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1.
Med Educ Online ; 25(1): 1710326, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31900104

RESUMO

Background: Medical residents usually suffer from work overload and experience both personal and professional distress, which affects their level of the empathy to patients. Psychological capital (PsyCap) is a psychological resource that is negatively associated with indicators of distress.Objective: This study explored the potential mediating effect of PsyCap on the relationship between distress and empathy, which may help healthcare professionals in their defense of empathy erosion due to distress.Design: A total of 620 first-year residents were recruited for this cross-sectional survey. Empathy and PsyCap of residents were assessed by the Chinese version of the Jefferson Scale of Physician Empathy and the Psychological Capital Questionnaire, respectively. In this study, both personal and professional aspects contributing to resident distress were investigated by the Satisfaction with Life Scale and an occupational distress scale. T-tests and one-way ANOVA were used to test differences in empathy of residents. Pearson's correlation was used to examine correlations between distress, PsyCap, and empathy. Structured equation modeling was used to conduct the pathway analysis to test the mediating effect of PsyCap on the association between distress and empathy.Results: 537 residents (68.6%) completed the survey. Distress, empathy, and PsyCap were significantly correlated (P < .01) and in the expected directions. The first step analysis showed that as distress increased, the empathy of residents significantly decreased (P < .01), with the direct effect coefficient being 0.265. When PsyCap was included, the direct effect coefficient decreased to 0.033. This indirect effect was significant (P < .01). The variance accounted for was 81.14%, which indicated a partial mediating effect of PsyCap.Conclusions: PsyCap may serve a significant protective role against the impact of distress on the level of empathy of medical residents. In addition to reducing distress, PsyCap development could be considered in empathy decline prevention and empathy cultivating strategies.Abbreviations: PsyCap: Psychological capital; JSPE: Jefferson Scale of Physician Empathy; PCQ: Psychological Capital Questionnaire; SWLS: Satisfaction with Life Scale; VAF: Variance accounted for; SD: Standard deviation.

2.
BMC Pregnancy Childbirth ; 20(1): 53, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992220

RESUMO

BACKGROUND: Gestational diabetes mellitus (GDM) is a growing global epidemic. Our study aims to confirm the association between circulatory coiled-coil domain-containing 80 (CCDC80) in pregnant women with GDM, to investigate the discriminatory power of CCDC80 on GDM, and to explore the relationships between this molecular level and clinical cardiometabolic parameters. METHODS: A 1:2 matched case-control study with 61 GDM patients and 122 controls was conducted using a propensity score matching protocol. All participants were screened from a multicenter prospective pre-birth cohort: Born in Shenyang Cohort Study (BISCS). During 24 and 28 weeks of gestation, follow-up individuals underwent an oral glucose tolerance test (OGTT) and blood sampling for cardiometabolic characterization. RESULTS: Following propensity score matching adjustment for clinical variables, including maternal age, gestational age, body mass index, SBP and DBP, plasma CCDC80 levels were significantly decreased in patients with GDM when compared with controls (0.25 ± 0.10 vs. 0.31 ± 0.12 ng/ml, P = 0.003). Conditional multi-logistic regression analyses after adjustments for potential confounding factors revealed that CCDC80 was a strong and independent protective factor for GDM (ORs < 1). In addition, the results of the ROC analysis indicated the CCDC80 exhibited the capability to identify pregnant women with GDM (AUC = 0.633). Finally, multivariate regression analyses showed that CCDC80 levels were positively associated with AST, monoamine oxidase, complement C1q, LDL-C, apolipoprotein A1and B, and negatively associated with blood glucose levels at 1 h post- OGTT. CONCLUSIONS: Biomarker CCDC80 could be of great value for the development of prediction, diagnosis and therapeutic strategies against GDM in pregnant women.

3.
Appetite ; 144: 104447, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31560936

RESUMO

OBJECTIVE: To examine the relationships between caregiver perceptions of their neighborhood food environment and home food environment and between caregiver perceptions of neighborhood food environment and childhood obesity. DESIGN: Cross-sectional. SETTING: A total of twenty-six primary schools in northeast China. PARTICIPANTS: Anthropometric measurements and questionnaire surveys were carried out on 3670 children (aged 9-12 years) and their caregivers. RESULTS: Children of caregivers who perceived high local healthy food availability were more likely to always have fruits, vegetables, 100% juice, and low-fat milk or skim milk in their homes. Children of caregivers who perceived fast-food shopping to be easy were more likely to eat out for fast food. Children of caregivers who perceived high general access to food shopping were less likely to always have fruits, vegetables, and sugar-free breakfast in their home, and were more likely to eat out for fast food. CONCLUSIONS: Future public health programs and interventions should take into consideration the role caregivers play in connecting neighborhood food environments with the home food environment.

4.
BMC Pregnancy Childbirth ; 19(1): 444, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775666

RESUMO

BACKGROUND: The sleep quality of pregnant women in the third trimester is related to mental health. However, there is still a lack of large-scale cohort research exploring this relationship in the second trimester. Thus, we assessed the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression. METHODS: We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to maternal age. RESULTS: PSQI scores were positively associated with antenatal PPS scores (ß: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (ß: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (ß: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality (PSQI scores ≥5) was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64) after adjusting maternal age, BMI, gestational age, smoking, educational level, annual household income and social support. The association of poor sleep quality (PSQI scores ≥5) in the second trimester with postnatal depression status was significant among women more than or equal to 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) but not among women less than 30 years old after adjusting covariates above. CONCLUSION: Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women's mental health status.

5.
Obes Facts ; 12(6): 653-668, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31645033

RESUMO

OBJECTIVES: The purpose of this research was to conduct a meta-analysis of the role that physical activity (PA) plays in influencing the critical proinflammatory cytokine levels associated with overweight/obese children and adolescents to explore the effectiveness of exercise intervention within this population. METHODS: With searches of the PubMed, EMBASE, and CENTRAL databases, we updated our meta-analysis up to November 2018. The randomized controlled trials (RCT) evaluated the ability of exercise training to increase the following factors in children and/or adolescents classified as obese or overweight: tumor necrosis factor (TNF)-α, interleukin (IL)-6, and C-reactive protein (CRP). RESULTS: Eleven RCT comprising 623 children and/or adolescents who were obese or overweight (i.e., 393 with PA and 230 controls) were suitable for use in this study. The meta-analysis showed that PA in general was associated with a significant reduction of CRP levels (mean difference = -0.45 mg/L, p = 0.02) in overweight/obese children and adolescents. Based on 115 overweight and obese youths, this study suggests that PA does not significantly mitigate IL-6 levels (mean difference = -0.39 pg/mL, p = 0.08), although there was a trend towards a reduction. Additionally, no close connection was observed between PA and TNF-α levels at 0.04 pg/mL (p = 0.78). Moreover, meta-regression analysis revealed a statistical association between CPR levels and changes in BMI or changes in adiponectin; likewise, IL-6 levels dramatically impacted the effect of exercise on changes in adiponectin. CONCLUSIONS: PA was associated with significantly reduced CRP levels, whereas there was no significant association with IL-6 or TNF-α in overweight/obese children or adolescents; however, there was a trend towards a reduction of IL-6.

6.
BMJ Open ; 9(8): e026162, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31420382

RESUMO

OBJECTIVES: To administer a cross-cultural adaptation of the Team Interaction Scale (TIS), test its psychometric properties and investigate influencing factors of team interactions in a physician population in Chinese tertiary hospitals. DESIGN: Cross-sectional survey. SETTINGS: Two rounds of surveys, a pilot and a large sampling survey, were conducted in two and nine tertiary hospitals, respectively, in Liaoning Province, China. PARTICIPANTS: In the pilot survey, 363 of 390 physicians sampled were included in the analysis, resulting in an effective response rate of 93.08%. In the large sampling survey, the effective response rate was 89.10% (3653 of 4100 physicians). OUTCOME MEASURES: The TIS and a short version of a burn-out scale were administrated to assess the physician's team interaction and burn-out. Psychometric properties of TIS were tested by confirmatory factor analysis (CFA), exploratory factor analysis (EFA) and internal consistency analysis. Gender, age, discipline, education level, professional title, hospital scale and burn-out were explored as influencing factors with independent sample t-tests, one-way analyses of variance and a correlation analysis. RESULTS: Based on CFA, a 17-item modified scale was developed following the pilot survey. In the large sampling survey, EFA was conducted with half of the samples, producing six dimensions: 'Communication', 'Coordination', 'Mutual help', 'Team goals', 'Work norms' and 'Cohesion and conflict resolution'. Fit of the modified model was confirmed by CFA with the other half of the samples (root mean square error of approximation=0.067, Comparative Fit Index=0.98, Normed Fit Index=0.97, Goodness of Fit Index=0.94, Adjusted Goodness of Fit Index=0.92). A high Cronbach's α coefficient of 0.98 demonstrated reliability of the modified scale. The Team Interaction Score was significantly lower in younger physicians, in men, in paediatricians and in physicians from larger-scale tertiary hospitals. Team Interaction Scores were negatively associated with burn-out. CONCLUSIONS: The adapted TIS, containing 17 items and six dimensions, was reliable and valid for Chinese tertiary hospital physicians. To address physician burn-out, team interaction should be highlighted.

7.
Free Radic Biol Med ; 141: 393-407, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31279968

RESUMO

Exposure to fine particular matter (≤2.5 µM, PM2.5) contributes to increased risk of obesity and type 2 diabetes. Hydroxytyrosol (HT), a simple polyphenol found in virgin olive oil, is considered to be beneficial for cardiovascular and metabolic disorders. The current study determined whether HT could improve PM2.5-induced adiposity and insulin resistance (IR), and explored the underlying mechanisms. Fifteen adult female C57BL/6j mice on a chow diet were randomly divided into three groups receiving (1) sterile PBS, (2) PM2.5 suspended in sterile PBS (1 mg/mL) and (3) PM2.5+HT (50 mg/kg/day). PM2.5/PBS exposure was administered by oropharynx instillation every other day and HT supplementation was achieved by gavage every day. Four-week PM2.5 exposure did not affect body weight, but significantly increased visceral fat mass. The abdominal adiposity coincided with adipocyte hypertrophy and proliferation in visceral white adipose tissue (WAT), as well as decreased metabolic activity in brown adipose tissue and subcutaneous WAT. PM2.5 enhanced the oxidative stress by diminishing antioxidant enzyme activities in liver and serum, whereas contents of 4-hydroxynonenal (4-HNE), malondialdehyde (MDA) levels in liver and serum were elevated. These changes were accompanied by macrophage infiltration and activation of NF-κB pathway in the liver. Moreover, PM2.5 exposure led to glucose intolerance and insulin insensitivity, impaired hepatic glycogenesis, and decreased insulin-stimulated Akt phosphorylation in peripheral tissues. Importantly, HT treatment prevented PM2.5-induced visceral adipogenesis, oxidative stress, hepatic inflammation and NF-κB activation, systemic and peripheral IR. In vitro, after HepG2 cells were incubated with PM2.5 (0, 5, 25, 50, 100 and 200 µg/mL), reduced glutathione depletion and 4-HNE, 8-hydroxy-2'-deoxyguanosine, MDA increment in a dose-dependent manner were observed; likewise, insulin-stimulated glucose uptake decreased in a dose-dependent manner. Further, with antioxidant NAC and NF-κB inhibitor PDTC, we confirmed that HT attenuated PM2.5-induced IR through restraining NF-κB activation evoked by oxidative stress. In addition, HT could expand gut microbiota richness, reduce pathogenic bacteria and accommodate the microbial architecture in PM2.5-exposed mice, which were correlated with parameters of adiposity, oxidative stress and glycometabolism. HT could effectively correct imbalanced oxidative stress triggered by PM2.5, in turn ameliorated NF-κB pathway and insulin signaling. Gut microbiota may mediate the actions of HT.

8.
BMC Pediatr ; 19(1): 184, 2019 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-31176368

RESUMO

BACKGROUND: Television (TV) viewing may affect children's obesity status. In the present study the association between TV viewing and early childhood overweight/obese status was investigated as well as the association based on age difference. METHODS: The present study included 933 children 1-5 years of age that were individually matched on a 1:2 (cases: controls) ratio based on age and community. Cochran-Mantel-Haenszel test was used to evaluate the association between TV viewing time and the related unhealthy behaviors. Conditional logistic regression models were used to quantify the association between TV viewing and children overweight/obese status in two age groups. The effects of TV viewing-related behaviors on the associations were further investigated. RESULTS: TV viewing time > 1 h was positively associated with the prevalence of TV viewing-related unhealthy behaviors (P < 0.05). After controlling for these behaviors, the association between TV viewing and childhood overweight/obese status was significant among 4- to 5-year-old children (odds ratio, OR = 1.72, 95% confidence interval, CI: 1.16--2.54), but not significant among 1- to 3-year-old children. CONCLUSIONS: Childhood overweight/obese status was positively associated with longer TV viewing time only among 4- to 5-year-old children. The results from the present study may help in identifying the population susceptible for overweight and obesity caused by TV viewing.

9.
Diabetes Metab Syndr Obes ; 12: 685-702, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31190929

RESUMO

Purpose: To determine the plasma concentrations of butyrylcholinesterase (BChE), also known as pseudocholinesterase, in different weight categories of adolescents, and to explore the possible association between plasma BChE and overweight (OW), obesity, and metabolic syndrome (MetS) in Chinese adolescents. Patients and methods: This cross-sectional study included 1,236 Chinese adolescents (194 obese [OB], 188 OW, 732 normal weight [NW], and 122 underweight [UW]). The biochemical variables and anthropometric variables of the study participants were evaluated. Plasma BChE level was measured by DGKC method. Results: OB was associated with a higher prevalence of upper strata plasma BChE levels when compared with the BChE levels in UW, NW, and OW group. A logistic regression analysis showed that plasma BChE was positively associated with the OB group when compared with the NW group. Boys in the OW group, but not the OB group, had a significantly higher prevalence of upper stratum of BChE levels. Plasma triglyceride, total cholesterol, low-density lipoprotein-cholesterol, and ApoB levels were positively associated with the upper stratum of BChE levels when compared with lower stratum. MetS and most of its components were more prevalent among subjects with upper stratum rather than lower stratum BChE levels. Receiver operating characteristic curves for plasma BChE in subjects with MetS indicated that the AUC was 0.80 (95%CI:0.70-0.90,P<0.001) and 0.89 (95%CI:0.82-0.95,P<0.001) in girls and boys, respectively. After adjusting for age, the multivariate-adjusted odds ratio for MetS in the upper stratum of BChE levels was 8.73 (95%CI: 3.49-21.84) in the boys cohorts and also in the girls cohorts (OR=1.71, 95%CI: 1.35-21.70). Conclusion: This study confirmed an association between BChE levels and weight status in Chinese adolescents, and demonstrated that the upper strata of plasma BChE levels were associated with being OW, and even more highly associated with obesity. Plasma BChE levels were positively associated with MetS and its components and could be useful for identifying adolescents with MetS.

10.
Cancer Manag Res ; 11: 1453-1464, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30863156

RESUMO

Purpose: The evidence from recent epidemiological studies investigating the relationship between bone mineral density (BMD) and the risk of breast cancer (BC) remains inconsistent. Materials and methods: The PubMed, EMBASE, and Web of Science databases were comprehensively searched by two independent authors to identify related cohort studies from the inception of the databases through January 31, 2018. Similarly, two researchers separately extracted the data from the selected studies, and any differences were resolved by discussion. Summarized relative risks (RRs) and 95% CIs were summarized via inverse variance weighted random-effects meta-analysis. Heterogeneity among studies was assessed with the I 2 statistic. Results: Ten studies with 1,522 BC patients among 81,902 participants were included in this meta-analysis. Compared to the participants with the lowest BMD at the lumbar spine, those with the highest BMD had a significantly lower RR for BC (RR =0.75; 95% CI =0.60-0.93; I 2=23.0%). In the subgroup analyses, although the directions of the results were consistent with those of the main findings, not all showed statistical significance. We failed to detect an association between BMD at the femoral neck or total hip and the risk of BC (RR =0.94; 95% CI =0.66-1.33; I 2=72.5%). Furthermore, the results of the dose-response analysis did not show a significant association between BMD at the lumbar spine, femoral neck, or total hip and the risk of BC. Funnel plot and statistical analyses showed no evidence of publication bias. Conclusion: There is no relationship between BMD and the risk of BC. More prospective cohort studies are warranted to further investigate this issue.

11.
BMC Pregnancy Childbirth ; 19(1): 105, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-30922244

RESUMO

BACKGROUND: Maternal body mass index is linked to short- and long-term unfavorable health outcomes both for child and mother. We conducted a systematic review and meta-analysis of population-based cohort studies to evaluate maternal BMI and the risk of harmful neonatal outcomes in China. METHODS: Six databases identified 2454 articles; 46 met the inclusion criteria for this study. The dichotomous data on maternal BMI and harmful neonatal outcomes were extracted. Pooled statistics (odds ratios, ORs) were derived from Stata/SE, ver. 12.0. Sensitivity analyses assessed the robustness of the results. Meta-regression and subgroup meta-analyses explored heterogeneity. RESULTS: The meta-analysis revealed that compared with normal BMI, high maternal BMI is associated with fetal overgrowth, defined as macrosomia ≥4000 g (OR 1.91, 95% CI 1.75-2.09); birth weight ≥ 90% for gestational age (OR 1.88, 95% CI 1.64-2.15); and increased risk of premature birth (OR 1.38, 95% CI 1.25-2.52) and neonatal asphyxia (OR 1.74, 95% CI 1.39-2.17). Maternal underweight increased the risk of low birth weight (OR 1.61, 95% CI 1.33-1.93) and small for gestational age (OR 1.75, 95% CI 1.51-2.02). CONCLUSIONS: Raised as well as low pre-pregnancy BMI is associated with adverse neonatal outcomes. Management of weight during pregnancy might help reduce their adverse neonatal outcomes in future intervention studies or programmes.


Assuntos
Índice de Massa Corporal , Obesidade/fisiopatologia , Complicações na Gravidez/fisiopatologia , Resultado da Gravidez/epidemiologia , Adulto , Peso ao Nascer , China/epidemiologia , Feminino , Macrossomia Fetal/etiologia , Ganho de Peso na Gestação , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Obesidade/complicações , Gravidez , Complicações na Gravidez/etiologia , Fatores de Risco
12.
Front Microbiol ; 10: 390, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30886607

RESUMO

Obesity is a common chronic metabolic disease that is harmful to human health and predisposes the affected individuals to a cluster of pathologies. Insulin resistance (IR) is one of the most frequent complications of obesity. Hydroxytyrosol (HT) may reduce obesity and IR in high-fat diet (HFD)-fed mice; however, the mechanism underlying is still unknown. Systemic low-grade inflammation and intestinal dysfunction are thought to be associated with obesity and IR. In this study, we found that HFD feeding for 8 weeks altered the intestinal microbiota, injured intestinal barrier function, increased endotoxin release into the blood, enhanced the expression of inflammatory factors (TNF-α, IL-1ß, IL-6) and lipid accumulation in liver, caused obesity, and aggravated IR via the JNK/IRS (Ser 307) pathway in HFD mice. We also found that HT gavage could reverse those effects and the beneficial effects of HT were transferable through fecal microbiota transplantation. Our data indicate that HT can improve obesity and IR by altering the composition of the intestinal microbiota and improving integrity of the intestinal wall. We propose that HT replenishment may be used as a dietary intervention strategy to prevent obesity and IR.

13.
Artigo em Inglês | MEDLINE | ID: mdl-30836654

RESUMO

Changes in lifestyle and food environment have created a heavy burden of obesity and chronic disease in China. However, measurements of the food environment have been rarely reported in China or other countries with similar food cultures; this measurement shortage is partially due to the lack of valid and reliable measurement tools. The aim of the present study was to adapt and validate a Chinese version of the Nutritional Environment Measurement Survey for Stores (C-NEMS-S). Categories and items of the NEMS-S were culturally adapted to fit the Chinese population and included grains, dry beans, starchy tubers, vegetables, fruits, seafood, meat and poultry, dietary oils, milk, bread, instant noodles, and beverages. A scoring sheet for each food category was created to measure availability, quality, and pricing. Then, the C-NEMS-S was validated in 10 large-sized supermarkets and 10 convenience stores in Shenyang, China. Two trained raters performed their evaluations separately at the same store. The intra-class correlation coefficient (ICC) of the availability composite score was 0.98. All food measures had a moderate or good ICC (0.41 to 1.00). The kappa for each food measure ranged from 0.52 to 1.00. C-NEMS-S was able to show the difference in healthy food availability between large-sized supermarkets and convenience stores, as well as the price differences between healthier options and regular options. Large-sized supermarkets had a significantly higher total score (p < 0.001) and healthier option availability for all food measures (all items were statistically significant (p < 0.05), except sugar-free beverages). Healthier options cost more than regular options for grains, milk, bread, and instant noodles (from 4% to 153%). The adapted C-NEMS-S can be used to measure the consumer food environment in stores in China.


Assuntos
Inquéritos Nutricionais , China , Comércio/estatística & dados numéricos , Comportamento do Consumidor , Alimentos/economia , Humanos , Estado Nutricional , Reprodutibilidade dos Testes
14.
BMJ Open ; 9(2): e024177, 2019 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-30765401

RESUMO

OBJECTIVE: Based on a nationally representative adolescent sample, we examined the association of depression on the prevalence of overweight or obesity and whether this association was moderated by gender. METHODS: There were 1081 adolescents from the China Family Panel Studies that participated in our study. Depression in adolescents was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Ordered logistic regression model was used to quantify its association with overweight or obesity. Analyses were performed for the total group, and separately for males and females. RESULTS: The prevalence of depression in Chinese adolescents was 23.22%. Depression (CES-D ≥16) was significantly associated with overweight or obesity (OR=1.47, 95% CI: 1.14 to 1.91, p=0.004) after adjustment for personal, household and regional confounders. Among four subdimensions of depression, depressed affect and lack of positive affect were significantly associated with increases in the odds of overweight or obesity. In females, only lack of positive affect was significantly associated with overweight or obesity, whereas the estimated associations of all other measures of depression on overweight or obesity were positive in males. CONCLUSIONS: These findings provide evidence that depression is associated with overweight or obesity among adolescents in China, especially among males.


Assuntos
Depressão/complicações , Obesidade Pediátrica/etiologia , Adolescente , Criança , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Obesidade Pediátrica/epidemiologia , Escalas de Graduação Psiquiátrica , Fatores Sexuais
15.
Nutrients ; 11(2)2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30769927

RESUMO

Dietary patterns during pregnancy have been shown to influence the development of gestational diabetes mellitus (GDM). However, evidence from Asian populations is limited and inconsistent. We conducted a prospective cohort study in China to assess the relationship between dietary patterns and GDM. We administered three-day food diaries (TFD) and food frequency questionnaires (FFQ) at the second trimester. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 24⁻28 weeks of gestation. We identified dietary patterns using principal components analysis and used multivariable logistic regression to investigate associations of dietary patterns with GDM. Of the 1014 participants, 23.5% were diagnosed with GDM. Both the TFD and FFQ identified a "traditional pattern", consisting of high vegetable, fruit, and rice intake, which was associated with a lower GDM risk (odds ratio (OR) for quartile 4 versus quartile 1: 0.40, 95% CI: 0.23⁻0.71 for traditional pattern (TFD); OR: 0.44, CI: 0.27⁻0.70 for traditional pattern (FFQ)). The protective associations were more pronounced among women ≥35 years old. A whole grain⁻seafood TFD pattern was associated with higher risk of GDM (OR: 1.73, 95% CI: 1.10⁻2.74). These findings may provide evidence for making dietary guidelines among pregnant women in Chinese populations to prevent GDM.


Assuntos
Glicemia , Diabetes Gestacional/prevenção & controle , Comportamento Alimentar , Frutas , Oryza , Verduras , Adulto , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Estudos de Coortes , Diabetes Gestacional/epidemiologia , Feminino , Alimentos/classificação , Humanos , Gravidez , Estudos Prospectivos , Fatores de Risco
16.
Nutrients ; 11(2)2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30695989

RESUMO

Studies to examine the associations of gestational weight gain (GWG) with offspring weight status during infancy are needed, especially among Asian populations. We examined 801 mother⁻infant pairs from a prospective cohort study in China to assess the associations of total and trimester-specific GWG with early infant weight status. We used linear mixed effects models and linear regression models to examine the longitudinal and time-point associations of GWG rate (kg/week) with infant growth measures (z-scores of body-mass-index (BMIZ), weight-for-age (WFAZ) and length-for-age (LFAZ)) at birth, 1, 3, and 6 months. Greater total GWG rate was associated with higher BMIZ (ß:1.34 SD units (95% CI: 0.84, 1.83) per 1 kg/week increase in GWG) and higher WFAZ (ß:1.18 SD units (95% CI: 1.01, 2.28)) across the first 6 months of life. GWG rate in the first two trimesters but not in the third trimester was positively associated with infant BMIZ. The association between GWG rate and infant BMIZ was significant at all timepoints and more pronounced in normal weight women and among male infants. In conclusion, greater GWG rate is positively associated with offspring BMIZ in the first 6 months of life, the association is mostly driven by GWG in the first two trimesters.


Assuntos
Ganho de Peso na Gestação , Trimestres da Gravidez , China , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Estudos Prospectivos
17.
Hepatology ; 70(2): 577-586, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30506561

RESUMO

Although adherence to healthy dietary guidelines has been associated with a reduced risk of several health outcomes, including cardiovascular diseases, type 2 diabetes, and some cancers, little is known about the role of dietary patterns in the development of hepatocellular carcinoma (HCC). We prospectively assessed the associations of three key commonly used a priori dietary patterns-the Alternative Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet (AMED), and Dietary Approaches to Stop Hypertension (DASH)-with risk of incident HCC in the Health Professionals Follow-Up Study (HPFS) and the Nurses' Health Study (NHS), two large prospective cohort studies. Diet was assessed almost every 4 years using validated food frequency questionnaires (FFQs). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. During up to 32 years of follow-up, 160 incident HCC cases were identified. After adjustment for most HCC risk factors, participants in the highest tertile of Alternative Healthy Eating Index-2010 (AHEI-2010) had a multivariable HR of 0.61 (95% CI, 0.39-0.95; Ptrend = 0.03), compared with those in the lowest tertile. There was a suggestive, but nonsignificant, inverse association for Alternate Mediterranean Diet (AMED; HR = 0.75; 95% CI, 0.49-1.15; Ptrend = 0.18) and a null association for Dietary Approaches to Stop Hypertension (DASH; HR = 0.90; 95% CI, 0.59-1.36; Ptrend = 0.61) in relation to the risk of HCC development. Conclusion: Our findings suggest that better adherence to the AHEI-2010 may decrease the risk of developing HCC among U.S. adults. Future studies are needed to replicate our results, examine these associations in other populations, and elucidate the underlying mechanisms.

18.
Br J Cancer ; 119(11): 1436-1442, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30401889

RESUMO

BACKGROUND: Previous studies have shown a positive association between type 2 diabetes (T2D) and colorectal cancer (CRC) risk. However, it is uncertain whether this association differs by duration of T2D or sex. We thus investigated the associations of T2D and its duration with the risk of incident CRC. METHODS: We followed 87,523 women from the Nurses' Health Study (1980-2012) and 47,240 men from the Health Professionals Follow-up Study (1986-2012). Data on physician-diagnosed T2D was collected at baseline with a questionnaire and updated biennially. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: We documented 3000 CRC cases during up to 32 years of follow-up. Among men, T2D was associated with increased risk of CRC compared to those without T2D (HR: 1.42; 95% CI: 1.12-1.81). This positive association persisted in sensitivity analyses by excluding CRC identified within 1 year of diabetes diagnosis and patients with T2D who used hypoglycaemic medications. Among women, T2D was positively, but not statistically significantly, associated with CRC risk (HR: 1.17; 95% CI: 0.98-1.39). CONCLUSIONS: Our findings support that T2D was associated with a moderately higher risk of developing CRC in men; a weaker, nonsignificant positive association was observed in women.


Assuntos
Neoplasias Colorretais/complicações , Neoplasias Colorretais/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos/epidemiologia
19.
Food Funct ; 9(11): 5660-5673, 2018 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-30302474

RESUMO

Obesity is a severe public health problem worldwide. Our study aims to assess whether a saponin-enriched extract from the leaves of Boussingaultia gracilis (SBG) could attenuate obesity and its related metabolic disorders in mice and to explore the potential mechanism of this effect. Three-week old male mice were fed with a HFD for 7 weeks followed by a 10-week period in which the mice were supplemented with distilled water or SBG (250 mg per kg bodyweight). We demonstrated that SBG supplementation for 10 weeks mitigated obesity and its complications in diet-induced obesity (DIO) mice, such as reducing the hepatic damage underlying steatosis, modulating lipid metabolism, enhancing adipocyte thermogenesis, restoring insulin sensitivity and glucose homeostasis, and alleviating inflammation status. Finally, we established an untargeted metabolomics approach based on UPLC-MS to profile the metabolic changes in liver tissue and thereby discovered novel potential biomarkers to clarify the mechanisms of action of SBG in treating a mouse model of DIO. Thirty-nine potential biomarkers and five metabolic pathways contributing to the beneficial effect of SBG were discovered and identified.


Assuntos
Caryophyllales/química , Obesidade/prevenção & controle , Saponinas/farmacologia , Adipócitos/efeitos dos fármacos , Adipócitos/metabolismo , Animais , Proteína C-Reativa/metabolismo , Colesterol/sangue , Dieta Hiperlipídica , Modelos Animais de Doenças , Teste de Tolerância a Glucose , Inflamação/tratamento farmacológico , Resistência à Insulina , Metabolismo dos Lipídeos/efeitos dos fármacos , Fígado/metabolismo , Masculino , Metabolômica , Camundongos , Camundongos Endogâmicos ICR , Camundongos Obesos , NF-kappa B/genética , NF-kappa B/metabolismo , PPAR alfa/genética , PPAR alfa/metabolismo , Extratos Vegetais/farmacologia , Proteína de Ligação a Elemento Regulador de Esterol 1/genética , Proteína de Ligação a Elemento Regulador de Esterol 1/metabolismo , Triglicerídeos/sangue
20.
BMC Med Educ ; 18(1): 212, 2018 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-30223813

RESUMO

BACKGROUND: Although it has been nearly 15 years since the Medical Professionalism in the New Millennium: A Physician Charter (the Physician Charter) was proposed to reaffirm medical professionalism in response to the new challenges in healthcare delivery in the new century, the manner in which Chinese medical students agree with and fulfill the principles and responsibilities of professionalism defined in the Physician Charter still remains unknown. METHODS: In March 2016, 748 fifth-year medical students from China Medical University (CMU) participated in a survey in which they indicated their rate of agreement with and manner of fulfillment of the principles and responsibilities defined in the Physician Charter using a 10-point Likert scale. The data were then analyzed by t-tests, exploratory factor analysis, and multiple linear regressions. RESULTS: The total score of agreement with the Physician Charter was significantly higher than that of fulfillment (p < 0.001). The largest difference between agreement and fulfillment scores were with the principle of social justice (P3), commitments to improving access to care (R6), and a just distribution of finite resources (R7). Exploratory factor analysis distinguished two principles - primacy of patient welfare (P1) and patient autonomy (P2) - from the others in terms of the gap between agreement and fulfillment. This is partially because the proportion of students who rated agreement lower than fulfillment of P1 or P2 was much higher than it was for any other principle or responsibility. Additionally, multiple linear regressions show that students who are enrolled in a five-year program or who was registered as a rural resident (i.e. holding a rural Hukou) had significantly higher scores of agreement, but not fulfillment. CONCLUSIONS: Chinese medical students endorsed the Physician Charter and its core values of medical professionalism, although they felt difficult to fulfill in practice. Medical educators and the health authority should act together to support and foster professional values.


Assuntos
Atitude do Pessoal de Saúde , Códigos de Ética , Profissionalismo/normas , Estudantes de Medicina , China , Relações Médico-Paciente , Profissionalismo/ética , Inquéritos e Questionários
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