Uncertainty stress and self-rated health during the early stage of the COVID-19 outbreak.

Objectives: The COVID-19 crisis caused unparalleled uncertainty stress and health-related symptoms among Chinese residents. This study aimed to characterize stress status during the early stage of the pandemic and explore the inner mechanism between uncertainty stress and self-rated health. Setting/participants: A cross-sectional design was conducted online from February 7 to 14, 2020. A total of 2534 Chinese participants were surveyed. Main outcome measures: Uncertainty stress, negative affect, sleep quality, and health status were measured by self-report. A sequential mediation model using bootstrapping method was applied to test these relationships. Results: Age, place of residence, marital status, occupation, household annual income, infection, and quarantine status significantly correlated with uncertainty stress. Higher uncertainty stress was negatively related with self-rated health (r = -0.256, p < 0.01) and positively associated with higher negative emotions (r = 0.646, p < 0.01). The sequential mediation model found total indirect effect (ß = -0.014, 95%C.I. = -0.017-0.010) and direct effect (ß = -0.010, 95%C.I. = -0.015-0.005) were significant in the relationship between uncertainty stress and self-rated health with mediating by negative affect and subjective sleep quality. Conclusions: Findings provided evidence-based information for stakeholders designing and implementing intervention strategies by providing psychological consultation services and public education to manage uncertainty stress and minimize the damage of negative affect and poor sleep.

Regional Internet Access and Mental Stress Among University Students: A Representative Nationwide Study of China.

Background: The Internet changed the lives of average citizens in the early part of the twenty-first century, and it has now become an essential part of daily life. Many studies reported that accessibility of Internet use is associated with mental health. However, previous studies examining this association were confined to local and community subpopulations and limited at the individual level, which increases the potential bias from the selection effect at a different level. Regional variables would be a stable estimate of people's socioeconomic and cultural environments and how these variables affect mental health needed to be studied. The objective of this study was to evaluate the association between regional Internet access, and mental stress among university students. Methods: Participants were 11,954 students, who were identified through a multistage survey sampling process conducted in 50 Chinese universities. Regional Internet access was retrieved from a national database, and mental stress was measured using the Perceived Stress Scale (Chinese Version) (CPSS). Both unadjusted and adjusted methods were considered in the analyses. Results: More than one-third 36.9% (95% CI: 24.4-49.5%) of university students in this study suffered from severe mental stress (SMR). The multilevel logistic regression model found that university students studied in low-level universities had 2.52 (95% C.I. 1.17 to 6.37) times the prevalence of SMR than those in high-level universities. Compared with small cities, students in a large city had a lower prevalence of SMR (OR 0.25; 95%C.I. 0.06 to 0.77). Most importantly, regional Internet access was negatively associated with students' SMR (OR 0.25; 95%C.I. 0.08 to 0.76). Conclusions: This study indicated that regional Internet access and other environmental factors including city size and type of universities contribute to students' mental health. The findings underscore that efforts to control excessive mental stress among students in China should pay greater attention to environmental determinants of stress and particularly to improve internet access.

Analysis of wedding appeals on cigarette packs in China.

INTRODUCTION: Exchanging or gifting cigarettes is a common practice in Chinese culture, often occurring during weddings to connote celebrations and happiness. We examined Chinese cigarette packs for wedding terminology and imagery to assess the extent to which packs are marketed for such occasions. METHODS: Cigarette packs were collected from Beijing, Guangzhou, Shanghai, Kunming and Chengdu in February 2017 using a systematic protocol designed to capture unique packs. Packs were coded by two independent coders for text and imagery of traditional Chinese wedding symbols, such as double happiness, dragon and phoenix, and other culturally specific phrases and images associated with weddings in China. RESULTS: From the sample of 738 unique cigarette packs, 68 (9.2%) contained either lexical and/or imagery appeals for wedding gifting. Of these 68 packs, 65 contained both lexical and imagery appeals, 1 pack had only a lexical appeal and 2 packs only included an imagery appeal. The most common appeal was 'double happiness' found on 56 packs (82.4%) for both lexical and imagery, followed by 'dragon and phoenix' found lexically on 12 packs (17.6%), and through imagery on 15 packs (22.1%). CONCLUSIONS: Chinese tobacco manufacturers take full advantage of the cigarette gifting and sharing culture demonstrated by packs with imagery and terminology specific to weddings. With only a 35% text health warning label, manufacturers have much real estate to make packs attractive for gifting on such occasions. Implementing plain packaging policies may be effective in decreasing gifting attractiveness for cigarette packs.

Association of Excessive WeChat Use with Mental Disorders: A Representative Nationwide Study in China.

OBJECTIVES: We examined associations between excessive WeChat use and mental disorders at the individual and contextual level. METHODS: We conducted a representative nationwide survey sampling process of 11,283 medical students from 30 universities in China. Mental health status was measured by the Chinese Health Questionnaire. Both unadjusted and adjusted methods were considered in the analyses. RESULTS: High frequency and long-time use prevalence was 19.1% and 31.2% respectively among WeChat users. The multilevel logistic regression model found that individual-level high frequency (OR = 1.26) and long-time use (OR = 1.24) were significantly associated with mental health disorders. University-level excessive WeChat use also was associated with the mental disorders (OR = 1.33 [high frequency use]; OR = 1.17 [long-time use]). Structural equation analysis showed that individual- and university-level high frequency and individual-level and university-level long-time WeChat use have a direct influence on poor mental health. The above variables, except individual-level long-time use, have an indirect influence on poor mental health through mental stress. CONCLUSIONS: This study provides new evidence that excessive WeChat use is associated with mental disorders. These findings underscore the importance of alerting people to the possible health risks of excessive social media use.

Predicting the histological invasiveness of pulmonary adenocarcinoma manifesting as persistent pure ground-glass nodules by ultra-high-resolution CT target scanning in the lateral or oblique body position.

BACKGROUND: Ultra-high-resolution computed tomography (U-HRCT) has improved image quality for displaying the detailed characteristics of disease states and lung anatomy. The purpose of this study was to retrospectively examine whether U-HRCT target scanning in the lateral or oblique body position (protocol G scan) could predict histological invasiveness of pulmonary adenocarcinoma manifesting as pure ground-glass nodules (pGGNs). METHODS: From January 2015 to December 2016, 260 patients with 306 pathologically confirmed pGGNs who underwent preoperative protocol G scans were retrospectively reviewed and analyzed. The U-HRCT findings of preinvasive lesions [atypical adenomatous hyperplasias (AAH) and adenocarcinomas in situ (AIS)] and invasive pulmonary adenocarcinomas [minimally invasive adenocarcinomas (MIA) and invasive adenocarcinomas (IAC)] were manually compared and analyzed using orthogonal multiplanar reformation (MPR) images. The logistic regression model was established to determine variables that could predict the invasiveness of pGGNs. Receiver operating characteristic (ROC) curve analysis was performed to evaluate their diagnostic performance. RESULTS: There were 213 preinvasive lesions (59 AAHs and 154 AISs) and 93 invasive pulmonary adenocarcinomas (53 MIAs and 40 IACs). Compared with the preinvasive lesions, invasive adenocarcinomas exhibited a larger diameter (13.5 vs. 9.3 mm, P=0.000), higher mean attenuation (-571 vs. -613 HU, P=0.002), higher representative attenuation (-475 vs. -547 HU, P=0.000), lower relative attenuation (-339 vs. -292 HU, P=0.000) and greater frequencies of heterogeneity (P=0.001), air bronchogram (P=0.000), bubble lucency (P=0.000), and pleural indentation (P=0.000). Multiple logistic analysis revealed that larger diameter [odds ratio (OR), 1.328; 95% CI: 1.208-1.461; P=0.000] and higher representative attenuation (OR, 1.005; 95% CI: 1.003-1.007; P=0.000) were significant predictive factors of invasive pulmonary adenocarcinomas from preinvasive lesions. The optimal cut-off value of the maximum diameter for invasive pulmonary adenocarcinomas was larger than 10 mm (sensitivity, 66.7%; specificity, 72.8%). CONCLUSIONS: The imaging features based on protocol G scanning can effectively help predict the histological invasiveness of pGGNs. The maximum diameter and representative attenuation are important parameters for predicting invasiveness.

Quantifying magnetic resonance imaging features to classify placenta accreta spectrum (PAS) in high-risk gravid patients.

OBJECTIVE: This study aimed to quantify the magnetic resonance imaging (MRI) features of placenta accreta spectrum (PAS) and to use MRI-based scores to classify them in high-risk gravid patients. MATERIALS AND METHODS: The clinical data and MRI features of 65 high-risk gravid patients diagnosed with PAS were retrospectively reviewed. The MRI features of PAS were analysed and compared using the chi-squared test, and the odds ratios (ORs) for significant risk factors for classification of PAS were identified via a multivariate logistic regression model. A receiver-operating characteristic (ROC) curve was used to calculate cut-off values and their corresponding sensitivity, specificity, and accuracy in classifying PAS. RESULTS: We identified 3 significant risk features for classification of PAS, including placental heterogeneity (OR = 13.604), abnormal vascularization at the placental-maternal interface (OR = 9.528), and focal myometrial interruption (OR = 118.779). The significant risk features for classification of PAS were scored according to their OR values, as 3 points (OR ≥ 20), 2 points (10 ≤ OR < 20), or 1 point (OR < 10). Based on the scores of the 3 risk features, a cut-off score of 4.5 points achieved optimal sensitivity (94.3%), specificity (90%), and accuracy (92.3%) for classifying PAS in high-risk gravid patients. CONCLUSION: Quantifying these MRI features including placental heterogeneity, abnormal vascularization at the placental-maternal interface, and focal myometrial interruption can make a classification of PAS in high-risk gravid patients.

Uncertainty stress, social capital, and suicidal ideation among Chinese medical students: Findings from a 22-university survey.

Respective associations between uncertainty stress and three dimensions of social capital with suicidal ideation were assessed among 4446 undergraduates from 22 Chinese universities in a cross-sectional study. Multiple logistic regression model and structural equation modeling were used to examine these relationships. Uncertainty stress was more strongly and uniquely associated with suicidal ideation than with life stress. Social capital, especially social networks, shared a dual role as a correlate of suicidal ideation and means to reduce the impact of uncertainty stress. School-based gender- and age-specific suicidal ideation interventions should emphasize social capital enhancement and uncertainty stress coping.

Real-world unassisted quit success and related contextual factors: a population-based study of Chinese male smokers.

OBJECTIVES: To examine the association of exposure to secondhand smoke (SHS) and tobacco advertising with unassisted smoking cessation among Chinese male smokers. METHODS: A questionnaire was administered to 6500 male adult smokers from six cities in China selected in a cross-sectional multistage sampling design. The survey collected self-reported demographic characteristics, smoking and cessation status, SHS exposure and tobacco advertising exposure, with 5782 valid questionnaires included in this study. Multiple logistic regression analysis was used to assess the association of unassisted smoking cessation with exposure to SHS and tobacco advertising. RESULTS: 42.1% of smokers who made unassisted quit attempts achieved abstinence (95% CI 32.5% to 51.7%). SHS (adjusted OR (aOR) 0.36; 95% CI 0.18 to 0.71; p=0.033) and tobacco advertising exposure (aOR 0.63; 95% CI 0.37 to 0.95; p=0.039) were negatively associated with unassisted smoking cessation. CONCLUSION: The vast majority of Chinese male smokers rely on unassisted methods to quit smoking. Success prevalence is high, which is very beneficial to health. This study suggests that exposure to secondhand smoking and tobacco advertising hinders the success of unassisted cessation. These findings speak to the need for environmental tobacco control measures to promote unassisted smoking cessation among Chinese adult male smokers.

Behavioral and psychosocial correlates of road traffic injuries: evidence from a nationwide study on Chinese undergraduates.

Objective: The purpose of this study was to investigate the prevalence and behavioral and psychosocial correlates of road traffic injuries (RTIs) among Chinese university students.Methods: A cross-sectional survey was conducted among fifty universities in China, using a multi-stage sampling methodology. The participants were asked to report their RTIs in the past year. The chi-square test and binary logistic regression analysis were utilized to identify factors associated with RTIs, including specific types of RTIs.Results: Among the 11,770 participants, a total of 1,482 university students reported at least one RTI yielding an overall weighted injury prevalence of 12.96% over the past year. Estimated weighted prevalence by type was 6.10%, 5.94%, 5.12%, and 5.35% for automobile (car, truck, or bus), bicycle, motorcycle, and pedestrian injuries, respectively. Logistic regression analysis found that students who studied at low-level universities, smoked cigarettes, drank alcohol, slept less than 7 hours, went to bed after 12:00 am, or students with psychological distress were more likely to experience overall and four types of RTIs. Students who studied in the eastern universities had a higher likelihood of automobile injury, motorcycle injury and pedestrian injury than those who studied in western universities.Conclusions: Several critical factors associated with RTIs were identified. These findings have implications for the design and implementation of RTI prevention and interventions programs targeted at university students.

Violent Injuries Among College Students in China: An Exploration of Gender Mental Stress Model.

The purpose of this study was to explore the gender-specific mental stress model of violent injuries among Chinese college students. A cross-sectional, multistage sampling process was employed to recruit a total of 5025 college students from 22 universities in China. Survey respondents reported their exposure to violent injuries and noted individual and environmental factors that could relate to violent injuries. Both unadjusted and adjusted statistical methods were used to examine the relationships between selected individual and environmental variables with violent injuries among male and female college students. The overall prevalence of violent injuries among male and female college students in this study was 4.40% (95% CI [0.10%, 7.80%]) and 5.20% (95% CI [0.05%, 10.35%]). The study found that higher mental stress (OR: 3.32), lower level universities (OR: 5.99), and family location in rural areas (OR: 4.00) were associated with a higher likelihood of violent injuries, and mothers employed as professionals (OR: 0.07) was associated with lower prevalence of violent injuries among male students. Unlike male students, mental stress and mothers' occupation were not associated with violent injuries among female students. University type was also associated with violent injuries but this association was inverted (OR: 0.06) among female students. This study found gender-specific relationships affecting violent injuries among college students in China. Prevention strategies need to be developed in consideration of gender influences and should be enacted to reduce the negative impact of violent injuries on society and personal health in China.

Diagnostic value of echocardiography on detecting the various types of anomalous origin of the left coronary artery from the pulmonary artery.

BACKGROUND: To assess the diagnostic value of echocardiography in detecting the various types of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). METHODS: A total of 30 patients with an established diagnosis of ALCAPA were retrospectively analyzed, and classified into infant- (n=20) and adult-type (n=10) groups according to the age of symptom manifestation and the mode of presentation. All patients underwent echocardiography examination. RESULTS: Twenty-four out of thirty patients were diagnosed with ALCAPA by echocardiography. The remaining six cases were confirmed by dual-source computed tomography (DSCT) and angiocardiography, respectively. In the infant-type group, there was negligible or no collateral flow between the right coronary artery (RCA) and the left coronary artery (LCA). Eighteen of these patients had enhanced echogenicity of left ventricular (LV) papillary muscles, different degrees of mitral regurgitation (MR) and the RCA to aortic annulus ratio (RCA/AO) was >0.12. In the adult-type group, all ten patients had RCA dilation and significant development of collateralization from the RCA to the dilated LCA. They all had mild MR and RCA/AO was >0.20. Preoperatively, left ventricular ejection fraction (LVEF) was significantly lower in infant-type group than in adult-type group (46.24%±5.47% vs. 61.43%±6.38%, P<0.01). Cardiac surgery significantly improved post-operative LVEF (60.12%±6.02%, P<0.01 vs. pre-operation) in infant-type group. CONCLUSIONS: Echocardiography plays a pivotal role in detecting ALCAPA. Imaging and clinical features differ significantly between infant- and adult-type cases.

The Impacts of Uncertainty Stress on Mental Disorders of Chinese College Students: Evidence From a Nationwide Study.

Objectives: This study aimed to examine the relationships between the types of stress and students' mental health, to distinguish the effects of stressors on mental health problems, and to explore the important role of uncertainty stress on the development of mental disorders in a nationally representative sample of Chinese college students. Methods: A cross-sectional multistage study was conducted. Participants were 11,954 students, who were recruited from 50 Chinese universities located in 43 cities covering 23 provinces, autonomous regions, and municipalities across China. The Student Daily Stress Questionnaire (SDSQ) was applied to measure the different types of stress, and mental health status was measured using the 12-item Chinese Health Questionnaire (CHQ). Both unadjusted and adjusted logistic regression models were utilized in the statistical analyses. Multilevel analyses were performed to examine the variation of mental disorder at both the individual and university levels. Results: The prevalence of mental disorders was 22.8% (95% CI: 22.0-23.5%). The unadjusted models showed that age, gender, grade, major, and university location and type were the correlates of mental disorders among students. The unadjusted models developed in this research found that study stress, life stress, and uncertainty stress were positively associated with mental disorder. The multilevel logistic regression models showed that uncertainty stress was far more likely to result in students' mental disorders than study or life stress after controlling for university level. The greater the perceived uncertainty stress, the higher the prevalence of mental disorders. Conclusion: This study provides robust evidence of the impact of uncertainty stress on mental disorders among college students. Compared with life and study stress, more attention should be given to uncertainty stress. The information from this study should be helpful when considering effective mental health policies and interventions among college students in China.

Male smoking reduction behaviour in response to China's 2015 cigarette tax increase.

OBJECTIVE: This study aims to evaluate Chinese male smokers' responses to China's 2015 6% ad valorem and RMB0.1 specific excise tax increase per cigarettes pack. METHODS: A male population-based cross-sectional survey with multistaged stratified sampling was employed to collect data in six cities in China. Descriptive methods and logistic models were used to assess responses and associated factors following the cigarette tax increase among male Chinese smokers. RESULTS: Among a potential sample of 6500 Chinese males, 6010 individuals were contacted and 5782 participants completed the questionnaires. Of the 2852 current smokers, 60.7% (95% CI: 58.9 to 62.5) did not think cigarettes were expensive, 77.9% (95% CI: 76.4 to 79.5) reported no reduction in smoking in response to the 2015 tax increase and 21.3% (95% CI: 19.8 to 22.8) were not aware of the cigarette tax increase. Smokers who were occasional smokers, intended to quit and thought cigarettes expensive were more likely to report reducing cigarette smoking following the tax increase, while those who had higher household income per capita, smoked more cigarettes, and purchased more expensive cigarettes were less likely to report reducing cigarette consumption. CONCLUSIONS: About one in five male Chinese smokers reported reduction in smoking following China's 2015 cigarette tax increase. This is a relatively large impact given the very modest tax increase. Even with the 2015 increase, the excise tax represents only 36.3% of the cigarette price in China. Tax increases are needed to achieve the WHO's recommended level of 70%.

Susceptibility to smoking and determinants among medical students: A representative nationwide study in China.

INTRODUCTION: The rationale behind why the majority of medical students are non-smokers, but some initiate smoking after becoming physicians is not fully understood in China. Exploring factors that may increase susceptibility to smoking initiation among medical students is an essential first step in assessing preventative actions. METHODS: Participants were 11954 students, who were identified through a multistage survey sampling process that included 50 universities in China. Subsequent analysis focused on 8916 non-smokers among medical students. Both unadjusted and adjusted logistic methods were considered in the data analyses. RESULTS: The prevalence of susceptibility to smoking was 23.0%. Multivariate logistic regression analyses found that exposure to secondhand smoke (SHS) in domestic places (OR= 1.63) and in public places (OR=1.78), cigarette advertising (OR=1.91) and promotional activities on campus (OR=1.90) were positively associated with susceptibility to smoking. In contrast, positive attitudes toward tobacco control on the part of health professionals, HPs, (OR=0.52) were negatively associated with susceptibility to smoking. Those who received information about the dangers of smoking (OR=0.75) and did not agree that light cigarettes are less harmful to health (OR=0.79) were less susceptible to smoke. Caring about exposure to secondhand smoke (OR=0.68 care, and OR=0.33 very) and advising family members to stop smoking (OR=0.81) were negatively associated with susceptibility to smoking. CONCLUSIONS: These findings underscore the importance of tobacco control training and establishing smoke-free campuses for reducing susceptibility to smoking among medical students.

Detection of pulmonary ground-glass opacity based on deep learning computer artificial intelligence.

BACKGROUND: A deep learning computer artificial intelligence system is helpful for early identification of ground glass opacities (GGOs). METHODS: Images from the Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) database were used in AlexNet and GoogLeNet to detect pulmonary nodules, and 221 GGO images provided by Xinhua Hospital were used in ResNet50 for detecting GGOs. We used computed tomography image radial reorganization to create the input image of the three-dimensional features, and used the extracted features for deep learning, network training, testing, and analysis. RESULTS: In the final evaluation results, we found that the accuracy of identification of lung nodule could reach 88.0%, with an F-score of 0.891. In terms of performance and accuracy, our method was better than the existing solutions. The GGO nodule classification achieved the best F-score of 0.87805. We propose a preprocessing method of red, green, and blue (RGB) superposition in the region of interest to effectively increase the differentiation between nodules and normal tissues, and that is the innovation of our research. CONCLUSIONS: The method of deep learning proposed in this study is more sensitive than other systems in recent years, and the average false positive is lower than that of others.

Are overweight people more susceptible to anxiety?

OBJECTIVES: This study aimed to investigate anxiety status and its relationship with body mass index (BMI) among empty nesters in China, so as to improve their quality of life and provide direction for further research. METHODS: A cross-sectional survey was conducted among 4901 empty nesters in Shanxi, China. Anxiety, weight, height, depression, socio-demographic variables, attention to daily nutritional health, social activities, and self-care ability were evaluated in the study. T-tests and chi-square tests were used to compare differences in categorical and continuous variables. Binary logistic regression was performed to explore the association between anxiety and BMI among male and female empty nesters. RESULTS: The results showed that 44.5% of empty nesters reported anxiety, of which, 43.2% were male participants and 45.9% were female participants. After adjusting for other variables, overweight empty nesters odds ratio (OR; 95% confidence interval [CI]) = 0.813 (0.692-0.954) were less likely to be anxious, compared with their normal-weight counterparts. Gender was a significant factor in the relationship, with the negative association between overweight and anxiety only found in female empty nesters OR (95%CI) = 0.718 (0.572-0.901). Income, education, complete self-care ability, and depression showed significant associations with anxiety. CONCLUSION: The prevalence of anxiety was high in the study population. Gender is a significant factor in the relationship between anxiety and BMI among empty nesters. The results intend to inform the government and media that overweight is a protective factor for anxiety among female empty nesters, necessitating a move toward eliminating weight bias.

Individual and regional factors affecting stress and problem alcohol use: A representative nationwide study of China.

OBJECTIVES: The objective of this study was to examine the association between individual and environmental stressors and problem alcohol use among Chinese university students. METHODS: Participants were 11,942 students, who were identified through a multistage survey sampling process that included 50 universities. Individual information, including feelings of stress and perceptions of problem alcohol use, was obtained by self report. Urban and regional variables were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were considered in the analyses. RESULTS: Almost one third (32.6%) of the students suffered from some form of severe stress while problem alcohol use prevalence was 7.3%, (95% CI: 4.1-10.4%). The multilevel logistic regression model found that uncertainty stress, gender, father's occupation and monthly expenses were associated with problem alcohol use. Of the contextual factors home region and the university city GDP and unemployment rate were important. When interactions were considered, the relationship between monthly expenses and financial uncertainty and problem drinking was most evident in high level universities. By contrast, the effects of uncertainty stress on problem drinking were most evident in middle and low level universities. CONCLUSIONS: The findings underscore that efforts to control problem alcohol use among students in China should pay greater attention to environmental determinants of stress and particularly to improvements in stress management in university settings.

Association between coronary artery atherosclerosis and plasma glucose levels assessed by dual-source computed tomography.

BACKGROUND: To assess the association between coronary artery atherosclerosis (CAA) and plasma glucose parameters in a randomly selected cohort of asymptomatic, community-dwelling, Chinese adults by dual-source computed tomography (DSCT). METHODS: We randomly selected participants and classified them into three groups based on their plasma glucose levels: normal glucose regulation (NGR), pre-diabetes, and diabetes mellitus (DM). The participants underwent DSCT, and those identified with CAA were divided into four groups according to the severity of their coronary artery stenosis. We analyzed the composition of plaques in all coronary artery segments according to the American Heart Association's (AHA) guidelines. We compared the severity of coronary artery stenosis and the plaque composition with plasma glucose parameters among participants. RESULTS: Out of a total of 335 participants, 118 were found to have CAA. The prevalence of CAA was highest (P value for trend =0.031) in the diabetic group (67.7%) followed by the pre-diabetic group (35.1%) then the NGR group (27.7%). Both calcified and mixed plaques were found in the coronary arteries of the diabetic group while mixed and non-calcified plaques predominated in the pre-diabetic and the NGR groups. When data from all subjects with CAA were analyzed, blood glucose parameters, fasting plasma glucose (FPG), 2-hr postprandial plasma glucose (PPG), and hemoglobin A1c (HbA1c), exhibited a positive correlation with the severity of coronary stenosis (P<0.05). Multivariable logistic regression models indicated a significantly higher risk of CAA among the diabetic patients. Triglyceride levels were positively correlated with the blood glucose parameters among the three groups while LDL-C was elevated in the DM group but not in the pre-diabetic group compared to the NGR group. CONCLUSIONS: The severity of CAA exhibited a direct correlation with the blood glucose parameters, FPG, PPG, and HbA1c. DSCT can accurately detect the presence and distribution of CAA in asymptomatic, community-dwelling subjects. DSCT is a useful screening tool for coronary artery disease (CAD).