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1.
J Diabetes Complications ; 35(3): 107830, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33446411

RESUMO

AIMS: To assess the effectiveness of renin-angiotensin-aldosterone system (RAAS) inhibitors, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) separately to prevent all-cause mortality, myocardial infarction (MI), stroke and heart failure (HF) in patients with diabetes considering the number needed to treat (NNT) and minimal clinical effect (MCE). METHODS: Data from 17 morbidity-mortality trials in patients with diabetes were used to calculate NNTs and evaluate MCE to prevent all-cause mortality, myocardial infarction, stroke, and heart failure. RESULTS: A total of 17 trials involving 42,037 patients were included in this meta-analysis. Mean follow-up was 3.7 years. ACEIs significantly reduced the risk of all-cause mortality, MI and HF; the corresponding mean NNTBs were 48, 62 and 78, respectively, but ARBs were only associated with a reduction in heart failure. The clinical significance assessment of the included trials indicated that most of the statistically significant trial results had no definitive clinical significance, and only some of them had possible clinical significance. CONCLUSIONS: Among patients with diabetes, ACEIs reduced all-cause mortality, MI and HF, whereas ARBs could only prevent HF. However, none of the results of these trials had clear clinical significance, and most had only possible clinical significance.


Assuntos
Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina , Diabetes Mellitus , Insuficiência Cardíaca , Infarto do Miocárdio , Acidente Vascular Cerebral , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Diabetes Mellitus/epidemiologia , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/prevenção & controle , Humanos , Mortalidade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/prevenção & controle , Sistema Renina-Angiotensina/efeitos dos fármacos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/prevenção & controle
2.
J Epidemiol ; 31(3): 180-186, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-32224596

RESUMO

BACKGROUND: The diagnosis of hypertension should be based on the mean of two or more properly measured BP readings on each of two visits for clinical practice, but a one-visit strategy was applied in most epidemiological surveys. The impact of hypertension definition based on two visits on estimates of hypertension burden is unknown. This study aims to assess the impact of hypertension diagnosis based on a two-visit strategy for estimating hypertension burden in China. METHODS: The one-visit and two-visit strategies were applied to investigate the incidence of hypertension in a cohort study based on the China Health and Nutrition Survey (CHNS) 1989-2011. Additionally the prevalence of hypertension was investigated in a cross-sectional study based on the CHNS 2006-2009/2011 and the hypertension burden in China was estimated with data from the 2012-2015 China hypertension survey. RESULTS: Overall, the age-adjusted incidence of hypertension based on the two-visit strategy (1.82%; 95% confidence interval [CI], 1.74-1.90%) was 62.1% lower than estimation based on the one-visit strategy (4.80%; 95% CI, 4.68-4.93%). Similar results were found in the prevalence of hypertension (one-visit: 18.13% [95% CI, 17.34-18.92%]; two-visit: 9.47% [95% CI, 8.87-10.07%]). When the two-visit strategy was applied to the 2012-2015 China hypertension survey, the hypertension burden was predicted to be overestimated by 25.5-47.8% (based on JNC 7) and 23.5-48.2% (based on the 2017 ACC/AHA). CONCLUSION: The hypertension burden would decrease from 244.5 million persons to 127.5-182.3 million persons in China if the two-visit strategy was applied.


Assuntos
Determinação da Pressão Arterial/estatística & dados numéricos , Hipertensão/diagnóstico , Visita a Consultório Médico/estatística & dados numéricos , Adolescente , Adulto , Idoso , Pressão Sanguínea/fisiologia , China/epidemiologia , Estudos de Coortes , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/etnologia , Incidência , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência
3.
Br J Nutr ; 124(7): 715-728, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-32378502

RESUMO

The effects of macronutrient intake on obesity are controversial. This research aims to investigate the associations between macronutrient intake and new-onset overweight/obesity. The relationship between the consumption of carbohydrate and total fat and obesity was assessed by the multivariable Cox model in this 11-year cohort, which included 6612 adults (3291 men and 3321 women) who were free of overweight and obesity at baseline. The dietary intake was recorded using a 24-h recall method for three consecutive days. Moreover, substitution models were developed to distinguish the effects of macronutrient composition alteration from energy intake modification. During 7·5 person years (interquartile range 4·3, 10·8) of follow-up, 1807 participants became overweight or obese. After adjusting for risk factors, the hazard ratio (HR) of overweight/obesity in extreme quintiles of fat was 1·48 (quintile 5 v. quintile 1, 95 % CI 1·16, 1·89; Ptrend = 0·02) in women. Additionally, replacing 5 % of energy from carbohydrate with equivalent energy from fat was associated with an estimated 4·3 % (HR 1·043, 95 % CI 1·007, 1·081) increase in overweight/obesity in women. Moreover, dietary carbohydrate was inversely associated with overweight/obesity (quintile 5 v. quintile 1, HR 0·70, 95 % CI 0·55, 0·89; Ptrend = 0·02) in women. Total fat was related to a higher risk of overweight/obesity, whereas high carbohydrate intake was related to a lower risk of overweight/obesity in women, which was not observed in men.


Assuntos
Dieta/efeitos adversos , Carboidratos da Dieta/análise , Gorduras na Dieta/análise , Obesidade/etiologia , Sobrepeso/etiologia , Adulto , China/epidemiologia , Inquéritos sobre Dietas , Carboidratos da Dieta/efeitos adversos , Gorduras na Dieta/efeitos adversos , Ingestão de Alimentos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Nutrientes/análise , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sexuais
4.
Gene ; 641: 292-296, 2018 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-29111204

RESUMO

OBJECTIVE: The association between mutations in the USP26 gene and male infertility has been studied intensively. However, the biological function of the mutant proteins remains to be elucidated. To confirm the effects of the reported mutations, we analyse the enzyme activity of USP26 between the wild-type and the variants from a molecular perspective. METHODS: Using pGEX-USP26 as a template, site-directed mutagenesis was conducted to generate nineteen USP26 mutant plasmids. Using Ub-Met-ß-gal and GST-Ub52 as model substrates, a USP cleavage assay was conducted to assess the enzymatic activities of the mutants. RESULTS: The enzyme activity of the Q156H mutant disappeared, but the other 18 mutants had the same activity as the wild type. E174# and E189# were terminal mutants, but they still had the same activity as the wild type. When we constructed the transcription terminal mutants E174#(1-522 bp), E174#(523-2742 bp), E189#(1-567 bp) and E189#(568-2742 bp) artificially, the enzyme activity of these four mutants disappeared. CONCLUSIONS: We have successfully constructed nineteen mutants of USP26. The enzyme activity of the Q156H mutant disappeared, but the enzyme activities of the other 18 mutants were the same as that of the wild type.


Assuntos
Cisteína Endopeptidases/genética , Mutação/genética , Escherichia coli/genética , Mutagênese Sítio-Dirigida/métodos , Proteínas Mutantes/genética , Plasmídeos/genética , Proteínas Recombinantes de Fusão/genética , Terminação da Transcrição Genética/fisiologia
5.
J Epidemiol ; 27(6): 282-286, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28427831

RESUMO

BACKGROUND: The prevalence of abdominal obesity is increasing dramatically worldwide. This study aimed to estimate the current prevalence of abdominal obesity from the 2011 China Health and Nutrition Survey (CHNS) and compare the data with other countries. METHODS: Waist circumference (WC) of 12,326 Chinese adults (aged 20 years or older) from the 2011 CHNS were analyzed by age group and region. Abdominal obesity was defined as a WC ≥90 cm for men and WC ≥80 cm for women based on World Health Organization (WHO) recommendations for Asians. RESULTS: In 2011, the age-adjusted mean WC was 85.9 cm (95% confidence interval [CI], 85.6-86.2 cm) for men and 80.7 cm (95% CI, 80.4-80.9 cm) for women. Based on the WHO recommendations, the age-adjusted prevalence of abdominal obesity was 44.0% (95% CI, 43.1%-44.8%) overall, 35.3% (95% CI, 34.1%-36.6%) in men, and 51.7% (95% CI, 50.5%-52.9%) in women. Moreover, the age-adjusted prevalence was 44.0% (95% CI, 42.7%-45.2%) in rural populations, 42.5% (95% CI, 40.7%-44.2%) in urban populations, and 45.2% (95% CI, 43.5%-46.9%) in megacity populations. The prevalence in China (35.3% for men and 51.7% for women) was lower than in Japan (50.8% for men) and the United States (43.5% for men and 64.7% for women). Similar results were observed when applying the criteria suggested by the Working Group on Obesity in China. CONCLUSIONS: In 2011, the age-adjusted prevalence of abdominal obesity in China was 35.3% in men and 51.7% in women.


Assuntos
Obesidade Abdominal/epidemiologia , Adulto , China/epidemiologia , Feminino , Saúde Global/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
6.
Prev Med ; 89: 23-30, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27155441

RESUMO

OBJECTIVES: We seek to investigate the joint effects of age and body mass index (BMI) on the incident hypertension subtypes among Chinese adults during 1989-2011. METHODS: We investigated the Incidence rates (IRs, per 100person-years) of hypertension subtypes, adjusted relative risks (RRs) and population attributable risk percent (PAR%) of BMI for hypertension, and clarified the age-specific effect of BMI on incident hypertension utilizing a dynamic cohort study from the China Health and Nutrition Survey (CHNS) 1989-2011. RESULTS: Normotensive participants (n=53,028) at baseline were included, with mean age was 41.7 (95% CI, 41.6-41.7)years old. During a total of 118,694person years (average was 6.38years) of follow-up, a total of 5208 incident cases of hypertension were documented. The IRs of hypertension were 4.4 (95% CI, 4.3-4.5), which increased gradually by age and BMI (Ptrend<0.001). Compared with those with BMI<22kg/m(2), the RR of hypertension was 3.13 (95% CI, 2.84-3.45) in the group with BMI≥28kg/m(2). The PAR% (BMI>22 vs. BMI<22) for hypertension in Chinese population was 32% (95% CI, 29-34%). Similar trends were observed in all age and BMI groups for both isolated systolic hypertension and systolic-diastolic hypertension, which were mainly affected by age. In contrast, the peak IR of isolated diastolic hypertension was observed in participants aged 30-49years with higher BMIs. CONCLUSIONS: The PAR% (IR of BP≥140/90 or treatment for BMI>22 vs. IR for BMI<22) of elevated body weight for hypertension was 32% in Chinese population.


Assuntos
Envelhecimento , Índice de Massa Corporal , Hipertensão/epidemiologia , Adulto , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Fatores de Risco
7.
J Epidemiol Community Health ; 70(5): 444-51, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26612877

RESUMO

BACKGROUND: This study aims to estimate the current prevalence and trends of hypertension subtypes among Chinese adults from 1991 to 2011. METHODS: We analysed the measurements of systolic and diastolic blood pressure among adults aged ≥18 years from the China Health and Nutrition Survey (CHNS) 1991-2011. The prevalence was age-adjusted to the 2010 census of Chinese adults. RESULTS: The adjusted prevalence in 2011 was 20.9% (95% CI 20.2% to 21.6%) of hypertension, 3.30% (95% CI 2.99% to 3.62%) of isolated systolic hypertension, 4.44% (95% CI 4.08% to 4.80%) of isolated diastolic hypertension, 4.11% (95% CI 3.76% to 4.46%) of systolic-diastolic hypertension and 9.01% (95% CI 8.51% to 9.51%) of current use of antihypertensive medication, respectively. From 1991 to 2011, the prevalence increased from 15.6% to 20.9% for hypertension (p<0.001) and from 3.04% to 3.30% for isolated systolic hypertension (p<0.001). However, the prevalence decreased from 4.77% to 4.44% for isolated diastolic hypertension (p=0.023) and from 5.27% to 4.11% for systolic-diastolic hypertension (p<0.001). Consistent with these findings, the percentage of current use of antihypertensive medication increased from 2.55% to 9.01%, which accounted for approximately 43.1% of the total number of cases in 2011. Importantly, only 36.9% (equivalent to 17.5% of the total number of hypertensive people) of cases of current use of antihypertensive medication were adequately controlled. CONCLUSIONS: Both the prevalence of hypertension and the percentage of current use of antihypertensive medication significantly increased from 1991 to 2011. Currently, about one-fifth of Chinese adults are hypertensive; however, only 17.5% of hypertension is controlled.


Assuntos
Determinação da Pressão Arterial , Hipertensão/classificação , Hipertensão/epidemiologia , Adulto , Povo Asiático , China/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
9.
Am J Prev Med ; 49(5): 661-669, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26275960

RESUMO

INTRODUCTION: The prevalence of obesity in Chinese adults increased from 1991 to 2000; however, recent changes in this trend are unclear. This study aims to estimate the current prevalence of obesity and to assess trends in obesity and BMI distribution in Chinese adults from 1991 through 2011. METHODS: Height and weight measurements of 12,249 Chinese adults from the 2011 China Health and Nutrition Survey were analyzed (in 2013) together with China Health and Nutrition Survey data for 1991-2009. Obesity was defined as BMI≥28.0 kg/m(2) based on the Working Group on Obesity in China criteria. RESULTS: In the 2011 survey, the age-adjusted mean BMI was 23.8 (95% CI=23.7, 23.9) for men and 23.4 (95% CI=23.2, 23.5) for women. The age-adjusted prevalence of obesity was 11.3% (95% CI=10.8%, 11.9%) overall, 11.8% (95% CI=10.8%, 12.6%) among men, and 11.0% (95% CI=10.3%, 11.8%) among women. Estimates of age-adjusted obesity prevalence among the Chinese population were significantly lower than those of the U.S. population (all p<0.05). Over the 20-year period, the prevalence of obesity increased from 2.88% to 11.8% among men (age-adjusted annual change in OR=1.08, 95% CI=1.07, 1.09, p<0.001) and from 4.55% to 11.0% among women (OR=1.05, 95% CI=1.05, 1.06, p<0.001). Similar significant findings were observed for both men and women based on WHO recommendations. CONCLUSIONS: The prevalence of obesity among both Chinese men and women increased significantly from 1991 through 2011, particularly among men.


Assuntos
Obesidade/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Distribuição por Sexo , Circunferência da Cintura , Adulto Jovem
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