95％CI:3.77-21.19).Diabetes and smoking combined interaction index was 3.65 (95％CI:1.68-7.94),the relative excess risk was 5.77 (95％ CI:0.49-11.04),the attributable proportion was 0.65 (95％ CI:0.42-0.87).Conclusion The results suggest that there are additive interactions between smoking and diabetes on stroke.

Trend analysis on the death rate of ischemic heart disease and cerebrovascular disease among Xuzhou residents from 2011 to 2015 / 中华心血管病杂志

Objective@#To analyze the epidemiological characteristics and trend of ischemic heart disease and cerebrovascular disease mortality among Xuzhou residents from 2011 to 2015.@*Methods@#The mortality data of the ischemic heart disease and cerebrovascular disease were obtained from the registration disease surveillance system covering the residents of the city from 2011 to 2015. Ischemic heart disease and cerebrovascular disease were identified according to the international classification of diseases (ICD-10), Ischemic heart diseases include I20 to I25 (angina pectoris, acute myocardial infarction, certain current complications following acute myocardial infarction, other acute ischemic heart diseases chronic ischemic heart disease); cerebrovascular diseases include I60 to I69 (subarachnoid hemorrhage, intracerebral hemorrhage, other non-traumatic hemorrhage, cerebral infarction, stroke not specified as hemorrhage or infarction, other cerebrovascular diseases, sequelae of cerebrovascular disease).@*Results@#(1)From 2011 to 2015, the chronic ischemia Cardio-Cerebrovascular disease mortality of residents in Xuzhou was 261.2 per one hundred thousand (129 950/49 748 321), 269.9 per one hundred thousand(69 562/25 775 930)for male residents, 252.0 per one hundred thousand(60 388/23 972 391)for female residents, the mortality rate in men was significantly higher than that in women (P<0.05). The chronic ischemic Cardio-Cerebrovascular disease mortality rate of urban residents was 243.8 per one hundred thousand(17 049/6 993 787), which was lower than the rate of rural residents (264.0 per one hundred thousand(112 901/42 754 534), P<0.05). (2)From 2011 to 2015, the mortality rate of ischemic heart disease in Xuzhou city remained unchanged: 117.1 per one hundred thousand(11 416/9 747 768), 126.8 per one hundred thousand(12 177/9 600 745), 112.0 per one hundred thousand(11 184/9 986 877), 115.2 per one hundred thousand(11 697/10 151 842), 117.1 per one hundred thousand(12 019/10 261 089, P>0.05). The mortality rate of cerebrovascular disease were 154.0 per one hundred thousand(15 014/9 747 768), 155.9 per one hundred thousand(14 964/9 600 745), 143.5 per one hundred thousand(14 330/9 986 877), 135.5 per one hundred thousand(13 752/10 151 842), 130.6 per one hundred thousand(13 397/10 261 089)respectively, presented with a downward trend(P<0.05). The mortality rate of ischemic cerebrovascular disease were 62.7 per one hundred thousand(6 108/9 747 768), 74.7 per one hundred thousand(7 176/9 600 745), 72.3 per one hundred thousand(7 221/9 986 877), 70.9 per one hundred thousand(7 200/10 151 842)and 72.4 per one hundred thousand(7 431/10 261 089)respectively(P>0.05). The mortality rate of hemorrhagic cerebrovascular disease were 77.6 per one hundred thousand(7 562/9 747 768), 71.6 per one hundred thousand(6 873/9 600 745), 61.2 per one hundred thousand(6 115/9 986 877), 55.3 per one hundred thousand(5 613/10 151 842)and 46.4 per one hundred thousand(4 763/10 261 089)respectively, presented with a downward trend(P<0.05). (3)The average death age due to ischemic heart diseases of all residents was (77.0±13.1)years old, (76.4±13.2) years old among urban residents, (77.1±7.1 )years old among rural residents, (74.3±13.5)years old for male residents, (80.0±12.0) years old for female residents. The average death age due to ischemic cerebrovascular diseases of all residents was (76.4±11.9)years old, (76.5±12.3) years old among urban residents, (76.4±11.9 )years old among rural residents, (74.3±12.2)years old among male residents, (79.0±11.1) years old among female residents. From 2011 to 2015, the death age due to ischemic heart diseases were (76.3±13.5), (77.2±13.0), (76.6±13.3), (77.1±12.9)and(77.8±12.9)years old respectively; the death age due to cerebrovascular disease were (75.8±12.1), (76.3±11.8), (76.6±11.8), (76.6±12.0)and(77.1±11.9)years old respectively. The Spearman rank correlation analysis showed that the death age due to ischemic heart disease and cerebrovascular disease increased year by year in the past 5 years. (r value was 0.033 and 0.038, respectively, all P<0.01).@*Conclusion@#From 2011 to 2015, the mortality of hemorrhagic cerebrovascular disease decreased, while the mortality of ischemic cardiovascular and cerebrovascular diseases remained unchanged among Xuzhou residents.

Relationship between alcohol dependence and new detected hypertension in adult residents of Xuzhou city / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the relationship between alcohol dependence and new detected hypertension in adult residents of Xuzhou city.</p><p><b>METHODS</b>Participants were sampled by stratified multi-stage randomly cluster sampling method from February 2013 to June 2013 among permanent residents aged 18 and more in Xuzhou city. The alcohol dependence was defined with Michigan Alcoholism Screening Test (MAST). Other information was obtained by questionnaire. Spearman correlation analysis and multivariate logistic regression analysis were performed to identify the relationship between alcohol dependence and new detected hypertension.</p><p><b>RESULTS</b>The alcohol dependence rate was 11.56% on the whole cohort (n=36 157), and 22.02%(3 854/17 501) for male and 1.74%(324/18 656) for female(P<0.01). The new detected hypertension rate was 9.46%(3 422/36 157) in the whole cohort. The new detected hypertension rate increased in proportion with the severity of alcohol dependence (P<0.01). Spearman correlation analysis showed that alcohol dependence was positively correlated with systemic blood pressure(r=0.071, P<0.01) and diastolic blood pressure (r=0.077, P<0.01). After adjusting for gender, age, marital status, body mass index, smoking status, physical activity level, educational level, income level and region, multivariate logistic regression analysis showed that alcohol dependence was an independent risk factor for hypertension (low alcohol dependence: OR=1.44, 95%CI 1.14-1.81, P<0.01; light alcohol dependence: OR=1.35, 95%CI 1.11-1.64, P<0.01; medium alcohol dependence: OR=1.83, 95%CI 1.40-2.41, P<0.01).</p><p><b>CONCLUSIONS</b>The alcohol dependence is an independent risk factor for new detected hypertension in adult residents of Xuzhou city. Intensive hypertension prevention and treatment strategies should be performed on this population based on our results.</p>

Interaction between depression and sleep quality in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective To explore the interaction of sleep quality and depression among patients with type 2 diabetes. Methods With multistage cluster sampling, all the participants were interviewed with self-designed questionnaire, diabetes-specific quality of life scale and self-rating depression scale, and Pittsburgh sleep quality index scale. Chi-square test was used for qualitative data. Risk factors were analyzed by means of multiple linear regression or logistic regression model. The indicator of interaction was calculated according to the delta method. Results There were 944 residents involved in the final analysis, including 365 males and 579 females. The average age was (64. 0 ± 10. 2) years. Compared with patients with type 2 diabetes mellitus( T2DM) who had good sleep quality and no depression symptoms, the risk of quality of life in those with good sleep quality but depression was 2. 75 (95% CI 1. 59-4. 77); and the risk of quality of life in those with poor sleep quality and no depression was 1. 55(95%CI 1. 03-2. 33). The risk of quality of life in those with poor sleep quality and depression was 4. 97(95% CI 2. 34-9. 63). Due to poor sleep quality and depression in patients with T2DM the combined interaction index was 2. 48 (95% CI 1. 44-4. 29), the relative excess risk was 3. 42(95% CI 2. 16-4. 67), and the attributable proportion was 0. 51(95% CI 0. 32-0. 70). Conclusion A combined interaction of poor sleep quality and depression in affecting the quality of life was found in type 2 diabetic patients. When both factors existed at the same time, the interaction effect of these 2 factors was greater than the single one.

Prevalence and influencing factors of overweight and obesity of adult residents in Xuzhou City of Jiangsu Province, 2013 / 中华健康管理学杂志

Objective To understand the prevalence and influencing factors of overweight and obesity in adult residents in Xuzhou City of Jiangsu Province,so as to provide scientific basis for health policies and intervention strategies.Methods A total of 39 445 participants were recruited by multi-stage random cluster sampling method,and health data were obtained through questionnaires and physical examinations.Results The prevalence of overweight and obesity was 34.60％ and 9.40％,respectively; and the standardized prevalence was 32.97％ and 8.67％.The prevalence of overweight or obesity in males was 36.73％ and 8.62％,in females 32.61％ and 10.13％.The prevalence of overweight or obesity was increased with age,although the prevalence of overweight was decreased after 55 years of age (18-:16.31％; 25-:27.38％; 35-:37.28％; 45-:41.55％; 55-:40.71％; 65-:37.64％; 75-:32.08％) and the prevalence of obesity was decreased after 75 years of age (18-:2.49％; 25-:6.41％; 35-:9.64％; 45-:11.24％; 55-:12.07％; 65-:12.45％; 75-:8.88％).There were significant difference of the prevalence of overweight/obesity by educational level (x2=178.41,P＜0.01; x2=243.59,P＜0.01),profession (x2=191.28,P＜0.01; x2=120.38,P＜0.01) and marital status (x2=431.67,P＜0.01; x2=118.43,P＜0.01).In Logistic regression,female,vegetable over-intake every day and current cigarette smoking were protective factors of overweight/obesity,while middle and old-age,alcohol drinking and big appetite were risk factors of overweight/obesity.Conclusions A higher morbidity rate of overweight/obesity was found in Xuzhou City,and comprehensive interventions should be taken for high risk populations.

Interaction between quality and duration of sleep on the prevalence of type 2 diabetes / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the effects related to quality and duration of sleep and their interactions on the prevalence of type-2 diabetes (T2DM).</p><p><b>METHODS</b>9 622 people aged 18 years and over were recruited for our cross-sectional study during March 2013 to May 2013. Unconditional logistic regression was used to analyze the relationship between quality and duration of sleep on T2DM. Bootstrap was used to calculate the relative excess risk of interaction (RERI), the attributable proportion (AP) of interaction and the synergy index (SI). 95% confidence intervals (CI) of RERI, AP and SI were estimated.</p><p><b>RESULTS</b>Concerning the comparison between cases and controls on both individual and total scores, other scores were all significantly different (P < 0.01), except for two items (time for falling asleep and drugs for hypnosis). The prevalence of T2DM in volunteers with poor sleeping quality was higher than that in volunteers with good sleeping quality (P < 0.01). Individuals with sleep duration <6 hours had a higher prevalence of T2DM, when compared with individuals with sleep duration of 6-8 hours (P < 0.01). After adjusting for age, gender, level of education, occupation, family history of diabetes, status on cigarette smoking, alcohol intake, physical activities and body mass index (BMI), the prevalence of T2DM appeared the highest in those with poor sleeping quality and short duration (OR = 4.78, 95% CI:3.32-6.99; P < 0.01), when compared with those who had good sleep quality and 6-8 h sleep duration. The risk of T2DM still increased in people who had poor sleep or long duration (OR = 1.92, 95% CI:1.18-3.31; P < 0.01). Values of RERI, AP and SI (with 95% CI) were 2.33 (1.23-8.79), 0.67(0.21-0.83) and 6.87 (2.33-10.75), respectively, for the interaction between poor sleep quality and short sleep duration, while 0.33 (-0.12-1.13), 0.17 (-0.03-0.51), 1.56 (0.76-2.74) for the interaction between good sleep quality and long sleep duration.</p><p><b>CONCLUSION</b>Our results suggested that there were additive interactions between poor quality and shorter duration of sleep.</p>