Comparative Effectiveness of Mobile Health-Based Comprehensive Smoking Cessation Modalities and Traditional Clinic-Delivered Treatments - Beijing Municipality, China, May 2022 to April 2024.

What is already known about this topic?: Most Chinese smokers have not accessed professional help due to a lack of sufficient smoking cessation services. Mobile health (mHealth) can mitigate obstacles related to time and transportation, thereby providing effective support for smokers seeking to quit. What is added by this report?: This study offers real-world evidence supporting the effectiveness of mHealth-based comprehensive smoking cessation interventions. The findings indicate that these modalities can significantly enhance abstinence rates, albeit to a lesser extent compared to traditional clinic-based treatments. Adherence to the intervention was identified as a critical factor influencing the effectiveness of smoking cessation strategies. What are the implications for public health practice?: The mHealth-based comprehensive smoking cessation modalities, with or without mailing cessation medications, present a promising approach to enhancing access to and utilization of smoking cessation services. This strategy addresses the significant challenge of limited smoking cessation resources in China.

Effectiveness and Acceptability of a Comprehensive Mobile Health-Based Modality for Smoking Cessation - Beijing Municipality, China, 2022.

What is already known on this topic?: Mobile health interventions have been demonstrated to be effective in aiding smoking cessation among smokers. Nevertheless, research on this topic remains limited in China. What is added by this report?: Following two months of utilizing the services of a comprehensive mobile health (mHealth)-based modality ("Way to Quit" modality) which integrated three online interventions through the WeChat application, 29.1% of participating smokers successfully quit smoking. Participants who used a greater number of online services were more likely to cease smoking. All services were scored highly for satisfaction among smokers. What are the implications for public health practice?: This study presents a practical and feasible method to assist Chinese smokers in quitting smoking. The results of this research suggest a promising direction for enhancing the accessibility and utilization of smoking cessation services. Additionally, these findings serve as a critical reference for addressing the obstacles faced by smoking cessation services in China.

Defining indicators for the scoping stage of health impact assessment to evaluate tobacco control policy in the city of Beijing.

INTRODUCTION: Beijing initiated the nation's most comprehensive tobacco control program that adheres to the WHO Framework Convention on Tobacco Control. This study aimed to identify a set of indicators for the scoping of an Health Impact Assessment (HIA) to assess this policy. METHODS: This study used a modified Delphi process. It proposed a tobacco control health impact framework based on the Driving forces- Pressure- State- Exposure- Effect- Action model and the Determinants of Health Theory. After a review of current surveillance system and literature, a working group of 13 experts with multidisciplinary background was established to formulate indicator evaluation criteria and conduct indicator scoring. Each indicator was scored by experts according to four evaluation criteria chosen. Indicators that obtained a total score above 80% and with standard error less than 5 were selected as the final set of indicators. Kendall's coefficient of concordance was calculated. RESULTS: Twenty-three out of 36 indicators were selected. Smoking prevalence, mortality rate, hospital admission rate, tobacco consumption and hospital admission fees of smoking related diseases achieved more than 90% of total scores and ranked as the top five. Kendall's concordance coefficient was 0.218 for all indicators. For all model composition, Kendall's concordance coefficients were statistically significant. CONCLUSION: This study identified a set of twenty-three indicators for scoping of HIA of a comprehensive tobacco control policy in Beijing based on a tobacco control health impact conceptual framework. The set of indicators achieved high scores and statistically significant consistency and has great potential to promote the evaluation of tobacco control policy in a global city. Further study might use the set of indicators for HIA on tobacco control policy to analyze empirical data.

Early-phase insulin hypersecretion associated with weight loss outcome after LSG: a prospective cohort study in Asian patients with BMI ≥28 kg/m2.

BACKGROUND: Obesity has become a global problem that poses a serious threat to human health. Laparoscopic sleeve gastrectomy (LSG) is an effective long-term treatment. However, the weight loss of some patients after LSG is still insufficient. It is necessary to investigate the factors associated with inadequate weight loss after LSG. OBJECTIVE: The objective of this study was to explore whether preoperative insulin secretion could be associated with weight loss after LSG in patients with obesity. SETTING: This is a single-center prospective cohort study conducted in a university hospital. METHODS: Patients from a prospective database who underwent LSG were analyzed. All 178 participants underwent a 75-g oral glucose tolerance test (OGTT) to assess preoperative insulin and c-peptide secretion before LSG. The areas under the curve (AUCs) for glucose, insulin, and c-peptide were determined in the OGTT. The percentage of excess weight loss (%EWL) and the percentage of total weight loss (%TWL) were used to estimate the effect of weight loss after LSG. Regression models were used to assess the correlation between preoperative insulin and c-peptide secretion with %EWL ≥75% and TWL ≥35% at 12 months after LSG. RESULTS: The AUCs of insulin and c-peptide were significantly lower in the %EWL ≥75% and %TWL ≥35% groups at 0-30 minutes, 0-60 minutes, and 0-120 minutes during the OGTT. At 30, 60, and 120 minutes during the OGTT, c-peptide levels were significantly lower in the %EWL ≥75% group and %TWL ≥35% group. The preoperative c-peptide level at 30 minutes during the OGTT (C30) was significantly negatively correlated with %EWL (ß = -.37, P < .001) and %TWL (ß = -.28, P = .011). Univariate logistic regression analysis showed that preoperative C30 was associated with %EWL ≥75% and %TWL ≥35% after LSG. According to multiple logistic regression analysis, patients with a low preoperative C30 had an 8-fold higher %TWL ≥35% after LSG than those with a high C30 (odds ratio: 8.41 [95% confidence interval: 1.46-48.58], P = .017). Similarly, patients with a low preoperative C30 had a 7-fold higher EWL% ≥75% after LSG than patients with a high C30 (odds ratio: 7.25 [95% confidence interval: 1.11-47.50], P = .039). CONCLUSIONS: The rate of weight loss after LSG is low among patients with preoperative hyperinsulinemia. The preoperative c-peptide level at 30 minutes during the OGTT is associated with weight loss after LSG.

Investigation of Health Literacy Status in Beijing, China.

BACKGROUND: The Chinese government uses health literacy as an evaluation to estimate population health status in national strategic planning. A health literacy survey system for the city of Beijing, China was established in 2012 with triennial surveys to obtain representative data for the whole city. OBJECTIVE: The objective of this study was to examine results of the 2015 Beijing Health Literacy Survey and to identify population subgroups that may warrant intervention due to high risk for not having adequate health literacy. METHODS: This was a cross-sectional study in which participants were selected by multistage stratified cluster sampling. The information was collected in 2015 in face-to-face interviews on the Chinese Citizen Health Literacy Questionnaire. A total of 12,876 interviews were included in the final analyses. Weighting was conducted in all statistical analyses to obtain representative estimates, and multiple logistic regression was applied to examine the independent influencing factors on health literacy level (adequate/inadequate). KEY RESULTS: Overall, 28% of participants had adequate health literacy. Urban residents had a higher proportion of participants with adequate health literacy compared to rural residents (29.5% vs. 19%, p < .01). Women (29.7%) had a higher proportion of participants with adequate health literacy compared to men (29.7% vs. 26.4%, p < .01). The proportion of participants with adequate health literacy was significantly different among age groups (χ2 = 332.9, p < .01). Residents age 25 to 34 years had the highest rate of adequate health literacy (33.9%). The proportion of participants with adequate health literacy increased as participants obtained more education (χ2 = 818.4, p < .01). Residents in households with higher income had a higher rate of adequate health literacy (χ2 = 462.4, p < .01). Gender, age, education, and household income were independently associated with the level of health literacy. CONCLUSIONS: Substantial variation exists in health literacy level among age groups, gender groups, and education groups. Taking these disparities into account is important when developing health policies and allocating resources. [HLRP: Health Literacy Research and Practice. 2020;4(3):e174-e184.] PLAIN LANGUAGE SUMMARY: The results of this investigation revealed the health literacy status of residents in Beijing, China, and the high-risk population that may be more likely to have low health literacy. Targeted health education interventions may be helpful to improve health literacy.

Early-onset type 2 diabetes: A high-risk factor for proliferative diabetic retinopathy (PDR) in patients with microalbuminuria.

We aim to explore the relationship between early-onset diabetes and proliferative diabetic retinopathy (PDR) in type 2 diabetes mellitus (T2DM) patients with microalbuminuria.A total of 461 T2DM patients with microalbuminuria were enrolled. Subjects were defined as early-onset or late-onset based on the age at which they were diagnosed with diabetes (<40 and ≥40 years, respectively). Medical history, anthropometry, and laboratory indicators were documented. PDR was defined as the presence of any of the following changes on fundus photography: neovascularization, vitreous hemorrhage, or preretinal hemorrhage.The prevalence of PDR was 6-fold higher in patients with early-onset than late-onset T2DM [(6.1% vs 1.0%), P = .004]. Univariate correlation analysis showed that early-onset diabetes, use of oral hypoglycemic drugs, and insulin therapy were risk factors for PDR. In multivariate logistic analysis, patients with early-onset diabetes exhibited a 7.00-fold [(95% confidence interval 1.40-38.26), P = .019] higher risk of PDR than subjects with late-onset diabetes after adjusting for sex; T2DM duration; systolic blood pressure; total triglyceride; glycated hemoglobin; insulin therapy; and the use of oral hypoglycemic drugs, antihypertensive drugs, and lipid-lowering drugs.In T2DM patients with microalbuminuria, early-onset diabetes is an independent risk factor for the development of PDR.

The appropriate remodeling of extracellular matrix is the key molecular signature in subcutaneous adipose tissue following Roux-en-Y gastric bypass.

AIMS: We sought to reveal the key molecular signature in subcutaneous adipose tissue (scAT) following Roux-en-Y gastric bypass (RYGB), through bioinformatics analysis and further verification in vivo. MAIN METHODS: We obtained a transcriptome data of scAT from RYGB and sham-operated rats from the Gene Expression Omnibus. The differentially expressed genes (DEGs) were screened and the DEGs-related Gene ontology (GO) functions and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were analyzed. Also, the protein-protein interaction (PPI) network was constructed among the DEGs. Furthermore, we established an experimental rat model to verify the bioinformatics findings. KEY FINDINGS: Using the method of bioinformatics, a total of 602 genes were found to be differentially expressed in scAT between the RYGB group and the sham-operated group. GO analysis showed that DEGs were significantly enriched in extracellular matrix(ECM) -associated functions or processes. KEGG pathway analysis revealed that the protein digestion and absorption pathway and ECM-receptor interaction pathway were the most significantly enriched pathways. The genes encoding ECM components and ECM remodeling-related proteins interact substantially in the PPI network. Then the results of rat experimental verified that the gene expression levels of ECM components(Collagen I and III) and ECM cross-linking related proteins(lysyl oxidase and lysyl oxidase-like 1) decreased and ECM dagradation-related proteins increased in scAT following RYGB. These beneficial results were positively associated with improved insulin resistance (IR). SIGNIFICANCE: Appropriate ECM remodeling, primarily the reduction of ECM deposition and cross-linking and the increase of ECM dagradation, may be the key molecular signature in scAT following RYGB.

Microwave-assisted synthesis, structure and anti-tumor activity of selenized Artemisia sphaerocephala polysaccharide.

In this work, selenylation of Artemisia sphaerocephala polysaccharide (SeASPMW) was studied by using H2SeO3/HNO3/BaCl2 reaction system in microwave field. SeASPMW exhibited the Se content range of 111-264µg/g with high yields (72.1-94.9%). 13C NMR results indicated that the weak C-6 substitution was occurred. The decrease (from 7.348×104g/mol to 1.736-4.667×104g/mol) in weight average molecular mass (MW) of SeASPMW was observed in size exclusion chromatography combined with multi angle laser light scattering (SEC-MALLS) analysis. SeASPMW exhibited a more rigid solution conformation which might be due to the degradation of polysaccharide chains in acidic reaction reagent. This was also supported by atomic force microscopy (AFM) result that SeASPMW showed short chains and island-like topography. In anti-tumor activity assays, SeASPMW6 exhibited the inhibition rates of 32.381% and 39.776% against human non-small cell lung cancer cell line (H1650) at the concentration of 100 and 200µg/mL, respectively. The relatively weak inhibition effect of SeASPMW was not related to cell apoptosis and cell cycle arrest, suggesting Se content might be a key factor to influence the anti-tumor activities of selenized polysaccharides in vitro.

Smoking reduced in urban restaurants: the effect of Beijing Smoking Control Regulation.

OBJECTIVE: To evaluate the effectiveness of Beijing Smoking Control Regulation, occurrence of smoking in restaurants was compared before and after the law took effect. METHODS: A cohort study design was used in a randomly selected sample of 176 restaurants in two districts of Beijing. Undercover visits were paid by investigators to the same restaurants at lunch or dinner time 5 months before the law took effect and 1-month after. The occurrence of smoking and presence of no-smoking signs were observed. RESULTS: Much less smoking was observed (14.8%) in restaurants compared to that before the law took effect (40.3%). The drop in smoking occurrence was more evident in open dining areas (from 32.4% to 5.1%) compared to the men's restrooms of the restaurants (23.8% to 18.8%). No intervention from restaurant staff was observed whenever smoking occurred. Posting of no-smoking signage increased considerably after the law came into effect (from 52.6% to 82.4%), but very few no-smoking signs included the symptom hotline number (38.5%) or the amount of penalty (5.6%). CONCLUSIONS: The Beijing Smoking Control Regulation achieved one of its intended goals of reducing smoking occurrences in restaurants, but further effort of strengthening implementation is still needed and should focus on boosting compliance with no-smoking sign requirements, reducing smoking in restrooms of the restaurants and mobilising the restaurant staff to intervene in case of violations.

A prospective study of impaired fasting glucose and type 2 diabetes in China: The Kailuan study.

The worldwide prevalence and incidence of diabetes and obesity are increasing in pandemic proportions. This is particularly relevant for China, where an extremely large population is growing, aging, and urbanizing. We thus conducted a prospective study to examine the prevalence and incidence of impaired fasting glucose (IFG) and diabetes, the rate at which fasting blood glucose rises, and the major modifiable risk factors associated with these outcomes in a large Chinese population from the Kailuan prospective study.A prospective cohort included 100,279 Chinese participants, aged 18 years or more, who had available information on fasting blood glucose concentrations at the start of the study (2006). Examination surveys were conducted every 2 years in 2008 and 2010. For the analyses of incident diabetes, we included 76,869 participants who were free of diabetes, cardiovascular disease, and cancer at the baseline and participants in the 2008 and/or 2010 follow-up. Diabetes was defined by a fasting blood glucose concentration ≥7 mmol/L, self-reported history, or active treatment with insulin or any oral hypoglycemic agent. IFG was defined by a fasting blood glucose concentration between 5.6 and 6.9 mmol/L.During the 4-year study, the prevalence of diabetes and IFG rose from 6.6% to 7.7%, and 17.3% to 22.6%, respectively. There were 17,811 incident cases of IFG and 4867 incident cases of diabetes. The age-standardized incident rate of IFG and diabetes were 62.6/1000 person-years (51.2/1000 person-years in women and 73.8/1000 person-years in men) and 10.0/1000 person-years (7.8/1000 person-years in women and 12.1/1000 person-years in men), respectively. We observed steady increases in fasting blood glucose with body anthropometrics and in every defined category of body mass index, including in those traditionally considered to be well within the "normal" range.In this large longitudinal study of Chinese adults, we observed a high prevalence and incidence of IFG and diabetes over 4 years of follow-up. Our findings are alarming for Chinese public health since steady rises in fasting blood glucose were seen across all permutations of body habitus, even apparently very lean individuals.

Synthesis of selenium-containing Artemisia sphaerocephala polysaccharides: Solution conformation and anti-tumor activities in vitro.

It has been reported in our previous work that selenized Artemisia sphaerocephala polysaccharides (SeASPs) with the Se content range of 168-1703µg/g were synthesized by using Na2SeO3/HNO3/BaCl2 system. In the present work, the solution property of SeASP was studied by using size exclusion chromatography combined with multi angle laser light scattering (SEC-MALLS). A decrease in df values indicated that SeASPs with different conformational features that were highly dependent on MW. SeASPs exhibited a more rigid conformation (df value of 1.29-1.52) in low molecular weight range (MW of 1.026-1.426×10(4)g/mol) and compact spherical conformation in high molecular weight range (MW of 2.268-4.363×10(4)g/mol). It could be due to the degradation of polysaccharide chains in HNO3, which was supported in monosaccharide composition analysis. Congo red (CR) spectrophotometric method and atomic force microscopy (AFM) results also confirmed the conformational transition and the evidence on the shape of the rigid chains. In vitro anti-tumor assays, SeASP2 displayed greater anti-proliferative effects against three tumor cell lines (hepatocellular carcinoma HepG-2 cells, lung adenocarcinom A549 cells and cervical squamous carcinoma Hela cells) in a dose-dependent manner. This suggested that selenylation could significantly enhance the anti-tumor activities of polysaccharide derivatives in vitro.

[Analysis of influence of inflammatory factor in patients with ovarian endometriosis follicular fluid on the outcome of in vitro fertilization].

OBJECTIVE: To observe the effect of follicular fluid IL-6, TNF-α on the clinical outcome of in vitro fertilization and embryo transfer (IVF-ET) in patients with ovarian endometriosis. METHOD: From June 2013 to June 2014, the data of 64 (from Tangshan Maternal and Child Health Hospital IVF center) ovarian endometriosis patients was analyzed retrospectively. 58 infertility cases caused by male side were used as control group. Oocyte retrieval rate, M II oocytes rate, fertilization rate, recovery-intracytoplasmic sperm injection (R-ICSI) rate, good quality embryo rate, biochemical pregnancy rate and clinical pregnancy rate were analyzed and compared between two groups. Changes in the expression of follicular fluid IL-6, TNF-α were detected. RESULTS: Oocyte retrieval rate, M II oocytes rate, fertilization rate, good quality embryo rate, biochemical pregnancy rate and clinical pregnancy rate in ovarian endometriosis group were significantly lower than those in the control group (all P < 0.05), while R-ICSI rate increased in ovarian endometriosis group compared with control group (P < 0.05). IL-6, TNF-α expressions of follicular fluid were higher in affected side of ovarian endometriosis patients than those in the unaffected side and those in control group. CONCLUSION: Inflammation microenvironment of the follicular fluid may influence IVF-ET outcomes in ovarian endometriosis patients.

The product of resting heart rate times blood pressure is associated with high brachial-ankle pulse wave velocity.

OBJECTIVE: To investigate potential associations between resting heart rate, blood pressure and the product of both, and the brachial-ankle pulse wave velocity (baPWV) as a maker of arterial stiffness. METHODS: The community-based "Asymptomatic Polyvascular Abnormalities in Community (APAC) Study" examined asymptomatic polyvascular abnormalities in a general Chinese population and included participants with an age of 40+ years without history of stroke and coronary heart disease. Arterial stiffness was defined as baPWV≥1400 cm/s. We measured and calculated the product of resting heart rate and systolic blood pressure (RHR-SBP) and the product of resting heart rate and mean arterial pressure (RHR-MAP). RESULTS: The study included 5153 participants with a mean age of 55.1 ± 11.8 years. Mean baPWV was 1586 ± 400 cm/s. Significant (P<0.0001) linear relationships were found between higher baPWV and higher resting heart rate or higher arterial blood pressure, with the highest baPWV observed in individuals from the highest quartiles of resting heart rate and blood pressure. After adjusting for confounding parameters such as age, sex, educational level, body mass index, fasting blood concentrations of glucose, blood lipids and high-sensitive C-reactive protein, smoking status and alcohol consumption, prevalence of arterial stiffness increased significantly (P<0.0001) with increasing RHR-SBP quartile (Odds Ratio (OR): 2.72;95%Confidence interval (CI):1.46,5.08) and increasing RHR-MAP (OR:2.10;95%CI:1.18,3.72). Similar results were obtained in multivariate linear regression analyses with baPWV as continuous variable. CONCLUSIONS: Higher baPWV as a marker of arterial stiffness was associated with a higher product of RHR-SBP and RHR-MAP in multivariate analysis. In addition to other vascular risk factors, higher resting heart rate in combination with higher blood pressure are risk factors for arterial stiffness.

[Effect of central obesity on the events of new-onset cerebral infarction among type 2 diabetes mellitus patients].

OBJECTIVE: To analyze the effect of central obesity on new-onset cerebral infarction events among type 2 diabetes mellitus patients in the Kailuan Group. METHODS: This was a prospective cohort study. In a total of 101 510 employees who had been carried out a healthy examination in Kailuan Group from Jul. 2006 to Oct. 2007. 8 306 type 2 diabetes mellitus patients were selected. According to the baseline waist measurement, the observed population was divided into two groups-with central obesity or without. The total period of follow-up was 38-53 (48.05 ± 3.09) months. RESULTS: 1) Mean age, BMI, the levels of SBP, DBP, pulse pressure, FPG, TC, LDL-C, uric acid significant increased in the central obesity group were higher than in the non-obese group (P < 0.01). 2) The incidence of new onset cerebral infarction in obese group was higher than that in the non-obese group (3.1% vs. 1.6%, 6.8%, P < 0.01; 3.3% vs. 1.7%, P < 0.01 in male respectively. 3) Results from the multiple logistic regression analysis showed that, compared with the non-obese group, the obese group had an increase of relative risk (RR) on new onset cerebral infarction events after adjustment on age, gender and other risk factors, with RR value as 2.07 (95%CI:1.39-3.09, P < 0.01). CONCLUSION: Type 2 diabetes mellitus patients with central obesity seemed to have increased the risk of new-onset cerebral infarction events.

[Impact of the waist circumference change on new onset of diabetes in the population with impaired fasting glucose].

OBJECTIVE: To explore the impact of the waist circumference change on new onset diabetes (NOD) in the impaired fasting glucose (IFG) population. METHODS: A total of 12 657 subjects who took part in the health examination from 2006 to 2007 and from 2010 to 2011 from the employees of Kailuan Group and met the inclusion criteria were selected as the observation cohort.Of the 12 657 subjects, 10 697 were male, 1960 were female, with age of (49.9 ± 11.3) years old. According to the baseline waist circumference (WC) measurements and its quartile in the health examinations during 2006 to 2007, the observation population was divided into four groups (first, second, third and the fourth quartile groups) . Multiple logistic regression analysis was used to test the relation between the increasing of WC and NOD. RESULTS: The incidences in the IFG population of NOD were 4.27% (1884/12 657) in the total population;4.25% (1581/10 697) in male and 4.44% (303/1960) in females, respectively (P < 0.05) . Along with increasing WC in the 4 quartile groups, the incidences of NOD was progressively increased, which were 2.19% (235/3083) , 3.07% (333/3114) , 4.47% (473/3037) and 7.08% (843/3423) , respectively;2.34% (213/2626) , 3.06% (282/2645) , 4.37% (393/2582), 7.00% (693/2844) in males and 1.38% (22/457) , 3.12% (51/469) , 5.05% (80/455) , 7.45% (150/579) in female (P < 0.05) . Multiple logistic regression analysis showed that compared with the first quartile group, the second, third and fourth quartile group had increased risk of NOD after adjusting for age, gender and other risk factors, the OR (95%CI) values were 1.38(1.13-1.68), 1.79 (1.47-2.09) and 3.10 (2.57-3.75), respectively. CONCLUSION: The incidence of NOD in the IFG population increased as the WC increased.

Serum uric acid levels and the risk of impaired fasting glucose: a prospective study in adults of north China.

OBJECTIVE: To prospectively investigate the association between serum uric acid (SUA) level and incidence of impaired fasting glucose (IFG) in adult Chinese. METHODS: We evaluated 13,328 women and 41,350 men without diabetes and IFG. The participants were classified into quintile according to baseline level of SUA. Data were analyzed to examine the association between SUA levels and the incidence of IFG. We used Cox regression models to estimate the relative risk of IFG after adjusting for known risk factors. RESULTS: For men, the second quintile of SUA has the lowest cumulative incidence of IFG (29.9%); the fifth quintile of SUA has the highest cumulative incidence of IFG (35.6%). After corrected with Cox regression, the first quartile and the fourth quartile have higher cumulative incidence of IFG than the second quintile, with the HR of 1.11(1.05-1.17) and 1.07(1.01-1.13), respectively. For women, the first quartile of SUA has the lowest cumulative incidence of IFG (20.7%), while the fifth quintile of SUA has the highest cumulative incidence of IFG (30.0%). However, there is no significant difference in IFG between different quintile after adjusted with Cox regression. CONCLUSIONS: The results of this prospective study suggest that there is a higher risk of developing IFG in association with low or high SUA concentrations for men. These relationships were independent of other known risk factors. There is no significant correlation in the risk of developing IFG in association with SUA concentrations for women. Analyses excluding participants with hypertension or with hyperlipidemia and analyses with participants stratified by age reached similar conclusion.

[Relationship between the level of waist circumference and the impaired fasting glucose of pre-diabetes].

OBJECTIVE: To explore the relationship between the level of waist circumference (WC) and the impaired fasting glucose (IFG) in people working for the Kailuan Enterprise. METHODS: A total of 101 510 subjects from the employees of Kailuan Group who took part in the health examination between 2006 to 2007, with fasting plasma glucose (FPG) < 6.1 mmol/L, no history of diabetes, completed data on FPG and WC examination and without using hypoglycemic agents, were selected as the observation cohort. Subjects who did not participate in the health examination from 2010 to 2011 and had incomplete data were finally excluded, ended up with 52 099 subjects available for final analysis. According to the baseline WC measurements and its quartile in the health examinations during 2006 to 2007, people under observation were divided into four groups (first, second, third and the forth quartile groups). Multiple logistic regression analysis was used to test the relation between the increasing of WC and IFG. RESULTS: (1) The incidence rate of IFG in the obese group was higher than that in non-obese group (10.5% vs. 6.8% , P < 0.01), along with an increasing WC noticed in the 4 quartile groups and the incidence rates of IFG were progressively increased, being 6.0%, 7.1%, 8.6% and 11.0% respectively in the total population(7.0%, 7.9%, 9.1% and 11.4% in males, 2.5%, 4.6%, 6.8% and 9.8% in females). (2)Results from the multiple logistic regression analysis showed that, when compared with the first quartile group, the second, third and fourth quartile groups had increased risks of IFG after adjustment on age, gender and other risk factors in the total population, with the OR values being 1.03, 1.15 and 1.30 respectively. After adjusting the above factors in genders, we also noticed the increased risks of IFG, with the OR value being 1.45, 1.66 and 2.08 in males, while 1.00, 1.09 and 1.23 in females, respectively. The influence of the second and third quartile groups on IFG was not significant in females, however. CONCLUSION: The incidence of IFG showed an increasing trend with the increase of WC.

[Association between blood pressure level and incidence of carotid artery plaque in middle-aged and elderly people].

OBJECTIVE: To explore the association between blood pressure level and incidence of carotid arterial plaque in middle-aged and elderly people. METHODS: A total of 5852 individuals were randomly stratified from the 101 510 health examination survey participants in Tangshan Kailuan Company community during 2006-2007. A total of 5440 people (age above 40 years old, free of stroke, TIA and myocardial infarction) were enrolled in the final analysis. A questionnaire survey, blood biochemical analysis and carotid artery ultrasound examination were finished by trained medical staff. Sixteen individuals without carotid artery plaques information and 35 individuals without blood pressure information were excluded. Finally, a total of 5389 participants [3235 male, mean age: (54.7 ± 11.8) years] were analyzed. According to 2010 Chinese guideline to prevention and treatment of hypertension and blood pressure level classification, participants were divided into normotensive group (n = 1377), high normal blood pressure group (n = 1971) and hypertensive group (n = 2041). Multivariate logistic regression analysis was used to determine the risk factors of the carotid artery plaques. RESULTS: Age, male gender, BMI, IMT, TG, FBG, smoking and alcohol drinking rate were significantly higher in high normal blood pressure group than in normotensive group (all P < 0.05), LDL-C, HDL-C, hs-CRP and TC were similar between these two groups. Incidence of carotid artery plaques in normotensive, high normal blood pressure and hypertensive groups was 24.8%, 37.4%, 60.2% respectively. The risk of carotid artery plaques was increased to 38% and 163% in high normal and hypertensive groups compared to normotensive group, the OR ratio was 1.38 (95%CI: 1.15-1.66) and 2.63 (95%CI: 2.18-3.18), respectively. After adjusting gender, age, smoking, alcohol consumption, TG, TC, HDL-C, FBG, hs-CRP and BMI, the risk of developing carotid artery plague was increased in proportion to increasing blood pressure and the OR value was 1.24 (95%CI:1.01-1.52) , 1.69 (95%CI:1.34-2.15) and 2.66 (95%CI:2.20-3.21) in high normal group I [SBP/DBP 121-129/80-84 mm Hg(1 mm Hg = 0.133 kPa)] and high normal group II (SBP/DBP 130-139/85-89 mm Hg) and hypertensive group, respectively. CONCLUSIONS: The cardiovascular risk factors and prevalence of carotid artery plague increase in proportion to blood pressure level in this cohort. The detection rate of carotid artery plague is already significantly increased in individuals with high normal blood pressure.

[Impact of baseline pulse pressure on new-onset cardio-and cerebrovascular events in diabetic population].

OBJECTIVE: To observe the association between baseline pulse pressure (PP) level and new-onset cardio-cerebrovascular events in diabetic population. METHODS: Physical examination data between July 2006 to October 2007 from a total of 101 510 employees of Kailuan Group were reviewed, 8306 subjects with a fasting plasma glucose level of ≥ 7.0 mmol/L or with confirmed diabetes diagnosis and were enrolled in this prospective cohort study. Subjects were followed up for 38-53 (48.1 ± 3.1) months and the cardio-cerebrovascular events were obtained every six months, association between baseline PP and new-onset cardio-cerebrovascular events in the diabetic population were analyzed. RESULTS: (1) Incidences of total cardio-cerebrovascular events in the PP groups were 3.4%, 2.8%, 4.5%, 6.4%, respectively. Incidences of cerebral infarction events and myocardial infarction were 2.1%, 1.6%, 2.9%, 3.9% and 1.1%, 0.7%, 1.0%, 1.7%, respectively. (2) Multivariate Cox's proportional hazards regression analysis indicated that baseline PP group was the risk factor for total cardio-cerebrovascular events, cerebral infarction events and myocardial infarction, and the risk for all the events of the PP ≥ 60 mm Hg (1 mm Hg = 0.133 kPa) group was increasing. The values of RR(95%CI) were 1.88 (95%CI 1.34-2.65, P < 0.01), 1.92 (95%CI 1.23-2.99, P < 0.01) and 1.52 (95%CI 0.82-2.81, P > 0.05) after adjust the other factors.(3) In line with increasing level of baseline PP, age, BMI, SBP, DBP, HDL-C, and hs-CRP levels significantly increased in this diabetic population (P < 0.01 or P < 0.05). CONCLUSION: The level of high baseline PP is a risk factor for new-onset cardio-cerebrovascular events in diabetic population.