Quantitative computed tomography-derived abdominal visceral adipose tissue and cardiometabolic risk in a large-scale population / 中华健康管理学杂志

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

Prevalence of osteoporosis in China: a multicenter, large-scale survey of a health checkup population / 中华健康管理学杂志

Objective The present study aimed to establish a bone mineral density (BMD) reference database in China and to investigate the prevalence of osteoporosis in Chinese adults aged 50 years and older using dual energy X-ray absorptiometry (DXA). Method A total of 75321 examineers over 25 years old who underwent health checkups in 7 health check centers between 2008 and 2018 were included. All centers used a GE Lunar-DXA system to measure BMD of the lumbar spine (L1-L4), femoral neck, and total femur. The same European Spine Phantom (ESP) was used for scanning 10 times at every center, a regression equation was generated, and BMD data were cross-calibrated in each center. Peak BMD and standard deviation (SD) were identified according to 5-year age groups, and T scores were calculated based on the peak BMD and SD. Osteoporosis was defined according to the World Health Organization criteria. The prevalence of osteoporosis was standardized based on 2010 national census data for the Chinese population. Result The mean BMD values decreased with age, were highest in North China, followed by Northeast China, East China, and Southwest China, respectively, and increased with body mass index. Males aged 20-30 years and females aged 35-40 years had peak BMD values. Peak BMD values of the lumbar spine, femoral neck, and total femur were 1.09 g/cm2, 0.97 g/cm2, and 0.97 g/cm2 in males, and 1.11 g/cm2, 0.84 g/cm2, and 0.88 g/cm2 in females, respectively. Among all scanned sites, the prevalence of osteoporosis was highest in the femoral neck in males (4.58％) and in the lumbar spine in females (23.38％). The age-standardized prevalence of osteoporosis at any site was 6.46％ in males and 29.13％ in females aged 50 years and older. Based on the 2010 national census data, 10879115 males and 49286542 females currently have osteoporosis. Conclusion Mean BMD values varied according to geographic region, body mass index, age group, and sex in Chinese adults. The age-standardized prevalence of osteoporosis was 6.46％ in males and 29.13％ in females aged 50 years and older.

Association between glycated albumin and arterial stiffness in a health screening population / 中华健康管理学杂志

Objective Serum glycated albumin (GA) is associated with the levels of blood glucose and short term glycemic fluctuation. The aim of this study was to investigate the associations between GA and arterial stiffness in a health screening population. Method A total of 11 014 participants (men, 56.2%;mean age, 46.8±7.8 years) who attended physical examination were invited and had completed standardized questionnaires. Serum GA and homocysteine (HCY), brachial-ankle pulse wave velocity (baPWV), and central systolic blood pressure (cSBP) were measured. A series of single and multiple factor analyses and stratified analysis were performed. Result The mean level of serum GA was lower in men (13.69 ± 2.69) than in women (13.82 ± 1.92) (t=2.78, P=0.005). The values of baPWV (men: F=53.9, P for trend<0.001;women:F=37.7, P for trend<0.001) and cSBP (men:F=10.3, P for trend<0.001;women:F=13.5, P for trend<0.001) increased with quartiles of GA levels in both men and women. After adjustment for age, history of hypertension, diabetes, family history of diabetes, smoking status, body mass index, waist circumference, blood pressure, blood lipids, kidney function, fasting glucose, postprandial glucose, and hemoglobin A1c, GA was positively associated with baPWV (βestimate, 0.019;95%CI:0.002-0.036;P=0.032) and cSBP (βestimate, 0.251; 95% CI: 0.107-0.394; P=0.001) in men. Stratified analysis also showed that the positive associations of GA with baPWV and cSBP remained significant in men both with and without diabetes or hypertension (P<0.05). However, the association between GA and HCY was not significant in multifactor analysis and stratified analysis. The above results were similar in women. Conclusion Serum GA levels were positively associated with baPWV and cSBP not only in patients with diabetes or hypertension but also in participants without diabetes or hypertension after adjusting for conventional factors and glucose markers. The findings suggest that GA may help detect the development of arterial stiffness in the health screening population.

Effect of lifestyle intervention on chronic disease in high-risk population / 中华健康管理学杂志

Objective To assess the effect of lifestyle intervention on risk factors of chronic disease.Methods A total of 400 adults with high-risk of chronic disease received 3 months' lifestyle intervention.The effect of lifestyle intervention was then estimated.Results A total of 387 adults took physical examination.After lifestyle intervention,body mass index,waist circumference,blood pressure,glucose,glyceride,total cholesterol,and high density liopportein were significant decreased (t values were 27.50,19.01,7.46,6.56,5.29,7.74,7.27 and-7.64,respectively; all P＜0.05); however,low density liopportein showed no significant difference (t=0.73,P=0.469).A total of 373 adults had lifestyle and cardiovascular risk estimated.The scores of lifestyle and physical exercise showed statistically significant difference before and after lifestyle intervention (x2 values were 48.405 and 50.778,respectively; both P＜0.05).However,diet,alcohol drinking and cigarette smoking showed no significant difference (x2 values were 0.087,0.112 and 1.410,respectively; all P＞0.05).Moreover,the estimated cardiovascular risk showed significant difference (x2=10.284,P＜0.05).Conclusion Lifestyle intervention could be an effective tool for those with higher risk of chronic disease.