[Study on the incidence and influencing factors of prediabetes in Chinese adults].

Objective: To explore the incidence and influencing factors of prediabetes in adults in China. Methods: Ten provinces (cities) were selected from the surveillance survey of chronic diseases and their risk factors in China in 2010; two monitoring sites were selected from each province (city) as follow-up spots, and a follow-up survey was conducted from 2016 to 2017. An unconditional logistic regression model was used to analyze the influencing factors of prediabetes. Results: A total of 5 578 participants were included in this study. During the follow-up period, 612 patients (268 males and 344 females) developed impaired glucose tolerone (IGT), with a total follow-up of 37 364.82 person-years, and the incidence of IGT was 16.4/1 000 person-years. Impaired fasting glucose (IFG) occurred in 290 patients (128 males and 162 females) with a total follow-up of 39 731.31 person-years, and the incidence of IFG was 7.3/1 000 person-years. The multivariate unconditional logistic regression model included age, urban and rural areas, family history of diabetes, BMI, central obesity, dyslipidemia, hypertension, and physical activity, and the results showed that age (≥50 years old: OR=1.60, 95%CI: 1.32-1.95), urban residents (OR=1.41, 95%CI: 1.16-1.71), obesity (OR=1.56, 95%CI: 1.12-2.19), dyslipidemia (OR=1.52, 95%CI: 1.25-1.83), hypertension (OR=1.32, 95%CI: 1.07-1.61) and physical inactivity (OR=1.25, 95%CI: 1.04-1.50) increase the risk of IGT. Age (≥50 years old: OR=1.31, 95%CI: 1.01-1.70), family history of diabetes (OR=1.71, 95%CI: 1.13-2.60), overweight (OR=1.41, 95%CI: 1.04-1.92), obesity (OR=2.09, 95%CI: 1.38-3.17) and hypertension (OR=1.53, 95%CI: 1.18-2.00) increase the risk of IFG. Conclusions: The incidence of IGT is higher than the IFG. People aged 50 and above, overweight and obese people, hypertension patients, dyslipidemia patients, people with insufficient physical activity, and family history of diabetes are prone to prediabetic events.

[Relationship between waist-to-height ratio and overall and type specific incidence of stroke in adults in China: a prospective study].

Objective: To analyze the association between waist-to-height ratio and the overall and type specific incidence of stroke in adults in China. Methods: A total of 36 632 people were selected from 60 surveillance sites (25 in urban area and 35 in rural area) in China Chronic Disease Surveillance Project in 2010. The China Chronic Disease Surveillance Project data in 2010 were used as baseline data. A total of 27 762 people were followed up from 2016 to 2017. Cox proportional risk regression model was used to analyze the risk ratio of waist-to-height ratio for the overall and type specific incidence of stroke. Subgroup analyses were performed based on baseline characteristics such as age and sex, and sensitivity analysis was performed by excluding those who died and those with diabetes at baseline survey. Results: A total of 27 112 subjects were included in the stroke analysis, and 1 333 stroke events were observed. A total of 26 907 subjects were included in the ischemic stroke analysis, and 1 128 ischemic stroke events were observed. A total of 25 984 subjects were included in the hemorrhagic stroke analysis, and 205 cases of hemorrhagic stroke were observed. After adjusting for relevant confounders and taking group with waist-to-height ratio of 0-0.45 as a reference, the stroke analysis indicated that in groups with waist-to-height ratio of 0.46-0.49, 0.50-0.54 and ≥0.55 the risk for stroke increased by 21% (HR=1.21, 95%CI:1.00-1.46), 26% (HR=1.26, 95%CI:1.04-1.53) and 60% (HR=1.60, 95%CI:1.29-1.99) respectively. Subgroup analysis revealed that age specific waist-to-height ratio had modification effect on the risk for stroke (interaction P=0.001). Ischemic stroke analysis indicated that in groups with waist-to-height ratio of 0.46-0.49, 0.50-0.54 and ≥0.55 the risk for ischemic stroke increased by 30% (HR=1.30, 95%CI: 1.05-1.60), 33% (HR=1.33, 95%CI: 1.07-1.64) and 61% (HR=1.61, 95%CI: 1.26-2.05) respectively. Subgroup analysis revealed that age specific waist-to-height ratio had modification effect on the risk for ischemic stroke (interaction P=0.024). Hemorrhagic stroke analysis indicated that in group with waist-to-height ratio of ≥0.55 the risk for hemorrhagic stroke increased by 73% (HR=1.73, 95%CI: 1.02-2.94), but the differences in the risk increase in groups with waist-to-height ratio of 0.46-0.49 and 0.50-0.54 were not significant. The sensitivity analysis showed no changes. Conclusions: In the prevention and control of stroke by body weight control, it is necessary to take waist to height ratio as one of the indicators of body weight control. Particular attention needed to be paid to the people aged <50 years with waist-to-height ratio of ≥0.55 as well as those with waist-to-height ratio of <0.5 (i.e., 0.46-0.49).

[Association between self-rated health status and risk of stroke in Chinese adults: a prospective study].

Objective: To explore the relationship between self-rated health status and risk of stroke in Chinese adults. Methods: Data was collected from the Chronic Disease Risk Factor Surveillance in China (2010) as baseline. A total of 60 follow-up monitors (25 urban and 35 rural) in 11 provinces were selected. A total of 36 195 participants without prior cardiovascular diseases were followed and investigated 27 441 people in 2016 and 2017. Cox proportional hazard regression model was used to analyze the self-assessed health status and stroke onset hazard ratio (HR), further conducted several subgroup analyses by demographic characteristics such as age and gender, and sensitivity analysis was performed by excluding death and baseline diabetes. Results: A total of 26 699 study subjects were included according to the inclusion criteria. We identified 1 332 stroke cases (32 subarachnoid hemorrhage, 197 cerebral hemorrhage, and 1 149 cerebral infarction) during an average of 6.4 years (171 431.1 person-years) of follow-up, and the incidence density was 7.77/1 000 person-years. After adjusting the related factors, the risk of stroke in participants with poor self-related health increased by 68% (HR=1.68, 95%CI:1.22-2.32) and the risk of ischemic stroke increased by 47% (HR=1.47, 95%CI:1.05-2.05), with a reference of excellent ones. In subgroup analysis, only age and BMI had an effect-modifying effect on the association between self-rated health and risk of stroke. Only age and dyslipidemia had an effect-modifying effect on the association between self-rated health and ischemic stroke risk (interaction P<0.05). The results of the sensitivity analysis were consistent with the results of the total population. Conclusion: People with poor self-assessed health, especially for those who were overweight/obesity with poor self-assessed health or age less than 60 or dyslipidemia are at increased risk of stroke and ischemic stroke and should be targeted for intervention.

[Association of body mass index and waist circumference with risk of ischemic stroke in adults in China: a prospective cohort study].

Objective: To explore the relationship between body mass index (BMI), waist circumference (WC) and the risk for ischemic stroke in adults in China. Methods: A total of 36 632 adults were selected from 60 surveillance areas (25 urban surveillance areas and 35 rural surveillance areas) in China Chronic Disease Surveillance Project in 2010 for a follow up study from 2016 to 2017 based on the baseline data in 2010. The follow up was completed for 27 762 adults. Cox proportional hazard regression model was used to analyze the association of body mass index and waist circumference with the risk for ischemic stroke in different populations. The death and hypercholesterolemia cases were excluded by sensitivity analysis. Results: A total of 26 907 adults were included in the analysis. During the follow up period, 1 128 ischemic stroke events were observed (491 in men and 637 in women). After adjusting the related confounding factors and taking normal BMI/normal WC group as the reference, the risk for ischemic stroke increased by 50% in normal BMI/abdominal obesity group (HR=1.50, 95%CI:1.07-2.08), 51% in overweight/abdominal obesity group (HR=1.51, 95%CI:1.20-1.91), 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.09-1.96), and 63% in normal BMI/abdominal obesity group (HR=1.63, 95%CI:1.12-2.38), 56% in overweight/abdominal obesity group (HR=1.56, 95%CI: 1.20-2.03) and 45% in obesity/abdominal obesity group (HR=1.45, 95%CI: 1.05-2.01) respectively in men and in men with CVD risk factors. There was no increased risks in the overweight/normal WC group. The risk increased by 40% in overweight/abdominal obesity group (HR=1.40, 95%CI:1.15-1.72) and 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.16-1.83), and 35% in overweight/abdominal obesity group (HR=1.35, 95%CI:1.08-1.69) and 30% in obesity/abdominal obesity group (HR=1.30, 95%CI:1.01-1.67) respectively in women and women with CVD risk factors. There were no risk increases in overweight/normal WC group and normal BMI/abdominal obesity group. Sensitivity analysis results showed no change. Conclusion: Overweight/obesity with abdominal obesity or abdominal obesity alone could increase the risk for stroke in men, and overweight/obesity with abdominal obesity could increase the risk for ischemic stroke in women; suggesting that BMI and WC should be used jointly to evaluate obesity in population for weight control to prevent ischemic stroke.

[Relationship between sedentary time and incidence of type 2 diabetes in adults in China: a prospective cohort study].

Objective: To explore the relationship between sedentary time and the incidence of type 2 diabetes in adults in China. Methods: Data collected from the Chinese Chronic Disease and Risk Factor Surveillance (CCDRFS) in 2010 were used as baseline data. Eight provinces where CCDRFS were conducted in 2010 were selected, and two surveillance spots (one in urban area and another one in rural area) of each provinces were further selected for the follow-up studies. After excluding diagnosed diabetes patients according to baseline data, a total of 8 625 of subjects were recruited as participants. In the follow up carried out from 2016 to 2017, a total of 5 991 people received complete follow up. Cox proportional hazards models were used to analyze the relationship between sedentary time and the incidence of type 2 diabetes, and subgroup analysis was conducted based on variables such as gender, geographic area, and urban area or rural areas. Results: A total of 5 782 subjects were included in final analysis. During an average 6.4 years of follow up (36 927.0 person-years), 592 participants developed type 2 diabetes, the incidence rate was 16.0 per 1 000 person years. Multivariate Cox regression analysis showed that after adjustment for possible confounders, compared with the 0.0-h/d group, the risk of diabetes incidence increased by 33% (HR=1.33, 95%CI: 1.05-1.68) for those who had sedentary time for more than 6.0 h every day. The subgroup analysis showed that the significant association was only observed in those who were men, current smokers, central obese, had family history of diabetes, had rural residency, and lived in eastern and central areas of China. Conclusions: Longer sedentary time can increase the risk of type 2 diabetes. Lifestyle intervention should be strengthened to reduce sedentary time, especially for people who had sedentary time for more than 6.0 h every day.

Dual effect of heparin and low molecular weight heparin on cultured smooth muscle cells.

The effects of heparin and low molecular weight heparin (LMWH) on the growth of cultured human aortic smooth muscle cells (hASMCs) were studied. The fourth-passage hASMCs were planted onto a 24-well plate (5 wells for each concentration of heparin or LMWH) and cultured by DMEM containing 5% either old or fresh human serum (HS), 10% fetal calf serum (FCS), and differing concentrations of heparin or LMWH (heparin and LMWH were presented as hexuronic acid) together with corresponding control groups (without heparin or LMWH) for 24h. hASMCs growth was estimated both morphologically and by 3H-TdR incorporation. The results revealed that both heparin and LMWH inhibited the proliferation of healthy growth hASMCs, but promoted the proliferation of weak growth hASMCs. These results suggest for the first time that heparin and LMWH have a dual regulative role (inhibition and promotion) in hASMCs growth and indicate that they may play an important role in controlling the proliferation of vascular smooth muscle cells and maintaining the integrity of vascular structure.