Prevalence of anemia of varying severity, geographic variations, and association with metabolic factors among women of reproductive age in China: a nationwide, population-based study.

To investigate the epidemiological characteristics of anemia of varying severity among women of reproductive age, we conducted a nationwide, cross-sectional study between January 1, 2019 and December 31, 2019, including 4 184 547 nonpregnant women aged 18-49 years from all 31 provinces in the mainland of China. Anemia was defined as having hemoglobin concentration < 120.0 g/L and categorized as mild, moderate, and severe. Multivariate logistic models with cluster effect were used to explore the association of anemia and metabolic risk factors. The standardized prevalence of anemia and moderate and worse anemia among women of reproductive age in China was 15.8% (95% CI 15.1%-16.6%) and 6.6% (6.3%-7.0%), respectively. The prevalence of anemia and the proportion of moderate and worse anemia significantly increased with age. We also observed great geographic variations in the prevalence of anemia, with a high likelihood in south, central, and northwest China. Moderate and/or severe anemia was positively associated with overweight and obesity, diabetes, and impaired kidney function. In conclusion, anemia remains a significant challenge for women of reproductive age in China. Geographic variations and metabolic risk factors should be considered in the comprehensive and targeting strategy for anemia reduction.

Insulin Resistance Is Better Estimated by Using Fasting Glucose, Lipid Profile, and Body Fat Percent Than by HOMA-IR in Japanese Patients with Type 2 Diabetes and Impaired Glucose Tolerance: An Exploratory Study.

Aims: The aim of the present study is to estimate insulin resistance (IR) using clinically available parameters except for serum insulin or C-peptide concentration to overcome the limitation of homeostasis model assessment of IR (HOMA-IR), which has been widely used in clinical practice. Patients and Methods: Fifty-two admitted patients with type 2 diabetes or impaired glucose tolerance were enrolled, and steady state plasma glucose (SSPG) method and cookie meal tolerance test were performed together with fasting blood sampling and anthropometric measurements. Insulin sensitivity measured by SSPG was estimated as glucose clearance corrected by the excretion of glucose into urine (C-GC). Results: Log-transformed (C-GC) was negatively correlated with fasting plasma glucose (FPG), log (Fasting triglyceride: TG), log (Fasting TG/Fasting high-density lipoprotein cholesterol: HDLC), and their area under the curves (AUCs). Fasting and AUC-HDLC was positively and fasting free fatty acid (FFA) was negatively correlated with log (C-GC). Body fat (%) was negatively correlated with log (C-GC). Multiple regression analysis on log (C-GC) as an outcome variable revealed that FPG, log (AUC-TG/AUC-HDLC), body fat (%), and fasting FFA were selected as significant predictive variables and contributed to log (C-GC) by 60% (adjusted R2). Replacing log (AUC-TG/AUC-HDLC) with its fasting value, log (Fasting TG/Fasting HDLC), this model still showed a strong contribution to log (C-GC) by 57% (adjusted R2). These contributions were stronger than those in log (HOMA-IR) (52.5%), log (Fasting C-peptide) (45.7%) to log (C-GC). Conclusions: It is plausible that our estimation for IR without the inclusion of plasma insulin concentration can be applied in Japanese patients whose HOMA-IR is not appropriately available. The model using fasting values is less complicated and could be the best way for the estimation of IR.

Tenofovir alafenamide significantly increased serum lipid levels compared with entecavir therapy in chronic hepatitis B virus patients.

BACKGROUND: Tenofovir alafenamide (TAF) has a serum lipid-raising effect in patients with HIV; however, its effect on serum lipids and nonalcoholic fatty liver disease (NAFLD) risk in patients with chronic hepatitis B (CHB) is unclear. AIM: To compare the effects of TAF and entecavir (ETV) on serum lipid levels in patients with CHB. METHODS: In this retrospective cohort study, the data including the clinical features, serum lipids, and metabolic factors of patients with CHB at baseline and approximately 1 year after TAF or ETV treatment were collected and analyzed. We used propensity score-matched models to assess the effects on high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol (TCHO). RESULTS: A total of 336 patients (75.60% male) were included; 63.69% received TAF and 36.31% received ETV. Compared with the ETV group, the TAF group had significantly higher TCHO levels after treatment (4.67 ± 0.90 vs 4.36 ± 1.05, P = 0.006). In a propensity score-matched model for body mass index, age, sex, smoking, drinking, presence of comorbidities such as NAFLD, cirrhosis, diabetes mellitus, and hypertension, TAF-treated patients had significantly increased TCHO levels compared to that at baseline (P = 0.019). There was no difference for the ETV group. Body mass index, sex, hypertension, baseline TCHO, and creatine kinase-MB isoenzyme levels were significantly associated with elevated TCHO levels in logistic regression analysis. However, 1-year TAF treatment did not increase the incidence of NAFLD. CONCLUSION: A greater increase in TCHO was observed in patients with CHB receiving TAF compared to those receiving ETV. However, TAF-induced dyslipidemia did not increase the incidence of NAFLD.

Laboratory blood test profiling reveals distinct biochemical and hemocyte features of KRAS mutated non-small cell lung cancer.

Background: The testing for capability of some routine blood test parameters to reflect the biology of non-small cell lung carcinoma with different driver mutations is of great interest and practice significance. We aim to screen these variables and, if allowed, develop a novel predictive model based on results of these routine blood tests commonly performed in clinical practice to inform which can help doctors assess the patient's genetic mutation status as early as possible before surgery. Methods: For the exploration cohort, we included 1,595 patients who were diagnosed with non-small cell lung cancer (NSCLC) and genetically profiled by a next-generation sequencing panel in the First Affiliated Hospital of Guangzhou Medical University. The external validation cohort, which consists of 197 NSCLC cancer patients from Sun Yat-sen University Cancer Hospital, was subsequently established. Results: We analyzed the association between 46 frequently tested laboratory variables and different genetic mutation types. KRAS mutation was found to be a unique subtype that exclusively correlated with several blood parameters in our study. Least absolute shrinkage and selection operator (LASSO) regression was performed, and the following parameters were found to be significantly associated with KRAS mutation: triglycerides [odds ratio (OR) =1.63], arterial oxygen partial pressure (OR =0.97), uric acid (OR =1.01), basophil count (OR =1.41), eosinophil count (OR =1.146), fibrinogen (OR =1.42), standard bicarbonate (OR =0.85), high-density lipoprotein cholesterol (OR =0.18), alpha-L-fucosidase (OR =1.07). The areas under the receiver-operator characteristic curve in the training set and the external validation set were 0.85 [95% confidence interval (CI): 0.81-0.88] and 0.81 (95% CI: 0.71-0.91), respectively. Conclusions: We developed a non-invasive, more cost-effective predictive model of NSCLC based on routinely available variables, with practical predictive power. This model can be used as a practical screening tool to guide the use of more specialized and expensive molecular assays for KRAS mutation in NSCLC. However, further studies are warranted to investigate the mechanism underlying such association between KRAS mutations and the related parameters of blood tests.

Corrigendum: Systolic blood pressure as the mediator of the effect of early menarche on the risk of coronary artery disease: A Mendelian randomization study.

[This corrects the article DOI: 10.3389/fcvm.2022.1023355.].

Lifestyle and metabolic factors for nonalcoholic fatty liver disease: Mendelian randomization study.

The risk factors for nonalcoholic fatty liver disease (NAFLD) have not been clearly identified. We conducted a Mendelian randomization (MR) study to explore this. Independent genetic variants strongly associated with 5 lifestyle and 9 metabolic factors were selected as instrumental variables from corresponding genome-wide association studies (GWASs). Summary-level data for NAFLD were obtained from a GWAS meta-analysis of 8434 cases and 770,180 non-cases (discovery dataset) and another GWAS meta-analysis of 1483 cases and 17,781 non-cases (replication dataset). Univariable and multivariable MR analyses were performed. There were associations with NAFLD for lifetime smoking index (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.31-1.93 per SD-increase), body mass index (BMI, OR 1.33, 95% CI 1.23-1.43 per SD-increase), waist circumference (OR 1.82; 95% CI 1.48-2.24 per SD-increase), type 2 diabetes (OR 1.21, 95% CI 1.15-1.27 per unit increase in log-transformed odds), systolic blood pressure (OR 1.17; 95% CI 1.07-1.26 per 10 mmHg increase), high-density lipoprotein cholesterol (OR 0.84, 95% CI 0.77-0.90 per SD-increase), and triglycerides (OR 1.23, 95% CI 1.15-1.33 per SD-increase). The associations for type 2 diabetes, systolic blood pressure, triglycerides, but not for high-density lipoprotein cholesterol remained strong after adjusting for genetically-predicted BMI. Genetic liability to type 2 diabetes mediated 51.4% (95% CI 13.4-89.3%) of the BMI-effects on NAFLD risk. There were suggestive inverse associations of genetically-predicted alcohol, coffee, and caffeine consumption, and vigorous physical activity with NAFLD risk. This study identified several lifestyle and metabolic factors that may be causally implicated in NAFLD.

Systolic blood pressure as the mediator of the effect of early menarche on the risk of coronary artery disease: A Mendelian randomization study.

Background: Menarche timing may not be directly associated with the risk of coronary artery disease (CAD). Therefore, we investigated the roles of metabolic factors in explaining the effect of age at menarche on CAD risk. Methods: We identified women with age at menarche and CAD by using three analytical methods: Mendelian randomization (MR), logistic regression analysis, and Cox proportional hazard regression. The first two analyses were performed in the Taiwan Biobank (N = 71,923) study, and the last analysis was performed in the Chin-Shan Community Cardiovascular Cohort study (N = 1,598). We further investigated the role of metabolic factors in mediating the effect of age at menarche on CAD risk by using three complementary methods with mediation analyses. Results: One standard deviation of earlier age at menarche was associated with a 2% higher CAD risk [odds ratio = 1.02, 95% confidence interval (CI) = 1.001-1.03] in the MR analysis, an 11% higher risk (odds ratio = 1.11, 95% CI = 1.02-1.21) in the logistic regression analysis, and a 57% higher risk (hazard ratio = 1.57, 95% CI = 1.12-2.19) in the Cox proportional hazard regression. All the analyses consistently supported the role of systolic blood pressure in mediating this effect. The MR results indicated that 29% (95% CI = 26%-32%) of the effect of genetically predicted earlier age at menarche on CAD risk was mediated by genetically predicted systolic blood pressure. Conclusion: The results obtained using different analytical methods suggest that interventions aimed at lowering systolic blood pressure can reduce the cases of CAD attributable to earlier age at menarche.

Association of Visit-to-Visit Variabilities in Metabolic Factors with Chronic Kidney Disease in Chinese Adults Living in Shanghai.

OBJECTIVE: This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease (CKD) in Shanghai community residents. METHODS: We used data from a cohort study of community residents who participated in three examinations in 2008, 2009, and 2013, respectively. Fasting plasma glucose (FPG) level, blood pressure (BP), and lipid levels were determined in 2,109 participants at all three visits, and CKD was evaluated between the second and the third visits. Visit-to-visit variabilities in metabolic factors were described by coefficients of variation (CV) at three visits. A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV. CKD was defined as the estimated glomerular filtration rate < 60 mL/min per 1.73 m 2 or urinary albumin-to-creatinine ratio ≥ 30 mg/g. RESULTS: A total of 200 (9.5%) participants had CKD at the third visit. Compared with the lowest quartile of CV, the highest quartile was associated with a 70% increased risk of CKD for FPG [odds ratio, OR = 1.70; 95% confidence interval ( CI) 1.06-2.72], 62% for systolic BP ( OR = 1.62, 95% CI 1.04-2.50), and 85% for low-density lipoprotein cholesterol ( OR = 1.85, 95% CI 1.23-2.80). Furthermore, the risk of CKD increased significantly with an increasing variability score. Compared with participants with score 0, participants with scores of 1, 2, and 3 were associated with 58% ( OR = 1.58, 95% CI 1.08-2.32), 121% ( OR = 2.21, 95% CI 1.40-3.49), and 548% ( OR = 6.48, 95% CI 3.18-13.21) higher risks of CKD, respectively. CONCLUSION: The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.

Prevalence and Incidence of Non-alcohol Fatty Liver Disease in Chronic Hepatitis B Population in Southeast China: A Community-Based Study.

Background: To investigate the prevalence and incidence of non-alcohol fatty liver disease (NAFLD) in a community-based chronic hepatitis B (CHB) population from Southeast China and evaluate the association between NAFLD and metabolic factors, viral factors, and underlying chronic diseases. Methods: CHB patients were recruited in 2012 and followed up from 2017 to 2019 in Zhejiang, China. NAFLD prevalence of the last visit and NAFLD incidence were calculated. Potential risk factors, including metabolic and viral factors, were also evaluated using Logistic or Cox regression models. Results: NAFLD prevalence of the last visit in 2019 was estimated at 26.76%. Waist circumference, body mass index (BMI), triglyceride (TG), low-density lipoprotein (LDL), and diabetes mellitus (DM) were found as associated factors. In subgroups analysis, HBV infection types were also identified as a risk factor in the non-diabetic population. HBeAg-negative hepatitis and immunotolerant had lower NAFLD prevalence than past CHB infection. NAFLD incidence was estimated at 22.63/1,000 person-years after 1,634.74 person-years of follow-up. Waist circumference, TG, LDL, and alkaline phosphatase (ALP) were identified as associated factors. Conclusion: The NAFLD prevalence and incidence in our study were slightly lower than previous reports from East Asia. Health education and healthy living habits were extremely important in reducing the NAFLD burden. Metabolic factors, history of DM, and viral factors were associated with NAFLD in CHB patients.

Fetal growth at different gestational periods and risk of impaired childhood growth, low childhood weight and obesity: a prospective birth cohort study.

OBJECTIVE: To examine the longitudinal associations of fetal growth with adverse child growth outcomes and to assess whether maternal metabolic factors modify the associations. DESIGN: Prospective cohort study. SETTING: Born in Guangzhou Cohort Study, China. POPULATION: A total of 4818 mother-child pairs. METHODS: Fetal growth was assessed according to estimated fetal weight (EFW) from 22 weeks of gestation until birth and the measurement of the birthweight. Fetal growth Z-scores were computed from random effects in the multilevel linear spline models to represent fetal size in early pregnancy (22 weeks of gestation) and growth in mid-pregnancy (22-27 weeks of gestation), early third trimester (28-36 weeks of gestation) and late third trimester (≥37 weeks of gestation). MAIN OUTCOME MEASURES: Z-scores for childhood stunting, low weight, overweight or obesity, length/height for age (LAZ/HAZ), weight for age (WAZ) and body mass index for age (BMIZ) at the age of 3 years. Adjusted associations were examined using multiple Poisson or linear regression models. RESULTS: Increased Z-scores of fetal size in early pregnancy and growth in mid-pregnancy and early third trimester were associated with a higher risk of childhood overweight or obesity (risk ratios 1.25-1.45). Fetal growth in each period was negatively associated with stunting and low weight, with the strongest associations observed for fetal size in early pregnancy and growth in mid-pregnancy. The results for continuous outcomes (LAZ/HAZ, WAZ and BMIZ) were similar. The associations of fetal growth with overweight or obesity in childhood were stronger among mothers who were underweight and who were overweight or obese than among mothers of normal weight. CONCLUSIONS: Accelerated fetal growth before 37 weeks of gestation is associated with children who are overweight or obese, whereas the critical period for stunting and low weight occurs before 28 weeks of gestation. TWEETABLE ABSTRACT: Fetal growth during different periods is differentially associated with childhood stunting, underweight and overweight or obesity.

Association of Visit-to-Visit Variabilities in Metabolic Factors with Chronic Kidney Disease in Chinese Adults Living in Shanghai / 生物医学与环境科学（英文）

Objective@#This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease (CKD) in Shanghai community residents.@*Methods@#We used data from a cohort study of community residents who participated in three examinations in 2008, 2009, and 2013, respectively. Fasting plasma glucose (FPG) level, blood pressure (BP), and lipid levels were determined in 2,109 participants at all three visits, and CKD was evaluated between the second and the third visits. Visit-to-visit variabilities in metabolic factors were described by coefficients of variation (CV) at three visits. A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV. CKD was defined as the estimated glomerular filtration rate < 60 mL/min per 1.73 m @*Results@#A total of 200 (9.5%) participants had CKD at the third visit. Compared with the lowest quartile of CV, the highest quartile was associated with a 70% increased risk of CKD for FPG [odds ratio, @*Conclusion@#The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.

[Analysis on detection status of cardio-metabolic related risk factors in women aged 15-49 years in 15 provinces in China].

Objective: To analyze the prevalence, co-prevalence of cardiovascular metabolic (CM) risk factors in women aged 15-49 years in China, and describe the influence of social economic factors on them. Methods: The project data of Nutritional Status and Health Transition of Chinese Residents in 2015 were used. The changes in epidemiological characteristics of central obesity, elevated blood pressure, FPG and TG, decreased HDL-C and co-prevalence of the risk factors in women aged 15-49 years were analyzed. According to the definition of the metabolic syndrome released by the International Diabetes Federation in 2005, five cardio-metabolic risk factors appeared as central obesity, increased triglycerides, decreased HDL-C, increased blood pressure and increased plasma glucose. Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time. Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors. Results: In 2015, in women aged 15-49 years in 15 provinces, the detection number (rates) of central obesity, elevated blood pressure, FPG and TG, decreased HDL-C, at least one CM risk factor and co-detection rate of CM risk factors were 944 (47.4%), 464 (23.3%), 123 (6.2%), 327 (16.4%), 1 025 (51.5%), 1 501 (75.4%), and 874 (43.9%), respectively. Compared with women aged 15-19 years, the women in age group of 25-, 30-, 35-, 40-, and 45-49 years were more likely to have central obesity (P<0.05), the women in age group of 30- 35-, 40-, and 45-49 years were more likely to have elevated blood pressure (P<0.05), the women aged 45-49 years were more likely to be affected by one or more CM risk factors (P<0.05), but the women in age group 25-29 years group had lower risk for elevated FPG (P<0.05). The odds of having central obesity, elevated blood pressure, FPG and TG, decreased HDL-C, at least one CM risk factor and co-prevalence of CM risk factors in women with BMI≥24.0 kg/m(2) were 14.16, 3.05, 2.46, 2.49, 2.42, 9.79 and 7.39 times higher than those in the women with BMI of 18.5-24.0 kg/m(2), respectively. The odds of having elevated FPG and TG in women aged 15-49 years in western China and the odds of having elevated blood pressure and FPG in women aged 15-49 years in eastern China were significantly higher than those in central China. No significant correlations were found between the prevalence and co-prevalence of CM risk factors and income level or urban and rural area residences in women aged 15-49 years. Conclusions: Age, BMI level and living area were the major influencing CM risk factors. The precise prevention and control measures should be taken in time for the adverse changes in CM risk factor prevalence.

[Analysis on cardio-metabolic related risk factors in farmers of 15 provinces in China].

Objective: To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China, to explore the influence of population economic factors on them. Methods: A total of 3 367 farmers, including fishermen or hunters, aged ≥18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015. Basic information (age, gender), data on anthropometric (body height, weight and waist size), blood biochemical and socioeconomic (occupation, income, education level and living area) were included. According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005, five cardio-metabolic risk factors appeared as central obesity, increased triglycerides, decreased HDL-C, increased blood pressure and increased plasma glucose. Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time. Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors. Results: In 3 367 framers of 15 provinces (autonomous region and municipality), the prevalence rates of central obesity, increased blood pressure, increased plasma glucose, increased triglycerides and decreased HDL-C were 51.8%, 59.0%, 17.0%, 25.5% and 38.7% respectively. Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69, 95%CI: 3.17-4.28) and decreased HDL-C (OR=3.28, 95%CI: 2.81- 3.82) were higher in women than in men, and the risks for increased blood pressure (OR=0.73, 95%CI: 0.63-0.84), increased blood glucose (OR=0.80, 95%CI: 0.67-0.97) were lower in women than in men. Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P<0.05). Framers in western China had obviously lower risk for central obesity compared with farmers in central China. No significant correlation was found between farmers' income level, education level or the prevalence of metabolic risk factors. Conclusion: In 15 provinces of China, the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5% of the farmers, and the co-prevalence of cardio-metabolic risk factor was found in 60% of farmers. The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender. It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.

High thiamine diphosphate level as a protective factor for Alzheimer's disease.

Objectives Thiamine diphosphate (TDP) is an indispensable coenzyme for three key enzymes in glucose metabolism. Reduced TDP levels in patients with Alzheimer's disease (AD) has been widely demonstrated and is a diagnostic biomarker for the disease. In this study, we further explored the correlation between altered TDP metabolism and AD along with other risk factors. Methods A 1:1 case-control study was employed with 90 AD patients and 90 control subjects with normal-range cognitive abilities as assayed by the Mini Mental Status Evaluation. Age (≤2 years variation), gender, and educational background were strictly matched. Levels of the main thiamine metabolites in whole blood samples, including TDP, thiamine monophosphate, and thiamine, were assayed using high-performance liquid chromatography. Apolipoprotein E genotypes, haemoglobin, and several metabolic factors (fasting glucose, uric acid, triglyceride, and total cholesterol) associated with AD were also measured. Results The odds ratio of TDP level for AD was 0.95 (with TDP level as a continuous variable) or 0.09 (with TDP level as a dichotomized variable with a cut-off value of 99.48 nmol/L). Blood TDP levels were significantly decreased in female AD patients compared to male AD patients. No correlations were identified between TDP levels and several metabolic factors (fasting glucose, uric acid, triglyceride, and total cholesterol). Conclusions TDP is a protective factor for AD and its protective efficacy may be independent of other metabolic factors. The difference of TDP levels between genders may be another possible explanation for the higher prevalence of AD in females.

The barberry juice effects on metabolic factors and oxidative stress in patients with type 2 diabetes: A randomized clinical trial.

AIM: The aim of this study was to investigate the effect of barberry juice (BJ) on cardiovascular risk factors in patients with type 2 diabetes (T2DM). METHODS: 46 diabetic Patients were randomly allocated to either the BJ group (n = 23) who consumed 200 ml of BJ daily for eight weeks, or the control group (n = 23) with no intervention. At the baseline and the end of 8-week intervention, blood pressure and biochemical markers were measured. RESULTS: forty-two Patients completed the study. After intervention systolic blood pressure (SBP), diastolic blood pressure (DBP), Fasting Blood Sugar (FBS) Total Cholesterol significantly decreased (P < 0.05 for treatment effect) also Triglyceride (TG) decrease significantly in BJ group. Paraoxonase-1(PON1) concentrations significantly increased in Bj group and have a significant difference (P < 0.0001 for treatment effect) compared with control group. CONCLUSIONS: This study revealed that BJ might decrease the risk of cardiovascular diseases in patients with diabetes.

Analysis on cardio-metabolic related risk factors in farmers of 15 provinces in China / 中华流行病学杂志

Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.

Analysis on cardio-metabolic related risk factors in farmers of 15 provinces in China / 中华流行病学杂志

Objective To analyze the prevalence and co-prevalence of cardio-metabolic related risk factors in farmers aged ≥18 years in China,to explore the influence of population economic factors on them.Methods A total of 3 367 farmers,including fishermen or hunters,aged ≥ 18 years were selected as study subjects from the database of Nutritional Status and Health Transition of Chinese Residents Project in 2015.Basic information (age,gender),data on anthropometric (body height,weight and waist size),blood biochemical and socioeconomic (occupation,income,education level and living area) were included.According to the definition of the metabolic syndrome released by the International Diabetes Federation (IDF) in 2005,five cardio-metabolic risk factors appeared as central obesity,increased triglycerides,decreased HDL-C,increased blood pressure and increased plasma glucose.Co-prevalence of risk factors was defined as detecting 2 or more risk factors in a person at the same time.Multivariate logistic regression model was used to analyze the relationship between socioeconomic factors and metabolic risk factors.Results In 3 367 framers of 15 provinces (autonomous region and municipality),the prevalence rates of central obesity,increased blood pressure,increased plasma glucose,increased triglycerides and decreased HDL-C were 51.8％,59.0％,17.0％,25.5％ and 38.7％ respectively.Multivariate logistic regression analysis showed that the risks for central obesity (OR=3.69,95％CI:3.17-4.28) and decreased HDL-C (OR=3.28,95％CI:2.81-3.82) were higher in women than in men,and the risks for increased blood pressure (OR=0.73,95％ CI:0.63-0.84),increased blood glucose (OR=0.80,95％ CI:0.67-0.97) were lower in women than in men.Age was positively correlated with the prevalence or co-prevalence of metabolic risk factors (trend P＜0.05).Framers in western China had obviously lower risk for central obesity compared with farmers in central China.No significant correlation was found between farmers' income level,education level or the prevalence of metabolic risk factors.Conclusion In 15 provinces of China,the prevalence of at least 1 kind of cardio-metabolic risk factor was found in 85.5％ of the farmers,and the co-prevalence of cardio-metabolic risk factor was found in 60％ of farmers.The prevalence and co-prevalence of cardio-metabolic risk factors were significantly associated with age and gender.It is suggested to take targeted nutritional intervention and health education according to the distribution characteristics of prevalence and co-prevalence of cardio-metabolic factors and strengthen the early prevention and control programs of the diseases.

The ongoing role of serum uric acid in blood pressure.

Positive association between blood pressure (BP) and uric acid is evident, but specific effect size of serum uric acid (SUA) at different levels on BP is unclear, and interaction effect of SUA with other metabolic factors on BP was rarely reported. A cross-sectional study was conducted by making use of data from an epidemic investigation. A total of 3658 subjects were enrolled in our data analysis. In male subjects, for each 1 mg/dL increase in the SUA level, systolic blood pressure (SBP) and diastolic blood pressure (DBP) increased by 1.339 mmHg [95% CI: 0.552-2.126] and 0.515 mmHg [95% CI: 0.013-1.016], respectively, after adjusting for age, fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), estimated-glomerular filtration rate (eGFR), body mass index (BMI), drinking, smoking, and waist-hip ratio (WHR). And in female subjects, for each 1 mg/dL increase in the SUA level, SBP and DBP increased by 1.180 mmHg [95% CI: 0.401-1.959] and 0.549 mmHg [95% CI: 0.086-1.011], respectively, after adjusting the same factors. In males, in subjects with SUA < 6 mg/dL, SBP increased by 0.585 mmHg [95% CI: -0.976 to 2.146] for each 1 mg/dL increase in the SUA level, while in subjects with SUA ≥ 6 mg/dL, SBP increased by 3.271 mmHg [95% CI: 1.244-5.297] (p interaction = 0.0369), after adjusting age, BMI, smoking, drinking, TG, TC, FPG, eGFR, and WHR. This difference was not observed in DBP and females. Interaction effects between SUA and BMI, TG, FPG on BP were discovered. In conclusion, higher level of SUA has a stronger effect on BP and other metabolic factors: FPG, TG, and BMI could strengthen the effect of SUA on BP.

The serum vitamin D level is inversely correlated with nonalcoholic fatty liver disease.

BACKGROUND/AIMS: A low vitamin D level has been associated with metabolic syndrome and diabetes. However, an association between a low vitamin D level and nonalcoholic fatty liver disease (NAFLD) has not yet been definitively established. This study aimed to characterize the relationship between a vitamin D level and NAFLD in Korea. METHODS: A cross-sectional study involving 6,055 health check-up subjects was conducted. NAFLD was diagnosed on the basis of typical ultrasonographic findings and a history of alcohol consumption. RESULTS: The subjects were aged 51.7 ± 10.3 years (mean ± SD) and 54.7% were female. NAFLD showed a significant inverse correlation with the vitamin D level after adjusting for age and sex [odds ratio (OR)=0.85, 95% confidence interval (CI)=0.75-0.96]. The age- and sex-adjusted prevalence of NAFLD decreased steadily with increasing vitamin D level [OR=0.74, 95% CI=0.60-0.90, lowest quintile (≤14.4 ng/mL) vs highest quintile (≥28.9 ng/mL), p for trend <0.001]. Multivariate regression analysis after adjusting for other metabolic factors revealed that NAFLD showed a significant inverse correlation with both the vitamin D level (>20 ng/mL) [OR=0.86, 95% CI=0.75-0.99] and the quintiles of the vitamin D level in a dose-dependent manner (p for trend=0.001). CONCLUSIONS: The serum level of vitamin D, even when within the normal range, was found to be inversely correlated with NAFLD in a dose-dependent manner. Vitamin D was found to be inversely correlated with NAFLD independent of known metabolic risk factors. These findings suggest that vitamin D exerts protective effects against NAFLD.

Stability of Metabolic Factor Before and After Bariatric Surgery.

BACKGROUND: A new metric called metabolic factor (resting metabolic rate/weight) has previously been established that can differentiate between people who are obese, overweight, and of normal weight. Previous studies were re-analyzed and found that people who lost weight did not experience a change in their metabolic factor. MATERIALS AND METHODS: The current study measured the metabolic factor of 18 individuals before and after bariatric surgery. RESULTS: As expected, individuals lost nearly 100 lb and therefore lowered their resting metabolic rate from 2614.3 to 1954.4 kcal (p < 0.05). However, the pre-operative metabolic factor of 8.1 (1.1) cal/lb did not change significantly as it slightly increased to 8.6 (0.88) after surgery (p = 0.19). Weight loss was not statistically significantly correlated with change in metabolic factor (r = 0.22). The follow-up metabolic factor negatively correlated with post-operative BMI, r = -0.48 (p < 0.05), indicating the higher the metabolic factor, the lower the post-operative BMI. CONCLUSIONS: This study seems to establish the possibility that metabolic factor is not simply a function of one's current weight, but instead might be a stable characteristic unique to each individual.