Reliability and Validity of Common Subjective Instruments in Assessing Physical Activity and Sedentary Behaviour in Chinese College Students.

The reliability and validity of common physical activity (PA) questionnaires are not well investigated in college students. This study aims to evaluate the reliability and validity of common subjective instruments in measuring PA and sedentary behaviour (SB) among college students. A total of 142 college students were included through convenience sampling. Each participant was asked to wear Actigraph wGT3X-BT accelerometers and fill physical activity logs (PAL) for 7 consecutive days. The Global Physical Activity Questionnaire (GPAQ), the International Physical Activity Questionnaire long-form (IPAQ-LF), and short-form (IPAQ-SF) were interviewed by face-to-face at both day 0 and day 8. Reliability was evaluated by intraclass correlation coefficient (ICC), while the validity was evaluated by Spearman correlation coefficient and Bland-Altman statistics. The instruments showed moderate reliability in reporting total PA (ICC = 0.50-0.62) and SB (ICC = 0.47-0.52), while moderate validity in reporting moderate and vigorous PA (MVPA) (r = 0.37-0.42), but fair to poor validity in reporting SB (r = 0.09-0.28). Bland-Altman plots showed that all the instruments would underestimate MVPA and overestimate SB. Thus, in Chinese younger adults, the GPAQ, IPAQ-LF, IPAQ-SF, and PAL provide limited but acceptable reliability and validity in measuring MVPA and SB, among which GPAQ might be the most valid instrument.

Association Between Change in Leisure-Time Physical Activity During the Postretirement Period and Incident Stroke.

OBJECTIVE: To investigate the association of change in leisure-time physical activity (LTPA) occurring during the post-retirement period with incident stroke. METHODS: The present study enrolled 12 644 retired workers from the Dongfeng-Tongji cohort (DFTJ) during April to October 2013. The change in LTPA was categorized as follows according to whether their LTPA time meeting the World Health Organization (WHO) recommended minimum (at least 150 minutes per week): (i) stayed inactive at both surveys; (ii) stayed inactive at 2008 survey but became active at 2013 survey; (iii) stayed active at 2008 survey but became inactive at 2013 survey; (iv) stayed active at both surveys. We used multivariable-adjusted Cox proportional hazards regression models to examine the association between change in LTPA and the risk of incident stroke. RESULTS: During 68 476 person-years of follow-up, we documented 549 incident stroke cases, including 434 incident ischemic stroke (IS) cases and 115 incident hemorrhagic stroke (HS) cases. Compared with participants who stayed active at both 2008 and 2013 surveys, those stayed active at 2008 survey but became inactive at 2013 survey had significant higher risks of incident total stroke (hazard ratio [HR] = 1.30; 95% confidence interval [95% CI]: 1.03, 1.65) and HS (HR = 2.34; 95% CI: 1.51, 3.63). When stratified by body mass index (BMI) categories, a significant elevated risk of total stroke was seen among over-weight participants who stayed active at 2008 survey but became inactive at 2013 survey (HR = 1.65; 95% CI: 1.20, 2.27). The risk of incident stroke decreased with increasing LTPA levels between two surveys (HR of per 150 minutes/week increase of LTPA: HR=0.97; 95% CI: 0.94, 1.00). In addition, we found that compared with participants who maintained their BMI and stayed active at both 2008 and 2013 surveys, those both inactive or became inactive had higher risks of stroke (HR = 2.13, 95% CI: 1.09, 4.15; HR = 1.50, 95% CI: 1.07, 2.08; respectively). CONCLUSION: Among Chinese older adults, increasing LTPA levels during the post-retirement period was associated with a lower risk of incident stroke. Retired individuals should be encouraged to participate in LTPA more frequently to lessen future risk of incident stroke.

Predictive value of gamma-glutamyl transpeptidase to lymphocyte count ratio in hepatocellular carcinoma patients with microvascular invasion.

BACKGROUND: Microvascular invasion (MVI) is an independent risk factor for poor prognosis in hepatocellular carcinoma (HCC). However, there is still a lack of preoperative markers to predict MVI in HCC. This study intends to explore the potential application value of the gamma-glutamyl transpeptidase (GGT) to lymphocyte count ratio (GLR) in predicting MVI in HCC and provide guidance for clinical diagnosis and treatment. METHODS: From March 2010 to December 2015, 230 HCC patients who underwent surgical treatment in the Affiliated Hospital of Guilin Medical University were selected. Clinicopathological parameters between the MVI group (n = 115) and the non-MVI group (n = 115) were comparatively analyzed. The GLR was used as the potential risk factor for HCC with MVI, and its optimal cut-off value was estimated by using the receiver operating characteristic (ROC) curve. The Kaplan-Meier method was used to analyze the survival of HCC patients, and univariate and multivariate Cox regression analyses were used to establish independent predictors affecting postoperative HCC patients. RESULTS: The GLR levels in the MVI group and non-MVI group were 84.83 ± 61.84 and 38.42 ± 33.52 (p <  0.001), respectively. According to ROC curve analysis, the optimal cut-off value of GLR was 56.0, and the area under the ROC curve (AUC) was 0.781 (95% CI, 0.719-0.833) for the risk prediction of MVI in HCC patients. Multivariate analysis showed that tumor size > 5 cm, HCC combined with MVI and GLR >  56.0 were independent risk factors for poor prognosis in HCC patients. In addition, compared with the non-MVI group, patients in the MVI group had shorter progression-free survival (PFS) and overall survival (OS). CONCLUSION: GLR could be a predictive biomarker of HCC after operation and a potential predictor of HCC combined with MVI.