Associations of vitamin D with novel and traditional anthropometric indices according to age and sex: a cross-sectional study in central southern China.

PURPOSE: Vitamin D insufficiency and obesity are recognized as worldwide concerns and have been linked with each other. New anthropometric indices reflect visceral obesity better than traditional anthropometric indices. Our aim was to identify the specific correlations of novel and traditional anthropometric indices with 25-hydroxyvitamin D (25(OH)D) concentrations by sex and age. METHODS: Cross-sectional data on sociodemographic characteristics, lifestyle factors, clinical characteristics and biochemical measurements were collected for 12,617 Chinese adults. Four traditional anthropometric indices, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and two novel anthropometric indices, body roundness index (BRI) and body shape index (ABSI), were calculated. RESULTS: In both sexes, the mean values of BMI, WC, WHtR and BRI tended to increase with 25(OH)D insufficiency, regardless of adjustment (all P < 0.05). Males with insufficient 25(OH)D had increased odds of obesity (assessed by BMI, WC, WHtR, BRI and ABSI) compared to the odds of males with sufficient 25(OH)D. Females with insufficient 25(OH)D had a higher chance of general obesity (assessed by BMI). Low 25(OH)D status was associated with indicators of obesity only in participants aged 45-64 years in both sexes. CONCLUSION: A inverse association between obesity and lower vitamin D levels was found. Moreover, in addition to BMI, novel indicators of visceral adiposity, such as BRI and ABSI, were associated with lower 25(OH)D serum concentrations in males. The effects of optimizing vitamin D levels in obese Chinese adults need further examination, particularly in middle-aged males. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Ideal cardiovascular health and the subclinical impairments of cardiovascular diseases: a cross-sectional study in central south China.

BACKGROUND: Ideal cardiovascular health (CVH) is related to a low cardiovascular disease risk profile. This study aimed to investigate CVH metrics with both the biomarkers and markers of subclinical impairments of cardiovascular diseases (CVDs) in subjects from central south China. METHODS: The ideal CVH score (non-smoking status; ideal body mass index; regular physical activity; healthy diet; and an optimal serum cholesterol, blood pressure, and glucose profile; 1 point for each; total score: 0-7) was collected from 3009 participants without a history of CVDs. Subclinical biomarkers were assessed using C-reactive protein, homocysteine, and microalbuminuria. The presence of subclinical disease markers was defined as having at least one of the following: increased carotid intima-media thickness, carotid plaque, left ventricular hypertrophy, left ventricular systolic dysfunction, or a reduced ankle-brachial index. The association of biomarkers and markers with the CVH score was evaluated using multivariate logistic regression and linear regression analyses. RESULTS: Only 0.2% of the study participants met all 7 ideal CVH metrics (CVH score = 7). Compared to the female participants, the male participants had poorer CVH profiles and a higher incidence of subclinical lesions (P < 0.05). In the fully adjusted models, per 1-unit increase in the CVH score was inversely associated with the biomarker levels (ß = -0.092 - -0.224, P < 0.05 for all) and the odds of the presence of markers (odds ratio, 0.808; 95% confidence interval, 0.755-0.865). Similar relationships were observed in the gender subgroups and were stronger in the females. CONCLUSION: A clear inverse association was observed between the biomarkers or markers of subclinical impairments and the CVH score in a central south Chinese population, implying the importance of ideal CVH for the primordial prevention of CVDs.

Correlations between brachial endothelial function and cardiovascular risk factors: a survey of 2,511 Chinese subjects.

OBJECTIVE: We examined the relationship of several cardiovascular risk factors (CVRF) to brachial artery flow-mediated dilatation (FMD) in Chinese subjects. METHODS: This was a cross-sectional study. In 2,511 Chinese adults (age 46.86±9.52 years, 1,891 men and 620 women) recruited from people who underwent health screening at The Third Xiangya Hospital, patients' CVRF [age, body mass index (BMI), waist circumference (WC), blood pressure (BP), cholesterol parameters, creatinine (Cr), uric acid (UA), glucose level and smoking] and prevalence of present disease (hypertension, diabetes mellitus, coronary heart disease and hyperlipidemia) were investigated. RESULTS: Multivariate analysis revealed that FMD negative correlated with age (ß=-0.29, P<0.001), gender (ß=-0.12, P<0.001), BMI (ß=-0.12, P=0.001), WC (ß=-0.10, P=0.011), systolic BP (SBP) (ß=-0.12, P<0.001), fasting glucose (ß=-0.04, P=0.009), total cholesterol (TC) (ß=-0.04, P=0.014), smoking (ß=-0.05, P=0.003), and baseline brachial artery diameter (ß=-0.35, P<0.001). FMD decreased with increasing age in both genders. In women, FMD was higher than men and age-related decline in FMD was steepest after age 40; FMD was similar in men above 55 years old. CONCLUSIONS: In Chinese subjects, FMD may be a usefully marker of CVRF. Age, gender, BMI, WC, SBP, fasting glucose, TC, smoking, and baseline brachial artery diameter were independent variables related to the impairment of FMD. The influence of CVRF on endothelial function is more in women than men.

Variable food-specific IgG antibody levels in healthy and symptomatic Chinese adults.

BACKGROUND: The presence of food-specific IgG antibodies in human serum may be useful for diagnosis of adverse food reactions. However, the clinical utility of testing for such antibodies remains very controversial. The aim of this study was to evaluate the serum levels and population distribution of food-specific IgGs and their association with chronic symptoms in a large-scale Chinese population. METHODOLOGY/PRINCIPAL FINDINGS: A total of 21305 adult participants from different regions of China had 14 type of food-specific serum IgG antibodies that were measured by enzyme-linked immunosorbent assay. Among these, 5,394 participants were randomly chosen to complete follow-up questionnaire surveys on their dietary characteristics and chronic symptoms. The concentrations of food-specific IgGs against 14 foods ranged from a median (interquartile range) of 7.3 (3.8, 12.6) U/mL of pork-specific IgG to 42.3 (28.8, 60.2) U/mL of crab-specific IgG. The concentration of food-specific IgGs was closely related to gender; after adjustment for region and age, women had higher concentrations of food-specific IgGs against all of the 14 foods except chicken (regression coefficient (95% CI): 0.01 (-0.003, 0.023); P = 0.129) and corn (0.002 (-0.013, 0.016); P = 0.825). Similar results were also found in the relationship of geographic region to the food-specific IgG concentrations for the 14 foods. Chronic symptoms were negatively associated with the concentrations of a few food-specific IgGs, and were positively associated with the concentrations of other food-specific IgGs. CONCLUSIONS: The levels of food-specific IgGs were variable both in healthy and in symptomatic Chinese adults. These findings raise awareness that demographic factors, the type of food and specific chronic symptoms should be considered before food elimination treatment based on IgG testing in patients with chronic symptoms is used in clinical practice.

Cardiovascular health status in Chinese adults in urban areas: analysis of the Chinese Health Examination Database 2010.

BACKGROUND: The American Heart Association (AHA) recently developed definitions of cardiovascular health for adults and children based on 7 cardiovascular disease risk factors or health behaviors. We applied this new construct to examine the cardiovascular health status in adult Chinese urban residents. METHODS: Data of 1,012,418 subjects aged 20-65 years (55% were men; mean age, 42.4 years) who received health examination at 58 health examination centers across China was analyzed. The AHA ideal health behaviors index and ideal health factor index were evaluated among the subjects. RESULTS: Only 0.6% of male and 2.6% of female subjects met all 7 health components, and only 39.1% of the subjects met 5 or more components of ideal cardiovascular health. The prevalence of "ideal", "intermediate" and "poor" cardiovascular health was 1.5%, 33.9% and 64.6%, respectively. CONCLUSION: About two-thirds of the adult Chinese urban population has "poor" cardiovascular health. Comprehensive individual and population-based interventions must be developed to improve cardiovascular health status in China.

[Effects of Xiaopi Yishen herbal extract granules in treatment of fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency: a prospective, randomized, placebo-controlled and double-blind clinical trial].

BACKGROUND: The demand for effective intervention for subhealth conditions is growing with increasing numbers of people being in a state of subhealth with a poor quality of life. Future research and evaluation of the treatment methods for subhealth conditions from the perspective of traditional Chinese medicine (TCM) may provide an important direction for developing effective management of these conditions. OBJECTIVE: To evaluate the efficacy and safety of Xiaopi Yishen herbal extract granules (XPYS-HEG), a compound traditional Chinese herbal medicine for relieving fatigue and promoting a cheerful spirit for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency. DESIGN, SETTING PARTICIPANTS AND INTERVENTIONS: A multi-center, randomized, double-blinded, placebo-controlled clinical study was undertaken. The study period was 18 weeks, including 6 weeks for intervention and 12 weeks for follow-up. Participants were recruited from medical center and outpatient clinics of three hospitals in China, i.e. Xiaotangshan Hospital of Beijing, the First Affiliated Hospital of Henan University of TCM and the Affiliated Hospital of Liaoning University of TCM. Two hundred participants who met the criteria of fatigue-predominant subhealth and liver-qi stagnation and spleen-qi deficiency in TCM were allocated randomly to the treatment group (XPYS, n=100) and control group (placebo, n=100). MAIN OUTCOME MEASURES: The total score of Fatigue Scale-14 (FS-14) was used to evaluate the fatigue status of subjects and the extent of liver-qi stagnation and spleen-qi deficiency syndrome was also recorded. RESULTS: Three cases in the XPYS group withdrew from the trial. There were 200 subjects who entered to full analysis set (FAS) analysis and 197 subjects fitted in the per-protocol set (PPS) analysis. (1) According to the score changes of FS-14, the effectiveness rates in the XPYS and placebo group were as follows: 14.0% vs 9.0% (FAS) and 14.4% vs 9.0% (PPS) for complete remission, 19.0% vs 15.0% (FAS) and 19.6% vs 15.0% (PPS) for obvious effects, 39.0% vs 26.0% (FAS) and 39.2% vs 26.0% (PPS) for effective, and 72.0% vs 50.0% (FAS) and 73.2% vs 50.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to the placebo statistically (P<0.05). (2) According to the score changes of TCM syndrome, the effectiveness rates in the XPYS group and placebo group were as follows: 1.0% vs 0.0% (FAS) and 1.0% vs 0.0% (PPS) for complete remission, 20.0% vs 7.0% (FAS) and 19.6% vs 7.0% (PPS) for obvious effects, 29.0% vs 24.0% (FAS) and 29.9% vs 24.0% (PPS) for effective, and 50.0% vs 31.0% (FAS) and 50.5% vs 31.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (3) The follow-up results at 12 weeks and 18 weeks showed that the efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (4) No adverse effects were found in the XPYS group. CONCLUSION: It can be concluded that XPYS-HEG is effective and safe for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency.

Cross-sectional and longitudinal association of cigarette smoking with carotid atherosclerosis in Chinese adults.

OBJECTIVE: To assess the cross-sectional and longitudinal association of cigarette smoking with carotid atherosclerosis in middle-aged and older Chinese adults. METHODS: The study population consisted of 1132 residents in Beijing (748 women and 384 men) aged 35 to 64 years. Information on baseline smoking characteristics, including smoking status and pack-years was collected in 1993-1994. The cohort was resurveyed in 2002 and common carotid artery intima-media thickness (CCA-IMT) and carotid plaques were measured by B-mode ultrasound. RESULTS: The multivariable-adjusted mean CCA-IMT at resurvey was significantly associated with smoking status at both resurvey and baseline, and was 0.72 mm for consistent current smokers, 0.71 mm for former and inconsistent smokers, and 0.70 mm for consistent never smokers at both surveys, respectively (p-trend<0.01). The multivariable-adjusted odds ratio [OR, 95% confidence interval (CI)] of having carotid plaques was 1.5 (1.0-2.1) for consistent current smokers vs consistent never smokers. In addition, there was a significant dose-response relationship between baseline smoking pack-years and multivariable-adjusted mean CCA-IMT and risk of having carotid plaques at resurvey. CONCLUSION: Smoking is associated with carotid atherosclerosis in middle-aged and older Chinese adults both cross-sectionally and longitudinally. Smoking cessation may play a significant role in prevention and control of cardiovascular diseases in China.

[Hypertension and subclinical carotid atherosclerosis in a general population of a rural areas in China].

OBJECTIVE: To explore the association of hypertension and carotid atherosclerosis in a general population in China. METHODS: A population-based epidemiological survey on cardiovascular diseases was performed in autumn, 2002. A total of 1198 rural residents with 426 men and 776 women aged 43 - 73 years, underwent carotid duplex examination. Hypertension was classified into 6 groups of optimal, normal, high-normal, stage 1, 2 and 3. RESULTS: (1) A significant positive dose-response relation was found between hypertension categories, duration of hypertension and intima-media thickness (IMT) in both genders (trend test P < 0.01). After adjustment of age, body mass index, total cholesterol, high density lipoprotein cholesterol, glucose and smoking, the relation did not change. The associations between duration of hypertension and IMT disappeared after further adjustment with blood pressure. (2) The occurrence of plaque was positively associated with blood pressure groups and duration of hypertension, as well as in the age-adjusted models. The associations between duration of hypertension and plaque weakened or disappeared after further adjustment with systolic blood pressure, diastolic blood pressure or hypertension categories. CONCLUSION: Hypertension was associated with subclinical carotid atherosclerosis. Prolonged course of disease might aggravate the carotid atherosclerosis.

[Features of heart rate, blood pressure, heart rate variability and cerebral blood flow during sequential head-up tilt test].

OBJECTIVE: To investigate the features of BP, HR, cerebral blood flow (CBF) and heart rate variation (HRV) during sequential head-up tilt table test (HUT) and provide information for methodology of testing tendency to syncope in pilots. METHOD: Sixteen healthy male were exposed to HUT +45 degrees 20 min, +60 degrees 20 min, and +75 degrees 20 min respectively with 5 min rests in between. CBFV, HR, HRV, BP were measured with transcranial doppler image (TCI), 12-Lead in phase ECG. RESULT: 1) As the tilt angle became larger, HR and DBP increased gradually (P<0.05), with SBP, PP and CBF Velocity (Vs,Vm,Vd) descended. There were significant differences among the various conditions. CV became smaller before +75 degrees, and then it began to increase. 2) Correlation between physiological indices and techno-indices were analyzed. At the point of 1 min, tilt angle was significantly positively correlated with SBP, DBP, MAP, Vd, and sdRR (P<0.01); At the point of 20 min, tilt angle was significantly positively correlated with HR and sdRR (P<0.01), but negatively correlated with SBP, PP, Vs and mRR (P<0.01), time of exposure was positively correlated with HP (P< 0.01), but negatively correlated with Vm, Vd, and mRR (P<0.01). 3) Correlation among physiological indices were also analyzed. HR were negatively correlated with SBP, Vs, Vm and Vd (P<0.01), SBP were significantly positively correlated with Vd, and mRR (P<0.01). Vs, Vm, Vd were significantly positively correlated with mRR and sdRR (P< 0.01). CONCLUSION: By investigating HR, BP, HRV and CBFV during of different angles, some advises for evaluating the tendency to syncope in pilots were put forward.