Body fat and muscle were associated with metabolically unhealthy phenotypes in normal weight and overweight/obesity in Yi people: A cross-sectional study in Southwest China.

This study aimed to determine the association between the absolute mass, distribution, and relative ratio of body fat and muscle with the metabolically unhealthy (MU) phenotypes in normal weight and overweight/obesity in Yi people in China. The cross-sectional data from the Yi Migrants Study was used, which included 3,053 Yi people aged 20-80 years from the rural and urban sets. Participants were classified according to body mass index and metabolic status. Body composition including body fat percentage (BFP), fat mass index (FMI), visceral fat grade (VFG), muscle mass index (MMI), and muscle/fat ratio (M/F) were measured by bioelectrical impedance analysis. Restricted cubic spline and logistics regression models were used to test the associations between body composition parameters with MU phenotypes. Receiver-operating characteristic curves (ROC) were used to analyze the predictive value of MU phenotypes. Among the normal weight and overweight/obesity, 26.31% (497/1,889) and 52.15% (607/1,164) were metabolically unhealthy. Stratified by BMI, covariance analysis showed higher body fat (BFP, FMI, and VFG) and MMI in MU participants than in healthy participants. BFP, FMI, VFG, and MMI were positively associated with MU phenotypes both in normal weight and overweight/obesity after adjustment. M/F was significantly lower than MU participants and was negatively associated with MU phenotypes. BFP, FMI, VFG, and M/F could better predict MU phenotypes than BMI. We concluded that BFP, FMI, and VFG were positively associated with MU phenotypes, while M/F was negatively associated with MU phenotypes across the BMI categories in Yi people. Body fat and muscle measurement could be a valuable approach for obesity management.

MC4R Gene Polymorphisms Interact With the Urbanized Living Environment on Obesity: Results From the Yi Migrant Study.

Objectives: This study aimed to determine the association of MC4R gene polymorphisms (rs17782313 and rs12970134) and urbanized living environment and the gene-environment interaction with obesity in Yi people in China. Methods: A 1:2 frequency-matched case-control study based on the cross-sectional data was designed. Those with BMI ≥28 kg/m2 were included as the case group. The age- and sex-matched controls were selected from those with BMI <24 kg/m2. Unconditional logistic models were used to determine the association of SNPs with obesity. Additive interaction was evaluated by calculating relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI). Results: A total of 322 cases and 643 controls were included. After adjustment, allele C of rs17782313 was significantly associated with obesity (additive model, OR = 1.52, 95%CI: 1.18-1.96) in Yi people. A similar association was found in allele A of rs12970134 (additive model, OR = 1.45, 95%CI: 1.13-1.89). Yi rural-to-urban migrants were found at 2.59-fold (95%CI: 1.70-3.95) higher odds of obesity than Yi farmers. Additive interactions were found between the two SNPs and rural-to-urban migration (rs17782313: AP = 0.65, 95%CI: 0.22-1.09; rs12970134: AP = 0.59, 95%CI: 0.02-1.17). Conclusion: MC4R gene polymorphisms positively interacted with the urbanized living environment on obesity in Yi people. The effect of the MC4R gene on obesity was modified by the living environment.

Factors Associated With HIV-Related Stigma Toward People Living With HIV Among Nurses in Liangshan Yi Autonomous Prefecture, China: A Cross-Sectional Study.

Background: The Liangshan Yi Autonomous Prefecture has one of the most serious human immunodeficiency virus (HIV) epidemics in China. Evidence shows HIV-related stigma toward people living with HIV (PLWH) among nurses impedes HIV prevention and treatment. However, only limited research about HIV-related stigma toward PLWH from the perspective of nurses in Liangshan has been conducted. Objective: This study aimed to assess HIV-related stigma toward PLWH among nurses and determine factors associated with it in Liangshan, China. Design: We conducted a cross-sectional survey using a stratified, random cluster sampling method. Participants: Registered nurses (N = 1,248; primary hospitals = 102, secondary hospitals = 592, tertiary hospitals = 554) who were aged 18 or older, worked in the selected hospitals for at least 6 months, and consented to participate were recruited. Methods: All participants completed an anonymous online survey measuring sociodemographic characteristics, HIV-related stigma and HIV knowledge. We used multiple stepwise regression analysis to examine factors associated with HIV-related stigma toward PLWH among these nurses. Results: The mean score of HIV-related stigma among nurses was 50.7 (SD = 8.3; range 25-78). Nurses who were more experienced, had higher levels of education, and were working in tertiary hospitals reported higher level of HIV-related stigma. Those who had better HIV knowledge, reported a willingness to receive HIV-related training, were working in areas that had a high prevalence of HIV, had prior experience working in AIDS specialized hospitals, and worked in hospitals that had policies to protect PLWH showed a lower level of HIV-related stigma toward PLWH. Conclusions: Our findings suggested that providing culturally congruent education and training about HIV and care, and having hospitals that promoted policies protecting PLWH, may reduce HIV-related stigma toward PLWH among nurses in China.

Association between age at arrival, duration of migration, and overweight/obesity in Chinese rural-to-urban migrants: the Yi migrant study.

BACKGROUND: Urbanization in China is rapidly proceeding, but rural-to-urban migration and its association with overweight and obesity is not well studied. This study aimed to explore the age at arrival, duration of migration, and the corresponding association with overweight/obesity in Yi migrants in China. METHODS: A cross-sectional study was conducted in rural and urban areas in 2015 in Sichuan province, China. Demographic characteristics, lifestyle factors, and anthropometry were collected. General linear regression models were used to assess the effect of duration of migration (1-10, 11-20, 21-30, and >30 years) on body mass index (BMI). Multi-variable logistic regression was used to examine the association between duration of migration and overweight/obesity (BMI ≥ 25 kg/m2). RESULTS: A total of 3056 Yi people (1894 Yi farmers and 1162 Yi migrants) aged 20 to 80 years were enrolled. After adjusting for age, sex, and other potential confounders, Yi migrants had 1.71 kg/m2 (95% confidence interval [CI]: 1.36-2.06) higher BMI and a 2.13-fold (95% CI: 1.71-2.65) higher risk of overweight/obesity than Yi farmers. In Yi migrants, stratified by age at arrival, no significant association between duration of migration and overweight/obesity was observed in those who were 0 to 20 years old at arrival. In comparison, in migrants >20 years old at arrival, compared with the reference group (1-10 years), long-term migration (>30 years) was found to be associated with overweight/obesity after adjustment (odds ratio: 1.85, 95% CI: 1.04-3.29). CONCLUSIONS: Yi migrants were observed to have greater risk of overweight/obesity than Yi farmers. In Yi migrants, the risk of overweight/obesity increased according to the duration of migration, especially in those who were older upon their arrival.

Secular Trends of the Impact of Overweight and Obesity on Hypertension in Yi People: Yi Migrant Study, 1996-2015.

BACKGROUND: Rising hypertension prevalence, coupled with increasing overweight and obesity rates, has been observed in Yi people. Moreover, the growing blood pressure level among Yi people was mostly attributable to the continuous increase of body mass index (BMI). However, little is known about the trend of association between them. METHODS: Consequently, we investigated the impact of overweight/obesity on hypertension over three periods (1996, 2007-2008, 2015) using data from Yi Migrant Study (n = 8749). The Yi Migrant Study incorporated three successive cross-sectional studies which were implemented by the same team with consistent protocols. RESULTS: Compared with period 1 (1996), the influence of overweight/obesity on hypertension risk significantly increased in period 2 (2007-2008) and period 3 (2015); relative excess risk due to interaction (RERI) was 1.59 (95% CI: 0.12, 3.05) and 1.41 (95% CI: 0.30, 2.78), respectively. Meanwhile, the overweight/obese population in period 3 did not show hypertension risk higher than that in period 2 (RERI = 0.15; 95% CI: -0.76, 1.07). Additionally, we observed a continuously growing trend of hypertension risk among normal weight Yi people. CONCLUSIONS: During the past two decades, there was a significant increase in the association between overweight/obesity and hypertension in Yi people, whereas the increasing trend has leveled off in more recent years. These findings suggest that overweight/obesity and hypertension are becoming more epidemic comorbidity over time. Interventions to prevent hypertension should focus not only on the overweight/obese population, but also on those with normal weight.

Association of Socioeconomic Status and Overweight/Obesity in Rural-to-Urban Migrants: Different Effects by Age at Arrival.

This study aims to investigate the association between socioeconomic status and overweight/obesity in rural-to-urban Yi migrants in China, and to explore whether the association varied by the age at arriving urban areas. The cross-sectional population-based data from the Yi Migrants Study in 2015 was used, which included 1,181 Yi migrants aged 20-80 years. Socioeconomic status was evaluated by education level, personal annual income, and a composited variable (socioeconomic status index, SESI). Measured weight and height were used to calculate BMI and to define overweight/obesity (BMI ≥ 24 kg/m2). The results suggested that the association of income and SESI with overweight/obesity was not significant when age at arrival (two groups, <20 and ≥20 years) was considered as a covariate. In the stratification analysis, reversed association was observed in the two groups of age at arrival. In migrants of <20 years of age at arrival, higher level of education and SESI were related to decreased risk of overweight/obesity. In contrary, in those of ≥20 years at arrival, higher socioeconomic status level was found to be related to increased risk. Our findings suggest that the effect of socioeconomic status on overweight/obesity was modified by the age at arrival in Yi migrants. Especially, the association between socioeconomic status and overweight/obesity was negative when migration before 20 years of age, and transfer to positive after 20 years.

The association between high-sensitivity C-reactive protein and blood pressure in Yi people.

BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) is a common risk factor for developing cardiovascular disease. However, there has been no study reporting the relationship between hs-CRP and blood pressure in Yi adults. The aim of this study is to investigate the association between hs-CRP and blood pressure in Yi adults. METHODS: In this cross-sectional study, included subjects were 2916 Yi migrants or farmers aged 20-80 years, recruited by using a stratified cluster sampling method from Liangshan Yi Autonomous Prefecture of Sichuan Province in 2014. The directed acyclic graphs(DAG) was used to select a minimal sufficient adjustment sets of variables which would identification the unconfounded effect of hs-CRP and hypertension. Multiple linear and multinomial logit analysis were used to estimate the effect of hs-CRP on SBP/DBP/MAP/PP and the prevalence of prehypertension/hypertension after adjustment for the relevant confounders. RESULTS: The median level of hs-CRP was 1.20 (0.50-3.06)mg/L in Yi migrants, and 0.84(0.36-2.52) mg/L in Yi farmers, and the prevalence of high hs-CRP was 23.25%. For hs-CRP > 3 mg/L group, the adjusted PP tended to have lower values (ß = - 1.49, 95%CI: - 2.49--0.49, P = 0.0034) compared with < 1 mg/L group. After adjusting for confounders, there were no significant association between hs-CRP and prehypertension/hypertension (P > 0.05). CONCLUSIONS: Our results suggest that high hs-CRP is prevalent in Yi people, and this study does not support hs-CRP as a risk factor of prehypertension or hypertension.

Status and associated factors of self-management in people living with HIV/AIDS in Liangshan area, China: a cross-sectional study.

Background: HIV self-management is a lifetime and central task for people living with HIV/AIDS (PLWH). To date, there is little evidence to identify the related factors of self-management in PLWH from China. Purpose: This study aimed to investigate the status and related factors of self-management in PLWH from the Liangshan area of Sichuan Province, China. Patients and methods: A total of 322 PLWH were recruited from August to December 2017 in the study. Demographics characteristics and disease-related data were documented for each participant, social support was measured by the Medical Outcomes Study Social Support Survey (MOS-SSS-C), and self-management was evaluated by the HIV Self-Management Scale. Descriptive statistics analysis, independent Student's t-test, one-way ANOVA, Spearman rank correlation, and multiple regression analysis were used to analyze the data. Results: The total score of HIV self-management was 38.26±7.17. Significant differences in self-management scores were found among the subgroups of different education level, marital status, nation, religion, resident place, occupation, infection route, symptom, research site, and household per capita monthly income. Self-management was positively significantly correlated with social support. Multiple regression analysis identified that nation, resident place, gender, marital status, and social support were the contributors of HIV self-management. Conclusion: The study demostrated that self-management in Yi Autonomous Prefecture was relatively low. The results indicate that the associated factors of self-management should be considered to develop effective intervention to improve the self-management of PLWH.

Twenty-year time trends in hypertension prevalence in Yi people of China: three successive cross-sectional studies, 1996-2015.

OBJECTIVE: To explore the trend of hypertension prevalence and related factors in Yi people from 1996 to 2015. METHODS: Three successive cross-sectional surveys were conducted in Liangshan Yi Autonomous Prefecture in 1996, 2007 and 2015, respectively. A total of 8448 participants aged 20-80 years (5040 Yi farmers, 3408 Yi migrants) were included in final analysis. RESULTS: Overall, the age-standardised prevalence of hypertension in migrants was significantly higher than in farmers. Furthermore, the age-standardised prevalence rates increased from 10.1% to 15.3% to 19.6% in Yi migrants and from 4.0% to 6.3% to 13.1% in Yi farmers during 1996 to 2007 to 2015. The highest 2015-to-1996 ratio of age-standardised hypertension prevalence was in male farmers (ratio=4.30), whereas despite the highest prevalence of hypertension, the equivalent figure in male migrants was 1.57. The older age, overweight and obesity were persistent risk factors of hypertension in three periods. After adjusted for age and body mass index, the difference of hypertension prevalence between 1996 and 2015 then vanished in male migrants (OR=1.335; 95% CI: 0.884 to 2.015) and female farmers (OR=1.267; 95% CI: 0.590 to 2.719). The disparities of hypertension prevalence between Yi migrants and farmers were not statistically significant in all subgroups when adjusted for age, body mass index and education. CONCLUSIONS: Over the past two decades, the hypertension prevalence in Yi people has significantly increased. Yi migrants were more likely to be hypertensive than Yi farmers which was predominantly driven by the discrepancy of body mass index between them.

Data Resource Profile: The China National Health Survey (CNHS).

The China National Health Survey (CNHS) is the first nationwide multi-ethnic cross-sectional interview and health examination conducted from 2012 to 2017. The survey is designed to study reference intervals for physiological constants as well as determinants of noncommunicable diseases among different ethnic populations in different areas, so that the data can be used to enhance clinical diagnosis strategies and health promotion. CNHS used a stratified, multistage cluster sampling method to obtain a sample of 53 895 people aged 20-80 years in 10 ethnic groups from 11 provinces or autonomous regions all over China. Blood samples were collected from each participant for the establishment of the China Multi-Ethnic Biobank (CMEB). CNHS collected data on demographic and socioeconomic information, lifestyle factors, anthropometric measures, laboratory tests and clinical profiles. These data provide a comprehensive resource for further study on risk factors of noncommunicable disease among different ethnic groups. Information about the CNHS database, including publication list, introduction of the survey design and methods, and guidelines for submitting electronic forms of data application, is available at [http://www.bmicc.cn/web/share/home].

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.

Increased expression of insulin-like growth factor-binding protein-3 is implicated in erectile dysfunction in two-kidney one-clip hypertensive rats after propranolol treatment.

This study aimed to investigate the role of insulin-like growth factor-binding protein-3 (IGFBP-3) in erectile dysfunction (ED) in two-kidney one-clip (2K-1C) hypertensive rats treated with the ß-blocking agent propranolol. Adult male Wistar rats were randomly divided into three groups: a normal control group, a hypertensive control group and a propranolol treatment group (n=9). After 4 weeks of propranolol treatment, intracavernous pressure (ICP) responses to electrical stimulation of the cavernous nerves were evaluated. The expression of IGFBP-3 and insulin-like growth factor-1 (IGF-1) mRNA and protein in the rat cavernous tissue were detected by quantitative real-time PCR and Western blot, respectively. The concentration of cyclic guanosine monophosphate (cGMP) in the cavernous tissue was determined by enzyme-linked immunosorbent assay (ELISA). Cavernosal pressure in response to cavernous nerve stimulation was decreased 4 weeks after propranolol treatment (P<0.01, compared to the hypertensive control group). IGFBP-3 mRNA and protein expression was increased in the propranolol treatment group compared to the hypertensive control group (P<0.01), whereas IGF-1 expression was decreased in the propranolol treatment group compared to the hypertensive control group (P<0.01). In addition, cavernous cGMP concentration was decreased in the propranolol treatment group compared to the hypertensive control group (P<0.01). Taken together, these results suggest that the upregulation of IGFBP-3 may play a role in the development of ED in hypertensive rats.

[Reconstruction of resected cavernous nerve].

The injury of the penile cavernous nerve is a common cause of erectile dysfunction (ED). Reconstruction of the resected cavernous nerve can restore penile erectile function to normal. The methods for cavernous nerve repair include direct anastomosis, autotransplantation of the nerve, and substitution of the biodegradable artificial nerve, among which only autotransplantation of the sural nerve is used clinically at present. Besides, the nerve growth factor plays an important role in nerve reconstruction. This paper summarizes the methods of cavernous nerve reconstruction in the recent years.