Obesity and lipid-related parameters for predicting metabolic syndrome in Chinese elderly population.

BACKGROUND: The present study evaluated the predictive ability of five known "best" obesity and lipid-related parameters, including body mass index (BMI), waist-to-height ratio (WHtR), triglyceride-to-high-density-lipoprotein-cholesterol (TG/HDL-C), lipid accumulation product (LAP) and visceral adiposity index (VAI), in identifying metabolic syndrome (MetS) in Chinese elderly population. METHODS: A total of 6722 elderly Chinese subjects (≥60 years) were recruited into our community-based cross-sectional study from April 2015 to July 2017. The anthropometrics, blood pressure, fasting plasma glucose, blood lipid profiles, family history and health-related behaviours were assessed. RESULTS: The prevalence of MetS was 40.4% (32.5% in males and 47.2% in females). With the increase in the number of MetS components (from 0 to 5), all the five parameters showed an increase trend in both genders (all P for trend < 0.001). According to receiver operating characteristic curve (ROC) analyses, all the five parameters performed high predictive value in identifying MetS. The statistical significance of the areas under the curves (AUCs) differences suggested that the AUCs of LAP were the greatest among others in both genders (AUCs were 0.897 in males and 0.875 in females). The optimal cut-off values of LAP were 26.35 in males and 31.04 in females. After adjustment for potentially confounding factors, LAP was strongly associated with the odds of having MetS in both genders, and ORs for MetS increased across quartiles using multivariate logistic regression analysis (P < 0.001). CONCLUSION: LAP appeared to be a superior parameter for predicting MetS in both Chinese elderly males and females, better than VAI, TG/HDL-C, WHtR and BMI.

Prevalence and associated factors of cognitive impairment among the elderly population: A nationwide cross-sectional study in China.

Background: Cognitive impairments are associated with increased risk for progression to dementia. In China, limited surveys have been conducted to estimate the national prevalence and risk factors associated with cognitive impairment in China. This study aims to assess the national prevalence and modifiable risk factors for cognitive impairments in the Chinese elderly population. Methods: This cross-sectional study was based on the 2018 China Health and Retirement Longitudinal Study. The Mini Mental State Examination (MMSE) is recommended to test for cognitive impairment. Univariate and multivariate logistic regression models were used in assessing risk factors for cognitive impairments in the Chinese elderly population. Results: A total of 3768 participants aged 60 years or older were enrolled in this study. The national prevalence of cognitive impairments was 22.24% in China, and the prevalence of cognitive impairment was higher in the south-west region than in the north region (29.94 vs. 16.53%, p < 0.05). The risk for cognitive impairments was higher in the following participants: not married or not living with spouse relative to married with spouse present (OR = 1.39, 95% CI, 1.15-1.70; p = 0.001), nap duration of ≥ 90 min relative to 30-60 min (OR = 1.54, 95% CI, 1.20-1.98; p = 0.001), sleep duration of ≥ 8 h relative to 6-8 h (OR = 1.73, 95% CI, 1.29-2.31; p < 0.001), and depression relative to no depression (OR = 1.67, 95% CI, 1.41-1.97; p < 0.001). The risk of cognitive impairment was lower in participants living in the urban areas relative to the rural areas (OR = 0.57, 95% CI, 0.47-0.69; p < 0.001) and consuming alcohol once a month relative to never consuming alcohol (OR = 0.69, 95% CI, 0.51-0.94; p = 0.02). Conclusion: Cognitive impairment prevalence was high in the Chinese elderly population. The potentially modifiable risk factors for cognitive impairment should be further assessed in the development of interventions for the elderly Chinese population.

A follow-up study to explore factors associated with rapid kidney function decline and new-onset kidney disease among Chinese elderly population.

AIM: To explore potential factors associated with rapid kidney function decline and new-onset kidney disease among a Chinese elderly population, and to examine the relationships between baseline serum uric acid (SUA), longitudinal change in SUA and rapid estimated glomerular filtration rate (eGFR) decline over 5 years for this Chinese elderly population. METHODS: A 5-year follow-up study was conducted from 2016 to 2020 in Xiamen City, China; and 2436 elderly people with normal kidney function at baseline was included. The multivariable logistic regressions were used to explore risk factors for rapid eGFR decline and new-onset kidney disease. RESULTS: The median age of subjects was 65 years, and 38.5% were men. These elderly people experienced a median 5-year decrease in eGFR of 14.50 mL/min/1.73 m2 , and 11.2% of them had developed new-onset kidney disease after 5-year follow-up. Participants with elevated SUA change from the normal group to the hyperuricemia group witnessed the highest decrease of eGFR after a 5-year follow-up than other groups. Multivariate analysis found advanced age, female, elevated baseline SUA, elevated SUA change, hypertension and triglyceride-glucose index were risk factors for rapid eGFR decline and new-onset kidney disease. CONCLUSION: The Chinese elderly population was more likely to encounter rapid renal function decline and new-onset kidney disease. A regular test for kidney disease was strongly recommended for these elderly people who were female, with advanced age, with elevated baseline SUA and elevated SUA change; and had high levels of insulin resistance, and blood pressure. The derived findings can offer significant evidence for targeted prevention for the Chinese elderly population. Geriatr Gerontol Int 2022; 22: 968-975.

Association Plasma Aß42 Levels with Alzheimer's Disease and Its Influencing Factors in Chinese Elderly Population.

Background and Purpose: Intracerebral Aß protein deposition is an important pathological mechanism of Alzheimer's disease (AD) and is one of the indicators of early diagnosis of AD. However, invasive lumbar puncture and Aß PET are difficult to perform in primary units, resulting delays in early diagnosis of AD. In recent years, it has been found that plasma Aß can reflect the pathological state of AD in early stage, but the results are not consistent. The objective of this study was to explore the association between plasma Aß42 levels and AD cognitive impairment and its influencing factors in Chinese elderly population, so as to provide guidance for the clinical application of plasma Aß42 as a blood biomarker of AD. Methods: This is a cross-sectional study based on the community population. Plasma samples were collected from 604 healthy controls (HC), 508 mild cognitive impairment (MCI) and 202 dementia with Alzheimer's type (DAT) patients from three cities. We analyzed the correlation between plasma Aß42 levels and cognitive function and the influence of confounding factors on the relationship between plasma Aß42 levels and AD. The independent influencing factors of plasma Aß42 levels were determined by covariance and linear regression analysis. Results: Our results suggest that there is a special linear relationship between plasma Aß42 and cognitive impairment of AD in Chinese elderly population, with Aß42 levels slightly decreased in early AD and significantly increased in moderate-to-severe AD (P<0.01). There are many factors influencing the association between plasma Aß42 levels and AD cognitive impairment, and sample source, gender and BMI are independent influencing factors of plasma Aß42. Conclusion: This indentifies that plasma Aß42 may be a peripheral biomarker for AD screening in Chinese elderly population, but it is necessary to establish standardized detection methods and establish different demarcation criteria for various influencing factors.

Hyperhomocysteinemia Increases Risk of Metabolic Syndrome and Cardiovascular Death in an Elderly Chinese Community Population of a 7-Year Follow-Up Study.

BACKGROUND: Hyperhomocysteinemia (HHcy) and abdominal obesity are risk factors for metabolic syndrome (MetS) and death from cardiovascular disease (CVD). Recent studies have shown a correlation between HHcy and abdominal obesity, suggesting that they may have a combined effect on the risk of MetS and CVD mortality. However, this suspicion remains to be confirmed, particularly in the elderly population. We explored their combined effects on the risk of MetS and CVD mortality among the community population aged 65 and above in China. METHODS AND RESULTS: This prospective study enrolled 3,675 Chinese community residents aged 65 and above in May 2013 with 7-year follow-up of all-cause and CVD mortality. HHcy was defined as the blood homocysteine (Hcy) level >15 µmol/L and abdominal obesity as waist circumference (WC) ≥90 cm for men and ≥80 cm for women (HWC). All participants were grouped into four categories by WC and the blood level of Hcy: NWC (normal WC) /HHcy(-), NWC/HHcy(+), HWC/HHcy(-), and HWC/HHcy(+). The relationship of combined HHcy and abdominal obesity with MetS and metabolic profile was evaluated by logistic regression analysis and the association of combined HHcy and abdominal obesity with CVD and all-cause mortality evaluated by Cox regression analysis. The prevalence of HHcy, abdominal obesity and MetS in elderly Chinese community residents was 40.1, 59.3, and 41.4%, respectively. Using group without HHcy and abdominal obesity [NWC/HHcy(-)] as reference, the participants of other three groups had significantly higher risk of MetS and its component abnormalities, with HWC/HHcy(+) group having the highest risk (OR = 13.52; 95% CI = 8.61-14.55). After a median of 6.94 (±1.48) years follow-up, 454 deaths occurred with 135 CVD deaths. Compared with NWC/HHcy(-) group, the risk of 7-year follow-up CVD mortality (HR = 1.75; 95% CI = 1.02-3.03) and all-cause mortality (HR = 1.23; 95% CI = 1.04-2.18) of HWC/HHcy(+) group increased considerably after adjustment for major MetS and CVD risk factors. CONCLUSIONS: There is high prevalence of HHcy, abdominal obesity, and MetS in the elderly Chinese community population. HHcy increases risk of MetS, CVD, and all-cause mortality, especially in the populations with abdominal obesity.

The Prognostic Value of Biomarkers on Detecting Non-Small Cell Lung Cancer in a Chinese Elderly Population.

BACKGROUND: Survival in non-small cell lung cancer (NSCLC) remains poor. Early detection of NSCLC is of great significance to provide a chance to improve survival. AIM: We constructed predictive models to evaluate the predictive value of four tumor biomarkers by including serum human epididymis protein 4 (HE4), carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), and cytokeratin 19 fragment (CY21-1) on detecting NSCLC in a Chinese elderly population. METHODS: A total of 363 patients with NSCLC and 433 subjects without cancer (healthy control group) were admitted to the respiratory department in our hospital. We assessed serum levels of these four tumor biomarkers in the two groups and then the predictive value of predictive models was evaluated. RESULTS: Serum median values of HE4 (143.3 pmol/L), CEA (4.60 ng/mL), SCCA (1.52 ng/mL), and CY21-1 (5.36 ng/mL) in patients with NSCLC were significantly higher than the healthy control group, respectively (all P<0.05). A multivariate logistic regression model showed that HE4 (OR=2.10, 95% CI=1.22-4.42, P=0.013), CEA (OR=2.30, 95% CI=1.44-4.53, P=0.004), SCCA (OR=2.20, 95% CI=1.29-4.55, P=0.011), and CY21-1 (OR=2.60, 95% CI=1.56-6.25, P<0.001) were significantly and independently associated with increased risk of NSCLC on admission after confounding factors were corrected. Importantly, the ROC curve suggested HE4 had a good value on predicting NSCLC in the Chinese elderly population. Additionally, the predictive model (CEA+SCCA+CY21-1+HE4) had better idea capability to detecting the existence of NSCLC (AUC=0.954, 95% CI=0.927-0.999, P<0.001). CONCLUSION: Our study showed that several lung cancer-related biomarkers were used to build prediction models, which has good value for early prediction of NSCLC.

Greater fruit intake was associated with better bone mineral status among Chinese elderly men and women: results of Hong Kong Mr. Os and Ms. Os studies.

OBJECTIVES: Although studies in white populations have reported the beneficial effects of intakes of fruit and vegetables (F&V) on bone mass, limited data are available in Asians, especially among the elderly population. We examined the association of F&V intakes and bone mineral status in Chinese elderly adults and explored the potential mechanisms. DESIGN, SETTING, AND PARTICIPANTS: The study was a population-based cross-sectional study among 4000 Hong Kong Chinese men and women aged 65 years and older. MEASUREMENTS: Habitual F&V intakes were ascertained from a validated food frequency questionnaire. Bone mineral measurements of the whole body, hip, lumber spine, and femoral neck were made by dual-energy X-ray absorptiometry. Information on demographic, health, and lifestyles factors was obtained by standardized questionnaire. Relations between F&V intakes and bone mass at various sites were assessed by regression models. RESULTS: Whole-body and femoral neck bone mineral density and content were significantly and positively associated with fruit intake in both men and women, even when adjustment for a range of potential confounders was made. A daily increase of 100 g/kcal total fruit intake was associated with 4.5% and 6.4% increase of BMD at whole body, and 3.9% and 4.8% increase at the femoral neck in men and women, respectively. No significant association was found between vegetable intake and bone mass. The adjustment for vitamin C intake, but not dietary acid load, attenuated the association between fruit intake and bone mass. CONCLUSIONS: Greater fruit intake was independently associated with better bone mineral status among Chinese elderly men and women. The association is probably modified by dietary vitamin C.