RESUMO
BACKGROUND AND AIMS: This study aimed to examine the cumulative effects of body mass index (BMI), body roundness index (BRI), pulse pressure (PP), triglycerides (TG), high-density lipoprotein cholesterol (HDL) and fasting plasma glucose (FPG) on Type 2 diabetes (T2D) morbidity. METHODS: A total of 78,456 participants aged older than 45 years were extracted from basic public health services in China. During the 2-year follow-up, 6,942 individuals had developed T2D. The binary logistic regression models and multinomial logistic regression models were conducted to investigate the effects of cumulative metabolic parameters on incident T2D, prediabetes regression and progression. RESULTS: We found statistically deleterious impacts of exposure to high cumulative BMI, BRI, PP, TG and low cumulative HDL on T2D morbidity and prediabetes progression. Compared to the group with low cumulative of all five parameters, the adjusted ORs for new-onset T2D for participants presenting with 1-2, 3, and 4-5 elevated metabolic parameters were 1.41(1.31,1.52), 1.93(1.74,2.13) and 2.21(1.94,2.51), respectively. There was additive interaction between FPG level and cumulative metabolic parameters with T2D. Compared with participants with the lowest quartile of FPG and low cumulative of all 5 parameters, those with the highest quartile of FPG and high cumulative of 4-5 parameters had a 14.63 [95% CI (12.27, 17.42)] higher risk of incident T2D. CONCLUSIONS: Participants with more numbers of high-cumulative metabolic parameters were associated with a higher risk of incident T2D and prediabetes progression. A high level of normal FPG could enhance these risks.
RESUMO
OBJECTIVE: To evaluate the influence of different salt iodine concentration on urinary iodine excrition among the target population and to determine the appropriate level of salt iodization to the local people. METHODS: In the 31-day random control trial, 1099 subjects from 399 families were randomly distributed into four groups and were supplied with iodized-salt with different iodine concentration of (6 +/- 2)mg/kg, (15 +/- 2)mg/kg, (24 +/- 2)mg/kg and (34 +/- 2)mg/kg, respectively. The original family salt was retrieved, whose iodine content was determined in those subjects' families with single-blind method. Baseline survey was conducted including salt and urinary iodine of the subjects. From the 27th day after the intervention, the urinary samples of the subjects were continuously collected for 5 days and urinary iodine was tesed respectively. Meanwhile, daily meal investigation was conducted to evaluate the influences originated from food. RESULTS: The median of local water iodine content was 3.05 microg/L and the average salt iodine concentration was (36.4 +/- 5.4)mg/kg while 98.8% of the household consumed sufficient iodized-salt. The medians of baseline urinary iodine of the subjects were 293.6 microg/L in city, and 508.8 microg/L in the countryside. The urinary iodine medians of four groups in the day of 28th after intervention were 97.2 microg/L, 198.6 microg/L, 249.4 microg/L, and 330.7 microg/L respectively in the city group, while they were 100.5 microg/L, 193.0 microg/L, 246.3 microg/L and 308.3 microg/L seperately in the countryside group. There was no statistically significant differences among the medians of urine iodine in the 27th, 28th, 29th, 30th and 31st day after intervention (P > 0.05). CONCLUSIONS: The target areas were with iodine deficiency which possessed high coverage of qualified iodized-salt at household level. The average urinary iodine level of the subjects was slightly higher than the standard level, according to the baseline survey. The intervetion trail showed that the salt iodine concentration of 15-24 mg/kg was sufficient to the local people.