Prevalences of metabolic syndrome and its sex-specific association with socioeconomic status in rural China: a cross-sectional study.

BACKGROUND: Few studies have reported the prevalence of metabolic syndrome (MS) and examined relationships between socioeconomic status and MS in rural China. This study aimed to evaluate the prevalence of MS and MS components as well as their associations with socioeconomic status among rural Chinese adults. METHODS: A cross-sectional study of 26,836 participants aged 20 years and older was conducted from June to December 2012 in Yuhuan City, Zhejiang Province, China, which is located on Yuhuan Island. A multivariable logistic regression model was used to identify risk factors for MS and their possible interactions. RESULTS: Among 26,836 subjects with an average age of 53.4 ± 14.0 years, 59% were female. The overall prevalence of MS was 20.5%, and there was a significant sex difference in the prevalence (15.1% for males vs. 24.2% for females, P < 0.001). Compared with males, females also showed a significantly higher proportion of most MS components. A significantly higher prevalence of MS was found among subjects who were elderly, had a lower income level, had a lower level of education, or were unemployed. Multiple significant interactions were observed between the prevalence of MS and sex, age or socioeconomic status (P < 0.001). The risk of MS increased significantly with age in females but not in males. Additionally, a lower income level and a lower level of education were significantly related to an increased risk only in females, and unemployed males had a higher risk of MS than unemployed females. CONCLUSIONS: The prevalence of MS and its components was relatively high in a rural island Chinese population with rapid urbanization, and sex-specific associations between socioeconomic factors and MS were found. Targeted preventive interventions should be developed and implemented to prevent and control MS among those with low socioeconomic status, especially females.

Associations Between Thyroid Volume and Physical Growth in Pubertal Girls: Thyroid Volume Indexes Need to Be Applied to Thyroid Volume Assessments.

Background: Thyroid volume (Tvol) is associated with many factors, but the current reference values for Tvol in children with sufficient iodine intake are inappropriate and need to be updated. Moderate changes in thyroid morphology and accentuated increases in body fat percentage occur during puberty as an adaption of the body and sexual development occurs. This study aimed to evaluate the influences of physical growth on Tvol and propose an easily applicable method for conducting Tvol assessments in pubertal girls with sufficient iodine intake.Methods: A cohort study was conducted on 481 pubertal girls in East China from 2017 to 2019. B-ultrasound was used to assess Tvol. Multiple linear regression models were used to estimate the associations of Tvol enlargement (dTvol) with changes in height (dH), weight (dW), waist circumference (dW), body mass index (dBMI), and body surface area (dBSA). Thyroid volume indexes (TVIs), including height thyroid volume index (HVI), weight and height thyroid volume index (WHVI), body mass index thyroid index (BMIV), and body surface area thyroid index (BSAV), were calculated to explore an appropriate method for Tvol assessments by Spearman correlation analyses. Results: Tvol, height, weight, BMI, and BSA increased significantly from baseline to follow-up (P<0.001). The associations between dTvol and physical growth were only observed in the 13 to 14-year-old group. dH, dW,dBMI, and dBSA were positively related to dTvol, with the maximum ß of 5.74 (95%CI: 2.54 to 8.94) on dBSA, while dWC was negatively related to dTvol (ß= -0.05, 95%CI: -0.08 to -0.03). Both dHVI and dBSAV were not associated with dH, dW, dBMI, or dBSA in both age groups (P>0.05). Conclusions: Thyroid volume was associated with physical growth in pubertal girls in East China, both age and anthropometric measurements must be comprehensively considered to establish the reference values for Tvol. HVI, and BSAV may be better indicators for Tvol assessments in pubertal girls.

Thyroid Function Changes and Pubertal Progress in Females: A Longitudinal Study in Iodine-Sufficient Areas of East China.

Background: The onset of puberty is influenced by thyroid function, and thyroid hormones (THs) fluctuate substantially during the period of pubertal development. However, it needs to be further clarified how THs change at specific puberty stages and how it influences pubertal development in girls. So far, longitudinal data from China are scarce. Methods: A cohort study was conducted among girls during puberty in iodine-sufficient regions of East China between 2017 to 2019. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant. Thyroid homeostasis structure parameters (THSPs), including the ratio of FT4 to FT3 (FT4/FT3), Jostel's TSH index (TSHI), and thyroid feedback quantile-based index (TFQI), were calculated. Puberty category scores (PCS), calculated based on the Puberty Development Scale (PDS), was used to assess the stage of puberty. Girls were grouped into three categories according to PCS changes (△PCS) and six categories according puberty stage (BPFP: pre-pubertal at both baseline and follow-up; BPFL: pre-pubertal at baseline and late-pubertal at follow-up, respectively; BPFT: pre-pubertal at baseline and post-pubertal at follow-up, respectively; BLFL: late-pubertal at both baseline and follow-up; BLFT: late-pubertal at baseline and post-pubertal at follow-up, respectively; BTFT: post-pubertal at both baseline and follow-up). Multiple linear regression analyses were used to evaluate the associations of THs changes with pubertal progress. Results: The levels of serum TSH and FT3 decreased while serum FT4 increased during the study period (P<0.001). In multiple linear regression analyses, after adjustment for covariables, FT3 decreased by an additional 0.24 pmol/L (95% CI: -0.47 to -0.01) in the higher △PCS group than the lower △PCS group. Compared with the BLFL group, the BPFT group showed an additional decline in FT3 (ß= -0.39 pmol/L, 95%CI: -0.73 to -0.04), the BTFT group showed a lower decline in TSH (ß=0.50 mU/L, 95% CI: 0.21 to 0.80) and a lower decline in TSHI (ß=0.24, 95%CI: 0.06 to 0.41), respectively. There was no association of △FT4 or △TFQI with △PCS or the puberty pattern. Conclusions: Serum TSH and FT3 decreased while serum FT4 increased among girls during puberty. Both the initial stage and the velocity of pubertal development were related to thyroid hormone fluctuations.

Thyroid Stimulating Hormone (TSH) Is Associated With General and Abdominal Obesity: A Cohort Study in School-Aged Girls During Puberty in East China.

Objectives: Although the association between thyroid stimulating hormone (TSH) and obesity in children has been investigated in several cross-sectional studies, no study evaluated this association among girls during puberty, which were in a key period closely related to the fluctuations of thyroid hormones and development of obesity. Therefore, we conducted a cohort study to investigate the association of general and abdominal obesity with TSH in girls during puberty. Setting and participants: A cohort study of 481 school-aged girls during puberty was conducted in four regions in east China, with a baseline survey in 2017 and a follow-up survey in 2019. Outcome measures: Anthropometric indexes including height, weight and waist circumference (WC) were measured, and body mass index (BMI) was then calculated. Blood samples were collected to determine TSH and free thyroxine (FT4). Results: Of the 474 girls at baseline survey, the prevalences of BMI-based general obesity and WC-based abdominal obesity were 19.8% (94/474) and 21.7% (103/474), respectively. Compared with normal weight girls, the median serum TSH level was significantly higher in general obese girls (P = 0.037), but not in central obese girls (P = 0.173). Multiple logistic regression models indicated that those in the highest tertile of serum TSH level had a significantly higher risk of BMI-based overweight/obesity (OR = 1.83, 95% CI 1.01 to 3.32) compared with the lowest tertile. Analyses from 435 girls prospectively followed-up for 2 years revealed that those with general or central obesity also had higher follow-up TSH level (P = 0.004 and P = 0.008, respectively). The TSH level for girls with general obesity at baseline but normal weight at follow-up was 0.45 mU/L (95% CI 0.11 to 0.79) higher than those with normal weight at baseline and follow-up. Conclusions: TSH was positively associated with both general and abdominal obesity among girls during puberty.

Enriched taxa were found among the gut microbiota of centenarians in East China.

BACKGROUND: Gut microbiota is closely related to age. Studies from Europe and the U.S. identified featured microbiota in different age groups for the elderly. Asian studies mainly focused on people living in longevity areas. Featured microbiota for the elderly people of different age groups, especially in the centenarian in the general population, has not been well investigated in China. METHOD: We conducted a comparative study by including 198 subjects of three age groups (65-70, 90-99, and 100+ years) in East China. Information regarding age, sex, height, weight, waist circumference, hip circumference, food preference, smoking status and alcohol consumption were collected by using a structured questionnaire. Fecal samples for each participant were collected as well. 16S rRNA gene sequencing were employed to analyze the gut microbiota composition. Logistic regression with LASSO feature selection was used to identify featured taxa in different age groups and to assess their potential interactions with other factors such as lifestyle. RESULT: The gut microbiota of the 90-99 year and 100+ year age groups showed more diversity, robustness, and richness compared with the 65-70 year age group. PCoA analysis showed a clear separation between the 65-70 and 100+ year age groups. At the species level, Bacteroides fragilis, Parabacteroides merdae, Ruminococcus gnavus, Coprococcus and Clostridium perfringens increased, but Bacteroides vulgatus, Ruminococcus sp.5139BFAA and Clostridium sp.AT5 decreased in the 90-99 year age group. The age differences in gut microbiota were similar across the strata of smoking, alcohol consumption status and food preference. CONCLUSION: Our study demonstrated age differences in many aspects of gut microbiota, such as overall diversity, microbiota structure, and relative abundance of key taxa. Moreover, the gut microbiota of centenarian was significantly different from those of younger age groups of the elderly.

Effects of different developmental patterns on thyroid morphological changes among children in pre-puberty and puberty / 中国学校卫生

Objective@#To investigate the effects of different developmental patterns on the increases of thyroid volume in children from different genders and periods, and to explore whether there is a synergistic effect on the initiation of puberty in girls, so as to provide a theoretical basis for reducing the risk of thyroid abnormalities in adulthood.@*Methods@#A multi-stage cluster sampling was used to select a primary school in Minhang District of Shanghai, Haimen City of Jiangsu Province and Yuhuan city of Zhejiang Province. A total of 784 children aged 8-10 years old were included in "8-10 years school-aged children cohort". At the same time, a total of 491 girls aged 11-13 years were included in the "11-13 years adolescent girls cohort". The content of survey on follow-up was consistent with the one on baseline. B-ultrasonography was used to measure thyroid volume. The physical development indexes such as height (H), weight (W) and waist circumference (WC) were measured. The morning urine samples were collected and the urinary iodine content was detected. The changes of body mass index (BMI), waist circumference (WC), and thyroid volume (V) were calculated (d BMI, d WC, and d V, respectively). According to the changes of BMI and WC, the subjects were classified into four types of developmental changes, namely "B-LW-L (low d BMI, low d WC)" "B-LW-H (low d BMI, high d WC)" "B-HW-L (high d BMI, low d WC)" and "B-HW-H (high d BMI , high d WC)". Results In partial correlation analysis, thyroid volume was significantly correlated with BMI and WC at baseline or follow-up(P<0.05). The changes of thyroid volume in 8-10 years old boys were related to the changes of BMI and WC (P<0.05), the changes of thyroid volume in 8-10 year old girls were only associated with the changes of WC (P=0.03), and no association was found in 11-13 year old girls(P>0.05). In multivariate logistic regression analysis, after adjusting for baseline age, region, and differences of urinary iodine, the risk of thyroid volume increasing in B-HW-H was 2.70 times (95%CI=1.29-5.66) higher than that of B-LW-L in boys aged 8-10 years; among girls aged 11-13 years, the risk of thyroid volume increasing in B-LW-H, B-HW-L and B-HW-H were 2.46 times (95%CI=1.31-4.61), 2.16 times (95%CI=1.15-4.03) and 1.79 times (95%CI=1.07-2.99), respectively; there was no interaction between menarche age and developmental pattern on thyroid volume change trend (P=0.49).@*Conclusion@#The thyroid volume in children and adolescents increases with the development of physical development. Different developmental patterns and estrogens have certain effects on thyroid morphological changes. To avoid obesity in childhood (especially with central obesity), timely identify and effectively intervene thyroid morphological abnormalities in childhood，and to reduce the risk of thyroid diseases in adulthood.

UCP2 and UCP3 variants and gene-environment interaction associated with prediabetes and T2DM in a rural population: a case control study in China.

BACKGROUND: There are disparities for the association between uncoupling proteins (UCP) and type 2 diabetes (T2DM). The study was to examine the associations of genetic variants of UCP2 and UCP3 with prediabetes and T2DM in a rural Chinese population. METHODS: A population-based case-control study of 397 adults with T2DM, 394 with prediabetes and 409 with normal glucose tolerance (NGT) was carried out in 2014 in a rural community in eastern China. Three groups were identified through a community survey and the prediabetes and NGT groups were frequently matched by age and gender with the T2DM group and they were not relatives of T2DM subjects. With r2 ≥ 0.8 and minor allele frequency (MAF) ≥0.05 for tag single nucleotide polymorphisms (SNPs) with potential function, three (rs660339, rs45560234 and rs643064) and six (rs7930460, rs15763, rs647126, rs1800849, rs3781907 and rs1685356) SNPs were selected respectively for UCP2 and UCP3 and genotyped in real time using the MassARRAY system (Sequenom; USA). The haplotypes, gene-environmental interaction and association between genetic variants of UCP2 and UCP3 and prediabetes or T2DM were explored. RESULTS: There were no significant differences in age and sex among three study groups. After the adjustment for possible covariates, the A allele of rs1800849 in UCP3 was significantly associated with prediabetes (aORAA vs GG = 1.68, 95% CI: 1.02-2.78), and the association was also significant under the recessive model (aOR AA vs GA + GG = 1.64, 95% CI: 1.02-2.66). Also, rs15763 was found to be marginally significantly associated with T2DM under dominant model (ORGA + AA vs GG = 0.73, 95% CI: 0.52-1.03, P = 0.072). No haplotype was significantly associated with prediabetes or T2DM. Multiplicative interactions for rs660339-overweight on T2DM were observed. In addition, the AA genotype of rs660339 was associated with an increased risk of T2DM in overweight subjects (OR = 1.48, 95%CI: 0.87-2.52) but with a decreased risk in those with normal weight (OR = 0.54, 95%CI: 0.28-1.05). CONCLUSIONS: Rs1800849 in UCP3 was significantly associated with prediabetes. Overweight might modify the effects of rs660339 of UCP2 on T2DM.

Associations of adiposity measurements with thyroid nodules in Chinese children living in iodine-sufficient areas: an observational study.

OBJECTIVES: Obesity has been found to be associated with an elevated risk of thyroid nodule(s), mainly in adults; however, evidence for this association in children was limited. The objective of this study was to investigate the association of adiposity and thyroid nodule(s) in children living in iodine-sufficiency areas. SETTING AND PARTICIPANTS: We conducted a cross-sectional study of 1403 Chinese children living in the East Coast of China in 2014. OUTCOME MEASURES: Anthropometric measures including height, weight and waist and hip circumferences were taken, and body mass index (BMI), body surface area (BSA) and waist-hip ratio (WHR) were then calculated. Thyroid ultrasonography was performed to assess thyroid volume and nodules. RESULTS: Based on BMI, 255 (18.17%) children were overweight and 174 (12.40%) were obese. Thyroid nodule(s) was detected in 18.46% of all participants and showed little age and sex variations. As compared with normal-weight children, obese children experienced significantly higher risks for solitary (OR 2.07 (95% CI 1.16 to 3.71)) and multiple (OR 1.67 (95% CI 1.03 to 2.70)) thyroid nodules. Similar associations with thyroid nodule(s) were observed with adiposity measured by waist circumference and BSA, but not WHR. There were no notable differences in the associations between children consuming iodised and non-iodised salt. CONCLUSIONS: These findings provide further evidence that childhood obesity is associated with the risk for thyroid nodule(s).

Urinary Antibiotics of Pregnant Women in Eastern China and Cumulative Health Risk Assessment.

Exposure to antibiotics during pregnancy can pose a systematic effect on human health. A few biomonitoring studies have demonstrated an extensive exposure of children to antibiotics, but there is still a lack of data for pregnant women. To assess the exposure of pregnant women to antibiotics and potential health risk, we investigated 536 pregnant women aged 16-42 years from two geographically different study sites in Eastern China in 2015. We measured 21 antibiotics of five categories (seven fluoroquinolones, three phenicols, four tetracyclines, three macrolides, and four sulfonamides) in urine using the isotope dilution ultraperformance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. The hazard index (HI) was calculated on the basis of estimated daily exposure dose and acceptable daily intakes. A total of 16 antibiotics were found in urine, with detection frequencies between 0.2 and 16.0%. Antibiotics were overall detected in 41.6% of urine, and two or more antibiotics were detected in 13.1% of urine. Ciprofloxacin, ofloxacin, and trimethoprim were most frequently detected in urine, with detection frequencies between 10 and 20%. The majority of the antibiotics tested had an estimated daily exposure dose less than 1 µg/kg/day, and 4.3% of pregnant women had a HI value of more than 1. These findings indicated that pregnant women were frequently exposed to antibiotics and some individuals were in the potential risk of adverse microbiological effects induced by antibiotics.

[Related factors for early-onset type 2 diabetes mellitus of rural adults in Yuhuan County of Zhejiang Province in 2012].

OBJECTIVE: To explore related factors for early-onset type 2 diabetes mellitus( EOD) in rural Chinese adults. METHODS: Totally, 1695 newly diagnosed cases of type 2 diabetes mellitus( T2DM) were recruited from baseline survey of Yuhuan Rural Adults Cohort for Diabetes during June to December 2012 in Yuhuan County, Zhejiang Province, China, and divided into EOD or late-onset type 2 diabetes mellitus( LOD) with their diagnosis age at ≤ 40 or > 40 years, respectively. Diagnosis age was compared among different characteristics. Logistic regression was used to analyze related factors in EOD. RESULTS: Among 1695 new T2 DM cases, near half( 47. 3%) were men and 85( 5. 0%) were grouped into EOD. Their mean age at diagnosis of T2 DM was( 60. 39 ±12. 49) years overall. Men or those with more than 9 education years, family average personal income ≥2000 Yuan per month, less occupational physical activities, smoking, drinking, overweight and family history of T2 DM had lower average age at diagnosis than women or those without them, while those with regular physical exercise had higher that than those without that. After the adjustment for other covariates, multiple logistic regression showed that more than 9 education years( OR = 6. 62, 95% CI 3. 87-11. 32), family average personal income ≥2000 Yuan per month( OR = 6. 60, 95% CI 3. 32-13. 12), and regular physical exercise( OR = 0. 37, 95% CI 0. 17-0. 80) were independently correlated to EOD. CONCLUSION: Education level, income, and regular exercise are significantly correlated to EOD in rural Chinese adults.

[Repeated cross-sectional studies on urinary iodine and iodine content of salt among school-aged children from 2012 to 2014 in Yuhuan County, Zhejiang Province].

OBJECTIVE: To investigate the iodine status and its change among school-aged children in their morning urine and eating salt from 2012 to 2014 in Yuhuan County, Zhejiang Province, China. METHODS: Three repeated cross-sectional studies were carried out at a same primary school in 2012, 2013 and 2014, respectively. Three classes were randomly selected from each of 3 to 5 grade by the cluster-stratified sampling every year. Totally, 1343 out of 1350 eligible children aged 8 to 10 years old were involved into this study. Their morning urine and salt eating at home were collected and tested. RESULTS: The overall median of urine iodine was 116.0 µg/L, and no significant change was found over year. The overall proportions of subjects with urine iodine < 50 µg/L, < 100 µg/L, and ≥ 300 µg/L were 4.8%, 38.6% and 3.5%, respectively, and there were little differences over year, gender and grade of children. An overall median of iodine from 1343 salt samples was 0.0 mg/kg and no year difference was statistically observed. The proportions of subjects consumed iodized salt significantly decreased from 25.1% in 2012 to 21.8% in 2013 and to 14.2% in 2014. There was a significant difference in urine iodine between subjects taken iodized salt or not and also a weak positive correlation between salt iodine and urine iodine. CONCLUSION: The nutritional status of iodine is overall stable, proper and safety in recent 3 years among school children in Yuhuan County. The coverage rate of iodized salt is very low.

Influence of Bisphenol A on Thyroid Volume and Structure Independent of Iodine in School Children.

BACKGROUND: Although several studies have evaluated the relationship between bisphenol A (BPA) and thyroid functions, their results are not entirely consistent. Little is known about BPA in relation to thyroid volume and structure. METHODS: We examined the association of BPA with thyroid volume and thyroid nodules using data from 718 Chinese children living in the East Coast of China in 2012. First morning urine samples were collected for the determination of urinary BPA, creatinine, and urinary iodine concentrations (UIC). Thyroid volume (TV) and nodules were assessed by thyroid ultrasonography. RESULTS: The median of TV was 3.14ml. 459(63.9%) children took iodized salt at home and the median of UIC was 159µg/l. BPA was detected in 99.9% of the urine samples and the medians for boys and girls were 2.64 and 2.35µg/g creatinine, respectively. Of all participants 14.0% had thyroid nodules. Urinary BPA concentration was inversely associated with thyroid volume (ß = -0.033, 95% CI: -0.053, -0.013) and the risk for multiple nodules (OR = 0.78; 95% CI: 0.63, 0.97). The associations above were similar for children who consumed iodized salt and those consumed non-iodized salt. CONCLUSIONS: The data suggest that BPA may be one of the influencing factors for TV and thyroid nodules and its effects are independent of iodine nutrition status in children.

Antibiotic body burden of Chinese school children: a multisite biomonitoring-based study.

To explore the antibiotic body burden of Chinese school children, total urinary concentrations (free and conjugated) of 18 representative antibiotics (5 macrolides, 2 ß-lactams, 3 tetracyclines, 4 quinolones, and 4 sulfonamides) were measured by ultraperformance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry among 1064 school students recruited from 3 economically and geographically distinct areas in east China in 2013. All 18 antibiotics were detected in urine samples with the detection frequencies ranging from 0.4 to 19.6%. The antibiotics were detected in 58.3% of urine samples overall, and this detection frequency reached at 74.4% in one study site. Of them, 47.8% of the urine samples had a sum of mass concentration of all antibiotics between 0.1 (minimum) and 20.0 ng/mL, and 8 antibiotics had their concentrations of above 1000 ng/mL in some urine samples. Three veterinary antibiotics, 4 human antibiotics, and 11 human/veterinary antibiotics were found overall in 6.3, 19.9, and 49.4% of urine samples, respectively. The detection frequencies and concentration levels of antibiotics in urine samples differed by study areas. Concerning mixed exposures, a total of 137 combinations of antibiotics and 20 combinations of antibiotic categories were found overall. Two or more antibiotics or categories were concurrently detected in more than 20% of urine samples. On the basis of a usage analysis, contaminated food or environment might be relevant exposure sources for tetracyclines, quinolones, and sulfonamides.

[Role of insulin resistance and ß cell function in the development of newly diagnosed type 2 diabetes].

OBJECTIVE: To assess the possible role of insulin resistance (IR) and ß cell function in the pathophysiology of newly diagnosed type 2 diabetics (T2DM). METHODS: An oral glucose tolerance test was obtained at the health cohort baseline. Subjects with normal glucose tolerance (NGT, n = 269), impaired glucose regulation (IGR, n = 269) and newly diagnosed type 2 diabetics (T2DM, n = 269) were defined by ADA criteria. Subjects with NGT and IGR were selected from residents living in the same community of diabetic patients with the same gender and age (± 3 years old). The T2DM group was sub-classified as isolated fasting hyperglycemia (IFH), isolated post-challenge hyperglycemia (IPH) and combined hyperglycemia (CH). The IGR group was sub-classified as impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and combined glucose intolerance (CGI). Homeostasis model assessment of insulin resistance (HOMA-IR), ß cell function (HOMA-ß) and deposition index (DI) were to evaluate the insulin resistance or sensitivity, islet ß cell function and that when insulin compensated respectively. RESULTS: From NGT to T2DM, HOMA-IR increased while HOMA-ß and DI decreased significantly (P < 0.05). After the adjustment of age, gender, obesity and hypertension, IFG and CGI subgroup had statistically higher HOMA-IR and lower HOMA-ß and DI, and IGT subgroup only had lower HOMA-ß and DI than NGT subgroup (P < 0.05). Compared to IGT subgroup, IFG and CGI subgroup had significantly higher HOMA-IR and lower HOMA-ß and DI (P < 0.05). IFH and CH subgroup had statistically higher HOMA-IR and lower HOMA-ß and DI than IFH subgroup (P < 0.05), DI of CH subgroup significantly decreased than that of IPH subgroup (P < 0.05). IFH and CH subgroup had statistically higher HOMA-IR and lower HOMA-ß and DI than IFG and CGI subgroup respectively. HOMA-ß and DI decreased of IPH subgroup compared to IGT subgroup, and multiple linear regression analysis showed that HOMA-IR had significant influence on fasting plasma glucose (FPG) in NGT (P < 0.05), whereas two-hour plasma glucose and FPG were influenced by DI (P < 0.05) in the progression. CONCLUSIONS: Both basic ß cell dysfunction and IR exist in IFG and CGI, while only basic ß cell dysfunction exist in IGT. The basic ß cell dysfunction and IR are the primary features of fasting hyperglycemia, and basic ß cell dysfunction also contribute to post- challenge hyperglycemia.

[Prevalence of hyperglycemia and related factors among rural adults aged 35 years old and above in Yuhuan County, Zhejiang Province].

OBJECTIVE: To describe the prevalence of hyperglycemia among rural adults aged 35 years old and above in Yuhuan, China. METHOD: A cross-sectional study was carried out as a baseline study of Rural Yuhuan Health Population Cohort in all communities in Yuhuan County, Zhejiang Province, China. A total of 125 479 subjects aged 35 years old or above participated in this study to collect the general demographics and measure hypertension, fast glucose and etc. In SPSS 16.0, non-conditional Logistic regression model was used for related factors analysis. RESULT: Among 118 274 eligible subjects, the average fasting glucose was (5.4 ± 1.8) mmol/L and the average for men was higher than that for women. The crude prevalences of diabetes, impaired fasting glucose and hyperglycemia were 10.1%, 19.4% and 29.5%(the age and sex standardized one was 9.3%, 19.8% and 29.1%), respectively. There were significant gender differences in both the average level of fasting glucose and the prevalence of hyperglycemia (P < 0. 001). The prevalences of hyperglycemia varied statistically over different age groups from 19.9% in the lowest group of 35 - 39 years old to 36.4% in the highest group of 60 - 64 years old. In the non-conditional logistic regression model, age, sex, farmer, regular exercise, smoking, alcohol drinking and body mass index were related to hyperglycemia after the adjustment of other covariates. CONCLUSION: Hyperglycemia was common in adults aged 35 years old and above living in rural China.

[Prevalence of hyperlipidemia and possible risk factors in rural Chinese adults: cohort study of health population in Yuhuan rural].

OBJECTIVE: To examine the prevalence of hyperlipidemia and its related factors in adults in rural Yuhuan, China. METHODS: A cross-sectional study was carried out as a baseline study of Rural Yuhuan Health Population Cohort in all communities in Yuhuan County, Zhejiang Province, China. A total of 118,571 subjects aged 35 years old or above participated in this study. The trained health/medical workers collected the general information, health conditions and so on by the face-to-face interview. Totally, 5 ml blood samples were taken. Hyperlipidemia was defined as blood triglyceride > or = 1.70 mmol/L and/or total cholesterols > or = 5.18 mmol/L. SPSS 16.0 was used for statistical analysis. Data of the fifth China population census 2000 was used as the standard population. RESULTS: Among 118,571 eligible subjects, the averages of blood triglyceride and total cholesterols were (1.71 +/- 14.42) mmol/L and (5.48 +/- 40.25 ) mmol/L, respectively, and there was a statistical difference in gender on blood triglyceride (t = 4.163, P < 0.001) but not on blood total cholesterols. The crude prevalences of hyperchol-esterolemia, hypertriglyceridemia, both hypercholesterolemia and hypertriglyceridemia, and hyperlipidemia were 38.4%, 24.2%, 13.2% and 49.3% and the age-standardized prevalence were 36.6%, 23.8%, 12.7% and 47.7% based on 2000 China national population, respectively. These prevalences were higher in male than in female significantly and varied statistically over different age groups from the lowest group of 35-39 years old to highest group of 55-59 years old or 60-64 years old. A non-conditional binary logistic model showed that age, male, farmer, education levels, smoking, alcohol consumption and body mass index were significantly related to hyperlipidemia. CONCLUSION: Hyperlipidemia, especial hypercholesterolemia, was common in adults aged 35 years old or above living in rural China.

[A cross-sectional study on urinary iodine and iodine content of salt among school children aged 8-10 years old in Yuhuan County, Zhejiang Province in 2012].

OBJECTIVE: To understand the level of urinary iodine and iodine content of salt among school children aged 8 to 10 years in Yuhuan County, Zhejiang Province. METHODS: A cross-sectional study was conducted in a primary school of Yuhuan County purposely selected in 2012. Totally, 450 children aged 8 to 10 years were involved by the cluster-stratified sampling. All subjects received a free physical examination and morning urine and salt using in the household were collected. Urinary iodine and the iodine content of salt the children were tested. RESULTS: Totally, 449 of 450 children provided the morning urine enough to be tested. The median of children's urinary iodine was 114.0 microg/L, and the proportions of them with the urinal iodine < 50 microg/L, < 100 microg/L and > or = 300 microg/L were 4.4%, 37.9% and 2.7%, respectively. Among 447 salt samples collected, the median of iodine content was 0.0 mg/kg. The coverage rate of iodized salt was 27.3%, the qualified rate of iodized salt was 92.6%, and the intake rate of qualified iodized salt was 25.3%. The median of urinary iodine of children with iodized salt was significantly higher than that of those without iodized salt (Z = 3.47, P = 0.001). CONCLUSION: Current nutritional status of iodine is overall proper and safety in the population of school children aged 8-10 years old in Yuhuan County.

[Evaluation on the efficacy of recombinant hepatitis B vaccine booster immunization in 2789 children aged over 10 years].

OBJECTIVE: To study the efficiency of booster immunization with different recombinant hepatitis B vaccines. METHODS: 2789 children aged over 10 years who had completed the basic immunization of hepatitis B vaccine under 1 year old were selected. All the sampled children were classified into four groups (A, B, C and D) and immunized with different hepatitis B vaccines produced by different companies respectively. Before booster immunization, their blood plasma specimens were detected for hepatitis B virus (HBV) surface antigen (HBsAg), antibodies to HBV surface antigen (anti-HBs) and antibodies to HBV core antigen (anti-HBc) by chemiluminescence. In each group, the anti-HBs positive children were immunized with one dosage and anti-HBs negative children were immunized three dosages of the same vaccine. Their blood specimens were collected again after 1 month, and detected for anti-HBs. RESULTS: The anti-HBs positive rates of A, B, C and D group were 36.43%, 37.59%, 42.91% and 46.46% respectively before immunization while 89.20%, 91.52%, 90.96% and 85.45% respectively after immunization with one dosage, 99.12%, 99.47%, 98.87% and 98.85% respectively after immunization with three dosages. The differences of anti-HBs positive rates in the four respective groups showed statistical significances between any two rates of pre-immunization, post-immunization with one dosage and post-immunization with three dosages (all P < 0.05). The anti-HBs positive conversion rates of four groups were 83.01%, 86.41%, 84.16% and 72.82% respectively after immunization with one dosage. The anti-HBs positive conversion rate of four groups were 98.62%, 99.16%, 98.03% and 97.84% respectively after immunization with three dosages and the difference of positive conversion rates in each group showed statistical significances between booster immunization with one dosage and booster immunization with three dosages. The average GMTs in anti-HBs positive children in the four groups were 2853.21, 6254.23, 3581.40 and 3021.32 mIU/ml respectively after immunization with one dosage. The average GMTs of anti-HBs negative children in the four groups were 273.08, 648.52, 387.87 and 245.36 mIU/ml respectively after immunization with one dosage, and were 632.30, 2341.14, 563.97 and 394.08 mIU/ml respectively after immunization with three dosages. CONCLUSION: Our data showed that it would be suitable to anyone to use the four vaccines for anti-HBs positive children aged over 10 years with one dosage and for anti-HBs negative children aged over 10 years with three dosage booster immunization.

Herpes simplex virus infections among rural residents in eastern China.

BACKGROUND: Herpes simplex virus (HSV) has two types: HSV-1 and HSV-2. Both infect epithelial cells and establish latent infections in neurons causing an infection that persists for life. Information on age- and gender-specific seroprevalence of HSV-1 and HSV-2 is valuable for understanding HSV transmission dynamics and designing population-based prevention and intervention programs for HSV. However, such information is not available for China. METHODS: Cryopreserved serum samples of all subjects aged 5 to 60 years from two randomly selected rural villages in Zhejiang province in Eastern China who had participated in the China national seroepidemiological survey of hepatitis B virus (HBV) infection conducted in 2006 were tested. Seroprevalence of HSV-1 and HSV-2 infections were determined by type-specific IgG antibody tests using an ELISA technique. Their 95% confidence intervals adjusted for the sampling fraction were calculated according to the Clopper-Pearson method. RESULTS: A total of 2,141 residents participated in the survey, with a response rate of 82.3%. HSV-1 seroprevalence was 92.0% overall, 89.1% for males and 94.2% for females. HSV-1 seroprevalence was 61.6% among children aged 5-9 years, 90.3% among 25-29 years, and nearly 100% among those aged > = 40 years. HSV-2 seroprevalence was 13.2% overall, 10.5% for males and 15.3% for females. No children aged 5-14 years were HSV-2 positive, and HSV-2 seroprevalence was 7.1% among 15-19 years and peaked at 24.3% among those aged 45-49 years. Neither HSV-1 nor HSV-2 infections were significantly different by gender. About 11.8% of study subjects were co-infected with both types of HSV. Among 549 participating couples, 8.6% were HSV-1 serodiscordant and 11.8% were HSV-2 serodiscordant. No one tested positive for HIV. The overall prevalence of HBsAg was 16.2%, 16.9% for males and 15.4% for females. CONCLUSIONS: HSV-1 was highly prevalent among all rural residents aged between 5-60 years in Eastern China, whereas HSV-2 was prevalent among sexually active people. HSV-1 and HSV-2 have different transmission modes and dynamics. Future HSV prevention and control programs in China should be type specific.

[Expression and clinical significance of IL-17 and IL-21 in patients with acute leukemia].

This study was aimed to investigate the effects of peripheral blood Th17 cells, IL-17 and IL-21 in the occurrence and development of acute leukemia. 60 patients with acute leukemia (19 patients with ALL, 41 patients with AML) were divided into non-remission group (group A, n=24), remission group (group B, n=36); 25 healthy volunteers were used as control group (group C). In addition to this, these 60 patients were divided into infection group (n=32) and non-infection group (n=28) on the basis of infection status. The concentration of IL-17 and IL-21 in the peripheral blood mononuclear cell culture supernatant after stimulation with anti-CD3 and anti-CD28 mAb were determined with ELISA. The expression of CD4+ IL-17+ cells was determined by flow cytometry. The results showed that (1) the concentrations of IL-17 and IL-21, and proportion of Th17 cells in group A and group B were much lower than those in group C (p<0.05); (2) the expression levels of IL-17 and IL-21, and the proportion of Th17 cells in group A were lower than those in group B (p<0.05); (3) the expression levels of Th17 and IL-17 in infection group were lower than those in non-infection group (p<0.05). It is concluded that Th17 cells may play important roles in the occurrence and development of acute leukemia through secreting IL-17 and IL-21, and their functional level can partially reflect the status of leukemia and can be used to evaluate the risks of infection in patients with leukemia.