Ideal Cardiovascular Health Metrics Attenuated Association of Age at Menarche With Type 2 Diabetes in Rural China.

Objective: It is not clear whether ideal cardiovascular health (ICH) metrics have an impact on the association between age at menarche and type 2 diabetes (T2DM) in rural postmenopausal Chinese women. Methods: In all, 15,450 postmenopausal women were enrolled from the Henan Rural Cohort study. Logistic regression models and interaction plots were used to analyze associations between age at menarche, ICH metrics and T2DM and interactive effects. Results: Age at menarche was inversely associated with risk of T2DM, with adjusted OR of 1.224, 1.116, 1.00 and 0.971, 0.850 for those with age at menarche ≤13, 14, 15-16 (reference), 17, and ≥18 years, respectively, and each year of delay in menarche age correlated with a 5.1% lower risk of T2DM. Negative interaction effects of age at menarche and number of ICH metrics on the risk of T2DM was observed. Conclusion: Meeting more ICH metrics might attenuate the association between early menstrual age and increased risk of T2DM, implying that meeting a higher number of ICH metrics may be an effective way to prevent T2DM for women of early menarche age.

Assessment of men involvement in family planning services use and associated factors in rural Ghana.

BACKGROUND: In low-and-middle income countries (LMICs) less attention is paid to men's involvement in Family Planning (FP) programs where public health officials have advocated the involvement of men as a strategy for addressing the dismal performance of FP programs. The study assessed the involvement of men in FP use and the factors which promote or hinder the uptake of FP services among partners in a rural setting of northern Ghana. METHODS: A cross-sectional descriptive study was used to collect data from 200 respondents. Study respondents were selected through random cluster sampling. RESULTS: The findings showed that male partners' knowledge (95.5%) and approval (72.8%) of FP services were high. About 48% of men were involved in FP service utilization. Having living children (aOR; 1.71(1.27, 2.15)) and being knowledgeable (aOR; 6.14(1.38, 10.90)) about FP were positively associated men's involvement in FP service utilization. The findings also indicated that men had a higher propensity (X2 = 4.5534, p = 0.033) of supporting a FP method use. Women who reported that their spouse supported FP method use were more likely to use a contraceptive method (X2 = 9.5223, P = 0.002) if their spouse supported FP method use (X2 = 9.5223, P = 0.002) and if their partners had some education (X2 = 14.1133, P = 0.000). Reasons for low contraceptive use were health risks, side effects, and socio-cultural norms. CONCLUSION: Family planning programs need to include men at all levels of health promotion and education of FP programs to help reduce misconceptions about contraceptive methods to increase acceptance and use among partners in rural settings of Ghana.

Secular trends of age at menarche and the effect of famine exposure on age at menarche in rural Chinese women.

BACKGROUND: Over the past few decades, more studies have suggested that the age at menarche (AAM) has continued to decline. However, the AAM for women in resource-constrained areas is not clear. Moreover, the association between the Chinese famine and AAM is still unclear in rural regions. AIM: The study aimed to investigate the secular trends of AAM for women born between 1935 and 2000 and to further explore the effect of famine on AAM in rural China. SUBJECTS AND METHODS: The study included 23,444 women participants from the baseline study of the Henan Rural Cohort study. Changing AAM over time was analysed using linear regressions. Multinomial logistic regression was conducted to analyse the association between famine exposure and AAM subgroups. RESULTS: The age-standardised mean AAM was 14.74 years. The average AAM declined from 16.98 years for those born in 1935 to 13.87 years for those born in 2000, a decline of 0.077 years per 1 year and 0.729 years per decade. Compared to the reference group, women exposed to famine during foetal, early childhood, middle childhood, and late childhood were 1.376 (95% CI = 1.071-1.769), 1.848 (95% CI = 1.512-2.259), 2.084 (95% CI = 1.725-2.518), and 2.146 (95% CI = 1.788-2.576) times more likely to be ≥18 years AAM than women unexposed to famine, respectively. CONCLUSION: AAM showed a decreasing trend in rural China. Furthermore, both foetal and childhood famine exposure, especially in late childhood, were positively associated with increased AAM compared to unexposed famine.

The Association Between Ideal Cardiovascular Health and Health-Related Quality of Life in Adults: A Population-Based Cross-Sectional Study.

Objectives: The study aimed to explore the association between Ideal cardiovascular health (ICH) and health-related quality of life (HRQoL) using the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) among rural population. Methods: This study included 20,683 participants aged 18-79 years from "the Henan Rural Cohort study". Generalized linear and Tobit regression models were employed to explore the associations of ICH with EQ-5D-5L utility scores and visual analogue scale (VAS) scores, respectively. Results: The mean EQ-5D-5L utility scores and VAS scores were 0.962 ± 0.095 and 79.52 ± 14.02, respectively. Comparing with poor CVH participants (EQ-5D-5L utility scores and VAS scores: 0.954 ± 0.111 and 78.44 ± 14.29), people with intermediate and ideal CVH had higher EQ-5D-5L utility scores (0.969 ± 0.079 and 0.959 ± 0.099) and VAS scores (80.43 ± 13.65 and 79.28 ± 14.14). ICH scores were positively correlated with EQ-5D-5L utility scores (0.007 (0.004, 0.009)) and VAS scores (0.295 (0.143, 0.446)), respectively. Conclusions: Higher ICH scores is positive associated with better HRQoL in rural population, which suggests that improvement of cardiovascular health may help to enhance HRQoL among rural population.

Prevalence and characteristics of alcohol consumption and risk of type 2 diabetes mellitus in rural China.

BACKGROUND: The study aimed to characterize the prevalence of alcohol consumption and further investigate the relationship between alcohol consumption and type 2 diabetes mellitus (T2DM). METHODS: We studied 39,259 participants aged 18 to 79 years of the Henan Rural Cohort study. The associations between alcohol consumption and T2DM were examined using the logistic regression models and restricted cubic spline. RESULTS: For men, alcohol abstinence was associated with an increased risk of T2DM (1.491(1.265, 1.758)), whereas current drinkers were not associated with T2DM (1.03(0.91, 1.15)). Further analysis of alcohol drinkers revealed that only high-risk drinkers of WHO drinking risk levels increased the risk of T2DM (1.289(1.061,1.566)) compared to never drinkers. The risk of T2DM increased as the age of starting to consume alcohol decreased and as the number of years of consuming alcohol and the alcohol intake increased only in men. We further found that the risk of T2DM decreased as the number of years of abstinence increases and no association between alcohol abstinence and T2DM was found after more than 10 years of abstinence among men. CONCLUSIONS: Our results suggested that reducing the amount of alcohol consumed and adhering to abstinence from alcohol consumption are beneficial in reducing the risk of T2DM. TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375.

Residential greenness and atherosclerotic cardiovascular disease risk in a rural Chinese adult population.

Residential greenness may be beneficial for cardiovascular health, but the evidence is still scarce, especially in developing countries. This study aimed to assess the associations between exposure to residential greenness and 10-year atherosclerotic cardiovascular disease (ASCVD) risk in a large rural Chinese adult population. This was a cross-sectional study based on 31,162 participants aged 35-74 years with complete data on predictors of the 10-year ASCVD risk from the Henan Rural Cohort Study. The satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were used to quantify residential greenness in a buffer radius of 500 m, 1000 m, and 3000 m. The high 10-years ASCVD risk was defined as the estimated risk ≥10% based on prediction equations from the China-PAR Project for Chinese populations. Multivariable-adjusted logistic regression models were performed to estimate the associations of greenness exposures with high 10-year ASCVD risk, and mediation analyses were employed to the potential mediators. For per interquartile range (IQR) increase in NDVI500-m, NDVI1000-m, NDVI3000-m, EVI500-m, EVI1000-m, and EVI3000-m, the adjusted OR (95% CI) of high 10-years ASCVD risk was 0.828 (0.793-0.866), 0.850 (0.817-0.885), 0.823 (0.792-0.855), 0.848 (0.809-0.889), 0.863 (0.826-0.901), 0.843 (0.805-0.883), respectively. Strong associations of NDVI500-m and EVI500-m with high 10-years ASCVD risk were found among participants with lower education level and lower averaged monthly income. The associations of greenness exposures with high 10-year ASCVD risk were partially explained by particulate matter with an aerodynamic diameter ≤1 µm, BMI, and physical activity. Enhancing residential greenness exposure may be beneficial for reducing the high 10-year ASCVD risk in rural Chinese adults.

Language and Communication Impact of Hypertension: A Qualitative Study.

Background. Hypertension (HTN) is the second main source of outpatient morbidity in Ghana, and the understanding of a disease is necessary for its prevention and management. Language and communication are contributing factors to HTN in Ghana. No studies have been conducted to assess knowledge/awareness of HTN (in the context of its understanding) among students in Ghana. Following a local name for HTN in Ghana, researchers interviewed students through a focus group to assess their understanding/perception (meaning, cause, and prevention) of the disease. Available literature has concerned itself with clients' knowledge of their condition (diagnosis) rather than their comprehension of the true nature of what HTN is. The objective of this study is to assess the knowledge/awareness of HTN in the context of its understanding of the meaning, perception, causes, and prevention of hypertension among students of Ghana's Senior High School (Second Cycle). Semistructured interviews with the use of the theme lists were employed. Focus group conversations and interviews were held in the local Akan (Twi) language, which was later translated, interpreted, and analyzed. Overall, 25 second-cycle students participated. 60% were between 15 and 17 years, 24% were ≥18 years, and 16% were <15 years of age. Males were 44% and females were 56%. Students gave diverse perceptions of their knowledge of HTN. The local language's translation of HTN has influenced and affected its meaning/understanding among some, thus affecting their perception of causes and prevention.

Preference for High Dietary Salt Intake Is Associated With Undiagnosed Type 2 Diabetes: The Henan Rural Cohort.

Background: Diabetes continues to be a serious disease burden globally. Nutrition plays a vital role in human life and health, and both inadequate and over nutrition have been implicated in cause the of disease. Objective: We explored the role of preference for high dietary salt intake and diabetes in a rural population. We also looked at possible mediating factors in the relationship between diabetes and preference for high dietary salt intake. Methods/Participants: Data from the Henan rural cohort in China were analyzed. Using multinomial regression models, the association between diabetes diagnosis type and reported preference for dietary salt was assessed. Adjusted odds ratios (aORs) with confidence interval (CI) at a 95% level are reported. Mediation analyses using structural equation models in Stata were performed. Results: Of the 39,183 participants included in the analyses, 4.07% were previously diagnosed with diabetes, and 5.80% with undiagnosed diabetes. Eighteen percent had a preference for salty meals, the mean age was 55.45 years, and 60% were women. Preference for salty meals was associated with undiagnosed diabetes (aOR = 1.17, 95% CI 1.03, 1.32), but not with previously diagnosed diabetes. Stratified analysis revealed that the association with undiagnosed diabetes was only significant in men (aOR = 1.36, 95% CI 1.13, 1.70) but not in women (aOR = 1.06, 95% CI 0.81, 1.38). BMI and central obesity fully mediated the association. Dietary salt intake was self-reported and therefore presents a limitation. Conclusion: Our study demonstrated that preference for high dietary salt intake is associated with undiagnosed diabetes but not prevalent diabetes.

Association of long-term exposure to ambient air pollutants with prolonged sleep latency: The Henan Rural Cohort Study.

BACKGROUND: Prolonged sleep latency is associated with far-reaching public health consequences. Although evidence about the effect of air pollution on sleep problem has been shown, the effect on sleep latency remained unknown. The study aimed to analyze the association between long-term exposure to air pollution and prolonged sleep latency in rural China. METHODS: In all, 27935 participants were included in the study from Henan Rural Cohort Study. A satellite-based spatiotemporal model was used to evaluate the 3-year average concentration of air pollutants at the home address of participants before the baseline survey. Air pollutants included NO2 (nitrogen dioxide), PM1 (particulate matter with aerodynamic diameters ≤1 µm), PM2.5 (particulate matter with aerodynamic diameters ≤ 2.5 µm), and PM10 (particulate matter with aerodynamic diametes ≤ 10 µm). A logistic regression model was conducted to assess the odds ratio (OR) and 95% confidence interval (95% CI) between air pollutants and prolonged sleep latency. RESULTS: There were 5825 (20.85%) participants with prolonged sleep latency. The average concentration of NO2, PM1, PM2.5, and PM10 were 38.22 (2.54) µg/m3, 56.29 (1.75) µg/m3, 72.30 (1.87) µg/m3, and 130.01 (4.58) µg/m3. The odds ratio (95%CI) of prolonged sleep latency with an IQR increase of NO2, PM1, PM2.5, and PM10 were 1.59 (1.33-1.90), 1.23 (1.13-1.33), 1.28 (1.13-1.45) and 1.43 (1.22-1.67). The stratified analysis showed the effect of air pollutants was stronger among those with stroke. CONCLUSION: Long-term exposure to NO2, PM1, PM2.5 and PM10 were associated with prolonged sleep latency. The adverse impact of air pollution should be considered when treating sleep problems.

Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan rural cohort.

BACKGROUND: The epidemiological evidence on the association of sleep quality on anxiety symptoms has been inconclusive. This study aimed to explore the association between sleep quality and anxiety symptoms in rural Chinese population and investigate whether age, lifestyles, and chronic diseases modified this association. METHODS: A total of 27,911 participants aged 18-79 years from the Henan Rural Cohort Study were included in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale. Poor sleep quality was defined as PSQI ≥6. Anxiety symptoms were evaluated with the two-item generalized anxiety disorder scale (GAD-2). Individual with score ≥ 3 was viewed as having anxiety symptoms. Logistic regression and restricted cubic spline were conducted to examine the association of sleep quality with anxiety symptoms. RESULTS: Altogether, 6087 (21.80%) participants were poor sleepers and 1557 (5.58%) had anxiety symptoms. The odds of anxiety were increased with increment of PSQI score after fitting restricted cubic splines. The poor sleep quality was associated with a higher possibility of anxiety symptoms [odd ratio (OR): 4.60, 95% confidence interval (CI): 3.70-5.72] in men, and (OR: 3.56, 95% CI: 3.10-4.09) in women for multivariable analysis. Further, stratified analyses showed that the effect of sleep quality on anxiety symptoms could be modified by age, marital status, smoking status, drinking status, hypertension, and type 2 diabetes mellitus. CONCLUSIONS: A dose-response association between PSQI score and anxiety symptoms was found. In addition, the relationship between poor sleep quality and greater anxiety symptoms was observed in this rural population, especially in participants aged ≥60 years and those with unhealthy habits or had a chronic disease. TRIAL REGISTRATION: The trial was prospectively registered on July 6, 2015 and available online at ClinicalTrials.gov ID: ChiCTR-OOC-15006699 .

Depressive symptoms are not associated with type 2 diabetes in a rural population in China: findings from the Henan rural cohort.

BACKGROUND: Depression is one of the most prevalent mental health challenges that affect all groups of persons. This study examines the association between type 2 diabetes and depressive symptoms (using PHQ-2) in a rural population. Other risk factors of depressive symptoms are examined. METHODS: Data from 30,001 participants from the Henan rural cohort was analyzed. Multivariable logistic regression analyses were performed to examine the associations between depressive symptoms (DS) and type 2 diabetes and other risk factors. Adjusted odds ratios (aOR) with confidence intervals (CI) at 95% are reported. RESULTS: The prevalence of DS in the study population is 5.86%, 6.69% in women, 4.74% in men, 5.80% in persons without diabetes and 6.81% in persons with diabetes (diagnosed and undiagnosed). DS prevalence was highest in persons with previously diagnosed diabetes (8.27%). No association was found between DS and diabetes (aOR = 0.95, CI at 95% 0.61-1.48; p=0.836). DS was associated with poor glycemic control (aOR=1.43, CI at 95% 1.04- 1.98; p= 0.034) in persons with previously diagnosed diabetes, persons with elevated triglycerides (aOR=1.19, CI at 95% 1.08-1.30; p<0.001), household income (aOR= 0.78, CI at 95% 0.63-0.97; p=0.027), marital status (aOR=1.37, CI at 95% 1.01-1.88, p=0.049) and hypertension treatment with medication (aOR=1.94, CI at 95% 1.48-2.55; p<0.001). LIMITATIONS: DS was assessed through self-report and may suffer recall or information bias. CONCLUSIONS: DS was not associated with diabetes in our study population. The association between poor glycemic control and DS calls for the integration of screening for depression among patients with diabetes.

Age at menopause, body mass index, and risk of type 2 diabetes mellitus in postmenopausal Chinese women: The Henan Rural Cohort study.

BACKGROUND AND AIM: The present study was conducted to explore the stratified and joint effects of age at menopause and body mass index (BMI) with the risk of type 2 diabetes mellitus (T2DM) in Chinese rural adults. METHODS AND RESULTS: A total of 15,406 postmenopausal Chinese women were included in this study. Multivariable logistic regression analysis was used to quantify the stratified and joint effects of age at menopause and BMI on T2DM. Overall, the mean age at menopause and BMI was 48.8 ± 4.7 years and 25.1 ± 3.6 kg/m2, respectively. In general, data suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, later menopause had a higher risk of T2DM (OR, 1.52; 95% CI, 1.16-2.01); 3) the risk of T2DM was higher only in patients with early or normal age at menopause and BMI ≥ 24, with 0R (95% CI) of (1.58, 1.28-1.94) and (1.48, 1.31-1.67), respectively. CONCLUSION: Our findings suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, a higher risk of T2DM was found only in those with later menopause; 3) women with later menopause had a higher risk of T2DM, irrespective of BMI; 4) in patients with early or normal age at menopause, a higher risk of T2DM was found only in patients with BMI ≥ 24. THE CHINESE CLINICAL TRIAL REGISTRATION: ChiCTR-OOC-1500669(URL:http://www.chictr.org.cn/showproj.aspx?proj=11375).

Ambient air pollutants aggravate association of snoring with prevalent hypertension: results from the Henan Rural Cohort.

AIM: We aimed to assess if snoring and ambient air pollutants were jointly associated with prevalent hypertension in a cross-sectional study. METHODS: A total of 28440 participants aged 18-79 years were obtained from the Henan Rural Cohort. Snoring evaluated using Pittsburgh sleep quality index (PSQI) scale was classified into 'Never', '<3 times/week' and '≥3 times/week' groups. Concentrations of air pollutants (PM1, PM2.5, PM10, and NO2) were evaluated by a satellite-based spatiotemporal model. The independent and joint associations between snoring and air pollutants on prevalence of hypertension were analyzed by logistic regression models. RESULTS: The mean age of all participants was 56.0 ± 12.2 years. The frequencies and prevalence of participants with hypertension were 3666 (32.39%) in men and 5576(32.57%) in women, respectively. The odds ratio (OR) and 95% confidence interval (CI) of participants with snoring frequency of <3 times/week, ≥3 times/week was 1.10(1.02-1.20), and 1.15(1.08-1.23) for hypertension, compared to those without snoring. Participants with a snoring (≥3 times/week) and higher exposure concentrations of PM1, PM2.5, PM10, and NO2 had 2.58-fold(95% CI: 2.30-2.90), 3.03-fold(95% CI: 2.69-3.41), 2.89-fold(95% CI: 2.57-3.25) and 2.75-fold(95% CI: 2.44-3.10) for hypertension, compared to those without snoring and low concentrations of air pollutants. Additionally, participants with high PM1 and ≥3 times/week snoring (OR: 1.32, 95% CI: 1.18-1.48) was at a higher likelihood for prevalent hypertension, compared to those without snoring and with high PM1. CONCLUSIONS: Snoring and high ambient air pollutants might be important predictors of hypertension, and higher concentration of PM1 might aggravate the association between snoring and hypertension.

Adiposity reduces the risk of osteoporosis in Chinese rural population: the Henan rural cohort study.

BACKGROUND: Adiposity plays a crucial role in the risk of osteoporosis. However, the impact of body fat distribution on the skeleton is contentious. The study was designed to explore the association of various adiposity indices with estimated bone mineral density (BMD) and the risk of osteoporosis based on body mass index (BMI), body fat percentage (BFP), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), and visceral fat index (VFI). METHODS: A total of 8475 subjects derived from the Henan Rural Cohort Study were analyzed. The estimated BMD of study participants were measured by calcaneal quantitative ultrasound (QUS). Linear regression and binary logistic regression were performed to estimate the association of adiposity and the outcomes. RESULTS: The mean age of the study participants was 55.23 ± 11.09 years and 59.61% were women. The crude and age-standardized prevalence of high osteoporosis risk was 16.24 and 11.82%. Per unit increment in adiposity indices was associated with 0.005-0.021 g/cm2 increase in estimated BMD. The adjusted odds ratios (95% confidence interval) for high osteoporosis risk in per 1 SD increase of WC, WHR, WHtR, BMI, BFP, and VFI were 0.820 (0.748, 0.898), 0.872 (0.811, 0.938), 0.825 (0.765, 0.891), 0.798 (0.726, 0.878), 0.882 (0.800, 0.972), and 0.807 (0.732, 0.889), respectively. Stratified analyses indicated greater effects on individuals aged 55 years or older. CONCLUSIONS: The adiposity indices have an inverse association with the risk of osteoporosis among Chinese rural population, especially in the elderly.

Association between long-term exposure to ambient air pollutants and excessive daytime sleepiness in Chinese rural population: The Henan Rural Cohort Study.

BACKGROUND: Excessive daytime sleepiness is associated with many adverse consequences, including cardiovascular diseases and mortality. Although exposure to air pollution has been suggested in connection with excessive daytime sleepiness, evidence in China is scarce. The study aimed to explore the association between long-term exposure to air pollution and excessive daytime sleepiness in rural China. METHODS: A lot of 27935 participants (60% females) from the Henan Rural Cohort Study were included in this analysis. A satellite-based spatiotemporal model estimated a 3-year average air pollution exposure to NO2 (nitrogen dioxide), PM1 (particulate matter with aerodynamic diameters not more than 1 µm) and PM2.5 (particulate matter with aerodynamic diameters not more than 2.5 µm) at the home address of participants before the baseline survey. Logistic regression was used to evaluate the odds ratio and 95% confidence interval between long-term air pollution and excessive daytime sleepiness. RESULTS: The average concentrations of NO2, PM1 and PM2.5 during three years preceding baseline survey were 38.22 µg/m³, 56.29 µg/m³ and 72.30 µg/m³. Exposure to NO2, PM1 and PM2.5 were all associated with excessive daytime sleepiness. Each 1 µg/m³ increment of NO2, PM1 and PM2.5 were related to a 20% (OR: 1.20, 95% CI: 1.13-1.27), 10% (OR: 1.10, 95% CI: 1.05-1.16) and 17% (OR: 1.17, 95% CI: 1.10-1.23) increase of the prevalence of excessive daytime sleepiness. CONCLUSION: The study demonstrated that long-term exposure to NO2, PM1 and PM2.5 were all associated with excessive daytime sleepiness. The impact of air pollution should be considered when treating individuals with excessive daytime sleepiness.

Trends of online news media reported suicides in Ghana (1997-2019).

BACKGROUND: Suicides have become headline news in most developing countries and often feature on front pages with accompanying graphic pictures on prominent news portals. There has been an increased reportage of suicides by the Ghanaian news media. This study aims to shed light on the trend of online news media reporting of suicides, and the epidemiology of media reported suicides in Ghana. METHODS: An online search was conducted for news media reports of suicides committed in Ghana. One hundred and forty-two (142) news media reported suicides spanning 1997 to 31st July 2019 were retrieved and included in the analyses. RESULTS: The victims of suicides were predominantly male (85.92%), young (mean age = 34.81 ± 15.71 years; range 10-86 years). Suicide by hanging (67.94%), the use of firearms (18.32%), and self-poisoning (8.93%) were the common methods used by the victims. There has been increased online news media reportage of suicides in Ghana in the last 3 years; 2017 witnessed the highest reportage of 30 (21%) cases. Marital or relationships and family problems were commonly cited as the reasons for the commission of suicides; mental disorders, and financial problems were also cited as immediate triggers of the suicides by close relations of the victims. CONCLUSION: There is an increased media reportage of suicides in Ghana, although this cannot be linked to a corresponding increase in suicide incidence. Interventions to decrease the risk of suicide among vulnerable populations (young adults) such as the identification of suicidal behavior, making mental healthcare services more accessible by integrating into the general healthcare service, public education, establishing a suicide hotline will be critical programs to help reduce suicide incidence in Ghana.

Fruit and vegetable intake modifies the associations between suppressor of cytokine signaling 3 genetic variants and type 2 diabetes.

PURPOSE: Type 2 diabetes is a complex disease determined by variable genes and environmental factors. The study was designed to investigate the effect of interactions of four polymorphisms of suppressor of cytokine signaling 3 (SOCS3) with fruit and vegetable (F&V) intake on type 2 diabetes in a rural population of China. METHODS: A total of 4411 participants from the rural areas of Henan, China were included in the study. Multivariate logistic regression and restricted cubic splines were used to estimate the associations between polymorphisms and risk allele score of SOCS3 and type 2 diabetes in different groups. Haplotype analysis was conducted to examine the effects of linkage inheritance at these four loci on type 2 diabetes. RESULTS: Three of the four polymorphisms showed significant associations with type 2 diabetes in the less F&V intake group after adjusting the covariates, the odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were 1.24 (1.08-1.41) for rs4969168, 1.16 (1.02-1.32) for rs9892622, and 1.21 (1.06-1.39) for rs9914220. No significant association was detected in the more F&V intake group. The obvious dose-response relationship between the risk allele score and type 2 diabetes was also noted only in the less F&V intake group. CONCLUSIONS: Variants of SOCS3 gene were associated with type 2 diabetes and the associations could be modified by the F&V intake.

Association of Night Sleep Duration and Ideal Cardiovascular Health in Rural China: The Henan Rural Cohort Study.

Introduction: We aimed to explore the association between night sleep duration and ideal cardiovascular health (ICH) among Chinese rural population. Methods: In all, 35,094 participants were included from the Henan Rural Cohort study. Information on sleep was collected using the Pittsburgh Sleep Quality Index. The ICH scores were evaluated. The associations between night sleep duration and ICH were examined using both linear regression and logistic regression models. Results: The mean night sleep duration for all participants was 7.75 ± 1.28 h. Compared with those with night sleep duration of 7 to <9 h by using linear regression model, a significant decrease in ICH scores was observed for participants with shorter [-0.077 (-0.131, -0.024)] and longer [-0.079 (-0.121, -0.036)] night sleep duration. Compared with 7 to <9 h, longer sleep duration [0.919 (0.851, 0.992)] were associated with decreased odds of ideal CVH. Conclusions: Shorter and longer night sleep duration are negatively associated with ICH among rural population. This suggests that it may be beneficial to include night sleep duration assessment in cardiovascular risk screening.

Night sleep duration and sleep initiation time with hypertension in Chinese rural population: the Henan Rural Cohort.

BACKGROUND: The study was conducted to evaluate the independent dose-response of the night sleep duration and sleep initiation time on hypertension, and to explore their combined effect with hypertension. METHODS: Participants from the Henan Rural Cohort were enrolled in this study. Information on sleep was collected using the Pittsburgh Sleep Quality Index. Hypertension was defined as systolic blood pressure/diastolic blood pressure ≥140/90 mmHg or self-reported hypertension and current use of anti-hypertensive medicines. Logistic regression and restricted cubic spline were conducted to evaluate the association of night sleep duration and sleep initiation time with hypertension. RESULTS: Of the 37 317 included participants, 12 333 suffered from hypertension. 14 474 (38.79%) were men and 22 843 (61.21%) were women, the mean age were 57.18 ± 12.10 and 55.24 ± 11.98 in men and women. Compared to reference (7-h), fully adjusted odd ratios (ORs) and 95% confidence interval (CI) of hypertension were 0.91 (0.66-1.25) in <5 h group and 1.74 (1.41-2.16) in ≥10 h among men, respectively. Fully adjusted ORs (95% CIs) for hypertension compared with reference (21:00-22:00) were 1.05 (95% CI 0.78-1.41) in the <20:00 group, 1.52 (1.25-1.85) in ≥24:00 in men. The combined effect of sleep duration and sleep initiation time on hypertension were statistically significant in the category of (≥8 h)/night and ≥24:00 (OR 1.87, 95% CI 1.07-3.25) compared to reference in fully adjusted model among men. CONCLUSIONS: Long night sleep duration and late sleep initiation time were associated with the higher odds of hypertension, and the sleep duration and sleep initiation time might cumulatively increase the prevalence of hypertension in men. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx? proj=11375.

Prevalence of impaired fasting glucose, type 2 diabetes and associated risk factors in undiagnosed Chinese rural population: the Henan Rural Cohort Study.

OBJECTIVE: This study estimated the burden and characterised the risk factors associated with diabetes and impaired fasting glucose (IFG) in an undiagnosed rural population. DESIGN: Data for 36 960 participants from the Henan Rural Cohort baseline with undiagnosed diabetes were analysed. X2 test and multivariate logistic regression analyses were performed to test for association between risk factors and diabetes and IFG. RESULTS: Women constituted 60.30% of the study participants, mean age of participants was 55.32±12.18 years, risk factors for diabetes and IFG were prevalent (75% dyslipidaemia, 57% overweight/obese, 50% central obesity and 18% metabolic syndrome). The prevalence of diabetes and IFG was 4.19% and 7.22%, respectively. Having a metabolic syndrome (adjusted OR (aOR) 4.7, 95% CI 4.27 to 5.33), dyslipidaemia (aOR 2.76, 95% CI 2.31 to 3.21), centrally obese (aOR 2.38, 95% CI 2.11 to 2.70), being overweight/obese (aOR 1.66, 95% CI 1.45 to 1.79) and a family history of diabetes (aOR 1.50, 95% CI 1.15 to 1.92) were associated with diabetes. These factors were also associated with IFG. Intake of high salt diet (aOR 1.16, 95% CI 1.02 to 1.32) and smoking (aOR 1.22, 95% CI 1.02 to 1.47; significant in men) were also associated with diabetes. Engaging in moderate physical activity (aOR 0.94, 95% CI 0.89 to 0.98) was noted to be negatively associated with diabetes. CONCLUSION: Diabetes and IFG remain prevalent in Chinese population with obesity and dyslipidaemia being some of the most significant predictors. Regular physical activity and consumption of fruits and vegetables may be beneficial in keeping blood glucose level low. TRIAL REGISTRATION NUMBER: ChiCTR-OOC-15006699.