Urinary Creatinine Concentrations and Its Explanatory Variables in General Chinese Population: Implications for Creatinine Limits and Creatinine Adjustment.

Objective: The study aimed to analyze the applicability of the World Health Organization's exclusionary guidelines for Urinary creatinine (Ucr) in the general Chinese population, and to identify Ucr related factors. Methods: We conduct a cross-sectional study using baseline data from 21,167 participants in the China National Human Biomonitoring Program. Mixed linear models and restricted cubic splines (RCS) were used to analyze the associations between explanatory variables and Ucr concentration. Results: The geometric mean and median concentrations of Ucr in the general Chinese population were 0.90 g/L and 1.01 g/L, respectively. And 9.36% samples were outside 0.3-3.0 g/L, including 7.83% below the lower limit and 1.53% above the upper limit. Middle age, male, obesity, smoking, higher frequency of red meat consumption and chronic kidney disease were associated significantly with higher concentrations of Ucr. Results of the RCS showed Ucr was positively and linearly associated with body mass index, inversely and linearly associated with systolic blood pressure, diastolic blood pressure, triglycerides level, and glomerular filtration rate, and were non-linearly associated with triiodothyronine. Conclusion: The age- and gender-specific cut-off values of Ucr that determine the validity of urine samples in the general Chinese population were recommended. To avoid introducing bias into epidemiologic associations, the potential predictors of Ucr observed in the current study should be considered when using Ucr to adjust for variations in urine dilution.

Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study.

OBJECTIVE: To examine the associations of blood pressure with all cause mortality and cause specific mortality at three years among oldest old people in China. DESIGN: Community based, longitudinal prospective study. SETTING: 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, conducted in 22 Chinese provinces. PARTICIPANTS: 4658 oldest old individuals (mean age 92.1 years). MAIN OUTCOME MEASURES: All cause mortality and cause specific mortality assessed at three year follow-up. RESULTS: 1997 deaths were recorded at three year follow-up. U shaped associations of mortality with systolic blood pressure, mean arterial pressure, and pulse pressure were identified; values of 143.5 mm Hg, 101 mm Hg, and 66 mm Hg conferred the minimum mortality risk, respectively. After adjustment for covariates, the U shaped association remained only for systolic blood pressure (minimum mortality risk at 129 mm Hg). Compared with a systolic blood pressure value of 129 mm Hg, risk of all cause mortality decreased for values lower than 107 mm Hg (from 1.47 (95% confidence interval 1.01 to 2.17) to 1.08 (1.01 to 1.17)), and increased for values greater than 154 mm Hg (from 1.08 (1.01 to 1.17) to 1.27 (1.02 to 1.58)). In the cause specific analysis, compared with a middle range of systolic blood pressure (107-154 mm Hg), higher values (>154 mm Hg) were associated with a higher risk of cardiovascular mortality (adjusted hazard ratio 1.51 (95% confidence interval 1.12 to 2.02)); lower values (<107 mm Hg) were associated with a higher risk of non-cardiovascular mortality (1.58 (1.26 to 1.98)). The U shaped associations remained in sensitivity and subgroup analyses. CONCLUSIONS: This study indicates a U shaped association between systolic blood pressure and all cause mortality at three years among oldest old people in China. This association could be explained by the finding that higher systolic blood pressure predicted a higher risk of death from cardiovascular disease, and that lower systolic blood pressure predicted a higher risk of death from non-cardiovascular causes. These results emphasise the importance of revisiting blood pressure management or establishing specific guidelines for management among oldest old individuals.

[Economic costs of both overweight and obesity among Chinese urban and rural residents, in 2010].

OBJECTIVE: Using the latest available data to estimate the direct economic burden of overweight and obesity in China. METHODS: 'Cost-of-illness' approach was used to calculate the costs of five major non-communicable diseases(NCDs)which were associated with overweight and obesity. National data from the 2010 Chinese Behavioral Risk Factors Surveillance Survey and the 2008 National Health Service Survey were used to compute the Population Attributable Risks(PARs) of overweight and obesity for each major NCDs. Costs specific to overweight and obesity were obtained by multiplying costs of each disease by the PARs for each NCD. RESULTS: In 2010, overweight and obesity were imposing a substantial economic burden on China, responsible for 42.9% of the medical and non-medical yearly costs of the major NCDs in China, with the amount as 90.768 billion RMB. CONCLUSION: The economic costs of overweight and obesity increased over the years, accounting for 4.5% of the national health expenditure. The high economic burden of overweight and obesity implied the need to develop and implement policies that addressing the behavior-related risk factors and the obese-genic environment, in order to curb the NCDs epidemic in China.

[The relationship between socioeconomic status and overweight and obesity among elementary school children in China].

OBJECTIVE: To analyze the relationship between socioeconomic status (SES) and overweight and obesity among elementary school children. METHODS: This cross-sectional study was conducted from September to November, 2010. A stratified random cluster sampling was used from sampling frame of eight provinces by the geographical and economic development distributions in mainland China. A total of 19 934 students aged 7-12 years old participated in this study. All subjects were evaluated the status of overweight and obesity. Green's scoring SES was used to evaluate the SES of the participants. Multivariate logistic regression analysis was performed to examine the relationship between SES and overweight and obesity among children. RESULTS: According to the scores of Green's SES, the participants' SES were divided into three levels, the prevalence of overweight were 7.4% (538/7295), 9.3% (560/6013) and 12.6% (832/6626), and the prevalence of obesity were 4.4% (321/7295) , 6.4% (387/6013) and 10.2% (677/6626) from low to high SES level, respectively (χ(2) value were 133.82, 180.27, respectively, P < 0.01). After adjusted by age, urban and rural and economic regions, compared with the participants with low SES, the OR (95%CI) of having overweight and obesity among participants with high SES were 1.83(1.61-2.08) for boys and 1.67(1.42-2.00) for girls; the OR (95%CI) with middle SES were 1.30(1.15-1.48) for boys and 1.23(1.04-1.46) for girls. CONCLUSION: The prevalence of overweight and obesity rises with the family's SES levels. There was a positive correlation between SES and overweight and obesity among school-aged children.

[Assessment of capacity for chronic noncommunicable diseases prevention and control of the Center for Disease Control and Prevention Organizations in China].

OBJECTIVE: To evaluate the capacity for noncommunicable diseases (NCDs) prevention and control in the Centers for Disease Control and Prevention (CDCs) in China. METHODS: All CDCs in China, including provincial, city and county CDCs were surveyed by questionnaires designed by China CDC including resource provided, capacity and efforts for NCDs. RESULTS: (1) RESOURCE: 7483 staff members worked on NCDs prevention and control, only accounting for 4.0% of all the CDCs' personnel; 23.6% of the staff members devoted their time to NCDs control less than 6 months in 2008. Fundings for NCDs prevention and control only accounted for 2.29%, 1.70% and 2.69% of the total funds of provincial, city and county CDCs, respectively. (2) Capacity: The proportions of CDCs that had professional institutes of NCD at provincial, city and county level were 100.0%, 62.8% and 43.7% respectively. CDCs mainly cooperated with health agencies regarding NCDs prevention and control programs. 34.7% of the staff members had educational background of college undergraduate or higher, 12.1% had senior professional titles, 61.7% of them worked for NCDs less than 5 years. The average person-times of continuing education in NCDs were 21.90, 4.60 and 1.68 at the provincial, city and county CDCs respectively. 8.7% of the CDCs sent their staff members for advanced studies on NCDs. All provincial CDCs carried out surveillance but only 4.2% of them published reports of NCDs in all the CDCs during the past three years. (3) Efforts: 43.5% and 30.8% of the county CDCs carried out surveillance and intervention of NCDs respectively in 2008. CONCLUSION: RESOURCEs for NCDs prevention and control were quite limited in CDCs. Fundings and staff members for NCDs were not enough, compared to the heavy disease burden of NCDs. Capacity for NCDs prevention and control need to be improved.

[A study on chronic diseases and other related health indicators of centenarians in longevity areas in China].

OBJECTIVE: To describe chronic diseases and other related health indicators of centenarians, compare these health indicators with other age groups in longevity areas in China. METHODS: Residents who participated in the project of Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2008 - 2009 were selected from 7 Longevity Areas.2029 people aged 40 and over attended the study from March to June, 2009, including 469 aged 40 and over, 436 aged 60 and over, 346 aged 80 and over, 380 aged 90 and over, 398 centenarians. Information, including socio-demographic, were collected by self-designed questionnaire. Calibrated instruments were used by the clinical personnel who had worked over 3 years to manually check subjects' health. Venous blood and urine samples were collected for blood and urine routine test, plasma macro and trace elements test, plasma biological test, using standard methods such as instrument analysis, atomic absorption spectrometry. Data analysis was conducted using descriptive statistical methods. RESULTS: In the groups aged 40 and over, 60 and over, 80 and over, 90 and over, 100 and over, the body mass index (BMI) were (23.2 +/- 4.6), (22.1 +/- 3.7), (20.2 +/- 3.4), (20.2 +/- 3.9) and (19.1 +/- 5.0) kg/m(2) in males (F = 22.78, P < 0.01) and (23.3 +/- 4.0), (21.6 +/- 3.5), (19.7 +/- 3.9), (19.0 +/- 4.8), (18.4 +/- 3.8) kg/m(2) in females (F = 51.84, P < 0.01); the prevalence of hypertension were 38.3% (80/209), 60.8% (166/273), 63.5% (106/167), 61.8% (68/110), 54.8% (34/62) in males (chi(2) = 34.26, P < 0.01) and 32.3% (84/260), 60.1% (98/163), 69.8% (125/179), 61.5% (166/270), 58.9% (198/336) in females (chi(2) = 78.45, P < 0.01); the prevalence of diabetes were 10.5% (22/209), 12.5% (34/273), 9.0% (15/167), 18.2% (20/110), 12.9% (8/62) in males (chi(2) = 5.92, P = 0.20) and 4.2% (11/260), 15.3% (25/163), 10.1% (18/179), 12.2% (33/270), 7.4% (25/336) in females (chi(2) = 19.25, P < 0.01). In groups aged 40 and over, 90 and over, 100 and over, the superoxide dismutase (SOD) activity were (29.03 +/- 5.79), (30.93 +/- 5.39), (31.63 +/- 5.92) U/ml in males (F = 4.40, P < 0.05) and (28.27 +/- 6.25), (30.86 +/- 5.72), (31.55 +/- 5.25) U/ml in females (F = 13.13, P < 0.05); levels of plasma calcium were (3.63 +/- 1.08), (3.09 +/- 0.91), (3.34 +/- 1.07) mmol/L in males (F = 5.71, P < 0.01) and (3.84 +/- 1.02), (3.19 +/- 1.16), (3.38 +/- 1.16) mmol/L in females (F = 11.61, P < 0.01); levels of selenium were (1.44 +/- 0.86), (1.28 +/- 0.60), (1.75 +/- 0.57)micromol/L in males (F = 3.79, P < 0.05) and (1.44 +/- 0.80), (1.48 +/- 0.81), (1.78 +/- 0.80) micromol/L in females (F = 8.69, P < 0.01); levels of iron were (63.25 +/- 49.05), (71.86 +/- 54.16), (138.36 +/- 77.60) micromol/L in males (F = 22.78, P < 0.01) and (64.86 +/- 57.72), (74.56 +/- 56.93), (106.56 +/- 74.08) micromol/L in females (F = 17.88, P < 0.01); levels of copper were (23.49 +/- 12.85), (17.96 +/- 7.57), (22.33 +/- 6.89) micromol/L in males (F = 5.18, P < 0.01) and (21.52 +/- 10.63), (19.60 +/- 9.57), (22.99 +/- 8.71) micromol/L in females (F = 5.68, P < 0.01); positive rates of high-sensitivity c-reactive protein (hsCRP) were 5.5% (8/146), 24.0% (18/75), 31.3% (10/32) in males (chi(2) = 22.62, P < 0.01) and 9.8% (12/122), 19.6% (40/204), 25.1% (49/195) in females (chi(2) = 11.24, P < 0.01). CONCLUSION: The results indicate that the centenarians have lower chronic diseases risks and higher anti-oxidants activity compared with other age groups, and have a high level of nutritional elements compared with those aged 90 and over. However, it is more common for them suffering from inflammation.