Cardiovascular risk profiles in relation to newly diagnosed type 2 diabetes diagnosed by either glucose or HbA1c criteria in Chinese adults in Qingdao, China.

AIMS: To study the cardiovascular disease risk profiles in newly diagnosed diabetes diagnosed by either glucose or/and HbA(1c) criteria in Chinese adults. METHODS: Two population-based cross-sectional studies were conducted in 2006 and 2009, respectively. Data from 1987 men and 2815 women aged 35-74 years were analysed. Newly diagnosed diabetes was defined according to either glucose (fasting and/or 2-h glucose), HbA(1c) or both criteria. RESULTS: Ageing, positive family history of diabetes, elevated levels of waist circumference, systolic blood pressure, total cholesterol, triglycerides and γ-glutamyl transferase were independently associated with newly diagnosed diabetes defined by glucose criterion alone, but not for diabetes defined by HbA(1c) criterion alone. Only waist circumference, total cholesterol and smoking were significantly associated with the presence of diabetes defined by HbA(1c) criterion alone. CONCLUSIONS: Cardiovascular disease risk profiles were different in patients with newly diagnosed diabetes defined by the two diagnostic criteria for diabetes. This may have certain clinical implications on diabetes management and research.

The association of gamma-glutamyltransferase and C-reactive protein with IFG/IGT in Chinese adults in Qingdao, China.

BACKGROUND: Serum gamma-glutamyltransferase (GGT) and C-reactive protein(CRP) have been previously shown to be associated with impaired fasting glucose/impaired glucose tolerance (IFG/IGT), but such an association has not been well verified, and is examined in a non-diabetic Chinese population. METHODS: A population-based cross-sectional study was conducted in 2006 in Qingdao, China. Data of 1143 men and 1689 women aged 35-74 years and free of diabetes at baseline were analyzed. Multivariable logistic regression analysis was performed to estimate the odds ratio (OR) and its 95% confidence interval (CI). RESULTS: Compared with the lowest quartile, the ORs (95%CI) for IFG/IGT corresponding to the highest quartile were 0.89(0.61,1.28) in men and 0.87(0.64,1.18) in women for CRP and 2.12(1.40,3.38) and 1.87(1.32,2.62) for GGT, when the two were fitted simultaneously in a model adjusting for age, school years, alcohol-drinking, smoking, family history of diabetes, systolic blood pressure, waist circumference, triglycerides and high-density lipoprotein. CONCLUSIONS: The elevated GGT, but not CRP, was independently associated with the presence of the IFG/IGT in both genders in this Chinese population.

Prevalence of metabolic syndrome in rural and urban Chinese population in Qingdao.

AIMS: To investigate the prevalence of metabolic syndrome and its components in both rural and urban Chinese population. SUBJECTS AND METHODS: A population-based crosssectional survey was conducted in Qingdao, China in 2006 with 6100 Chinese aged 35-74 yr invited and 5355 who attended; 3357 subjects, 1562 urban (46.5%) and 1795 rural residents (53.5%) met the inclusion criteria for the current data analysis. The metabolic syndrome definitions of National Cholesterol Education Program Adult Treatment Expert Panel III (NCEPATPIII) 2004, NCEP 2005 and International Diabetes Federation (IDF) were used. RESULTS: The age-standardized prevalences of metabolic syndrome were 16.2%, 32.2%, and 28.3% in men and 26.8%, 37.2%, and 34.6%in women, according to the definitions of the NCEP 2004, NCEP 2005, and IDF, respectively. Urban men have more risk factors and higher prevalence of the metabolic syndrome than rural men, but the differences in women were not that striking. Elevated blood pressure (62.6%) was, among risk factors, most common in the study population, followed by central obesity (53.4%), and hyperglycemia (52.2%) defined using the NCEP 2005 criteria. CONCLUSIONS: Metabolic disorders were common among adult Chinese in both rural and urban areas in Qingdao.

C-reactive protein and gamma-glutamyltransferase concentrations in relation to the prevalence of type 2 diabetes diagnosed by glucose or HbA1c criteria in Chinese adults in Qingdao, China.

AIMS: To investigate the association of C-reactive protein (CRP) and gamma glutamyltransferase (GGT) concentrations with newly diagnosed diabetes defined by either glucose or HbA1c criteria in Chinese adults. METHODS: A population-based cross-sectional study was conducted in 2006. Data from 1167 men and 1607 women aged 35-74 years were analyzed. Diabetes was defined according to either glucose or HbA1c criteria alone. RESULTS: Compared with nondiabetes, multivariate-adjusted OR (95%CI) was 1.13 (0.90,1.42) in men and 1.21 (1.00,1.45) in women for CRP and 1.42 (1.18,1.72) and 1.57 (1.31,1.87) for GGT, respectively. Neither CRP nor GGT was associated with the presence of diabetes defined by the HbA1c criterion. CONCLUSIONS: The effect of elevated CRP on diabetes defined by the glucose criterion was mediated through obesity, but elevated GGT was an independent risk factor for diabetes in this Chinese population. None of the two was, however, associated with the elevated HbA1c concentrations.

A simple Chinese risk score for undiagnosed diabetes.

AIMS: A diabetes risk score for screening undiagnosed diabetes was constructed and validated in Chinese adults. METHODS: Two consecutive population-based diabetes surveys among Chinese adults aged 20-74 years were conducted in 2002 (n = 1986) and 2006 (n = 4336). Demographic and anthropometric measures were collected following similar procedures. Standard 2-h 75-g oral glucose tolerance tests (OGTTs) were performed to diagnose diabetes in both surveys. Fasting capillary plasma glucose (FCG) and glycated haemoglobin (HbA(1c)) were also measured together with the OGTTs on the same day of the 2006 survey. Beta coefficients estimated using logistic regression analysis derived from data of the 2002 survey were used to develop the risk assessment algorithm. The performance of the algorithm was validated in the study population of the 2006 survey. RESULTS: Of all the variables tested, waist circumference, age and family history of diabetes were significant predictors of diabetes and were used to construct the risk assessment score. The score, ranging from 3 to 32, performed well when applied to the study population of the 2006 survey. The area under the receiver operating characteristic curve was 67.3% (95% CI, 64.9-69.7%) for the score, while it was 76.3% (73.5-79.0%) for FCG alone and 67.8% (64.9-70.8%) for HbA(1c) alone. At a cut-off point of 14, the sensitivity and specificity of the risk score were 84.2% (81.0-87.5%) and 39.8% (38.2-41.3%). CONCLUSIONS: The risk score based on age, waist circumference and family history of diabetes is efficient as a layperson-oriented diabetes screening tool for health promotion and for population-based screening programmes.

Increasing trend in the prevalence of Type 2 diabetes and pre-diabetes in the Chinese rural and urban population in Qingdao, China.

AIMS: To determine the secular trend of prevalence of Type 2 diabetes and pre-diabetes in a Chinese population from 2001 to 2006. METHODS: Two consecutive population-based surveys for diabetes were conducted in a randomly selected population aged 35-74 years and living in Qingdao, China in 2001-2002 (n = 10854) and 2006 (n = 4416). All participants underwent standardized 2-h 75-g oral glucose tolerance tests (OGTTs), along with fasting capillary plasma glucose (FCG) tests in 2006. One urban community underwent OGTTs directly in 2002 (n = 1815), while a two-step screening strategy using FCG as a first-line screening test followed by OGTTs was used in 9039 individuals in 2001. Diabetes and pre-diabetes was defined according to the 2006 World Health Organization/International Diabetes Federation criteria. RESULTS: Based on the results of direct OGTTs, the age-standardized prevalence of diabetes and pre-diabetes in urban areas was 12.2 and 15.4% in 2002, whereas the prevalences were 18.8 and 28.7% in urban areas and 14.1 and 20.2% in rural areas in 2006 (P < 0.001, in urban areas). Using the two-step screening strategy, the prevalence of diabetes in 2001 was 10.1% in urban and 7.7% in rural areas and 13.8% in urban and 12.2% in rural areas in 2006 (P < 0.001). Based on the data of the 2006 survey, the two-step screening strategy missed 30.2% of diabetes cases when compared with the number defined by the direct OGTT approach. CONCLUSIONS: Qingdao has experienced a marked increase in the prevalence of diabetes and pre-diabetes in the past 5 years. Intervention to prevent a further increase in the prevalence of diabetes is urgently required.

Risk factors associated with the dramatic increase in the prevalence of diabetes in the adult Chinese population in Qingdao, China.

OBJECTIVE: To investigate the major risk factors and their association with the dramatic increase in the prevalence of diabetes from 2001-2002 to 2006 in Qingdao, China. METHODS: Population-based cross-sectional studies on diabetes were performed in 4598 men and 7026 women aged 35-74 years. The 2006 World Health Organization diagnostic criteria for diabetes were used. RESULTS: The crude prevalence of diabetes was 11.3% in both men and women in urban areas and 5.3% and 8.9% in rural areas in 2001-2002. This increased to 19.2% and 16.1% in urban areas and 14.2% and 13.8% in rural areas in 2006 for men and women, respectively. The increase in diabetes prevalence from 2001-2002 to 2006 was paralleled by an increased body mass index in rural areas but not in urban areas. The major risk factors associated with diabetes were age, family history of diabetes, obesity, hypertension and high triglycerides. The multivariate adjusted odds ratio and 95% confidence interval for diabetes corresponding to a one standard deviation increase in waist circumference was 1.81 (1.47, 2.23) in urban men, 1.64 (1.26, 2.13) in rural men, 1.98 (1.66, 2.37) in urban women and 2.02 (1.63, 2.51) in rural women. Low socio-economic classes had a higher risk for diabetes in urban areas but a lower risk in rural areas, both associated with increased waist circumference. CONCLUSION: Established risk factors are of great importance for the prevalence of diabetes in the urban and rural Chinese populations and changes in these factors could explain the recent dramatic increase in diabetes prevalence, particularly in rural areas. Considering the high prevalence of obesity and physical inactivity, intervention is urgently required in China.