Heritability and genetic correlations of obesity indices and cardiometabolic traits in the Northern Chinese families.

OBJECTIVE: This study aimed to investigate the heritability of various obesity indices and their shared genetic factors with cardiometabolic traits in the Chinese nuclear family. METHODS: A total of 1270 individuals from 538 nuclear families were included in this cross-sectional study. Different indices were used to quantify fat mass and distribution, including body index mass (BMI), visceral fat index (VFI), and body fat percent (BFP). Heritability and genetic correlations for all quantitative traits were estimated using variance component models. The susceptibility-threshold model was utilized to estimate the heritability for binary traits. RESULTS: Heritability estimates for obesity indices were highest for BMI (59%), followed by BFP (49%), and VFI (40%). Heritability estimates for continuous cardiometabolic traits varied from 24% to 50%. All obesity measures exhibited consistently significant positive genetic correlations with blood pressure, fasting blood glucose, and uric acid (rG range: 0.26-0.57). However, diverse genetic correlations between various obesity indices and lipid profiles were observed. Significant genetic correlations were limited to specific pairs: BFP and total cholesterol (rG = 0.24), BFP and low-density lipoprotein cholesterol (rG = 0.25), and VFI and triglyceride (rG = 0.33). CONCLUSION: The genetic overlap between various obesity indices and cardiometabolic traits underscores the importance of pleiotropic genes. Further studies are warranted to investigate specific shared genetic and environmental factors between obesity and cardiometabolic diseases.

Sex-specific associations between total and regional Fat-to-muscle Mass ratio and cardiometabolic risk: findings from the China National Health Survey.

BACKGROUND: The fat-to-muscle mass ratio (FMR), integrating the antagonistic effects of fat and muscle mass, has been suggested as a valuable indicator to assess cardiometabolic health independent of overall adiposity. However, the specific associations of total and regional FMR with cardiometabolic risk are poorly understood. We aimed to examine sex-specific associations of total and regional FMR with single and clustered cardiometabolic risk factors (CRFs). METHODS: 13,505 participants aged 20 years and above were included in the cross-sectional study. Fat mass and muscle mass were assessed using a bioelectrical impedance analysis device. FMR was estimated as fat mass divided by muscle mass in corresponding body parts (whole body, arm, leg, and trunk). Clustered CRFs was defined as the presence of two or more risk factors, including hypertension, elevated blood glucose, dyslipidemia, insulin resistance (IR), and hyperuricemia. IR was assessed by the triglyceride glucose (TyG) index. Multivariable logistic regression models were applied to explore the associations of FMR in the whole body and body parts with single and clustered CRFs. RESULTS: The odds ratios (ORs) increased significantly for all single and clustered CRFs with the per quartile increase of total and regional FMR in both sexes (P for trend < 0.001), following adjustment for confounders. Among the regional parts, FMRs of the legs presented the strongest associations for clustered CRFs in both men and women, with adjusted OR of 8.54 (95% confidence interval (CI): 7.12-10.24) and 4.92 (95% CI: 4.24-5.71), respectively. Significant interactions (P for interaction < 0.05) were identified between age and FMRs across different body parts, as well as between BMI status and FMRs in different regions for clustered CRFs. Restricted cubic splines revealed significant non-linear relationships between FMRs of different body parts and clustered CRFs in both sexes (P for nonlinear < 0.05). CONCLUSIONS: FMRs in the whole body and different regions were significantly associated with single and clustered CRFs in the general Chinese population. The association between FMR and clustered CRFs was more pronounced in youngers than in the elderly.

Prevalence, associated factors, and gene polymorphisms of obesity in Tibetan adults in Qinghai, China.

OBJECTIVES: To explore the prevalence and associated factors of obesity in Tibetan adults in Qinghai, China, and to determine the association between the FTO (rs1121980 and rs17817449) and MC4R gene (rs17782313 and rs12970134) polymorphisms with obesity. METHODS: A cross-sectional survey was conducted in 2015 in Qinghai to selected Tibetan adults aged 20 to 80 years. Prevalence of obesity (BMI ≥ 28 kg/m2) and overweight (BMI 24 ~ 27.9 kg/m2) were evaluated. Multivariable logistic models were used to determine the associated factors. Pair-matched subjects of obesity cases and normal-weight controls were selected for the gene polymorphism analyses. Conditional logistic models were used to assess the association between gene polymorphisms with obesity. Additive and multiplicative gene-environment interactions were tested. RESULTS: A total of 1741 Tibetan adults were enrolled. The age- and sex- standardized prevalence of obesity and overweight was 18.09% and 31.71%, respectively. Male sex, older age, heavy level of leisure-time exercise, current smoke, and heavy level of occupational physical activity were associated with both obesity and overweight. MC4R gene polymorphisms were associated with obesity in Tibetan adults. No significant gene-environment interaction was detected. CONCLUSION: The prevalence of obesity and overweight in Tibetan adults was high. Both environmental and genetic factors contributed to the obesity prevalent.

Effects of long-term exposure to air pollutant mixture on blood pressure in typical areas of North China.

BACKGROUND: Studies about the combined effects of gaseous air pollutants and particulate matters are still rare. OBJECTIVES: This study was performed based on baseline survey of the Diverse Life-Course Cohort in the Beijing-Tianjin-Hebei (BTH) Region of North China to evaluate the association of long-term air pollutants with blood pressure and the combined effect of the air pollutants mixture among 32821 natural han population aged 20 years or above. METHODS: Three-year average exposure to air pollutants (PM10, PM2.5, PM1, O3, SO2, NO2, and CO) and PM2.5 components [black carbon (BC), ammonium (NH4+), nitrate (NO3-), sulfate (SO42-), and organic matter (OM)] of residential areas were calculated based on well-validated models. Generalized linear mixed models (GLMMs) were used to estimate the associations of air pollutants exposure with the systolic blood pressure (SBP), diastolic blood pressure (DBP), Mean arterial pressure (MAP), pulse pressure (PP) and prevalent hypertension. Quantile g-Computation and Bayesian Kernel Machine Regression (BKMR) were employed to assess the combined effect of the air pollutant mixture. RESULTS: We found that long-term exposures of O3, PM2.5, and PM2.5 components were stably and strongly associated with elevated SBP, DBP, and MAP and prevalent hypertension. O3 increased SBP, DBP, and MAP at a similar extent, but with greater effects; while, PM2.5 and PM2.5 components had a greater impact on SBP than DBP, which increased PP simultaneously. In multi-pollutant models, the combined effects of the air pollutant mixture on blood pressure and prevalent hypertension was predominantly influenced by O3, PM2.5, and O3, OM in different models, respectively. For example, O3, PM2.5 contributed 57.25 %, 39.22 % of the positive combined effect of the air pollutant mixture on SBP; and O3, OM positively contributed 70.00 %, 30.00 % on prevalent hypertension, respectively. There were interactions between O3, CO, SO2 and PM2.5 components on hbp, SBP and PP. CONCLUSIONS: The results showed positive associations of air pollutant mixtures with blood pressure, where O3 and PM2.5 (especially OM) might be primary contributors. There were interactions between gaseous air pollutants and PM2.5 components on blood pressure and prevalent hypertension.

BART-D2 subtype of EBV encoded BART miRNA cluster 1 region is strongly associated with endemic nasopharyngeal carcinoma.

Epstein-Barr virus (EBV)-encoded BamHI A rightward transcript (BART) microRNAs (miRNAs) play important roles in viral infection and tumorigenesis. The association of sequence variations in the BART miRNA cluster 1 region with diseases remains unclear. Herein, 6 types and 11 subtypes of BART cluster 1 were identified in 354 tumors and healthy donors (HDs) from nasopharyngeal carcinoma (NPC)-endemic and nonendemic China (genotyped data), and 905 EBV genomes retrieved from GenBank from diseased and normal people from around the world (archived data). The distributions of BART cluster 1 types/subtypes between NPC-endemic and nonendemic China; between Asian regions and Africa/Europe & Australia & United States; and among Asian regions (NPC-endemic China, NPC-nonendemic East Asia and Southeast Asia) were significantly different (p < 0.001). The subtype BART-D2 was not found outside Asia and was only common in NPC-endemic China. More importantly, BART-D2 had a higher frequency in NPCs than in HDs in NPC-endemic China (genotyped data, 78.0% vs. 44.1%, p < 0.001; achieved data, 89.3% vs. 43.7%, p < 0.001), and was also more frequent in NPCs than in HDs, gastric carcinomas, and lymphomas in NPC-nonendemic China (genotyped data, 27.9% vs. 1.9%, 2.4%, and 0.0%, p < 0.001). BART-D2 was preferentially linked with the high-risk subtypes for NPC previously reported, 162476C or 163364T, in the BALF2 gene, and was associated with NPC risk (p < 0.01). In vitro experiments showed that BART-D2 affected the expression of some mature BART miRNAs. These findings demonstrate geographically restricted variations of BART cluster 1 and identify distinct subtype that is confined to NPC-endemic China and is associated with NPC.

Prevalence and risk factors of oral human papillomavirus infection among 4212 healthy adults in Hebei, China.

BACKGROUND: Human papillomavirus (HPV) infection is an essential cause of oropharyngeal squamous cell carcinoma that is increasing in incidence worldwide. However, little is known about the epidemiology of oral HPV infection among healthy adults in China. METHODS: A study in northern China was conducted in 2021 as baseline data of Diverse Life-Course Cohort (DLCC). Residents who aged above 20 were eligible to participate. Oral swab specimens and questionnaires were collected from 4226 participants. HPV DNA in oral exfoliated cells was tested by Nested Polymerase Chain Reaction approach and sequencing. Univariate and multivariate analyses were performed to assess the associations between exposure factors and oral HPV infection. RESULTS: Overall prevalence of oral HPV infection was 4.08% (95%CI, 3.69%-4.68%). The most prevalent HPV type detected was HPV-81 (1.35%; 95% CI, 1.00%-1.70%), followed by HPV-16 (0.64%; 95% CI, 0.40%-0.88%). Oral HPV infection presented a bimodal pattern with respect to age in male and female participants. Oral HPV prevalence of male participants was significantly higher than prevalence of female participants (5.0% versus 3.6%, P = 0.041). Prevalence of oral HPV was higher among current smokers (OR = 1.59; 95% CI, 1.11-2.29; P = 0.039) and current drinkers (OR = 1.60; 95% CI, 1.14-2.25; P = 0.023). Current alcohol consumption was independently associated with oral HPV infection (OR = 1.74; 95% CI, 1.22-2.50; P = 0.010). CONCLUSIONS: Among healthy adults aged above 20 in Hebei, China, the prevalence of high-risk HPV infection was 1.92% (95%CI, 1.51%-2.34%). Oral HPV prevalence was independently associated with alcohol consumption. More tailored prevention strategies are needed to prevent oral HPV infection through smoking cessation, reduction of alcohol consumption, and HPV vaccination.

The association of nocturnal hypoxemia with dyslipidemia in sleep-disordered breathing population of Chinese community: a cross-sectional study.

BACKGROUND: Currently, there is limited and controversial clinical research on the correlation between sleep-disordered breathing (SDB) and dyslipidemia. This discrepancy in findings may be because studies that primarily focused on hospital-based populations may not be applicable to community-based populations. Therefore, the primary objective of this research endeavor is to scrutinize the correlation between nocturnal hypoxemia and blood lipid concentrations among adult individuals residing in the community who exhibit symptoms of SDB. Additionally, this study aimed to identify the nocturnal hypoxia parameters having the strongest correlation with this relationship. METHODS: This cross-sectional study collected data from The Guangdong Sleep Health Study, which included 3829 participants. Type IV sleep monitoring was employed to measure hypoxemia parameters, and lipoproteins were evaluated using fasting blood samples. To understand the association between dyslipidemia and hypoxemia parameters, a multivariable logistic regression model was used. Subgroup analyses were conducted to stratify data according to age, sex, waist circumference, and chronic diseases. RESULTS: The age of the individuals involved in the study spanned from 20 to 90 years. The average age of the participants was 56.15 ± 13.11 years. Of the total sample size, 55.7% were male. In the fully adjusted model, the meanSpO2 was negatively associated with hyperlipidemia (0.9303 [95% confidence interval 0.8719, 0.9925]). Upon conducting a nonlinearity test, the relationship between the meanSpO2 and hyperlipidemia was nonlinear. The inflection points were determined to be 95. When meanSpO2 ≥ 95%, a difference of 1 in the meanSpO2 corresponded to a 0.07 difference in the risk of hyperlipidemia. CONCLUSIONS: This study revealed that higher meanSpO2 is significantly and negatively associated with hyperlipidemia in adult community residents with SDB, particularly when the meanSpO2 exceeds 95. This finding emphasizes the importance of close monitoring for dyslipidemia, which is considered an early indicator of atherosclerosis in patients with SDB who experience nocturnal hypoxia.

The diverse life-course cohort (DLCC): protocol of a large-scale prospective study in China.

The Diverse Life-Course Cohort (DLCC) is a large-scale prospective study including around 130,000 participants in mainland China. The primary aims of DLCC include contributing to knowledge on noncommunicable chronic disease determinants, particularly cardiometabolic diseases, and exploring the long-term effect of ambient air pollutants or other environmental risk factors on health among all-age populations. The cohort consists of several sub-populations that cover the whole life-course and diverse resources: from premarital to adolescents, adults from workplace and communities ranged from 18 to 93 years old. Baseline assessment (2017-2021) included face-to-face standardized questionnaire interview and measurements to assess social and biological factors of health. Blood samples were collected from each participant (except for children younger than 6) to establish the biobank. DLCC consists of two visits. Visit 1 was conducted from 2017, and 114850 individuals from one of the world-class urban agglomerations: Beijing, Tianjin, and Hebei area were recruited. By the end of 2021, at least one follow-up was carried out, with an overall follow-up rate of 92.33%. In 2021, we initiated Visit 2, newly recruited 9,866 adults from Guangdong province (South China) and Hebei province (Central China), with research focuses on the comparations on ambient pollution hazards and other unique dietary or environmental risks for health. The baseline survey of Visit 2 was finished in July 2021. DLCC is still ongoing with a long-term follow-up design, and not limited by the current funding period. With reliable data and the well-established biobank which consists of over 120,000 individuals' blood samples, DLCC will provide invaluable resources for scientific research.

Body mass index was linked with multi-cardiometabolic abnormalities in Chinese children and adolescents: a community-based survey.

BACKGROUND: Evidence on how body mass index (BMI) influence cardiometabolic health remains sparse in Chinese children and adolescents, especially in south China. We aim to investigate the effect of overweight and/or obesity on high blood pressure (HBP), dyslipidemia, elevated serum uric acid (SUA) and their clustering among children and adolescents in an island in South China. METHODS: Using multi-stage cluster sampling method, 1577 children and adolescents aged 7-18 in Hainan province, south China, participated in the survey. The association between body mass index and cardiometabolic indexes were explored. Overweight and obesity were classified according to criteria of World Health Organization for children and adolescents aged 5 to 19. Restricted cubic spline models were used to examine the possible non-linear association between BMI and cardiometabolic profiles. Multivariable logistic regression models were fitted to examine the effect size of BMI on cardiometabolic disorders including HBP, elevated SUA and dyslipidemia. Comorbidity of at least two cardiometabolic abnormalities (HBP, dyslipidemia, elevated SUA) was defined as clustering of cardiometabolic risk factors. RESULTS: Comparing with normal weight and underweight subjects, overweight/obese youths had higher levels of BP, SUA, triglyceride, low-density lipoprotein but lower level of high-density lipoprotein. Overweight/obese youth had higher risk of dyslipidemia (OR:2.89, 95%CI: 1.65-5.06), HBP (OR:2.813, 95%CI: 1.20-6.59) and elevated SUA (OR: 2.493, 95%CI: 1.45-4.27), respectively, than their counterparts. The sex-, age-adjusted prevalence of abnormalities clustering was 32.61% (95% CI: 20.95% to 46.92%) in overweight/obesity group, much higher than in the under/normal weight group (8.85%, 95%CI: 7.44% to 10.48%). CONCLUSION: Excess adiposity increased the risk of elevated serum uric acid, serum lipids, blood pressure and their clustering among children and adolescents in south China.

Association between Serum Uric Acid and Hypertension in Han and Yugur of Gansu Province: The China National Health Survey.

INTRODUCTION: Serum uric acid (SUA) has been found correlated with an increased risk of hypertension, but evidence is sparse regarding the association in Gansu Province, especially in Yugur people. This study aimed to explore the nonlinear relationship between SUA levels and hypertension in Han and Yugur people in China. METHODS: The cross-sectional study samples (n = 5,327) were from the China National Health Survey (CNHS) in Gansu Province. Participants were selected using a multistage stratified cluster sampling method. SUA was measured by enzymatic methods. The restricted cubic spline regression was performed to evaluate the shape of the association. RESULTS: The overall prevalence of hypertension and hyperuricemia was 28.4% and 17.0%, respectively, in this study. Comparing the highest (>416.4 µmol/L) to the lowest (<254.1 µmol/L) SUA level groups, the multivariable adjusted differences and 95% confidence intervals (CIs) in blood pressure (BP) were 6.15 (4.22, 8.08) mm Hg and 4.87 (3.51, 6.23) mm Hg for SBP and DBP in Han, and 2.22 (-0.73, 5.18) mm Hg and 2.56 (0.38, 4.75) mm Hg for SBP and DBP in Yugur people, respectively. The corresponding odds ratios (95% CIs) for hypertension were 3.16 (2.26, 4.43) and 2.37 (1.46, 3.89) in Han and Yugur people, respectively. The restricted cubic spline regression models illustrated that both BP level and the risk of hypertension increased with elevated SUA levels in Han and Yugur people. CONCLUSIONS: SUA was significantly and independently associated with an increased risk of hypertension in Han and Yugur people. Prospective studies are needed to confirm these findings.

Association of long-term exposure to ambient particulate pollution with stage 1 hypertension defined by the 2017 ACC/AHA Hypertension Guideline and cardiovascular disease: The CHCN-BTH cohort study.

BACKGROUND: Evidence regarding the effects of ambient air pollution on new stage 1 hypertension defined by the 2017 ACC/AHA Hypertension Guideline remains sparse. OBJECTIVES: To investigate the association of long-term exposure to ambient PM2.5 with stage 1 hypertension and to explore the mediating and modifying effects of PM2.5 on cardiovascular disease (CVD). METHODS: A total of 32,135 participants aged 18-80 years were recruited in 2017. The three-year (2014-2016) average PM2.5 concentrations were assessed by a spatial statistical model. Blood pressure (BP) was divided into four categories according to the 2017 ACC/AHA Hypertension Guideline: normal BP (SBP<120 mmHg and DBP<80 mmHg), elevated BP (SBP 120-129 mmHg and DBP<80 mmHg), stage 1 hypertension (SBP 130-139 mmHg or DBP 80-89 mmHg), and stage 2 hypertension (SBP≥140 mmHg or DBP≥90 mmHg or taking antihypertensive medications). The associations of PM2.5 with BP categories were estimated by two-level generalized linear mixed models. Analyses stratified by age, mediation and interaction analyses of PM2.5 and stage 1 hypertension with CVD were performed. RESULTS: We detected a positive significant association between long-term exposure to PM2.5 and stage 1 hypertension. Compared to normal BP, the OR was 1.05 (95% CI: 1.02, 1.08) per 10 µg/m3 increase in PM2.5. The association was stronger than that of elevated BP but weaker than that of stage 2 hypertension. Stage 1 hypertension only partially mediated the association between PM2.5 and CVD, and the mediation proportions ranged from 1.55% to 11.00%. However, it modified the association between PM2.5 and CVD, which was greater in participants with stage 1 hypertension (OR: 1.66; 95% CI: 1.43, 1.93) than in participants with normal BP (OR: 1.32; 95% CI: 1.11, 1.57), with Pinteraction<0.001. In the analysis stratified by age, the above associations were age-specific, and significant associations were only observed in the young and middle-aged (<60 years) groups. CONCLUSIONS: Long-term exposure to ambient PM2.5 was significantly associated with stage 1 hypertension. This earlier stage of hypertension may be a trigger BP range for adverse effects of air pollution in the development of hypertension and CVD, especially in young and middle-aged individuals.

Prevalence and risk factors of refractive error in Qinghai, China: a cross-sectional study in Han and Tibetan adults in Xining and surrounding areas.

BACKGROUND: Our study aimed to explore the prevalence and risk factors of refractive error (RE) in Han and Tibetan population aged 50-79 years in Xining and surrounding areas in Qinghai Province on Qinghai-Tibet Plateau. METHODS: As part of the China National Health Survey, our cross-sectional study compared the age-adjusted prevalence of RE in Han and Tibetan older adults aged 50-79 years in Xining and surrounding areas. A multivariate logistic regression model was used to identify risk factors for myopia and hyperopia. RESULTS: Among 769 Han participants and 476 Tibetan participants, the age-adjusted prevalence of myopia (spherical equivalent (SE) < - 0.5D), hyperopia (SE > + 0.5D), high myopia (SE < -6.0D) and astigmatism (cylindrical equivalent > = 0.5D) is 28.56, 22.82, 2.80, and 69.38%. Han participants have higher age-adjusted prevalence of myopia (32.93% vs 21.64%, p < 0.001), high myopia (3.93% vs 1.02%, p = 0.001) and astigmatism (72.14% vs 64.94%, p = 0.021) compared to Tibetan participants. Being Tibetan is the protective factor of myopia compared to being Han (OR 0.58, 95%CI 0.42-0.79, p < 0.001). Older age (p = 0.032), longer time length in rural area (p = 0.048), undergraduate/graduate education level (p = 0.031), lighter active level (p = 0.007) and lower BMI (p = 0.015) are risk factors for myopia. Older age (all p < 0.001) and pterygium status of the same eye (p = 0.013) also increase the hyperopia risk. CONCLUSIONS: Our study found an overall prevalence of myopia of 28.56% in Xining and surrounding areas in adults older than 50 years. Han population has higher myopia risk than Tibetan population. More medical and social resources should be allocated to improve the vision and life quality of older adults.

Neck circumference as an indicator of elevated blood pressure independent from body composition: implications from the China nation health survey (CNHS).

BACKGROUND: The independent association of neck circumference (NC) on elevated blood pressure is still uncertain in adults of China. The aim of this study is to explore such association and investigate the predictive value of NC on hypertension. METHODS: A total of 4279 adults aged 20-80 years participated in the cross-sectional study in 2014. Anthropometric information, NC, body composition indexes such as waist circumference, hip circumference and body fat percentage, and blood pressure were measured. General linear regression model was used to explore the association between NC and blood pressure; Logistic regression models were fitted to calculate the multi-variable adjusted prevalence, and the association of NC with hypertension. RESULTS: The overall prevalence of hypertension and pre-hypertension were 11.05 and 23.63%, respectively. NC was positively associated with both SBP and DBP (p < 0.001). The adjusted prevalence of hypertension increased with elevated NC quartiles in both sexes (p for trend < 0.001), from 17.81 to 42.93% in male and 9.72 to 21.31% in female. For male, NC was only associated with hypertension (OR: 1.15, 95% CI: 1.05-1.25) but not with pre-hypertension (OR: 0.97, 95% CI: 0.88-1.06). However, in female, NC was associated with both pre-hypertension and hypertension, the BMI adjusted ORs were 1.15 (1.03-1.28) and 1.24 (1.14-1.34). The sex-specific AUCs for NC predicting hypertension were 0.633 in male and 0.663 in female, similar with AUCs of other body fat indexes. CONCLUSIONS: NC was associated with both pre-HTN and HTN independent from other body composition indexes. NC is a simple and useful anthropometric index to identify elevated blood pressure in Chinese adults.

Prevalence of, and biochemical and anthropometric risk factors for, dyslipidemia in children and adolescents aged 7 to 18 years in China: A cross-sectional study.

OBJECTIVE: This study aimed to investigate the prevalence of dyslipidemia and its risk factors in children and adolescents aged 7 to 18 years in China. METHODS: A cross-sectional study was conducted from November, 2013 to July, 2014. A total of 2283 children and adolescents from urban and rural areas in Hainan (South China) and Shaanxi Provinces (Northwest China) were selected using multi-stage stratified cluster sampling method. Each participant underwent anthropometric and serum biochemical tests which included serum lipids and hepatitis B virus surface antigen (HBsAg). RESULTS: The overall prevalence of high total cholesterol (TC), high triglyceride (TG), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), hyperlipidemia and dyslipidemia were 6.5%, 7.5%, 5.2%, 9.1%, 14.3%, and 20.6%, respectively. After standardization by age, girls had higher prevalence of high TC (8.2%), high LDL-C (6.6%), and hyperlipidemia (16.4%), but lower prevalence of low HDL-C (8.21%) than boys (4.2%, 3.4%, 11.9%, and 11.3%, respectively). The risk of dyslipidemia increased with age (OR = 1.067, 95% CI: 1.030-1.106). Boys had a decreased risk of dyslipidemia (OR = 0.798, 95% CI: 0.640-0.994). The restricted cubic spline revealed a linear relationship between BMI and the risk of dyslipidemia (P < .001). Subjects who were HBsAg positive had higher risk of dyslipidemia (OR = 1.550, 95% CI: 1.050-2.287) compared with those who were HBsAg negative. CONCLUSIONS: Our study highlights the high prevalence of dyslipidemia in youth in China, and is the first study to reveal a positive association between positive status for HBsAg and abnormal lipid levels in children and adolescents.

Muscle fitness and its association with body mass index in children and adolescents aged 7-18 years in China: a cross-sectional study.

BACKGROUND: The present study was the first one aimed to investigate the current muscle fitness and its associated factors among children and adolescents in mainland China. METHODS: From Nov 2013 to Jul 2014, 2283 children and adolescents aged 7-18 were recruited in Hainan and Shaanxi Provinces in China by cross-sectional design. Information on anthropometry and muscle fitness, measured by hand grip strength (GS), vertical jump (VJ) and sit-and-reach (SR), were collected. Analysis of covariance was performed by using general linear regression models to identify the association between BMI and muscle fitness. RESULTS: The means of GS, VJ and SR in boys were 22.30 ± 11.55 kg, 22.93 ± 6.80 cm and 3.58 ± 7.31 cm, respectively, and in girls were 16.61 ± 6.87 kg, 18.11 ± 4.08 cm and 7.18 ± 5.72 cm, respectively. GS (from 8.26 kg in the 7-8-year-old group to 27.91 kg in the 17-18 group) and SR (from 1.75 cm in the-8-year-old group to 10.12 cm in the 17-18 group) increased with age (both p for trend < 0.001). Boys had higher GS and VJ, but significantly lower SR than girls in each age group (p < 0.001). After adjusting for age, sex, residential areas and study regions, GS increased with elevated BMI (compared with normal weight group, the regression coefficient for thinness and overweight/obesity were - 2.997(95%CI: -3.693 to - 2.301) and 1.220 (95%CI: 0.285 to 2.155), respectively. With the p values less than 0.001 and 0.011, respectively). For VJ, there was no difference found between normal weight group and overweight/obesity group (p = 0.550), but the thinness group had the lowest performance (regression coefficient = - 2.681, 95%CI from - 3.965 to - 1.397, p < 0.001). For SR, compared with normal weight group, the regression coefficients for thinness and overweight/obesity were - 1.313(95%CI: -2.228 to - 0.399) and - 1.623(95%CI: -3.216 to - 0.030) respectively, both p < 0.05. CONCLUSIONS: Increased body weight may have a positive association with isometric muscle strength measured by grip strength, but a negative one with strength of lifting the body. Sex difference was also found in the performance of flexibility.

Increasing prevalence of overweight and obesity in Yi farmers and migrants from 2007 to 2015 in China: the Yi migrant study.

BACKGROUND: With the social development and lifestyle transition, increasing trends of overweight and obesity prevalence are commonly reported worldwide. Data focusing on overweight and obesity trends in rural residents and rural-to-urban migrants in China are limited. This study aims to assess the changes and related factors of overweight and obesity in Yi farmers and migrants in southwest China from 2007 to 2015, and to assess the disparities in prevalence changes. METHODS: Pseudo-panel data was obtained from two cross-sectional studies conducted in Sichuan province, southwest China in 2007 and 2015. Standardized prevalence of overweight and obesity were evaluated by direct method using the 2010 national census population as the standard. Prevalence differences of overweight and obesity were calculated in each group and compared between groups to evaluate the disparity in prevalence changes. Generalized linear mixed model was performed to determine factors related to overweight/obesity. RESULTS: Standardized prevalence of overweight increased in both groups (from 5.54 to 16.65% in Yi farmers, from 27.91 to 33.61% in Yi migrants). Standardized prevalence of obesity increased only in Yi farmers (from 0.37 to 3.13%). Prevalence difference of overweight in Yi farmers was higher than that in Yi migrants (11.11 vs. 5.70), but prevalence differences of obesity were not significantly different between Yi farmers and migrants. CONCLUSIONS: Prevalence of overweight and obesity in Yi farmers, and prevalence of overweight in Yi migrants increased from 2007 to 2015. Yi farmers were developing overweight at a greater pace than migrants. More attention should be paid to spread health knowledge and encourage healthy lifestyle in Yi people, especially Yi farmers.

[Review on the association between social culture and HIV prevalence among MSM in China].

Social culture have significant influence on HIV transmission. Men who have sex with men (MSM), have their own sub-culture, by which made them very different with other population in social norm, behavior mode, as well as some HIV related behavior and the disease transmission risk. Up to date, study focused on the association between social culture and HIV transmission among MSM was limited, thus we reviewed relevant studies in the view of social culture and sub-culture of MSM, analyzed how social culture could potentially influence HIV transmission, and how sub-culture could affect MSM's friend-making, HIV risk behaviors in three aspects including social identity, social norm and social development. Furthermore, we provided some recommendations and suggestions on the future work.

Prevalence and patterns of multimorbidity in China during 2002-2022: A systematic review and meta-analysis.

BACKGROUND: Multimorbidity is common, particularly among elderly people. Restructuring health service systems to better manage this public health issue requires knowledge regarding disease prevalence and patterns. We quantified the epidemiology characteristics of multimorbidity among adults in China to inform policy-making and resource allocation. METHODS: We searched 10 databases for studies (January 2000-October 2023) reporting primary epidemiological multimorbidity data for adults in China. We included observational studies; we excluded duplicate publications and studies investigating a single comorbidity pattern, focused on specific population categories, using medical insurance reimbursement data, and with unclear/incomplete data. We assessed risk of bias using the STROBE checklist and estimated heterogeneity among studies. The prevalence was pooled using the random-effects method and sample size as weight. FINDINGS: Of 13,998 records retrieved, 67 studies (30 in English, 37 in Chinese) were included. The prevalence (95% confidence interval) of multimorbidity was 25.4% (15.1%, 35.7%) among Chinese adults. Among 42 studies reporting age-specific prevalence, multimorbidity prevalence increased rapidly with age: 3.3% (0%, 15.2%) for age 18-29 years, 5.9% (0%, 12.9%) for 30-44 years, 17.6% (6.1%, 29.1%) for 45-59 years, 32.4% (16.1%, 48.7%) for 60-69 years, 38.5% (23.6%, 53.4%) for 70-79 years, and 40.2% (20.8%, 59.6%) for age ≥ 80 years. Overall prevalence of multimorbidity has increased in recent years, with regional disparity. The most common patterns included hypertension with hearing impairment (10.4% [95% CI: 4.3%, 16.5%]), dyslipidemia (8.9% [4.1%, 13.6%]), and diabetes (8.7% [3.7%, 13.8%]). CONCLUSION: Multimorbidity was present nearly one in four Chinese adults, with hypertensive diseases and other comorbidities being the most-observed pattern; the prevalence increased rapidly with increased age. There is huge variation in the prevalence of multimorbidity across China. Coordinated, comprehensive strategies are urgently needed to control the ongoing impact of multimorbidity.

Lifestyle and clinical factors as predictive indicators of cardiometabolic multimorbidity in Chinese adults: Baseline findings of the Beijing Health Management Cohort (BHMC) study.

BACKGROUND: Cardiometabolic multimorbidity (CMM) is increasing globally as a result of lifestyle changes and the aging population. Even though previous studies have examined risk factors associated with CMM, there is a shortage of prediction models that can accurately identify high-risk individuals for early prevention. METHODS: In the baseline survey of the Beijing Health Management Cohort, a total of 77,752 adults aged 18 years or older were recruited from 2020 to 2021. Data on lifestyle factors, clinical profiles, and diagnoses of diabetes, coronary heart disease, and stroke were collected. Logistic regression models were used to identify risk factors for CMM. Nomograms were developed to estimate an individual's probability of CMM based on the identified risk factors. The performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC). RESULTS: In men, the top three risk factors for CMM were hypertension (OR: 3.52, 95 % CI: 2.97-4.18), eating very fast (3.43, 2.27-5.16), and dyslipidemia (2.59, 2.20-3.06). In women, hypertension showed the strongest association with CMM (3.62, 2.90-4.52), followed by night sleep duration less than 5 h per day (2.41, 1.67-3.50) and dyslipidemia (1.91, 1.58-2.32). The ORs for holding passive and depressed psychological traits were 1.49 (95%CI: 1.08-2.06) in men and 1.58 (1.03-2.43) in women. Prediction models incorporating these factors demonstrated good discrimination in the test set, with AUC 0.84 (0.83-0.86) for men and 0.90 (0.89-0.91) for women. The sex-specific nomograms were established based on selected predictors. CONCLUSIONS: Modifiable lifestyle factors, metabolic health and psychological trait are associated with the risk of CMM. The developed prediction models and nomograms could facilitate early identification of individuals at high-risk of CMM.