[Association of BMI with acute exacerbation in mild to moderate chronic obstructive pulmonary disease patients in community: a prospective study].

Objective: BMI may play a protective role in reducing the mortality rate of patients with chronic obstructive pulmonary disease (COPD), but its effect on acute exacerbation of COPD remain unclear. Methods: Subjects were selected from the COPD patients registration system established in 2014 in Pudong new district, Shanghai. COPD patients from 8 communities were selected by cluster sampling and follow up was conducted prospectively for 18 months. Basic information and BMI were obtained from baseline survey, and acute exacerbations were collected during follow-up. The association between BMI and risk of acute exacerbation was evaluated by using multiple negative binomial regression. Results: Among 328 community COPD patients, 295 who completed the follow up were included in the analysis, in whom 96.3% (284/295) were mild COPD patients. During the follow-up, 11.1% (33/295) of the patients reported acute exacerbation. The results of multiple negative binomial regression suggested that, the risk for acute exacerbation decreased with the increase of BMI (IRR=0.85, 95%CI:0.73-0.98), overweight patients with BMI ≥25.0 kg/m2 (IRR=0.36, 95%CI:0.13-0.91) or moderate BMI (T2 vs. T1, IRR=0.31, 95%CI:0.11-0.77) had lower risk for acute exacerbation compared with the patients with normal or low BMI. BMI had a linear correlation with the risk of acute exacerbation. Conclusion: The risk for acute exacerbation in patients with mild or moderate COPD in communities decreased with the increase of BMI, and being overweight might be a protective factor for the acute exacerbation of COPD.

[Relationship of body mass index, waist circumference and waist-to-hip ratio with diabetes mellitus in community residents aged 15 years old and above in Pudong new district, Shanghai].

Objective: To analyze the relationship of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) with diabetes mellitus in community residents aged ≥15 years in Pudong new district of Shanghai, and provide evidence for the prevention and treatment of diabetes mellitus. Methods: Using multi-stage stratified cluster sampling method, a total of 7 194 community residents aged ≥15 years were surveyed by using questionnaire, physical examination and laboratory tests in 2016. The relationship of BMI, waist circumference and waist-hip ratio with diabetes mellitus was analyzed by χ(2) test, single factor linear correlation and logistic regression analyses. Results: In 2016, the crude prevalence rate of diabetes mellitus in Pudong was 27.37%, which was 12.75% after standardization. The prevalence rate of diabetes mellitus was slightly higher in men than in women and was increased with age. The levels of FPG, 2 h plasma glucose and HbA1c were positively correlated with BMI, WC and WHR. After adjusting the confounding factors, multiple logistic regression analysis showed that obesity (OR=1.351, P<0.01), excessive waist circumference (OR=1.255, P<0.01) and high WHR (OR=1.291, P<0.01) were risk factors for diabetes mellitus. Conclusions: The increase of obesity, WC and WHR will increase the risk for diabetes mellitus. It is important to maintain healthy weight, especially the control of WC and WHR, reduce the accumulation of abdominal fat to reduce the risk for diabetes mellitus.

Anthropometric measurements for prediction of metabolic risk among Chinese adults in Pudong new area of Shanghai.

BACKGROUND: Numerous studies have demonstrated the ability of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict the risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). This study aimed to evaluate the predictive value of these anthropometries for metabolic abnormalities and related diseases in Chinese adults. MATERIAL & METHODS: A cross-sectional study was conducted in 2 477 men and 3 107 women at 20-79 years old who were randomly selected from Pudong New Area of Shanghai, China, through a multistage sampling process. Anthropometric variables and blood pressure were measured according to a standardized protocol, and a fasting blood sample was collected from each subject for biochemical analysis. RESULTS: Prevalence of the metabolic syndrome was observed to increase with increasing BMI, WC, WHR and WHtR in both sexes. Participants with any metabolic abnormality had a higher body size than those without. The associations of anthropometries with each metabolic factor were significant and equal for BMI, WC, WHR and WHtR. Areas under the receiver operating characteristic curves (AUC) ranged from 0.59 to 0.72 across the 4 anthropometries in predicting individual and clusters of metabolic factors. However, none of the 4 anthropometries identified newly-diagnosed T2DM or hypertension with a high sensitivity or specificity. CONCLUSION: Our findings suggest that the independent use of BMI, WC, WHR, or WHtR may not be an effective tool to predict metabolic factors and related chronic diseases in Chinese adults.