The association between alcohol drinking and glycemic management among people with type 2 diabetes in China.

INTRODUCTION: To investigate the association between alcohol drinking and glycemic management among adult patients with type 2 diabetes in regional China. MATERIALS AND METHODS: In this cross-sectional survey conducted in Nanjing Municipality of China in 2018, adult type 2 diabetes patients were randomly selected from urban and rural communities. The outcome variable was the glycemic management status. The explanatory measure was alcohol drinking. Mixed-effects regression models were employed to estimate odds ratios (ORs) and 95% confidence interval (95% CI) for examining the associations of alcohol drinking with glycemic management among type 2 diabetes patients. RESULTS: Among the overall 5,663 participants, the glycemic management rate was 39.8% (95% CI = 38.5, 41.1), with 41.2% (95% CI = 39.7, 42.7), 43.9% (95% CI = 38.9, 48.8), and 34.1% (95% CI = 31.5, 36.7) for non-drinkers, mild/moderate drinkers, and heavy drinkers, respectively. After adjustment for potential confounders and community-level clustering effect, heavy and mild/moderate alcohol drinkers were at 0.76 (95% CI = 0.66, 0.89) and 1.04 (95% CI = 0.87, 1.28) times odds to have glycemia under control than non-drinkers among the overall participants. Furthermore, when stratified separately by gender and use of anti-diabetes agents, the scenario within men, either regular or irregular users of anti-diabetes agents was the same as that for overall participants, while the association between alcohol drinking and glycemic management became non-significant among women. CONCLUSIONS: Heavy alcohol drinking might have a negative effect on glycemic management among patients with type 2 diabetes irrespective of the use of anti-diabetes agents in regional China. This study has important public health implications regarding precision intervention on patients' glycemia control for type 2 diabetes management.

Association of socioeconomic status with metabolic syndrome and its components among adult population: a community-based cross-sectional study in Nanjing Municipality of China.

OBJECTIVES: To investigate the association of metabolic syndrome (MetS) and its components with socioeconomic status (SES) among general and gender-specific adult population in Nanjing municipality, China. DESIGN: Cross-sectional study. PARTICIPANTS: 13287 participants completed the survey. A participant: (1) must be a local registered resident, (2) aged 18+ years, (3) had no literal or physical/mental problems and (4) was not pregnant. STUDY MEASURES: MetS was the outcome variable, which was defined based on the diagnostic criteria released by the Chinese Diabetes Society. SES was the main explanatory measure, which was indicated with educational attainment and family average income (FAI), separately. RESULTS: The prevalence of MetS was 19.7% (95% CI=19.0% to 20.4%) among overall participants, and 24.6% (95% CI=23.5% to 25.6%) and 15.5% (95% CI=14.7% to 16.4%) for men and women, respectively. After controlling for potential confounders, participants with either college level (OR=0.51, 95% CI=0.43 to 0.60) or high school level education (OR=0.78, 95% CI=0.70 to 0.90) were at lower odds to experience MetS compared with those with primary education, while only those within upper FAI tertile were at significantly lower risk of MetS relative to their counterparts within lower FAI category (OR=0.85, 95% CI=0.76 to 0.97) among overall participants. Meanwhile, with respect to the five components of MetS, higher educational level predicted lower waist circumference (WC), triglycerides, systolic blood pressure (SBP) and diastolic blood pressure (DBP) and fasting glucose concentration among all participants. And higher FAI was associated with lower WC and SBP and DBP in women, and with lower SBP and DBP in men. CONCLUSIONS: Education and FAI each were inversely associated with MetS and its components at the present stage of economic development in Nanjing Municipality of China. It has important public health implications that the tailored prevention strategies for MetS should be put into consideration of the intervention of MetS components and subgroups of people with different SES.

The joint association of physical activity and sedentary behavior with metabolic syndrome among urban men aged 60+ years in regional China.

Objectives: Metabolic syndrome (MetS) is a major public health issue worldwide, which is preventable through physical activity (PA) promotion and sedentary behavior (SB) reduction. However, the joint association of PA and SB with MetS was not well-investigated, particularly in elderly people. This study aimed to examine separate and joint associations of PA and SB with MetS among elderly urban men in China. Methods: In this cross-sectional study conducted in mid-2018, participants were urban men aged 60+ years randomly selected from in Nanjing of China. Exposure variables were PA and SB. The outcome variable was MetS. A participant was categorized as "having MetS" or "not having MetS" in the analysis. Independent variables were PA and SB, which were categorized as "sufficient PA or insufficient PA" and "shortened SB or prolonged SB", respectively. Mixed-effects logistics regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the association of PA and SB with MetS. Results: Totally, 5,520 from 5,792 eligible participants were randomly recruited and their mean age was 68.9 (standard deviation: 16.9) years. The prevalence of MetS was 30.8% (95%CI = 29.6%, 32.0%) among urban men aged 60+ years in the study. After adjustment for potential confounders, subjects with sufficient PA were less likely (OR = 0.77, 95%CI = 0.67, 0.88) to experience MetS, independently of SB, relative to their counterparts with insufficient PA, while a lower odds (OR = 0.74; 95%CI = 0.61, 0.89) of experiencing MetS was examined for participants with shortened SB, also independently of PA, compared to those with prolonged SB in the study. Furthermore, compared to participants with insufficient PA and prolonged SB, those either within categories of insufficient PA and shortened SB (OR = 0.81; 95%CI = 0.65, 0.99), sufficient PA and prolonged SB (OR = 0.80; 95%CI = 0.70, 0.92), or sufficient PA and shortened SB (OR = 0.41; 95%CI = 0.26, 0.63) were at significantly lower risk to experience MetS, respectively. Conclusions: PA was negatively associated with MetS, and SB was positively linked to MetS, which were independent of each other. Moreover, sufficient PA and shortened SB might exert additively joint influence on MetS. This study has important implications that concurrent PA promotion and SB reduction shall be encouraged for people to optimize the effectiveness of MetS prevention.

The clinical characteristics of Chinese elderly patients with different durations of type 2 diabetes mellitus.

Aims: To explore the clinical characteristics among elderly (aged ≥60 years) patients with type 2 diabetes (T2DM) of different durations. Methods: Clinical characteristics were investigated in 3840 elderly T2DM patients according to their different durations of diabetes (< 1 year, 1~5 years, 5~10 years, and ≥ 10 years). Kruskal-Wallis and Dunn tests were used to assess the differences among groups for continuous variables. The chi-square and post hoc tests were carried out for dichotomous variables. The logistic regression was adopted to investigate the relationships between various durations of diabetes and the control rates of achieving the control targets for T2DM as well as diabetic vascular complications. Results: There were 972, 896, 875 and 1097 patients with a duration of diabetes of <1, 1~5, 5~10 and ≥10 years, respectively. In logistic regression models adjusted for age, sex, education, BMI, smoking and family history of diabetes, elderly T2DM patients with a duration of diabetes of ≥10 years were more likely to reach the comprehensive control targets for TC (ORTC = 1.36, 95% CI =1.14-1.63), LDL-C (ORLDL-C = 1.39, 95% CI =1.17-1.66), TG (ORTG = 1.76, 95% CI =1.46-2.12) and BMI (ORBMI = 1.82, 95% CI =1.52-2.18). Elderly T2DM patients with a duration of diabetes of 1~5 years were more likely to achieve the HbA1c control target (ORHbA1c = 1.92, 95% CI = 1.59-2.31) than elderly T2DM patients with a duration of diabetes of <1 year. Furthermore, in elderly T2DM patients with a duration of diabetes of 5~10 years or ≥ 10 years, the duration of diabetes was positively associated with diabetic macrovascular complications (coronary heart disease and peripheral artery disease). In elderly T2DM patients with a duration of diabetes of over 10 years, the duration of diabetes was associated with diabetes kidney disease (all P < 0.05). Conclusions: It is worth noting that the clinical characteristics of elderly patients with type 2 diabetes in different durations of diabetes are different.

The achievement of comprehensive control targets among type 2 diabetes mellitus patients of different ages.

OBJECTIVE: To evaluate achievement of comprehensive controls among patients with type 2 diabetes mellitus (T2DM) in different age groups. RESULTS: The elderly patients had higher control rates for BMI (44.36%), TC (50.83%) and LDL-C (48.27%) than those aged 60-80 years and younger patients (all P <0.05). Multiple logistic regression revealed that elderly patients were more likely to achieve control targets for HbA1c (odd ratio (OR) = 2.19), TC (OR = 1.32), HDL-C (OR = 1.35), and TG (OR = 1.74) than younger patients. This effect was stronger in males (ORHbA1c = 2.27; ORTC = 1.41; ORHDL-C = 1.51; ORTG = 1.80). By contrast, elderly females were only more likely to achieve HbA1c < 7.0% (OR=1.88). CONCLUSIONS: Our findings suggest that comprehensive control strategies still should be strengthened. METHODS: A total of 3126 T2DM patients were included, and detected blood pressure (BP), body mass index (BMI), glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). We divided patients into three age groups (<60, 60-80 and ≥ 80 years), to assess the differences in achieving the control targets.

Effectiveness of a clinic-based randomized controlled intervention for type 2 diabetes management: an innovative model of intensified diabetes management in Mainland China (C-IDM study).

OBJECTIVES: Highly efficient diabetes management programs are needed for tackling diabetes in China. This study aimed to assess the effectiveness of a clinic-based intensified diabetes management model (C-IDM) in Mainland China. RESEARCH DESIGN AND METHODS: A 2-year clinic-based randomized controlled trial was conducted among patients with type 2 diabetes in Nanjing, China. The C-IDM intervention components comprised four domains (disease targeting management, express referral channel, expert visit, patients' self-management) and an integrated running system (disease control centers, general hospitals and local clinics). Control group participants received their usual care, while intervention participants received both the C-IDM package and the usual services. The primary outcome variable was change of hemoglobin A1c (HbA1c). Mixed-effects models were used to compute effect estimates and 95% CI with consideration of both individual and cluster-level confounders. RESULTS: Overall, 1095 of 1143 participants were assessed at study completion. The mean change in HbA1c was significantly greater in the intervention group than in the control group (mean difference (MD)=-0.57, 95% CI -0.79 to -0.36). Similar results were observed for change in body mass index (MD=-0.29, 95% CI -0.49 to -0.10). Participants in the intervention group were more likely to achieve normal HbA1c and body weight compared with their counterparts in control group after adjusting for potentially confounding variables (adjusted OR=1.94, 95% CI 1.35 to 2.81 and 1.79, 95% CI 1.13 to 2.85, respectively). CONCLUSIONS: The C-IDM model is feasible and effective in large-scale management of patients with type 2 diabetes in China. It has public health implications for tackling the burden of diabetes in China. TRIAL REGISTRATION NUMBER: ChiCTR-IOR-15006019.

Association of Thyroid Function With the Estimated Glomerular Filtration Rate in a Large Chinese Euthyroid Population.

BACKGROUND/AIMS: We aimed to explore whether thyroid function within a normal range is associated with the estimated glomerular filtration rate (eGFR) and the incidence of chronic kidney disease (CKD) in a large Chinese population. METHODS: We conducted a cross-sectional study that included 10,859 euthyroid individuals who underwent an annual regular health checkup in Jiangsu Province Official Hospital between August 2012 and August 2013. We measured the thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels using a Roche modular analytics E170 and then calculated the eGFR using the Chinese modified Modification of Diet in Renal Disease (CMDRD) equation. RESULTS: In multiple linear regression models, TSH was negatively associated with eGFR after adjusting for confounding factors (ß = -0.072, P = 1.994×10-22). The significance remained in both males and females. No significant association was observed between FT4 and eGFR. In the logistic regression model, we did not observe significant associations of TSH or FT3 with CKD. Participants in the highest quartile of FT4 versus the lowest quartile (reference) had an increased risk of CKD (OR = 1.763, P = 0.012). The risk of CKD was more pronounced in females with the highest quartile of FT4 (OR = 2.424, P = 0.029). CONCLUSION: Our findings suggest that TSH is associated with eGFR in euthyroid individuals and that higher FT4 is associated with an increased risk of CKD. More cohort studies are warranted to confirm whether the association is causal.

Serum uric acid to creatinine ratio correlates with ß-cell function in type 2 diabetes.

BACKGROUND: The correlation between serum uric acid (SUA) and ß-cell function remains controversial. The present study aims to use a new index, renal function-normalized SUA, to observe its correlation with ß-cell function in patients with type 2 diabetes (T2DM). METHODS: A total of 713 patients with T2DM received standard 75-g oral glucose tolerance and insulin release test. Renal function-normalized SUA was calculated using SUA/creatinine and ß-cell function was assessed by HOMA-B. Binary logistic regression analysis was used to estimate the association between SUA/creatinine and ß-cell function. RESULTS: There are positive correlations between SUA/creatinine and HOMA-B (r = 0.143, P < 0.001), as well as other indexes of ß-cell function including modified ß-cell function index (r = 0.104, P = 0.007), InsAUC30 (r = 0.100, P = 0.008), and InsAUC120 (r = 0.124, P = 0.001). SUA/creatinine also positively correlates with insulin resistance (HOMA-IR: r = 0.161, P < 0.001). Moreover, multivariate analysis revealed that SUA/creatinine was significantly associated with preserved ß-cell function, independently of potential confounders including sex, BMI, and renal function. CONCLUSIONS: SUA to creatinine ratio correlates with ß-cell function in T2DM patients.

Serum uric acid to creatinine ratio: A predictor of incident chronic kidney disease in type 2 diabetes mellitus patients with preserved kidney function.

BACKGROUND: Serum uric acid has shown to be a predictor of renal disease progression in most but not all studies. This study aims to test whether renal function-normalized serum uric acid is superior to serum uric acid as the predictor of incident chronic kidney disease in type 2 diabetes mellitus patients. METHODS: In this study, 1339 type 2 diabetes mellitus patients with estimated glomerular filtration rate ⩾60 mL/min/1.73 m2 and normouricemia were included. Renal function-normalized serum uric acid was calculated using serum uric acid/creatinine. Cox regression analysis was used to estimate the association between serum uric acid, renal function-normalized serum uric acid and incident chronic kidney disease. RESULTS: In total, 74 (5.53%) patients developed to chronic kidney disease 3 or greater during a median follow-up of 4 years, with older ages, longer diabetes duration and lower estimated glomerular filtration rate at baseline. The decline rate of estimated glomerular filtration rate was positively correlated with serum uric acid/creatinine ( r = 0.219, p < 0.001), but not serum uric acid ( r = 0.005, p = 0.858). Moreover, multivariate analysis revealed that serum uric acid was not an independent risk factor for incident chronic kidney disease ( p = 0.055), whereas serum uric acid to creatinine ratio was significantly associated with incident chronic kidney disease independently of potential confounders including baseline estimated glomerular filtration rate. CONCLUSION: serum uric acid to creatinine ratio might be a better predictor of incident chronic kidney disease in type 2 diabetes mellitus patients.

Evaluation of glycemic control in patients with type 2 diabetes mellitus in Chinese communities: a cross-sectional study.

This study aimed to evaluate the glycemic levels in Chinese patients with type 2 diabetes mellitus (T2DM) and to explore the factors related to the results of glycemic control. A total of 2454 T2DM patients from 11 communities were examined for glycosylated hemoglobin levels and glycemic control options. Potential factors related to the results of glycemic control were analyzed using logistic regression. Of all the patients, 55.3 % achieved the glycemic control target of HbA1c < 7 %. Multivariate analysis showed that male sex (OR 1.345, 95 % CI 1.022-1.769; P = 0.034), higher levels of fasting blood glucose (OR 1.954, 95 % CI 1.778-2.147; P < 0.001), and low-density lipoprotein cholesterol (OR 1.181, 95 % CI 1.020-1.367; P = 0.026) were significantly associated with poor glycemic control. The complexity of antidiabetics was also associated with poor glycemic control (P < 0.05). Compared to diet and exercise, insulin injection was most strongly associated with poor glycemic control (OR 6.210, 95 % CI 4.054-9.514; P < 0.001). Male patients with higher levels of total cholesterol, lower levels of high-density lipoprotein cholesterol, or longer diabetic durations showed poor glycemic control, which was not found in female patients. Glycemic control was not satisfactory in T2DM patients of Nanjing communities. Various factors are associated with poor results of glycemic control.

Lack of association between anemia and renal disease progression in Chinese patients with type 2 diabetes.

AIMS/INTRODUCTION: Anemia has a close interaction with renal dysfunction in diabetes patients. More proof is still awaited on the relationship between anemia and the progression of renal disease in this population. MATERIALS AND METHODS: In the present longitudinal study, 1,645 Chinese type 2 diabetes patients without end-stage renal disease were included in the analysis in Nanjing, China, during January 2006 and December 2012. All patients were managed by staged diabetes management protocol, and clinical parameters were collected at each visit. The end-point of progression of renal disease was evaluated during the follow up. Cox regression analysis was used to estimate the risk of anemia on renal disease progression. RESULTS: On recruitment, 350 (21.3%) patients had anemia, which was more common among those with older ages, longer diabetes duration, lower estimated glomerular filtration rate or more albuminura. On median follow up of 49 months (range 28-62 months), 37 patients (2.2%) developed the defined renal end-point. Compared with those without anemia, patients with anemia had a higher risk of renal disease progression. However, multivariate analysis showed that anemia lost its statistical significance once estimated glomerular filtration rate was added into the model. Although the incidence of renal disease progression markedly increased by anemia status in patients of estimated glomerular filtration rate <60 mL/min/1.73 m(2), anemia was still not an independent risk factor for renal disease progression in this subgroup. CONCLUSIONS: Anemia was a common finding in Chinese type 2 diabetes patients. Anemia was a risk factor for renal disease progression, but lost its significance once baseline renal function was adjusted.

Cardiovascular risk and events in 17 low-, middle-, and high-income countries.

BACKGROUND: More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. METHODS: We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater risk-factor burden). Participants were followed for incident cardiovascular disease and death for a mean of 4.1 years. RESULTS: The mean INTERHEART Risk Score was highest in high-income countries, intermediate in middle-income countries, and lowest in low-income countries (P<0.001). However, the rates of major cardiovascular events (death from cardiovascular causes, myocardial infarction, stroke, or heart failure) were lower in high-income countries than in middle- and low-income countries (3.99 events per 1000 person-years vs. 5.38 and 6.43 events per 1000 person-years, respectively; P<0.001). Case fatality rates were also lowest in high-income countries (6.5%, 15.9%, and 17.3% in high-, middle-, and low-income countries, respectively; P=0.01). Urban communities had a higher risk-factor burden than rural communities but lower rates of cardiovascular events (4.83 vs. 6.25 events per 1000 person-years, P<0.001) and case fatality rates (13.52% vs. 17.25%, P<0.001). The use of preventive medications and revascularization procedures was significantly more common in high-income countries than in middle- or low-income countries (P<0.001). CONCLUSIONS: Although the risk-factor burden was lowest in low-income countries, the rates of major cardiovascular disease and death were substantially higher in low-income countries than in high-income countries. The high burden of risk factors in high-income countries may have been mitigated by better control of risk factors and more frequent use of proven pharmacologic therapies and revascularization. (Funded by the Population Health Research Institute and others.).

[Influence of electroacupuncture intervention on serum ghrelin content and bone mineral density in ovariectomized rats].

OBJECTIVE: To observe the influence of electroacupuncture (EA) on serum ghrelin content and bone mineral density in ovariectomized (OVX) rats so as to explore its mechanism underlying improvement of postmenopausal osteoporosis. METHODS: Thirty ovariectomized SD rats with osteoporosis were randomized into model, EA and estrogen groups (n = 10) and other 10 rats received sham operation were assigned to be control group. For OVX rats of the EA group, EA (2 Hz, 1-3 mA) was applied to "Sanyinjiao" (SP 6) + "Guanyuan" (CV 4) or "Shenshu" (BL 23) + "Housanli" (ST 36), alternately for 20 min, once daily for consecutive 3 months. For rats of the estrogen group, subcutaneous injection of estradiol benzoate (0.1 mg/kg) was given once a week for 3 months. The bone mineral density (BMD) of the lumbar vertebrae and femur were detected by using a bone densitometer, and serum ghrelin content was assayed by ELISA. RESULTS: In comparison with the sham operation group, serum ghrelin level of the model group was significantly increased, and BMD of both lumbar vertebrae and femur were significantly decreased (P < 0.05). Compared with the model group, the serum ghrelin levels were considerably decreased in both EA group and estrogen group, while BMD levels were significantly upregulated in the EA and estrogen groups (P < 0.05). The effects of the EA group were obviously inferior to those of the estrogen group (P < 0.05). CONCLUSION: Acupuncture intervention can improve bone density and lower serum ghrelin level in OVX rats, which may contribute to its effect in improving osteoporosis.

Validity of glycated hemoglobin in screening and diagnosing type 2 diabetes mellitus in Chinese subjects.

BACKGROUND/AIMS: The application of glycated hemoglobin (HbA(1c)) for the diagnosis of diabetes is currently under extensive discussion. In this study, we explored the validity of using HbA(1c) as a screening and diagnostic test in Chinese subjects recruited in Nanjing, China. METHODS: In total, 497 subjects (361 men and 136 women) with fasting plasma glucose (PG) ≥ 5.6 mmol/L were recruited to undergo the oral glucose tolerance test (OGTT) and HbA(1c) test. Plasma lipid, uric acid, and blood pressure were also measured. RESULTS: Using a receiver operating characteristic curve, the optimal cutoff point of HbA(1c) related to diabetes diagnosed by the OGTT was 6.3%, with a sensitivity and specificity of 79.6% and 82.2%, respectively, and the area under the curve was 0.87 (95% confidence interval, 0.83 to 0.92). A HbA(1c) level of 6.5% had a sensitivity and specificity of 62.7% and 93.5%, respectively. When comparing the HbA(1c) ≥ 6.5% or OGTT methods for diagnosing diabetes, the former group had significantly higher HbA(1c) levels and lower levels of fasting and 2-hour PG than the latter group. No significant difference was observed in the other metabolism indexes between the two groups. CONCLUSIONS: Our results suggest that HbA(1c) ≥ 6.5% has reasonably good specificity for diagnosing diabetes in Chinese subjects, which is in concordance with the American Diabetes Association recommendations.

Cardiovascular disease risk factors are highly prevalent in the office-working population of Nanjing in China.

OBJECTIVE: To establish a profile of the modifiable cardiovascular disease (CVD) risk factors in the office-working population of Nanjing, China. BACKGROUND: With increasing modernization in China, CVD is now common among Chinese. Relevant information on the prevalence of CVD risk factors in China is, however, limited. METHODS: We recruited 2648 office working people aged 23-79 years without history of CVD or diabetes from 7 work units of Nanjing during the years 2003 to 2005. Information from a self-reported questionnaire on lifestyle, physical examination, fasting blood for lipid profiles, and a 75-gram oral glucose tolerance test (OGTT) were obtained from each participant. We analyzed the following 7 CVD risk factors: smoking, inadequate physical activity, unhealthy dietary habit, obesity, hypertension, dyslipidemia, and hyperglycemia. RESULTS: The whole study population had an average of 2.8 risk factors, while 95.6%, 79.4% and 55.6% of them had respectively ≥ 1, ≥ 2 and ≥ 3 of the 7 CVD risk factors. Men had a higher proportion of smoking, hypertension, dyslipidemia, hyperglycemia, but lower in light physical activity compared with women. Number of CVD risk factors increased with age. Although risk factors in men were more common than women, they increased alarmingly in postmenopausal women. CONCLUSIONS: CVD risk factors are common in office-working people in Nanjing, China. Effective interventions and treatment against risk factors should be adopted in the high risk population, which may greatly reduce the future burden of CVD in the Chinese population.

Chronic kidney disease and associated cardiovascular risk factors in chinese with type 2 diabetes.

BACKGROUND: To determine the frequency of chronic kidney disease (CKD) and its associated risk factors in Chinese type 2 diabetic patients, we conducted a cross-sectional study in Nanjing, China, in the period between January 2008 and December 2009. METHODS: Patients with type 2 diabetes under the care by Jiangsu Province Official Hospital, Nanjing, China were invited for assessment. CKD was defined as the presence of albuminuria or estimated glomerular filtration rate <60 mL/min/1.73 m(2). Albuminuria was defined as urinary albumin-to-creatinine ratio ≥30 mg/g. RESULTS: We recruited 1,521 urban Chinese patients with type 2 diabetes (mean age, 63.9±12.0 years). The frequency of CKD and albuminuria was 31.0% and 28.9%, respectively. After adjusted by age and sex, hypertension, anemia and duration of diabetes were significantly associated with CKD with odds ratio (95% confidence interval) being 1.93 (1.28 to 2.93), 1.70 (1.09 to 2.64), and 1.03 (1.00 to 1.06), respectively. CONCLUSION: In conclusion, CKD was common in the urban Nanjing Chinese with type 2 diabetes. Strategies to prevent or delay progression of kidney disease in diabetes should be carried out at the early disease course of type 2 diabetes.

[Familial pedigree analysis of Shen-yin deficiency syndrome in families with type 2 diabetes mellitus GU].

OBJECTIVE: To analyse the familial aggregation and genetic predisposition of Shen-yin deficiency syndrome (SYDS) in families with diabetes mellitus type 2 (DM2). Methods One hundred and forty-one DM2 patients were collected from 32 family lines in Nanjin area, in which the probands were differentiated as DM2 with SYDS. On them, genetic analysis on the characteristics of SYDS was conducted using pedigree analysis, morbidity and heritability of the first-degree relatives of the probands were calculated, and the action of familial SYDS factor on the genesis of the syndrome was assessed by multiple factors regression analysis. Results The morbidity rate of SYDS in the first-degree relatives of the probands was 33.71%, and the heritability, calculated by Falconer formula, was 80.6%. The fitting result of regression analysis showed that familial factor played an important role in SYDS genesis (OR = 5.61, P = 0.001), but DM2 itself is not an independent risk factor for it. Conclusion DM2 with SYDS shows the tendency of familial aggregation and genetic predisposition, genetic factor is associated with the genesis of the syndrome. Pedigree research is a good method for exploring the relationship between syndrome and genetic factor.