Evaluation of anthropometric indices for metabolic syndrome in Chinese adults aged 40 years and over.

BACKGROUND: The prevalence of metabolic syndrome (MetS) is increasing worldwide with a marked impact in cardiovascular disease (CVD) and diabetes risk. AIM OF THE STUDY: To evaluate the anthropometric indices for metabolic syndrome (MetS) and determine the optimal cut-off values of waist circumference (WC), body mass index (BMI), and waist height ratio (WHtR) for MetS in Chinese adults aged 40 years and over. METHODS: A sample of Chinese adults aged 40 years and over including 430 men and 638 women was investigated. Blood pressure, weight, height, and WC were measured; HDL-cholesterol (HDL-C), Triglyceride (TG), and plasma glucose were examined. Receiver operating characteristics (ROC) curve analyses were used to evaluate the optimal cut-off point of WC, BMI, and WHtR for MetS. RESULTS: According to the ROC curve analysis, the optimal cut-off point for WC was found to be 84.0 cm in men and 80.0 cm in women; for BMI, it was 26.0 in men and 25.0 in women; and for WHtR, it was 0.5 in both men and women. WHtR has the highest predictive value for fast plasma glucose in women, while BMI has the better prediction of dyslipidemia in men. CONCLUSIONS: Anthropometric indices (WC, BMI, and WHtR) are useful screening tools for obesity, MetS, and CVD risk factors. BMI may be a better indicator than the others for screening obesity, dyslipidemia, and other risk components in Chinese men aged 40 years and over, while WHtR may be better for Chinese women, especially among those aged 70 years and over.

Prevalence estimates for primary brain tumors in China: a multi-center cross-sectional study.

BACKGROUND: Although the first leading cause of death in China was malignant neoplasms (mortality, 374.1 per 100,000 person-years), the full impact of primary brain tumors (PBT) on the healthcare system is not completely described because there are a few well documented reports about the epidemiologic features of brain tumors. This study aimed to report a comprehensive assessment on the prevalence of PBT. METHODS: A multicenter cross-sectional study on brain tumor (MCSBT) in China was initiated in five regional centers: Daqing (northeast), Puyang (north of China), Shiyan (center of China), Ma'anshan (center of China) and Shanghai (southeast). Prevalence rate was calculated by counting the number of people living with a PBT between October 1, 2005 and September 30, 2006 and dividing by the total population of the five communities at January 1, 2006. Estimates of prevalence were expressed as percentages and grouped according to gender and to age in fifteen-year categories. Within these strata, the rates were estimated with 95% confidence intervals (CI) using the accurate calculation of CI for Poisson distribution. A chi-square test was used to compare the various frequencies with α < 0.05. Age-standardized prevalence with the direct method was calculated with the ten-year age-specific prevalence and the age distribution of the Chinese population in 2010, obtained from World population prospects: the 2008 revision. RESULTS: We estimated that the overall prevalence of PBT was 24.56 per 100,000 (95%CI, 14.85 to 34.27), and the overall prevalence of PBT in female population (30.57 per 100,000 and its 95%CI ranged from 19.73 to 41.41) was higher than that in male population (18.84 per 100,000 and its 95%CI ranged from 10.33 to 27.35). However, the discrepancy between genders was not statistically significant because the 95%CI overlapped. Of 272 cases of newly diagnosed PBT, the proportion of histological subtypes by age groups, gender was statistically different (χ(2) = 52.6510, P < 0.0001). More than half of all reported tumors (52.57%) were either gliomas or meningiomas. For the youngest (aged from 0 - 19) strata of the population, glioma appeared to occur more than other subtypes, accounting for 55.56% of all of cases. The majority of brain tumors presented in those aged from 20 to 59 years was pituitary adenomas (45.12%) and gliomas (31.10%). Opposed to brain tumors in adults and teenage, gliomas only accounted for 22.22%. Meanwhile, the median ages at diagnosis of the patients with PBT were similar between males and females except for pituitary adenomas (male: 59 years old; female: 45 years old). CONCLUSIONS: Age standardized prevalence of PBT is 22.52 per 100,000 (95%CI, 13.22 to 31.82) for all populations, 17.64 per 100,000 (95%CI, 9.41 to 25.87) for men, and 27.94 per 100,000 (95%CI, 17.58 to 38.30) for women. Age standardization to China's 2010 population yielded an estimated population of 304 954 cases with PBT. Our prevalence estimates provide a conservative basis on which to plan health care services and to develop programmatic strategies for surviving. In the future, it would be helpful to have long-term observed survival rates that would make the assumptions and the resulting imprecision in the current estimates unnecessary.

Obesity and its associations with hypertension and type 2 diabetes among Chinese adults age 40 years and over.

AIM: To investigate the prevalence of obesity in a Chinese community according to the World Health Organization recommended criteria for Asians in 2000 based on body mass index (BMI) and waist circumference (WC), and to examine the associations between obesity and the risk of hypertension and type 2 diabetes among adults age 40 years and over in Shanghai, China. METHODS: A population-based survey was conducted in Youyi Community in Shanghai. Five thousand seventy-one subjects (1917 men and 3154 women) were included in this study. Standard questionnaires were used to collect baseline data of participants. Body weight, height, WC, blood pressure, and glucose in the blood were measured. RESULTS: The prevalence of general obesity was 44.6% (46.4% for men and 43.6% for women) according to BMI and 36.1% (25.5% for men and 42.6% for women) for central obesity according to WC. The prevalence of obesity I was higher in men (41.6%) than in women (36.2%; chi(2) =14.8, P<0.05), although the rate was higher in women than in men for obesity II (7.4% versus 4.8%, chi(2) =13.6, P<0.01) or central obesity (42.6% versus 25.5%, chi(2) =152.1, P<0.01). Odds ratios of hypertension and type 2 diabetes were significantly higher in the obesity group compared with either the group with BMI 18.5-<23.0kg/m(2) or the group with WC<90cm for men or <80cm for women. CONCLUSIONS: According to the criteria of obesity for Asians, the prevalence of obesity among Chinese adults age 40 years and over in Shanghai is high. Subjects with obesity have a significantly higher risk of hypertension and type 2 diabetes.

Serum C-reactive protein (CRP) and microalbuminuria in relation to fasting and 2-h postload plasma glucose in a Chinese population.

OBJECTIVE: Serum C-reactive protein (CRP) and microalbuminuria are predictors of cardiovascular disease. The association of these factors of cardiovascular risk with fasting and 2-h postload plasma glucose in a group of Chinese subjects was investigated. DESIGN: This was a cross-sectional cohort study. SUBJECTS AND METHODS: In 1776 subjects randomly selected from the permanent residents of a community in the city of Shanghai, China, a simplified 75-g oral glucose tolerance test (fasting and 2-h postload blood sampling only) was performed, and serum CRP concentrations and urinary albumin : creatinine ratio were measured. RESULTS: Serum CRP concentration significantly increased from 1.62 mg/l in normoglycaemic subjects to 2.63 mg/l in subjects with impaired glucose regulation, and to 3.09 mg/l in newly diagnosed diabetic patients (P < 0.0001). The corresponding prevalence of microalbuminuria also increased from 4.3% to 6.6% and to 11.4% (P < 0.0001). Both before and after adjustment for confounders, fasting and 2-h postload plasma glucose levels were significantly associated with serum CRP concentration and the risk of microalbuminuria (P < 0.003). However, the association for CRP tended to be more prominent with 2-h postload plasma glucose than with fasting plasma glucose. Indeed, with adjustments applied, for 1 SD change in fasting and 2-h postload plasma glucose concentration, serum CRP concentration increased by 14% and 18% (between the two regression coefficients, P = 0.01), respectively. With similar adjustments, for 1 SD change in fasting and 2-h postload plasma glucose concentration, the odds of microalbuminuria increased by 28% and 32% (P = 0.28 for the difference between 28% and 32%), respectively. CONCLUSIONS: Our finding suggests that in Chinese plasma glucose, especially 2-h postload, is associated with biological markers of cardiovascular disease, such as serum CRP concentration and microalbuminuria.

Association of WBC count and glucose metabolism among Chinese population aged 40 years and over.

Chronic subclinical inflammation may be involved in the pathogenesis of Type 2 diabetes. We examined whether elevated WBC count, a marker of inflammation, was associated with worsening of glucose tolerance among Chinese population aged 40 years and over. Based on the 75g OGTT, 1016 subjects aged from 40 to 88 years were classified into four groups: NFG/NGT (n=299), isolated IFG (n=213), IGT (n=213) and Type 2 diabetes (n=291). We compared the WBC count among the four groups and investigated relevant variables associated significantly with the WBC count. The IGT and Type 2 diabetes groups had a significantly higher WBC count than the NFG/NGT and isolated IFG groups. By stepwise regression analyses, we found that waist circumference, DBP, total cholesterol, HDL cholesterol and 2-h PG showed an independent association with the WBC count. In the analysis stratified by sex and smoking status, WBC count was independently associated with age and triglycerides in males, whereas it was associated with BMI, SBP, triglycerides and 2-h PG in females. BMI, SBP, triglycerides and 2-h PG showed an independent association with WBC count in subjects who never smoked. We concluded that an increase in WBC count was associated with the deterioration of glucose tolerance. WBC count was associated with lipid metabolism in males and with various components of the metabolic syndrome in females and subjects who never smoked.

[Prevalence and predictors of microalbuminuria in persons with various glucose tolerance levels].

OBJECTIVE: To investigate the prevalence of microalbuminuria in persons with various glucose tolerance levels and the risk factors for the development of microalbuminuria. METHODS: Early morning urine samples were collected from 1,779 subjects with all the data necessary for this survey from a population screened in Baoshan Community, Shanghai by cluster sampling, including 752 with normal glucose tolerance (NGT), 505 impaired glucose tolerance (IGR), and 522 type 2 diabetes mellitus (T2DM) diagnosed according to a 75 g oral glucose tolerance test (OGTT). Urinary albumin-to-creatinine ratio (ACR) was measured by rate-nephelometry method. RESULTS: (1) The incidence rate of MAU of the T2DM group was 11.3%, significantly higher than those of the NGT and IGR groups (4.7% and 6.1% respectively, both P < 0.01). (2) Logistic regression showed that MAU was significantly correlated with 2 h PG, systolic blood pressure, and triglyceride. CONCLUSION: The prevalence of MAU is significantly higher in the diabetic patients. 2 h PG, systolic blood pressure, and triglyceride and independent risk factors of MAU.