Associations between anthropometric parameters (body mass index, waist circumference and waist to hip ratio) and newly diagnosed hyperuricemia in adults in Qingdao, China: A cross-sectional study.

BACKGROUND AND OBJECTIVES: To evaluate the association between anthropometric parameter of obesity and newly diagnosed hyperuricemia (HUA) in a general Chinese population. METHODS AND STUDY DESIGN: A population- based cross-sectional survey included 9 615 participants (3777 men and 5838 women) aged 35-74 years in 2006 and 2009 in Qingdao, China. The multivariate linear regression was used to assess the linear associations between anthropometric parameter of obesity [body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)] and serum uric acid. The logistic regression model was performed to estimate the associations between BMI, WC, WHR and newly diagnosed HUA. RESULTS: The prevalence of newly diagnosed HUA was higher in men than in women (19.46% vs 11.34%, p<0.05). Multivariate liner regression showed that BMI, WC and WHR were positively correlated with serum uric acid. Multivariate logistic regression revealed that being overweight [men, odds ratios (OR): 1.69, 95% confidence intervals (95% CI): 1.37-2.08; women, OR: 1.67, 95% CI: 1.34-2.09] and obese (men, OR: 3.01, 95% CI: 2.38-3.79; women, OR: 2.91, 95% CI: 2.31-3.67) were significantly associated with a higher risk of newly diagnosed HUA. Abdominal obesity (WC: men, OR: 2.26, 95% CI: 1.88-2.73; women, OR: 1.96, 95% CI: 1.61-2.39; WHR: men, OR: 1.91, 95% CI: 1.61-2.26; women, OR: 1.39, 95% CI: 1.16-1.67) were associated with an increased risk of newly diagnosed HUA. CONCLUSIONS: This study demonstrated that BMI, WC and WHR were positively correlated with serum uric acid in both genders. Meanwhile, overweight, obese and abdominal obesity were associated with increased risk of newly diagnosed HUA.

Evaluation of scrub typhus diagnosis in China: analysis of nationwide surveillance data from 2006 to 2016.

BACKGROUND: Scrub typhus is a life-threatening disease caused by Orientia tsutsugamushi, and specific antimicrobial medicine is available. Early and accurate diagnosis is essential for reducing the risk of severe complications and death. In this study, we aimed to evaluate the case diagnosis situation among medical care institutions and geographical regions in China, and the results will benefit both clinical practice and the disease surveillance system. METHODS: We extracted individual scrub typhus case data 2006-2016 from a national disease surveillance system in China. The diagnosis category and interval time from illness onset to diagnosis were compared among three levels of medical care institutions and provinces. The descriptive analysis method was performed in our study. RESULTS: During the 11-year study period, 93 481 scrub typhus cases, including 57 deaths, were recorded in the nationwide surveillance system. The overall proportion of laboratory-confirmed cases was only 4.7%, and this proportion varied greatly among primary medical centres (2.8%), county level hospitals (4.2%), and city level hospitals (6.3%). Notably, the proportion of laboratory-confirmed cases has consistently decreased from 16.3% in 2006 to 2.6% in 2016, and the same decreasing trend was found among all three levels of medical care institutions. The interval from illness onset to case diagnosis (Tdiag) for all cases was 5 days (interquartile range [IQR]: 2-9 days) and decreased from 7 days (IQR: 3-11 days) in 2006 to 5 days (IQR: 2-8 days) in 2016. The risk of death for patients with a Tdiag of > 7 days was 2.2 times higher (OR = 2.21, 95% CI: 1.05-5.21) than that of patients with a Tdiag of < 2 days. CONCLUSIONS: The interval time from illness onset to diagnosis for scrub typhus cases decreased greatly in China; however, the diagnosis rate of cases with laboratory-confirmed results must be increased among all levels of medical care institutions to reduce both the risk of death and the misuse of antibiotics associated with scrub typhus.

The Ability of Baseline Triglycerides and Total Cholesterol Concentrations to Predict Incidence of Type 2 Diabetes Mellitus in Chinese Men and Women: A Longitudinal Study in Qingdao, China.

OBJECTIVE: The purpose of this study was to assess the association between triglycerides (TG), total cholesterol (TC) at baseline, and type 2 diabetes mellitus (T2DM) incidence in a general Chinese population. Further, it aimed to evaluate the ability of TG and TC to predict T2DM incidence. METHODS: Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012-2015. TG, TC, and T2DM status were measured. Cox proportional hazards models were used to estimate the association between TG, TC, and T2DM incidence. The receiver operating characteristic (ROC) curve was used to evaluate the ability of TG and TC to identify T2DM participants. RESULTS: The incidence of T2DM significantly increased with TG in women and TC in both men and women (Ptrend < 0.05). Univariate Cox regression indicated that higher TG {borderline high TG [hazards ratio (HR): 2.05; 95% confidence interval (CI): 1.40, 3.00] and hypertriglyceridemia [HR: 2.64; 95% CI: 1.68, 4.15]} and TC [hypercholesterolemia (HR: 2.05; 95% CI: 1.43, 2.95)] were significantly associated with increased risk of T2DM incidence in women but not in men. Multivariate Cox regression showed that hypertriglyceridemia in women (HR: 1.78, 95% CI: 1.07, 2.97), borderline high TC in men (HR: 1.61, 95% CI: 1.04, 2.48), and hypercholesterolemia in women (HR: 1.68, 95% CI: 1.81, 2.61) had a higher significant risk of T2DM incidence. The optimal cutoff values of TG were > 1.15 and > 1.23 mmol/L in men and women, respectively. For TC, they were > 5.17 and > 5.77 mmol/L in men and women, respectively. The area under the ROCs of TG and TC were 0.54 (0.51-0.57) and 0.55 (0.52-0.58), respectively, in men, and 0.60 (0.58-0.62) and 0.59 (0.56-0.61), respectively, in women. CONCLUSION: Elevated TG and TC were risk factors for T2DM incidence. However, no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women. Hence, TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.