Association between metabolic syndrome severity score and cardiovascular disease: results from a longitudinal cohort study on Chinese adults.

Objective: This study aimed to quantify the severity of metabolic syndrome(MetS) and investigate its association with cardiovascular disease(CVD) risk on Chinese adults. Methods: 13,500 participants from the Zhejiang Adult Chronic Disease Study were followed up between 2010 and 2021. A continuous MetS severity score derived from the five components of MetS was used to quantify MetS severity, and the association between MetS severity and the risk of incident CVD was assessed using Cox proportional hazard and restricted cubic spline regression. Results: Both the presence and severity of MetS were strongly associated with CVD risk. MetS was related to an increased risk of CVD (hazard ratio(HR):1.700, 95% confidence interval(CI): 1.380-2.094). Compared with the hazard ratio for CVD in the lowest quartile of the MetS severity score, that in the second, third, and highest quartiles were 1.812 (1.329-2.470), 1.746 (1.265-2.410), and 2.817 (2.015-3.938), respectively. A linear and positive dose-response relationship was observed between the MetS severity and CVD risk (P for non-linearity = 0.437). Similar results were found in various sensitivity analyses. Conclusion: The MetS severity score was significantly associated with CVD risk. Assessing MetS severity and further ensuring intervention measures according to the different severities of MetS may be more useful in preventing CVD.

Whole fresh fruit intake and risk of incident diabetes in different glycemic stages: a nationwide prospective cohort investigation.

PURPOSE: Fruit intake is beneficial to several chronic diseases, but controversial in diabetes. We aimed to investigate prospectively the associations of whole fresh fruit intake with risk of incident type 2 diabetes (T2D) in subjects with different glucose regulation capacities. METHODS: The present study included 79,922 non-diabetic participants aged ≥ 40 years from an ongoing nationwide prospective cohort in China. Baseline fruit intake information was collected by a validated food frequency questionnaire. Plasma HbA1c, fasting and 2 h post-loading glucose levels were measured at both baseline and follow-up examinations. Cox proportional hazards models were used to calculate hazard ratio (HR) and 95% confidence intervals (CI) for incident diabetes among participants with normal glucose tolerance (NGT) and prediabetes, after adjusted for multiple confounders. Restricted cubic spline analysis was applied for dose-response relation. RESULTS: During a median 3.8-year follow-up, 5886 (7.36%) participants developed diabetes. Overall, we identified a linear and dose-dependent inverse association between dietary whole fresh fruit intake and risk of incident T2D. Each 100 g/d higher fruit intake was associated with 2.8% lower risk of diabetes (HR 0.972, 95%CI [0.949-0.996], P = 0.0217), majorly benefiting NGT subjects with 15.2% lower risk (HR 0.848, 95%CI [0.766-0.940], P = 0.0017), while not significant in prediabetes (HR 0.981, 95%CI 0.957-4.005, P = 0.1268). Similarly, the inverse association was present in normoglycemia individuals with a 48.6% lower risk of diabetes when consuming fruits > 7 times/week comparing to those < 1 time/week (HR 0.514, 95% CI [0.368-0.948]), but not in prediabetes (HR 0.883, 95% CI [0.762-1.023]). CONCLUSION: These findings suggest that higher frequency and amount of fresh fruit intake may protect against incident T2D, especially in NGT, but not in prediabetes, highlighting the dietary recommendation of higher fresh fruit consumption to prevent T2D in normoglycemia population.

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study.

OBJECTIVE: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. METHODS: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. RESULTS: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). CONCLUSION: An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.

The association between diabetes and thyroid cancer risk: a hospital-based case-control study in China.

BACKGROUND: Previous studies have indicated inconsistent relationships of diabetes with thyroid cancer risk, yet little is known in China. In this study, we aimed to investigate the associations between diabetes, diabetes duration and the risk of thyroid cancer in Chinese population. METHODS: A 1:1 matched case-control study was performed between 2015 and 2017 in Zhejiang Province including 2,937 thyroid cancer cases and 2,937 healthy controls. Odds ratios (ORs) with 95 % confidence intervals (CIs) for thyroid cancer were estimated in logistic regression models. Specific effects stratified by age, as well as sex, body mass index (BMI) and family history of diabetes were also examined. RESULTS: Overall, neither diabetes (OR = 0.75, 95 % CI: 0.21-2.73) nor diabetes duration (OR = 0.14, 95 % CI: 0.02-1.22 for diabetes duration ≦ 5 years; OR = 2.10, 95 % CI: 0.32-13.94 for diabetes duration > 5 years) was significantly associated with thyroid cancer. In stratified analyses, significant lower risk of thyroid cancer was observed among subjects with diabetes and shorter diabetes duration ( ≦ 5 years), but limited to those who were aged more than 40 years, female, overweight/obese and had positive family history of diabetes. CONCLUSIONS: Diabetes and shorter diabetes duration were significantly associated with decreased risk of thyroid cancer in individuals characterized by older age, female sex, higher BMI and positive family history of diabetes.

Trends in prevalence of gestational diabetes mellitus in Zhejiang Province, China, 2016-2018.

BACKGROUND: Limited population-based studies have investigated the secular trend of prevalence of gestational diabetes mellitus (GDM) in mainland China. Therefore, this study aimed to estimate the prevalence of GDM and time trends in Chinese female population. METHODS: Based on Diabetes Surveillance System of Zhejiang Province, 97,063 diagnosed GDM cases aged 20-50 years were identified from January 1, 2016 to December 31, 2018. Annual prevalence, prevalence rate ratios (PRRs) and average annual percentage change with their 95% confidence intervals (CIs) were reported. RESULTS: The age-standardized overall prevalence of GDM was reported to be 7.30% (95% CI 7.27-7.33%); 9.13% (95% CI 9.07-9.19%) in urban areas and 6.24% (95% CI 6.21-6.27%) in rural areas. Compared with 20-24 years age group, women in advanced age groups (25-50 years) were at higher risk for GDM (PRRs ranged from 1.37 to 8.95 and the 95% CIs did not include the null). Compared with rural areas, the risk for GDM was higher in urban areas (PRR: 1.69, 95% CI 1.67-1.72). The standardized annual prevalence increased from 6.02% in 2016 to 7.94% in 2018, with an average annual increase of 5.48%, and grew more rapidly in rural than urban areas (11.28% vs. 0.00%). CONCLUSIONS: This study suggested a significant increase in the prevalence of GDM among Chinese female population in Zhejiang province during 2016-2018, especially in women characterized by advanced age and rural areas.

Sleep duration and behavioral correlates in middle and high school students: a cross-sectional study in Zhejiang province, China.

OBJECTIVE: To investigate the sleep duration and correlates from lifestyle, dietary and weight control behaviors in Chinese adolescents. METHODS: Data were from 2017 Zhejiang Youth Risk Behavior Survey. A total of 17059 adolescents were included in this study and sleep duration and other behaviors information was collected via a self-reported questionnaire. Regression coefficients (ß), calculated by multivariable linear regression, were used to assess the effects of related behaviors on sleep duration, adjusting for potential confounding factors. RESULTS: Overall, the mean sleep duration in adolescents was 7.99 h. Ever smoking, engaging in moderate physical activity and muscle strengthening activity, attending physical education classes, and watching television were significantly associated with longer sleep duration (P trend ≦0.01 for all). Adolescents with breakfast, fruits, vegetables, milk and soft drinks intake were more likely to have longer sleep duration (P trend <0.05 for all). Weight perception of overweight and weight control behaviors including exercising and eating less food, fewer calories were significantly associated with the short sleep duration (P trend <0.05 for all). CONCLUSION: Chinese adolescents slept less than the counterparts in Western countries. Various lifestyle, dietary and weight control behaviors were associated with sleep duration.

Menstrual, reproductive and hormonal factors and thyroid cancer: a hospital-based case-control study in China.

BACKGROUND: There have been considerable studies on the effects of reproductive factors on thyroid cancer risk, while findings are inconsistent. In this analysis, we aimed to investigate the associations between menstrual, reproductive and hormonal factors with thyroid cancer occurrence in a population of Chinese women. METHODS: Using data from a 1:1 matched case-control study performed between 2015 and 2017 in Zhejiang Province of China, a second analysis of 2261 pairs of female subjects was conducted. The possible effects for thyroid cancer were evaluated in logistic regression models by odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Later age at first pregnancy (for > 25 vs. ≦ 20 years, OR: 0.47, 95% CI 0.23-0.96) and longer duration of breast feeding (for 6-12 vs. ≦ 6 months, OR: 0.49, 95% CI 0.24-0.98) were significantly associated with decreased occurrence of thyroid cancer, while no trend was observed. Stratified by age at enrollment, only the association with duration of breast feeding remained significant, but limited to younger women (≦ 50 years). CONCLUSIONS: Our results suggested that women with later age at first pregnancy or longer breast feeding duration were less likely to have thyroid cancer. These findings supported an influence role of reproductive factors in thyroid cancer risk.

Automated classification of ICD-O-3 morphology code from pathology reports using text-mining and support vector machine / 预防医学

Objective@#To evaluate the accuracy of automated classification of ICD-O-3 morphology code from pathology reports by text-mining and support vector machine ( SVM ) , in order to provide basis for automated tumor coding in Chinese. @*Methods@#The tumor report cards of Zhejiang residents from 2017 to 2019 were collected from Chronic Disease Surveillance Information Management System of Zhejiang Province. According to ICD-O-3, the keywords of the pathology reports were extracted, and SVM was used for automatic classification. The classification results were compared with those of 16 professionals with more than two years of experience in tumor coding, and the accuracy rate, recall rate and F-score were calculated for effect evaluation. @*Results@#Totally 83 082 cases from 2017 to 2019 were included and were categorized into 17 morphological classifications, with 52 877 ( 63.65% ) cases of adenocarcinoma, squamous carcinoma and transitional cell carcinoma. A total of 1 090 keywords were enrolled into main corpus. The total F-score, accuracy rate and recall rate are 85.69, 77.20% and 96.27%, respectively. @*Conclusion@#Text-mining combined with SVM can improve the efficiency of ICD-O-3 morphology coding; however, the accuracy needs to be further improved.

Association between chronic hepatitis B virus infection anddiabetes among adults / 预防医学

Objective@#To explore the association between chronic hepatitis B virus infection and diabetes among adults.@*Methods@#The baseline data of China Kadoorie Biobank ( CKB ) study from Tongxiang of Zhejiang Province was used for analysis. Community residents were investigated in the study from August 2004 to May 2008, including questionnaire survey, physical measurement and biological sample test. Univariate and multivariate logistic regression models were used to estimate the association of chronic hepatitis B virus infection with diabetes.@*Results@#Totally 52 888 participants were included in the final analysis. The overall prevalence of HBsAg-positive was 3.55% ( N=1 877 ). The overall prevalence of diabetes was 5.17% ( N=2 733 ). The prevalence of HBsAg-positive in diabetic patients was 3.51% ( N=96 ). Both univariate and multivariate logistic regression models indicated that there was no association between chronic hepatitis B virus infection and diabetes（ P>0.05 ）. @*Conclusion@#No significant association has been found between chronic hepatitis B virus infection and diabetes among adults.

Associations between trying to control weight, weight control behaviors and current electronic cigarette usage in middle and high school students: A cross-sectional study in Zhejiang Province, China.

INTRODUCTION: Previous research has indicated that weight control behaviors are linked to cigarette smoking, whether these relationships extend to electronic cigarettes (e-cigarettes) is unknown. This study aims to examine the association between weight control behaviors and current e-cigarette usage among middle and high school students in China. METHODS: Based on the 2017 Zhejiang Youth Risk Behavior Survey, 17359 students were included and relevant data involving e-cigarette and weight control behaviors were collected via self-reported questionnaires. Logistic regression models were used to examine the associations between trying to control weight, specific weight control behaviors and current e-cigarette usage. Odds ratios (ORs) and their 95% confidence intervals (CIs) are reported. RESULTS: Of the 17359 students, 374 (2.15%) were current e-cigarette users. No significant association was observed between trying to control weight and current e-cigarette usage (OR=1.01; 95% CI: 0.81-1.28). Significant associations were found between current e-cigarette usage and unhealthy weight control behaviors of eating less food, fewer calories (OR=1.74; 95% CI: 1.33-2.27), as well as taking laxatives (OR=3.34; 95% CI: 2.11-5.27), taking diet pills (OR=2.63; 95% CI: 1.72-4.02) and going without eating for 24 hours or more (OR=2.74; 95% CI: 1.86-4.04). CONCLUSIONS: A positive association was found between unhealthy weight control behaviors and current e-cigarette usage in adolescents. Specific education programs on unhealthy weight control behaviors should be considered in adolescents.

Incidence and Time Trends of Type 2 Diabetes Mellitus among Adults in Zhejiang Province, China, 2007-2017.

AIMS: Population-based incidence data are paramount to assess the effects of prevention strategies for diabetes, yet the relevant studies in mainland China are scarce. This study is aimed at estimating the type 2 diabetes mellitus (T2DM) incidence and time trends in Chinese adults. Material and Methods. Based on the Diabetes Surveillance System of Zhejiang Province, 879,769 newly diagnosed T2DM cases were identified from January 1, 2007, to December 31, 2017. Annual incidence, incidence rate ratios (IRRs), and average annual percentage change with their 95% confidence intervals (CIs) were reported. RESULTS: The age-standardized overall incidence rate of T2DM was reported to be 281.73 (95% CI: 281.26-282.20) per 100,000 person-years, 293.19 (95% CI: 292.51-293.87) in males and 270.42 (95% CI: 269.76-271.09) in females. Compared with the ≥80 years age group, younger adults were at lower risk for T2DM (IRRs ranged from 0.035 to 0.986 and the 95% CIs did not include the null), except for the 70-79 years age group (IRR: 1.087, 95% CI: 1.077-1.097). Compared with females and rural areas, the risk for T2DM was higher in males (IRR: 1.083, 95% CI: 1.079-1.088) and urban areas (IRR: 1.005, 95% CI: 1.001-1.009), respectively. The standardized annual incidence rate increased from 164.85 in 2007 to 268.65 per 100,000 person-years in 2017, with an average annual increase of 4.01% and grew more rapidly in male, younger, and rural area populations. CONCLUSIONS: Our study suggested a significant increase in the incidence rate of T2DM among Chinese over the past decade, especially in adults characterized by male sex, younger age, and rural areas.

Association between cigarette smoking during pregnancy and gestational diabetes mellitus: a meta-analysis.

Aims: Several studies have been carried out to examine the association between cigarette smoking during pregnancy and risk of developing gestational diabetes mellitus (GDM), yet the findings are mixed. Therefore, we aimed to estimate the relationship between cigarette smoking during pregnancy and GDM risk.Material and methods: PubMed, ScienceDirect, and Cochrane Library databases were searched up to December 2017. Studies on cigarette smoking during pregnancy and GDM were retrieved. The pooled odds ratios (ORs) and their 95% confidence intervals (CIs) for highest versus lowest level of cigarette smoking were calculated using a random-effects model.Results: Compared to nonsmoking, the pooled ORs of cigarette smoking during pregnancy were 0.98 (95% CI: 0.88-1.10) for GDM. Specifically, the pooled ORs of light smoking and heavy smoking during pregnancy for GDM were 1.10 (95% CI: 0.97-1.25) and 1.02 (95% CI: 0.67-1.53), respectively.Conclusions: Our findings suggest that there is no significant association between cigarette smoking during pregnancy and risk of GDM.

Awareness, current use of electronic cigarettes and associated smoking factors in Zhejiang Chinese adolescents.

OBJECTIVES: The present study aims at examining the prevalence of awareness and current use of electronic cigarettes (e-cigarettes) among middle and high school students from Zhejiang, China. Smoking-related factors associated with e-cigarettes use will also be explored. METHODS: This cross-sectional study was based on 2017 Zhejiang Youth Risk Behavior Survey. A total of 24,157 adolescents were recruited and relevant data of e-cigarettes and smoking-related factors were collected via a self-reported questionnaire. Logistic regression models were used to examine the association between e-cigarettes current use and the smoking-related factors. Odds ratios (ORs) and their 95% confidence intervals (CIs) were reported. RESULTS: Overall, 70.61% of middle and high school students reported hearing of e-cigarettes, while only 2.15% reported using e-cigarettes in the past month. Among smoking-related factors, cigarette smoking (ever and current), use of other tobacco products, second hand smoke exposure and previous attempts to quit smoking were significantly associated with higher current e-cigarettes use in adolescents. CONCLUSIONS: These results presented high awareness of e-cigarettes while relatively low use in Chinese adolescents. Smoking-related factors were significantly associated with increased e-cigarettes use.

Analysis of Mortality and Survival Rate of Liver Cancer in Zhejiang Province in China: A General Population-Based Study.

Background: Few accurate up-to-date studies provide liver cancer mortality and survival information in Zhejiang province. This research aimed to depict the mortality and survival of liver cancer in Zhejiang province in China during 2005-2010. Methods: The data were collected from the Zhejiang Chronic Disease Surveillance Information and Management System, and the mortality rates of liver cancer were calculated by gender, age, and areas. Chinese population census in 2000 and Segi's world population were used for age-standardized mortality rate. The observed and relative survival rates of liver cancer patients were analyzed. Results: The crude mortality rate of liver cancer was 32.11/105. The age-standardized mortality rate was 17.39/105 and 23.07/105 by Chinese population (ASIRC) and Segi's world population (ASIRW), respectively. The crude liver cancer mortality rate and age-standardized rate in urban areas were lower than those of rural areas. The overall 1-, 3-, and 5-year observed survival (OS) rates of liver cancer patients were 38.61%, 21.65%, and 16.83%, respectively. The 1-, 3-, and 5-year relative survival (RS) rates of liver cancer patients were 39.49%, 23.27%, and 19.09%, respectively. Survival rate decreased obviously within 1 to 5 years and then leveled off. It was shown that the male overall survival rate was higher than the female one and the difference was statistically significant (P<0.05). Conclusions: Both lower mortality and better survival rates were observed in urban areas, compared to rural areas. Relevant parties including government, public resource, and propaganda department should devote enough attention to rural areas.

Factors associated with glycemic control in community-dwelling elderly individuals with type 2 diabetes mellitus in Zhejiang, China: a cross-sectional study.

BACKGROUND: Although exercise seems to be beneficial for type 2 diabetes mellitus (T2DM) patients, there is limited research elucidating the optimal accessible indices of adiposity and insulin resistance for identifying elderly T2DM patients with poor glycemic control, which could be improved by performing regular exercise. METHODS: A community-based, cross-sectional study was conducted with 918 Chinese elderly individuals with T2DM in Zhejiang. Relevant risk factors for poor glycemic control, as determined using glycated haemoglobin A1c (HbA1c) > 7%, were explored using logistic regression analyses and included body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), fasting blood glucose (FBG), triglycerides (TGs), total cholesterol (TC), the product of fasting triglycerides and glucose (TyG), visceral adiposity index (VAI), lipid accumulation product (LAP), TyG-BMI, and TyG-WC. Comparisons of the risk factors' ability to discriminate poor glycemic control as well as their optimal cutoff values were determined using receiver operating characteristic (ROC) analyses, and then the extent of poor glycemic control risk reduction through regular exercise was examined using multivariate logistic regression analyses. RESULTS: The overall poor glycemic control rate was 49.3%. The factors associated with poor glycemic control included FBG > 3.869, TyG > 8.73, TyG-BMI > 222.45, and TyG-WC > 713.48 in logistic regression analyses. The optimal cutoff points of FBG, TyG, TyG-WC, and TyG-BMI in discriminating poor glycemic control were 7.38, 9.22, 813.33, and 227.77, and their corresponding areas under the ROC curves were 0.864(0.840-0.886), 0.684(0.653-0.714), 0.604(0.571-0.635), and 0.574(0.541-0.606), respectively. Occasional and regular exercise reduced the odds ratios (95% confidence interval) of poor glycemic control to 0.187 (0.063-0.557) and 0.183 (0.059-0.571) for subjects with TyG-WC > 813.33 (p = 0.008), to 0.349 (0.156-0.782) and 0.284 (0.123-0.652) for subjects with TyG > 9.22 (p = 0.011), and to 0.390 (0.175-0.869) and 0.300(0.130-0.688) for subjects with TyG-BMI > 227.77 (p = 0.017), respectively, after adjusting for multiple confounding factors. CONCLUSION: Among elderly individuals with T2DM, poor glycemic control risk might be identified using indices calculated from FBG, TG, BMI, and WC measurements, which are indicative of adiposity and insulin resistance. TyG-WC seems to be an accessible and useful indicator to identify which elderly T2DM patients would benefit from performing regular exercise to achieve good glycemic control.

Associations between stressful life events and diabetes: Findings from the China Kadoorie Biobank study of 500,000 adults.

AIMS/INTRODUCTION: Evidence has shown that stressful life events are associated with the development of diabetes, yet studies in mainland China are scarce. In the present study, we explored the associations between cumulative and specific stressful life events and the prevalence of diabetes in Chinese adults. MATERIALS AND METHODS: The cross-sectional data were from the China Kadoorie Biobank study, which enrolled approximately 500,000 adults aged 30-79 years from 10 diverse regions of China. Logistic regression models were used to calculate the adjusted odds ratio (OR) and the 95% confidence interval (CI). RESULTS: Of the 473,607 participants, 25,301 (5.34%) had type 2 diabetes (2.68% clinically-identified and 2.66% screen-detected). Participants who experienced one and two or more stressful life events were 1.10-fold (OR 1.10, 95% CI 1.05-1.16) and 1.33-fold (OR 1.33, 95% CI 1.13-1.57) more likely to have type 2 diabetes. Three categories of work-related events (OR 1.15, 95% CI 1.01-1.31), as well as family-related events (OR 1.11, 95% CI 1.06-1.18) and personal-related events (OR 1.18, 95% CI 1.03-1.36), were associated with an increased likelihood of type 2 diabetes. Regarding the specific life events, the ORs of loss of job or retirement, as well as major conflict within family, death or major illness of other close family member and major injury or traffic accident, were 1.24 (95% CI 1.02-1.52), 1.24 (95% CI 1.08-1.43), 1.13 (95% CI 1.06-1.20) and 1.20 (95% CI 1.01-1.43), respectively. CONCLUSIONS: The present study showed that cumulative and specific stressful life events were significantly associated with an increased prevalence of diabetes.

Age at natural menopause and associated factors in adult women: Findings from the China Kadoorie Biobank study in Zhejiang rural area.

OBJECTIVES: To investigate the factors associated with age at natural menopause in a large population of Chinese adult women. METHODS: This cross-sectional study was part of the baseline survey of China Kadoorie Biobank in Zhejiang Province. A total of 17,076 postmenopausal women were included in the present study. Relevant data of socio-demographic, lifestyle, dietary and reproductive characteristics were collected. Multinomial logistic regression models were used to examine the associated factors of age at natural menopause with adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were reported. RESULTS: The mean age at natural menopause was 48.94 years, with 3.40% of the women experienced premature menopause and 6.75% early menopause. Younger age, higher education, consumption of meat (1-3 days per week) and increased parity were associated with late menopause. Current smoking, underweight, higher physical activity, consumption of sea food (1-3 days per week), fresh eggs (≥4 days per week), fresh fruits (≥1 day per week), taking vitamins, experiencing severe food shortage, earlier age at menarche and older age at first birth were associated with earlier age at natural menopause. CONCLUSIONS: These results suggest that certain factors involved with socio-demographic, lifestyle, dietary and reproductive characteristics are related to the age at natural menopause in Chinese women.

Smoking by family members and friends and electronic-cigarette use in adolescence: A systematic review and meta-analysis.

INTRODUCTION: Evidence suggests that smoking by family members and friends is a strong predictor of smoking uptake in adolescents, yet the influence on electronic cigarette (e-cigarette) use has not been systematically reviewed and quantified. METHODS: Relevant studies were identified by searches of the PubMed and ScienceDirect databases up to December 2016. The summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: A total of 21 studies were included in this meta-analysis. A positive association was observed between adolescent e-cigarette use and smoking by family members (OR=1.47, 95% CI=1.30-1.66) and friends (OR=2.72, 95% CI=1.87-3.95), even after adjusting for the individual smoking status. Stratified by family members, the association with smoking in siblings (OR=1.87, 95% CI=1.35-2.60) was more prominent than that in parents (OR=1.41, 95% CI=1.191-.68) and other family members (OR=1.39, 95% CI=1.12-1.72). CONCLUSIONS: The present meta-analysis suggests that smoking by family members and friends is significantly associated with increased probability of e-cigarette use in adolescents.

Age at natural menopause and risk of diabetes in adult women: Findings from the China Kadoorie Biobank study in the Zhejiang area.

AIMS/INTRODUCTION: There has been considerable professional debate on the association between age at menopause and diabetes risk, while the findings are controversial. The present study explored the association between late menopause and the prevalence of diabetes in the Chinese population. MATERIAL AND METHODS: The data were part of the baseline survey of China Kadoorie Biobank from Zhejiang Province. A total of 17,076 postmenopausal women were included in the present study. Logistic regression models were used to calculate the adjusted odds ratios and their 95% confidence intervals. RESULTS: Of the participating women, 1,288 (7.54%) had type 2 diabetes. In comparison with those with menopause at 46-52 years, women with menopause at a later age (≥53 years) were 1.21-fold (95% confidence interval 1.03-1.43) more likely to have diabetes. CONCLUSIONS: The present findings suggested that later age at menopause was associated with an increased prevalence of diabetes.

Gender disparity in the associations of overweight/obesity with occupational activity, transport to/from work, leisure-time physical activity, and leisure-time spent sitting in working adults: A cross-sectional study.

BACKGROUND: The associations of occupational activity (OA), commuting, leisure-time physical activity (LTPA), and sitting with overweight/obesity in working adults are controversial. This study explored these factors with the risk of overall and abdominal overweight/obesity in a Chinese working population and whether these associations differ by gender. METHODS: A cross-sectional study was conducted. Data analysis was done among 6739 employed participants. Multivariate logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the studied associations. RESULTS: For male employees, those with heavy OA had a lower overall (OR 0.76; 95% CI, 0.62-0.93) and abdominal (OR 0.76; 95% CI, 0.62-0.93) overweight/obesity risk than those with light OA. Those with LTPA ≥150 min/week had a lower risk of overall (OR 0.73; 95% CI, 0.56-0.96) and abdominal (OR 0.70; 95% CI, 0.53-0.91) overweight/obesity than those with LTPA <150 min/week. Men with leisure-sitting time <2.5 h/day had a significantly lower risk of abdominal overweight/obesity than those sitting ≥4 h/day (OR 0.80; 95% CI, 0.65-0.99). And men who cycled to/from work had a lower risk of overall (OR 0.69; 95% CI, 0.53-0.90) and abdominal overweight/obesity (OR 0.71; 95% CI, 0.54-0.92) than passive transports. However, the above significant associations disappeared among female employees. CONCLUSIONS: Heavy OA, cycling to/from work, and LTPA were associated with lower risk of overall or abdominal overweight/obesity in male employees. Reducing leisure sitting time can also help male employees reduce the risk of abdominal overweight/obesity. More research on gender disparity in the risk of overweight and obesity should be done.