Comparison of the profiles of patients defined by age-adapted and fixed threshold CKD criteria: a nationwide, cross-sectional study.

Background: Kidney function declines naturally with advancing age. Therefore an age-adapted estimated glomerular filtration rate (eGFR) threshold has been proposed instead of the fixed threshold for CKD definition. This study aims to describe and compare the profile of CKD patients defined by these two criteria in a Chinese population. Method: We recruited adult participants with selected biochemical tests from the Chinese Physiological Constant and Health Condition survey conducted from 2007 to 2011, with the GFR estimated by the Chronic Kidney Disease Epidemiology Collaboration formula. The age-adapted threshold of eGFR is 75, 60 and 45 ml/min/1.73 m2 for the population <40 years of age, 40-64 years and >64 years, respectively. The fixed threshold is 60 ml/min/1.73 m2 for all ages. Results: Among the recruited 23 438 participants, 480 were diagnosed with CKD by fixed threshold criteria, while 391 were diagnosed with CKD by age-adapted criteria. Patients diagnosed by fixed threshold criteria were significantly older (66.4 versus 43.4 years; P < .001) and had a higher prevalence of all CVD risk factors compared with the non-CKD population. In contrast, age-adapted criteria defined a younger patient group and were not significantly associated with diabetes or obesity. When adjusted by age and gender, fixed threshold-defined CKD was not significantly associated with the number of coexisting CVD risk factors, while age-adapted-defined CKD was significantly associated. We also found that the CKD patients defined by age-adapted criteria matched well with the 2.5th percentile of eGFR in Chinese individuals. When compared with their age- and gender-matched controls, patients included by age-adapted criteria but excluded by fixed threshold criteria had a significantly higher prevalence of hypertension (23.2% versus 7.7%; P < .001) and hyperuricaemia (25.0% versus 5.5%; P < .001), while patients included only by the fixed threshold criteria were not significantly different in the prevalence of CVD risk factors and CKD-related disturbance except for hyperuricaemia (41.2% versus 14.0%; P < .001). Conclusion: An age-adapted criterion is more closely associated with CVD risk factors and CKD-related diseases compared with fixed threshold criteria.

Long-term ambient PM2.5 exposure associated with cardiovascular risk factors in Chinese less educated population.

INTRODUCTION: Long-term exposure to ambient air pollution is related to major cardiovascular risk factors including diabetes, hypertension, hyperlipidemia and overweight, but with few studies in high-concentration nations like China so far. We aimed to investigate the association between long-term exposure to ambient fine particulate matter (particles with an aerodynamic diameter ≤ 2.5 µm, PM2.5) and major cardiovascular risk factors in China. METHODS: Adult participants with selected biochemical tests were recruited from the Chinese Physiological Constant and Health Condition (CPCHC) survey conducted from 2007 to 2011. Gridded PM2.5 data used were derived from satellite-observed data with adjustment of ground-observed data. District-level PM2.5 data were generated to estimate the association using multivariate logistic regression model and generalized additive model. RESULTS: A total of 19,236 participants from the CPCHC survey were included with an average age of 42.8 ± 16.1 years, of which nearly half were male (47.0%). The annual average PM2.5 exposure before the CPCHC survey was 33.4 (14.8-53.4) µg/m3, ranging from 8.0 µg/m3 (Xiwuqi) to 94.7 µg/m3 (Chengdu). Elevated PM2.5 was associated with increased prevalence of hypertension (odds ratio (OR) =1.022, 95% confidence interval (95%CI): 1.001, 1.043) and decreased prevalence of overweight (OR = 0.926, 95%CI: 0.910, 0.942). Education significantly interacted with PM2.5 in association with all the interesting risk factors. Each 10 µg/m3 increment of PM2.5 was associated with increased prevalence of diabetes (OR = 1.118, 95%CI: 1.037, 1.206), hypertension (OR = 1.101, 95%CI: 1.056, 1.147), overweight (OR = 1.071, 95%CI: 1.030, 1.114) in participants with poor education, but not in well-educated population. PM2.5 exposure was negatively associated with hyperlipidemia in all participants (OR = 0.939, 95%CI: 0.921, 0.957). The results were robust in all the sensitivity analyses. CONCLUSION: Association between long-term PM2.5 exposure and cardiovascular risk factors might be modified by education. PM2.5 was associated with a higher prevalence of diabetes, hypertension, and overweight in a less-educated population with time-expose dependency. Long-term exposure to PM2.5 might be associated with a lower prevalence of hyperlipidemia.

Prevalence of and lifestyle factors associated with metabolic syndrome determined using multi-level models in Chinese adults from a cross-sectional survey.

People living in the same area are more likely to experience similar socioeconomic characteristics, which leads to cluster effect and influences the generalizability of data regarding metabolic syndrome (MetS). However, previous studies did not consider or adjust for the cluster effect of living circumstances. The aim of this study was to determine the prevalence of MetS and associated lifestyle factors in Chinese adults 18 to 80 years of age, using multi-level generalized estimation equation (GEE).The participants came from a large-scale cross-sectional population survey. A total of 28,062 participants underwent all the blood tests. Participants meeting at least 3 of the 5 diagnostic criteria were defined as having MetS. Multi-level GEE was used to evaluate the relationship between MetS and lifestyle covariates to control the cluster effect of living circumstances. Odds ratios (ORs) and their 95% confidence intervals (CIs) were used to assess the strength of each relationship.A total of 65.70% of the participants had at least 1 clinical feature of MetS, and 2926 were diagnosed with MetS (prevalence 14.03%). 32.74%, 18.93%, 10.25%, 3.25%, and 0.53% of the participants had 1, 2, 3, 4, and 5 components, respectively. The prevalence of MetS in men (12.31%) was lower than in women (15.57%). After controlling for the cluster effect of living circumstances, many demographic and lifestyle characteristics were associated with MetS. Overweight (OR = 1.670, 95%CI: 1.600-1.743), obesity (OR = 2.287, 95% CI: 2.136-2.449), current alcohol consumption (OR = 1.053, 95% CI: 1.020-1.086), physical labor (OR=1.070, 95% CI: 1.040-1.101), a high-salt diet (OR=1.040, 95% CI: 1.009-1.071), hyperuricemia (OR=1.264, 95% CI: 1.215-1.316), short sleep duration (OR=1.032, 95% CI: 1.009-1.055), and a family history of cardiovascular disease (OR=1.065, 95% CI: 1.019-1.113), or cerebrovascular disease (OR=1.055, 95% CI: 1.007-1.104) increased the risk of MetS. The risk of MetS increased 6.9% (OR = 1.069, 95% CI: 1.053-1.085) with each 5% increase in body fat percentage.MetS has become a serious public health challenge in China. Many lifestyle factors have been found to be closely associated with MetS, including obesity, a high-salt diet, alcohol consumption, and short sleep duration. Therefore, changes in lifestyle are very important for adults to reduce the prevalence of MetS.

Association between obesity indicators and cardiovascular risk factors among adults in low-income Han Chinese from southwest China.

There may be differences in optimal anthropometric cut-offs for diagnosing obesity among different regions of China. However, there has been little studies about choosing effective obesity indicators in Han People of low-income Chinese adults in southwest China. The purpose of this study was to compare and evaluate the associations between different obesity indicators and cardiovascular disease risk factors (CVDRF) and choose the optimal cut-off values.A cross-sectional study was carried out in southwest of China, with multi-stage sampling enrolling 2112 subjects aged 20 to 80 years old. Anthropometric measurements included Body mass index (BMI), waist circumference (WC), Hip circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We measured the percentage of body fat (PBF) by bioelectrical impedance analyzer to assess the body composition. The validity of different obesity indicators in assessing CVDRF risk were assessed through comparison area under curve of different indicators in assessing CVDRF risk in different gender. Logistic regression models were used to evaluate the association between the obesity indicators and CVDRF.When both male and female were considered, the optimal indicators were WHtR and percentage of body fat PBF for hypertension, WHR and WHtR for dyslipidemia. Both WC and WHtR were optimal indicators in assessing metabolic syndrome risk for both genders. When both disease and gender were considered, WHtR was the best associated indicators with various CVDRF. The cut-off of BMI and WC were consistent to the definition of obesity in Working Group of China. The WHtR positively correlated with the CVDRF. The cut-off of WHtR to do what was approximately 0.50 for adults in both genders in southwest of China.WHtR may be the best associated indicators for obesity-related CVDRF among the others (BMI, WC, Hip circumference, PBF, and WHR) in southwest of China. The cut-off of WHtR was approximately 0.50 for adults in both genders in southwest of China.

Prevalence of metabolic syndrome among ethnic groups in China.

BACKGROUND: Metabolic syndrome (MetS) is common in China, which has a multi-ethnic population of 1·3 billion. We set out to determine the prevalence of MetS and its components in different ethnic groups. METHODS: This nationwide cross-sectional survey involved 24,796 participants from eight ethnicities in six provinces in China from 2008 to 2011. MetS was defined using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Results were analysed using SPSS version 22·0 in 2018. Logistic regression was used for deriving odds ratios and 95% confidence intervals of risk factors for the MetS. RESULTS: The prevalence of MetS increased with age from 3·60% to 21·68%. After age standardization, the prevalence of MetS, in descending order, was 35·42% (Korean), 22·82% (Hui), 19·80% (Han), 13·72% (Miao), 12·90% (Tujia), 12·04% (Li), 11·61% (Mongolian), 6·17% (Tibetan). Korean ethnicity was associated with a higher prevalence in five components of MetS, while Tibetan ethnicity was associated with lower prevalence except decreased HDL cholesterol. Logistic regression analyses showed that age, drinking and being non-Tibetan were associated with a higher risk of MetS. CONCLUSIONS: Within one country, albeit a large one, the prevalence of MetS can vary greatly. Chinese of Korean ethnicity had a much higher prevalence than Tibetan ethnicity. Measures to tackle MetS should be tailored to the ethnic groups within a population.

Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model.

Chinese children are facing health challenges brought by chronic non-communicable diseases, such as physical problems and psychological related health problems. Childhood represents a critical life period when the long-term dietary and lifestyle behaviors are formed. It is necessary to survey the prevalence of suboptimal health status (SHS) among Chinese children and to research the relationship between SHS and lifestyles. This study aimed to examine the prevalence of SHS among Chinese children using a large-scale population survey sample covering school students and nonstudent children, and clarified the relationships between SHS and lifestyle factors using multi-level models controlled for the cluster effect of location and the confounding effect of demographics. Multi-level generalized estimating equation models were used to examine the relationships between SHS and lifestyle factors. Prevalence ratios (PR) and 95% confidence intervals (CI) were used to assess the strength of these relationships. Of the 29,560 children, 14,393 reported one or more SHS symptoms, giving a SHS prevalence of 48.69%. The prevalence of SHS for boys (46.07%) was lower than that for girls (51.05%). After controlling for the cluster effect of living areas and confounding effect of demographic characteristics, lifestyle factors associated with SHS were: less sleep duration, current smokers (PR = 1.085, 95%CI: 1.027-1.147), current drinkers (PR = 1.072, 95%CI: 1.016-1.131), children' parents suffering from chronic diseases (PR = 1.294, 95%CI: 1.179-1.421), poor sleep quality (PR = 1.470, 95%CI: 1.394-1.550), stress (PR = 1.545, 95%CI: 1.398-1.707), negative life events (PR = 1.237, 95%CI: 1.088-1.406), hypertension (PR = 1.046, 95%CI: 1.009-1.084), unhealthy diet choice (PR = 1.091, 95%CI: 1.051-1.133) and irregular meal time (PR = 1.210, 95%CI: 1.163-1.259). Children who could exercise regularly (PR = 0.897, 95%CI: 0.868-0.927) and those with regular medical checkup (PR = 0.891, 95%CI: 0.854-0.929) were associated with lower prevalence probability of SHS. SHS has become a serious public health challenge for Chinese children. Unhealthy lifestyles were closely associated with SHS. Implementation of preventative strategies are needed to reduce the potential SHS burden associated with these widespread high-risk unhealthy lifestyle behaviors.

Prevalence of Suboptimal Health Status and the Relationships between Suboptimal Health Status and Lifestyle Factors among Chinese Adults Using a Multi-Level Generalized Estimating Equation Model.

This study examined the prevalence of suboptimal health among Chinese adults based on a large-scale national survey and clarified the relationship between suboptimal health and lifestyle factors. We used multi-level generalized estimating equation models to examine the relationships between suboptimal health and lifestyle factors. Of the 48,978 respondents, 34,021 reported one or more suboptimal health symptoms, giving a suboptimal health status prevalence of 69.46%. After controlling for the cluster effect of living areas and confounding effect of demographic characteristics, factors associated with suboptimal health were: current smoking (odds ratio (OR) = 1.083, 95% confidence interval (CI): 1.055-1.111), drinking alcohol (OR = 1.075, 95% CI: 1.025-1.127), family history of disease (OR = 1.203, 95% CI: 1.055-1.111), sleeping <6 h per day (OR = 1.235, 95% CI: 1.152-1.256), poor sleep quality (OR = 1.594, 95% CI: 1.515-1.676), stress (OR = 1.588, 95% CI: 1.496-1.686), negative life events (OR = 1.114, 95% CI: 1.045-1.187), unhealthy diet choices (OR = 1.093, 95% CI: 1.033-1.156), and not regularly having meals at fixed hours (OR = 1.231, 95% CI: 1.105-1.372). Respondents who exercised regularly had lower odds of having suboptimal health status (OR = 0.913, 95% CI: 0.849-0.983). Suboptimal health has become a serious public health challenge in China. The health status of the population could be effectively improved by improving lifestyle behaviors.

Serum Gamma-Glutamyltransferase Levels are Associated with Cardiovascular Risk Factors in China: A Nationwide Population-Based Study.

Serum gamma-glutamyltransferase (GGT), which is mainly derived from the liver, is a sensitive marker of liver cell damage and oxidative stress. More recently, it has been found that increased GGT plasma activity is also associated with cardiovascular disease (CVD). However, data on the relationship between GGT and cardiovascular risk factors (CRFs) are lacking in nationally representative samples of the Chinese population. Here, we aim to investigate both the association between GGT and CRFs and CRF clustering. A cross-sectional survey was conducted in a representative sample of 22897 adults aged 18 years and older from 2007 to 2011 nationally, which included a plurality of ethnic minorities. The participants were then divided into quartiles of sex-specific serum GGT. From the low to high GGT quartiles, the incidence of each CRF and clustered risk factors increased after adjusting for age, uric acid (UA), ethnicity, drinking, and all other risk factors. Individuals in the upper stratum (>75th percentile) had higher prevalence rates of CRFs than did those in the lower stratum (all P < 0.05). Furthermore, the subjects with clustering of 1, 2, or ≥3 CRFs were still more likely to belong to the upper GGT quartiles (75th percentiles) than were those without risk factors (all P < 0.05). In conclusion, our data highlight that there is an association between higher serum GGT levels and prevalence of CRFs, which tend to cluster with the increase in GGT activity in Chinese adults.

Study of depression influencing factors with zero-inflated regression models in a large-scale population survey.

OBJECTIVES: The number of depression symptoms can be considered as count data in order to get complete and accurate analyses findings in studies of depression. This study aims to compare the goodness of fit of four count outcomes models by a large survey sample to identify the optimum model for a risk factor study of the number of depression symptoms. METHODS: 15 820 subjects, aged 10 to 80 years old, who were not suffering from serious chronic diseases and had not run a high fever in the past 15 days, agreed to take part in this survey; 15 462 subjects completed all the survey scales. The number of depression symptoms was the sum of the 'positive' responses of seven depression questions. Four count outcomes models and a logistic model were constructed to identify the optimum model of the number of depression symptoms. RESULTS: The mean number of depression symptoms was 1.37±1.55. The over-dispersion test statistic O was 308.011. The alpha dispersion parameter was 0.475 (95% CI 0.443 to 0.508), which was significantly larger than 0. The Vuong test statistic Z was 6.782 and the P value was <0.001, which showed that there were too many zero counts to be accounted for with traditional negative binomial distribution. The zero-inflated negative binomial (ZINB) model had the largest log likelihood and smallest AIC and BIC, suggesting best goodness of fit. In addition, predictive probabilities for many counts in the ZINB model fitted the observed counts best. CONCLUSIONS: All fitting test statistics and the predictive probability curve produced the same findings that the ZINB model was the best model for fitting the number of depression symptoms, assessing both the presence or absence of depression and its severity.

Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population.

Hyperuricemia is common in China and the relevance of hyperuricemia and cardiovascular disease (CVD) risk has been highlighted, but to date there has been rarely nation-wide study in China. Here, we aim to estimate the current prevalence of hyperuricemia and evaluate the associations between hyperuricemia and cardiovascular risk factors (CRFs) clustering in a large sample of China adults including a plurality of ethnic minorities. Generally, a nationally representative sample of 22983 adults aged ≥18 years was recruited from 2007 to 2011. Questionnaire data and information on anthropometric characteristics, and laboratory measurements were collected. We define hyperuricemia as SUA ≥416 mmol/L for men and SUA ≥357 mmol/L for women. We found that the prevalence of hyperuricemia was 13.0% (18.5% in men and 8.0% in women). To our estimation, hyperuricemic subjects had higher prevalence rates of CRFs clustering than non-hyperuricemic subjects. Furthermore, there was a dose-response association between the number of CVD risk factors clustering and hyperuricemia. Our study revealed a high prevalence of hyperuricemia and CVD risk factors clustering among Chinese adults, and hyperuricemia was significantly associated with coexistence of more CVD risk factors. Therefore, guidance and effective lifestyle intervention are required to prevent hyperuricemia and CVD risk factors in China.

Relation between metabolic syndrome and body compositions among Chinese adolescents and adults from a large-scale population survey.

BACKGROUND: Few nationally representative surveys regarding body composition and metabolic syndrome (MetS) have been done in a large-scale representative Chinese population to explore the prediction of body composition indicators for MetS. The objective of this study was to examine the relation of body composition and MetS and to determine the optimal cut-off values of body composition indicators that predict MetS in a large representative Chinese sample based on multiple provinces and ethnicities, covering a broad age range from 10 to 80 years old. METHODS: The subjects came from a large-scale population survey on Chinese physiological constants and health conditions conducted in six provinces. 32,036 subjects completed all blood biochemical testing and body composition measure. Subjects meeting at least 3 of the following 5 criteria qualify as having MetS: elevated blood pressure, lower high density lipoprotein cholesterol level, higher triglyceride level, higher fasting glucose level and abdominal obesity. RESULTS: The total prevalence rate of MetS for males (9.29%) was lower than for females (11.58%). The prevalence rates were 12.03% for male adults and 15.57% for female adults respectively. The risk of MetS increased 44.6% (OR = 1.446, 95%CI: 1.414-1.521) for males and 53.4% (OR = 1.534, 95%CI: 1.472-1.598) for females with each 5% increase of percentage of body fat. The risk of MetS increased two-fold (OR = 2.020, 95%CI: 1.920-2.125 for males; OR = 2.047, 95%CI: 1.954-2.144 for females respectively) with each 5% increase of waist-hip ratio. The risk of MetS increased three-fold (OR = 2.915, 95%CI: 2.742-3.099 for males; OR = 2.950, 95%CI: 2.784-3.127 for females respectively) with each 5% increase of Waist-to-Height Ratio (WHtR). Areas under the receiver operating curve (AUC) of most body composition indicators were larger than 0.70 and the sensitivities and the specificities of most cut-off values were larger than 0.65. AUCs of WHR and WHtR were the largest. The optimal cut-off values of WHtR were 0.51 for males and 0.53 for females. CONCLUSION: MetS has become a serious public health challenge in China. Body composition variables were closely related to MetS and they were reliable indicators in the screening of the presence of MetS.

Optimal body fat percentage cut-off values for identifying cardiovascular risk factors in Mongolian and Han adults: a population-based cross-sectional study in Inner Mongolia, China.

OBJECTIVE: The present study was designed to determine the optimal cut-off values of body fat percentage (BF%) for the detection of cardiovascular disease (CVD) risk factors in Mongolian and Han adults. METHOD: This cross-sectional study involving 3221 Chinese adults (2308 Han and 913 Mongolian) aged 20-80 years was conducted in Inner Mongolia Autonomous Region, China, in 2014. Data from a standardised questionnaire, physical examination and blood sample were obtained. The BF% was estimated using bioelectrical impedance analysis. Optimal BF% cut-offs were analysed by receiver operating characteristic curves to predict the risk of diabetes, hypertension and dyslipidaemia. Binary logistic regression analysis was performed to evaluate the OR of each CVD risk factor according to obesity defined by BF%. RESULTS: Mean BF% levels were lower in men than in women (22.54±5.77 vs 32.95±6.18 in Han, 23.86±5.72 vs 33.98±6.40 in Mongolian population, respectively; p<0.001). In Han population, the area under curve (AUC) values for BF% ranged from 0.589 to 0.699 for men and from 0.711 to 0.763 for women. Compared with men, AUCs for diabetes and clustering of ≥2 risk factors in women were significantly higher (p<0.05). The AUCs for BF% in women (0.685-0.783) were similar with those in men (0.686-0.736) for CVD risk factors in Mongolian population. In Han adults, the optimal BF% cut-off values to detect CVD risk factors varied from 18.7% to 24.2% in men and 32.7% to 35.4% in women. In Mongolian population, the optimal cut-off values of BF% for men and women ranged from 21.0% to 24.6% and from 35.7% to 40.0%, respectively. Subjects with high BF% (≥24% in men, ≥34% in women) had higher risk of CVD risk factors in Han (age-adjusted ORs from 1.479 to 3.680, 2.660 to 4.016, respectively). In Mongolia, adults with high BF% (≥25% in men, ≥35% in women) had higher risk of CVD risk factors (age-adjusted ORs from 2.587 to 3.772, 2.061 to 4.882, respectively). CONCLUSIONS: The optimal BF% cut-offs for obesity for the prediction of CVD risk factors in Chinese men and women were approximately 24% and 34% for Han adults and 25% and 35% for Mongolian population of Inner Mongolia, China, respectively.

Study of Zero-Inflated Regression Models in a Large-Scale Population Survey of Sub-Health Status and Its Influencing Factors.

Objective Sub-health status has progressively gained more attention from both medical professionals and the publics. Treating the number of sub-health symptoms as count data rather than dichotomous data helps to completely and accurately analyze findings in sub-healthy population. This study aims to compare the goodness of fit for count outcome models to identify the optimum model for sub-health study. Methods The sample of the study derived from a large-scale population survey on physiological and psychological constants from 2007 to 2011 in 4 provinces and 2 autonomous regions in China. We constructed four count outcome models using SAS: Poisson model, negative binomial (NB) model, zero-inflated Poisson (ZIP) model and zero-inflated negative binomial (ZINB) model. The number of sub-health symptoms was used as the main outcome measure. The alpha dispersion parameter and O test were used to identify over-dispersed data, and Vuong test was used to evaluate the excessive zero count. The goodness of fit of regression models were determined by predictive probability curves and statistics of likelihood ratio test. Results Of all 78 307 respondents, 38.53% reported no sub-health symptoms. The mean number of sub-health symptoms was 2.98, and the standard deviation was 3.72. The statistic O in over-dispersion test was 720.995 (P<0.001); the estimated alpha was 0.618 (95% CI: 0.600-0.636) comparing ZINB model and ZIP model; Vuong test statistic Z was 45.487. These results indicated over-dispersion of the data and excessive zero counts in this sub-health study. ZINB model had the largest log likelihood (-167 519), the smallest Akaike's Information Criterion coefficient (335 112) and the smallest Bayesian information criterion coefficient (335455), indicating its best goodness of fit. The predictive probabilities for most counts in ZINB model fitted the observed counts best. The logit section of ZINB model analysis showed that age, sex, occupation, smoking, alcohol drinking, ethnicity and obesity were determinants for presence of sub-health symptoms; the binomial negative section of ZINB model analysis showed that sex, occupation, smoking, alcohol drinking, ethnicity, marital status and obesity had significant effect on the severity of sub-health. Conclusions All tests for goodness of fit and the predictive probability curve produced the same finding that ZINB model was the optimum model for exploring the influencing factors of sub-health symptoms.

Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey.

BACKGROUND: Up to date, most of previous studies about Chinese prehypertension were conducted based on a small sample or in only one province, which could not represent the general population in China. Furthermore, no information on the ethnic difference in prevalence of prehypertension has been reported in China. The aim of this study is to examine the sex-specific, age-specific and ethnic-specific prevalence of prehypertension and associated risk factors in a large-scale multi-ethnic Chinese adult population. METHODS: The subjects came from a large-scale population survey about Chinese physiological constants and health conditions conducted in six provinces. 47, 495 adults completed blood pressure measurement. Prehypertension was defined as not being on antihypertensive medications and having SBP of 120-139 mmHg and/or DBP of 80-89 mmHg. Odds ratio (OR) and its 95 % confidence interval (CI) from logistic models were used to reflect the prevalence of prehypertension. RESULTS: The mean age of all subjects was 43.9 ± 16.8 years. The prevalence of hypertension and prehypertension for all them was 29.5 and 36.4 %, respectively. The prevalence of hypertension and prehypertension for males (33.2 and 41.1 %, respectively) was higher than that for females (27.0 and 33.2 %, respectively), and P < 0.001. The mean age of the subjects was 54.8 ± 14.0 years for hypertensive, 44.0 ± 16.0 years for prehypertensive and 35.3 ± 14.5 years for normotensive. With aging, subjects had more odds of getting prehypertension. Multivariate logistic model indicated that males (OR = 2.076, 95 % CI: 1.952-2.208), laborers with mental work (OR = 1.084, 95 % CI: 1.020-1.152), Yi (OR = 1.347, 95 %CI: 1.210-1.500) and Hui subjects (OR = 1.133, 95 % CI: 1.024-1.253), alcohol drinkers (OR = 1.147, 95 % CI: 1.072-1.228), the generally obese (OR = 2.460, 95 % CI: 2.190-2.763), the overweight (OR = 1.667, 95 % CI: 1.563-1.788), the abdominally obese (OR = 1.371, 95 % CI: 1.280-1.467) and subjects with family history of cardiovascular diseases (OR = 1.132, 95 % CI: 1.045-1.226) had higher prevalence of prehypertension. Subjects with higher educational level (OR = 0.687, 95 % CI: 0.627-0.752 for university) and Miao (OR = 0.753, 95 % CI: 0.623-0.910), Tibetan (OR = 0.521, 95 % CI: 0.442-0.613), Tujia (OR = 0.779, 95 % CI: 0.677-0.898) subjects had lower prevalence. CONCLUSION: High prevalence rate of prehypertension was general in Chinese adults. Many sociodemographic characteristics were significantly associated with prehypertension. There were important clinical significance and public health significance about age-specific, gender-specific and ethnic-specific Chinese prehypertension conditions studies.

Prevalence, awareness, treatment, control and risk factors related to hypertension among urban adults in Inner Mongolia 2014: differences between Mongolian and Han populations.

BACKGROUND: Han and Mongolian populations constitute approximately 96% of the population of Inner Mongolia Autonomous Region, and the two ethnic groups have different genetic backgrounds and lifestyle. We aim to assess the prevalence, awareness, treatment, control, and related risk factors of hypertension among urban adults in Inner Mongolia, with the comparison of the differences between Mongolian and Han populations in this respect. METHODS: Three thousand two hundred fifty-one individuals aged 20-80 years (2326 Han and 925 Mongolian) were selected using a multistage cluster sampling method from Inner Mongolia in 2014. The adjusted prevalence, awareness, treatment and control of hypertension were evaluated by the Logistic regression. In addition, possible interactions were also tested. When interactions were found significant, strata-specific analysis were performed. Multivariate logistic regression was used for estimating independent associations between risk factors and hypertension. RESULTS: The prevalence of hypertension was 27.47% for Han population, 31.46% for Mongolian population. The adjusted prevalence, awareness, treatment and control of hypertension were 26.45, 65.43, 78.24 and 48.28% in Han, and 31.30, 68.22, 85.57 and 50.55% in Mongolian, respectively. There was no significant difference in the adjusted awareness, treatment and control of hypertension among Mongolian and Han adult residents (all P >0.05). Lower prevalence of hypertension was associated with younger age and healthy weight in both Mongolian and Han adults. Within Han adults, high education, moderate physical activity and non-alcohol drinkers were additionally associated with lower prevalence of hypertension, whereas within Mongolian adults, lower prevalence was associated with being female. Among residents with medium education level, nondrinkers had 0.60 times lower odds of having hypertension than current drinkers (OR = 0.60, 95% CI: 0.44-0.82); among residents with high education level, nondrinkers has 0.65 times lower odds of having hypertension than current drinkers (OR = 0.65, 95% CI: 0.43-0.97). CONCLUSIONS: Mongolian population had a higher prevalence of hypertension than Han population. There were no significant difference between Mongolian and Han population in awareness, treatment and control of hypertension, which suggested that there was no difference between the two ethnicities in the distribution of health resources.

Prevalence and Clustering of Major Cardiovascular Risk Factors in China: A Recent Cross-Sectional Survey.

Cardiovascular disease is the leading cause of death in the Chinese population. Although general prevalence estimates of cardiovascular risk factors (CVRFs) are available for Chinese adults, prevalence estimates covering all adult age groups by race/ethnicity have not been reported. The aim of this study is to estimate the current prevalence and clustering of major CVRFs in Chinese adults, including a plurality of ethnic minorities.A cross-sectional survey was conducted in a nationally representative sample of 23,010 adults aged 18 years and older from 2007 to 2011. Questionnaires and physical examinations were performed, and fasting blood was collected for laboratory measurements. The prevalence of traditional CVRFs, including hypertension, diabetes, dyslipidemia, overweight, and current smoking, were determined.The prevalence of the major CVRFs, including hypertension, diabetes, dyslipidemia, overweight, and current smoking were 24.3%, 4.3%, 49.3%, 32.0%, and 21.7%, respectively. These risk factors were significantly associated with sex, age, region, ethnicity, and education levels. Overall, 70.3%, 40.3%, and 16.7% of Chinese adults had ≥1, ≥2, or ≥3 CVRFs, respectively. Men, northern and rural residents were more likely to have clustered CVRFs compared with women, southern and urban residents, respectively. Compared with Han residents, Hui and Mongolian residents were more likely, and Tujia and Miao residents were less likely, to have ≥1, ≥2, or ≥3 risk factors. The prevalence of Chinese women having ≥1, ≥2, or ≥3 CVRFs decreased with increasing levels of education.The prevalence and clustering of CVRFs is still high in Chinese adults ≥18 years old, especially in men and in individuals living in the northern and rural areas. Of note, there are differences in cardiovascular risk among different ethnic groups. Therefore, targeted and enhanced intervention measures are required to reduce the risk of cardiovascular disease and the corresponding economic burden of disease in China.

Disparities in Hypertension Prevalence, Awareness, Treatment and Control between Bouyei and Han: Results from a Bi-Ethnic Health Survey in Developing Regions from South China.

Hypertension is highly prevalent in low-income population. This study aims to investigate ethnic disparities in hypertension and identify modifiable factors related to its occurrence and control in developing regions in South China. Blood pressure was measured in the Bouyei and Han populations during a community-based health survey in Guizhou, 2012. A multistage stratified sampling method was adopted to recruit Bouyei and Han aged from 20 to 80 years. Taking mixed effects into consideration, multilevel logistic models with random intercept were used for data analysis. The prevalence rates of hypertension were 35.3% for the Bouyei and 33.7% for the Han. Among the hypertensive participants, 30.1% of the Bouyei and 40.2% of the Han were aware of their hypertensive conditions, 19.7% of the Bouyei and 31.1% of the Han were receiving treatment, and only 3.6% of the Bouyei and 9.9% of the Han had their blood pressure under control. Age-sex standardized rates of awareness, treatment, and control were consistently lower in the Bouyei than the Han. Such ethnic disparities were more evident in the elderly population. Avoidance of excessive alcohol consumption and better education were favorable lifestyle for reduction in risk of hypertension. Moderate physical activity improved control of hypertension in Bouyei patients under treatment. Conclusively, hypertension awareness, treatment, and control were substantially lower in Bouyei than Han, particularly in the elderly population. Such ethnic disparities indicate that elderly Bouyei population should be targeted for tailored interventions in the future.

Prevalence of Obesity and Related Factors among Bouyei and Han Peoples in Guizhou Province, Southwest China.

OBJECTIVE: To investigate the prevalence of general and abdominal obesity and associated factors in Bouyei and Han peoples. DESIGN: A cross-sectional study was carried out in Guizhou province, southwest China in 2012, with multi-stage sampling to enroll 4551 participants aged 20 to 80 years. General and abdominal obesity were defined by World Health Organization (WHO) for Chinese. A design-based analysis was performed to evaluate prevalence of obesity and its related factors. RESULTS: Bouyei people had a significantly lower prevalence of general obesity (4.8% vs. 10.9%, p < 0.05) and abdominal obesity (13.6% vs. 26.8%, p < 0.05) than that in Han people. Prevalence of obesity increased with age until middle-age period and declined thereafter. Men aged 40-49 years group and women aged 50-59 years group have the highest prevalence of general obesity. Prevalence of abdominal obesity was higher than that of general obesity. Middle-age, Higher income, Han people were significantly associated with an increased risk of General/abdominal obesity. CONCLUSIONS: Bouyei people had a lower prevalence of general and abdominal obesity than the Han people. Etiological studies should be conducted to determine underlying genetic factors and dietary factors.

Gender-specific prevalence and associated risk factors of high normal blood pressure and hypertension among multi-ethnic Chinese adolescents aged 8-18 years old.

AIM: To date, accurate reports about the prevalence of high normal blood pressure (BP) and hypertension among Chinese adolescents have been rare. We examine the sex-specific and age-specific prevalence of high normal BP and hypertension, and the associated risk factors among multi-ethnic Chinese adolescents from a large and representative sample. METHODS: 29,997 adolescents aged 8-18 years old received blood pressure measurement on one clinical visit. RESULTS: The overall prevalence was 4.15% for hypertension (4.73% for boys and 3.62% for girls) and 29.85% for high normal BP (33.40% for boys and 26.65% for girls). The odds ratios (ORs) increased with age, but the absolute changes of ORs were significantly different between boys and girls. Compared with that of the Han counterparts, the risk of high normal BP was 1.960-fold, 1.283-fold and 1.618-fold for Yi boys, Mongolian boys and Yi girls, respectively, whereas the OR was 0.440 for Tibetan boys, 0.492 for Tibetan girls and 0.794 for Korean girls. Compared with those of normal weight, overweight and obese adolescents had significantly increased risk of high normal BP (OR = 3.377 for obese boys and OR = 2.009 for overweight boys; OR = 2.865 for obese girls and OR = 1.738 for overweight girls). Rural adolescents had a higher risk of hypertension than those living in urban areas. CONCLUSION: The prevalence of high normal BP and hypertension was high in Chinese adolescents. Age, ethnicity, obesity, overweight, abnormal waist circumference, family history of cardiovascular diseases and dwelling at rural districts were significantly associated with pediatric high normal BP or hypertension.