Protocol for Shenzhen Ageing Cohort Study (SZ-ageing): a prospective observational cohort study of elderly disability and cognitive impairment.

INTRODUCTION: The incidence and prevalence of disability and cognitive impairment, which are age-related, increase as China has become an ageing society. This study aims to establish the Shenzhen Ageing Cohort Study (SZ-ageing) to explore the epidemiological situation, risk factors and biomarkers of disability and cognitive impairment among Chinese elderly individuals. METHODS: About 3000 participants aged 65 years and older are to be recruited from communities in Shenzhen by using a multistage sampling method. They will receive a baseline investigation between 2022 and 2024. The comprehensive data on disability and cognitive impairment will be collected by using standardised questionnaires, standardised scale assessments, clinical measurements and clinical laboratory tests. Active follow-up surveys with the same content as the baseline investigation will be conducted every 3 years. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the ethics committee of the Shenzhen Center for Chronic Disease Control (SZCCC-2022-001-01-PJ; 21 February 2022). The research findings will be presented at professional conferences and submitted to peer-reviewed journals. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR2200060055).

Concordance of Non-Alcoholic Fatty Liver Disease and Associated Factors among Older Married Couples in China.

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases which affects mainly middle-aged and older adults, resulting in a considerable disease burden. Evidence of concordance on NAFLD and lifestyle factors within older married couples in China is limited. This study aimed to evaluate spousal concordance regarding lifestyle factors and NAFLD among older Chinese couples. Methods: We conducted a cross-sectional study using data from 58,122 married couples aged 65 years and over recruited from Shenzhen, China during 2018−2020. Logistic regression analyses were used to estimate the reciprocal associations in NAFLD within couples after incremental adjustment for potential confounders. Results: There was a marked concordance regarding NAFLD among older married couples in our study. After adjustment for confounders, the odds of having NAFLD were significantly related to the person's spouse also having NAFLD (1.84 times higher in husbands and 1.79 times higher in wives). The spousal concordance of NAFLD was similar, irrespective of gender. Couples with both a higher educational level and abdominal obesity were more likely to have a concordance of NAFLD compared to couples with both a lower educational level and no abdominal obesity, respectively (p < 0.05). Conclusion: Our results indicated that health care professionals should bear in mind the marked spousal concordance with respect to risk factors and NAFLD for the prevention and early detection of the highly prevalent disease in older Chinese adults.

Long-term exposure to ambient air pollution and serum liver enzymes in older adults: A population-based longitudinal study.

PURPOSE: To investigate the association of long-term exposure to ambient air pollution with serum liver enzymes in older adults. METHODS: In this longitudinal study, we investigated 318,911 adults aged 65 years or older and assessed their long-term residential exposure to particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5), particulate matter with an aerodynamic diameter ≤10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). Linear mixed models and generalized linear mixed models were implemented for exposure-response analyses. RESULTS: Each interquartile range (IQR) increase of PM2.5, PM10, SO2, NO2, CO, and O3 exposures was significantly associated with a 4.6%, 4.6%, 5.6%, 4.6%, 6.2%, and 3.6% increase in alanine aminotransferase (ALT), and a 4.6%, 5.2%, 3.6%, 3.3%, 6.1%, and 4.0% increase in aspartate aminotransferase (AST), respectively. Each IQR increase of PM2.5, PM10, SO2, NO2, CO, and O3 exposures was significantly associated with a 23%, 24%, 28%, 17%, 31%, and 19% increase in odds of elevated ALT (>40 U/L), and a 32%, 39%, 40%, 32%, 57%, and 25% increase in odds of elevated AST (>40 U/L), respectively. CONCLUSIONS: Long-term exposure to ambient air pollution was significantly associated with increased serum liver enzyme levels in older adults, suggesting that air pollution exposures may induce hepatocellular injury.

Anaemia and associated factors among older adults in an urban district in China: a large-scale cross-sectional study.

OBJECTIVE: Anaemia leads to poor health outcomes in older adults; however, most current research in China has focused on younger adults. This study aimed to investigate the prevalence of anaemia and its associated factors in older adults in an urban district in China. DESIGN: A cross-sectional study. SETTING: An urbanised region, Shenzhen, China. PARTICIPANTS: A total of 121 981 participants aged ≥65 years were recruited at local community health service centres in Shenzhen from January to December 2018. PRIMARY OUTCOMES: The prevalence of anaemia was analysed and potential associated factors were evaluated. RESULTS: The mean haemoglobin level was 136.40±16.66 g/L and the prevalence of anaemia was 15.43%. The prevalences of mild, moderate and severe anaemia were 12.24%, 2.94% and 0.25%, respectively. Anaemia was positively associated with older age, being underweight (adjusted OR (AOR) 2.06, 95% CI 1.93 to 2.20), diabetes (AOR 1.23, 95% CI 1.19 to 1.28) and chronic kidney disease (AOR 1.41, 95% CI 1.36 to 1.46), and inversely with higher education level, current-smoker (AOR 0.84, 95% CI 0.78 to 0.89), non-habitual drinker (AOR 0.86, 95% CI 0.81 to 0.92), habitual drinker (AOR 0.81, 95% CI 0.75 to 0.87), overweight (AOR 0.67, 95% CI 0.64 to 0.70), obesity (AOR 0.57, 95% CI 0.53 to 0.61), central obesity (AOR 0.86, 95% CI 0.82 to 0.89), hypertension (AOR 0.86, 95% CI 0.83 to 0.89) and dyslipidaemia (AOR 0.81, 95% CI 0.78 to 0.84). CONCLUSION: Anaemia is prevalent among people aged 65 years and older in China. Screening of high-risk populations and treatment of senile anaemia should be a top priority in Shenzhen, and should be listed as important public health intervention measures for implementation.

Cross-sectional and longitudinal associations of apolipoprotein A1 and B with glycosylated hemoglobin in Chinese adults.

Apolipoproteins exert a key role on glucose metabolism; however, scarce data have examined the relationship between apolipoproteins and glycated haemoglobin (HbA1c) in Chinese adults. This study determined the cross-sectional and longitudinal associations of serum Apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB) and the ApoB/A1 ratio with HbA1c in Chinese adults. A total of 1448 subjects (584 men and 864 women) aged 54.8 years were included in a baseline survey, and the concentrations of Apo and HbA1c were measured. A total of 826 participants were followed up approximately once after 3.94 ± 0.62 years. In cross-sectional analysis, serum ApoA1 was inversely associated with HbA1c, while ApoB and the ApoB/A1 ratio were positively associated with HbA1c. After further adjusting for the potential covariates, a higher ApoA1 was associated with lower HbA1c (Quartile 4 [Q4] vs. Q1 = 5.673% vs. 5.796%, P-trend = 0.014). In contrast, positive association of ApoB concentration and the ApoB/A1 ratio with HbA1c level were showed (Q4 vs. Q1 = 5.805% vs. 5.589% for ApoB; Q4 vs. Q1 = 5.841% vs. 5.582% for ApoB/A1 ratio). The longitudinal results showed no significant associations of ApoA1, ApoB levels and the ApoB/A1 ratio with HbA1c changes (all P-trends > 0.05). Path analysis suggested that body mass index did not have mediating effect on Apo-HbA1c association. Our findings revealed that higher ApoA1, lower ApoB concentrations and the ApoB/A1 ratio were associated with lower HbA1c level in Chinese adults.

Prevalence, treatment, control of type 2 diabetes and the risk factors among elderly people in Shenzhen: results from the urban Chinese population.

BACKGROUND: Type 2 diabetes is regarded as one of the major public health problems worldwide. We aim to investigate the prevalence, treatment, and control rate in the Chinese urban population aged 65 years or older and also identified associated risk factors. METHODS: One hundred twenty-four thousand seven participants aged 65 years old and older were recruited from January 2018 through December 2018 at local community health service centers in Shenzhen. Fasting plasma glucose, as well as other biochemical indicators, were measured by standard methods. The analysis of multivariate logistic regression was applied to assess associated risk factors of type 2 diabetes. RESULTS: Approximately 22.5% of elderly urban Chinese residents had diabetes. Among people with diabetes, 54.8% received medical treatment. Only 34.4% of those who were treated had their glycemic controlled. The prevalence of T2D increased with increasing age before 80 years old, male, inadequate active physical activity, drinking, previous history of CVD, higher BMI, central obesity, and hypertension. CONCLUSIONS: Our findings suggested that attention should be paid to the prevention and control of T2D in Chinese urban elderly population. The health policy department should develop effective strategies aimed at improving health care management of T2D in elderly adults.

Association of Serum Uric Acid with Metabolic Syndrome and Its Components: A Cross-Sectional Study in Chinese Coastal Population.

Objective: Few studies reported the association between serum uric acid and the prevalence of metabolic syndrome in China's coastal residents. We aimed to examine the association between serum uric acid and the prevalence of metabolic syndrome as well as its components in adults and elderly from Shenzhen (a China's coastal city). Methods: We conducted a survey in a community-based household population in Shenzhen, collecting data about 4049 participants aged 20-69 years. Based on the data, we determined the prevalence of metabolic syndrome in adults and elderly with different serum uric acid concentrations. Results: According to the revised National Cholesterol Education Program Adult Treatment Panel III, the prevalence of the metabolic syndrome in the surveyed participants was 24.69% [95% confidence interval (CI): 23.4%-26.0%]. The prevalence of metabolic syndrome in participants with serum uric acid levels <4, 4-4.9, 5-5.9, 6-6.9, 7-7.9, and ≥8 mg/dL is 10.12% (95% CI: 8.2%-12.0%), 17.92% (95% CI: 15.8%-20.1%), 31.05% (95% CI: 28.1%-34.0%), 39.47% (95% CI: 35.4%-43.8%), 49.39% (95% CI: 43.1%-55.7%), and 52.57% (95% CI: 42.5%-62.5%), respectively. Multivariable logistic regression analysis showed that participants with higher serum uric acid levels were at a higher risk of high triglycerides, low high-density lipoprotein, central obesity, high blood pressure, or high fasting glucose (P < 0.001). Conclusions: Serum uric acid levels were closely associated with metabolic syndrome and its components in Chinese coastal population.

6-Year trends in lipids among adults in Shenzhen, China.

BACKGROUND: There may be a beneficial effect on lipid levels in Shenzhen in recent years. In this study, we aimed to examine trends in serum lipids in population in Shenzhen between 2009 and 2015. METHODS: We enrolled 2210 adults aged 18-70 years from two independent cross-sectional studies conducted in 2009 and 2015. Blood lipid profiles, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), were measured. Chi-square test, t-test and multivariate logistic regression analysis were applied for data analysis. RESULTS: From 2009 to 2015, mean LDL-C declined from 3.05 ± 0.76 mmol/L in 2009 to 2.27 ± 0.75 mmol/L in 2015 (P < 0.001). Similarly, a significant 7.09% decrease in the prevalence of high LDL-C was observed over the same period (P < 0.001). There was an increasing trend in the prevalence of low HDL-C among adults in Shenzhen (P < 0.001). A no-significant increase in prevalence of dyslipidemia was also observed over this 6-year interval (P = 0.139). The prevalence of dyslipidemia was closely related with increasing age, male gender, current smoker, diabetes, obesity and overweight. CONCLUSION: This study shows a favourable downward trend in LDL-C concentration in Shenzhen. However, more intense strategies are needed to control dyslipidemia.

[Experimental study of protective effects of Xuebijing injection on stress-induced organ damage in rabbit].

OBJECTIVE: To investigate the protective effects of the integrated traditional Chinese and western medicine Xuebijing injection on stress-induced organ damage in rabbits. METHODS: Forty rabbits were randomly divided into four groups: the control group, the model group, the western medicine group, and the Xuebijing group. The stress-induced organ damage model was replicated by soak the rabbits in water, the animals in the western medicine group and Xuebijing group received injection of lytic cocktail and Xuebijing, respectively. The changes in cortisol (Cor), thromboxane A(2) (TXA(2)), endothelin (ET), nitric oxide synthase (NOS) were determined at different time points in all the groups. The pathologic changes of the gastric mucosa, the adrenal gland and the cardiac muscle cell were observed. RESULTS: The content of Cor increased significantly in model group (P<0.01). The content of Cor decreased in the western medicine group and Xuebijing group, the changes showed no significant difference between two groups (P>0.05). The contents of ET, TXA(2) decreased and NOS increased in Xuebijing group compared with the western medicine group, the differences were significant (all P<0.05). The pathological changes of the gastric mucosa, the adrenal gland and the cardiac myocyte were less marked in Xuebijing group, compared with the western medicine group, the difference was significant (P<0.05). CONCLUSION: Xuebijing has better protective effects on stress-induced organ damage.

[Clinical observation on treatment of 18 patients with pulmonary infection after renal transplantation by integrative traditional Chinese and Western medicine].

OBJECTIVE: To observe the therapeutic effect of integrative traditional Chinese and Western medicine in treating patients with pulmonary infection after renal transplantation. METHODS: Thirty-four inpatients were randomly divided into the treated group (n=18) and the control group (n=16). They were treated with conventional therapy, including corticosteroid, anti-viral, anti-bacterial, symptomatic and supporting therapy, to the treated group, the modified qingwen baidu decoction (MQBD) was administered additionally. RESULTS: Fifty of the 18 patients in the treated group were cured, 2 improved and 1 died, the cure rate being 83.3% and the total effective rate 94.4%; while 8 of the 16 patients in the control group were cured, 2 improved and 6 died, the cure rate being 50.0% and the total effective rate 62.5%, comparison between these two groups showed significant difference (P < 0.05). CONCLUSION: Promising effect could be obtained for treatment of patients with pulmonary infection after renal transplantation by adding MQBD, a Chinese herbal medicine for clearing heat and detoxication, cooling blood and removing fire, on the basis of conventional western medical treatment.