Is serum cystatin-C a reliable marker for metabolic syndrome?

Purpose

Chronic kidney disease and metabolic syndrome are recognized as major cardiovascular risk factors. It has been shown that cystatin C has a stronger association with mortality risk than creatinine-based estimations of glomerular filtration rate. We measured cystatin values in dyslipidemic patients and looked for correlations between renal function, cystatin, and metabolic syndrome.

Methods

There were 925 dyslipidemic patients prospectively included in this cross-sectional study and evaluated over 10 months. Each visit included clinical and biological assessment.

Results

Most patients exhibited cardiovascular risk factors other than dyslipidemia: hypertension in 34%, diabetes in 11%, and smoking in 18%. Mean triglycerides were 149 ± 136 mg/dL, mean high-density lipoprotein cholesterol 54 ± 14 mg/dL, and low-density lipoprotein 167 ± 48 mg/dL. Metabolic syndrome was present in 238 (26%) patients. Plasma creatinine did not differ between control group and metabolic syndrome patients (80 ± 26 vs 82 ± 20 μmol/L, respectively, P = .2), but creatinine clearance evaluated by abbreviated Modification of Diet in Renal Disease Study formula was lower in the metabolic syndrome group than in the non-metabolic-syndrome group (83.3 ± 18.8 mL/min/1.73m² vs 86.8 ± 16.9 mL/min/1.73m², respectively, P <.007). Cystatin value was significantly higher in metabolic syndrome patients than in others (0.86 ± 0.23 vs 0.79 ± 0.20 mg/L, respectively, P <.0001), independently of serum creatinine level and creatinine clearance. Furthermore, there was a progressive increase in cystatin, as a function of the number of metabolic syndrome components.

Conclusions

Our study shows that cystatin is associated with metabolic syndrome in dyslipidemic patients. Cystatin may be an interesting marker of metabolic syndrome and of increased cardiovascular and renal risk.     

First Trimester Neck Circumference as a Predictor for the Development of Gestational Diabetes Mellitus

Backgrounds

This study aimed to evaluate the relationship between neck circumference (NC) and gestational diabetes mellitus (GDM), and the efficacy of NC in predicting GDM by comparing with pregestational body mass index (preBMI) in southern Chinese woman.

Eating breakfast and snacks while television viewing are associated with some cardio metabolic risk factors among Iranian children

Aim

We aimed to investigate the association of eating meals while television viewing (TVV) and screen-based behaviors with cardio metabolic risk factors (CRFs) among school-aged children in Shiraz.

Overweight is an independent risk factor for cardiovascular disease in Chinese populations

In the last decade of the 20th century, cardiovascular disease was the leading cause of death in China, accounting for one‐third of the total deaths. In comparison with western populations, the mean body weight or body mass index (BMI) of the Chinese population was lower, but showed an increasing trend. Whether the variation within lower levels of BMI or waist circumference was associated with other risk factors of cardiovascular disease, and whether they contribute independently to the risk of cardiovascular disease in the Chinese population, was investigated in this study. In keeping with a uniform study design, in each of 14 study populations at different geographical locations and with different characteristics, the incidence rates of stroke, coronary heart disease (CHD) and the causes of death were monitored in ≈100 000 residents from 1991 to 1995 using the MONICA procedure. Risk factors were surveyed in a random cluster sample of 1000 subjects (35–59 years of age) from each population under surveillance using internationally standardized methods and a centralized system to ensure quality control. Among the risk factors, body weight, height, and waist and hip circumferences were measured. Cross‐sectional stratified analyses were used to analyse the relationship of BMI (kg m^?2) or waist circumference to other metabolic risk factors. Ten cohorts among the 14 study populations with 24 734 participants were surveyed from 1982 to 1985 as a baseline for further study and were followed‐up for 9 years taking the events of stroke, CHD and different causes of death as end‐points. Cox regression models were used to explore the association of BMI with the relative risks of stroke, CHD and total death. The survey in 14 random samples with a total number of 19 741 subjects showed that the mean BMI (20.8–25.1) and waist circumference (67.8–86.7 cm) were much lower than those of western populations. There was, however, variation in the anthropometric measurements among populations within China. Thus, rates of overweight varied from 2.7% to 48.1% and obesity from 0% to 9.5% on the basis of the World Health Organization (WHO) classification, but these values were lower than those found in western populations. Data from the 10 cohort samples compared with baseline data in the early 1980s showed that the mean BMIs increased significantly in eight populations during the early 1990s with the differences ranging from 0.5 to 2.5 kg m^?2. Despite the lower level of BMI and the lower rate of overweight, cross‐sectional analyses showed that the prevalence of hypertension, high fasting serum glucose, high serum total cholesterol and low high‐density lipoprotein cholesterol (HDL‐C) and their clustering were all raised with increases in BMI or waist circumference. The prospective cohort study showed that the BMI was one of the independent risk factors for stroke and CHD in Chinese populations. Hence, in a Chinese population characterized by lower levels of BMI and great variability in rates of overweight, variation of BMI was significantly related to the prevalence of other metabolic risk factors and their clustering. Overweight was one of the independent risk factors for stroke and CHD, both at population and individual levels. Given the increasing trends of BMI in the last 10 years, during the period of economic transition there is a need to encourage the population to adopt healthy dietary habits and to increase their physical activity. Health education and health promotion are important for the prevention and non‐pharmacological therapy of cardiovascular disease in China.     

腰围与心率变异性相关性分析

目的探讨腰围对心率变异性（HRV）的影响。方法193例研究对象按腰围分为正常与异常两组。检测HRV、BMI、腰围、腰臀比、脂肪含量、脂肪比例、FPG、TC、TG、HDL-C、LDL-C、血尿酸等指标。结果腰围异常组除LF/HF外HRV各指标均低于正常组（P〈0.01）;协方差分析校正年龄、性别、吸烟、腰围、SBP、DBP、FPG、TC、TG、HDL-C、LDL-C、血尿酸后HRV所有指标差异均有统计学意义（P〈0.01）。结论腰围可影响HRV,腰围异常时HRV降低。     

Interactive relations of type 2 diabetes and abdominal obesity to cognitive impairment: A cross-sectional study in rural area of Xi'an in China

Aims

Type 2 diabetes and obesity, which are frequently comorbid, have been associated with cognitive impairment. We aim to examine the potential modulating effect between obesity and diabetes on cognitive impairment.

社会生态模式在儿童青少年肥胖防控中对体格指标的干预效果

目的：：探索利用社会生态模型,从“学生-学校-家庭”三个层面对学生肥胖进行干预是否有效。方法：利用分层整群抽样方法选择北京市房山区城市小学、乡村小学、城市中学和乡村中学各4所,共16所学校7~18岁学生共得到有效样本3175人,每层4所学校各选取2所学校共1661人,另2所学校作对照组,利用社会生态模型从“学生-学校-家庭”三个层面进行为期3个月的肥胖干预。干预方式包括健康教育、环境改善等,干预内容涉及肥胖相关知识、健康饮食与运动等。检测干预前后身体形态指标。结果：干预可以整体改善超重肥胖( OR=1.12,P<0.05),降低腰围、腰臀比(waist-hip ratio,WHR)等中心性肥胖指标(adjusted difference=0.63、0.02,P<0.05);女生腰围和WHR降低(adjusted difference=0.52、0.02,P<0.05)并改善了超重肥胖(OR=1.18,P<0.05),男生腰围和WHR降低(adjusted difference=0.73、0.01,P<0.05),女生效果优于男生;城市地区WHR降低(adjusted difference=0.01, P<0.05),乡村地区腰围和WHR降低(adjusted difference=1.05、0.02,P<0.05)并改善了超重肥胖(OR=1.43, P<0.05),乡村效果优于城市;小学WHR降低(adjusted difference=0.02,P<0.05)并改善了超重肥胖(OR=1.21, P<0.05),中学WHR降低(adjusted difference=0.02,P<0.05),小学效果优于中学;干预措施有效降低超重肥胖学生的超重肥胖率(χ2=11.01,P<0.01)。结论：“学生-学校-家庭”社会生态模式干预方法短期内可改善腰围、WHR等中心性肥胖指标,可以作为一种有效干预手段推广使用。     

蛋白质摄入量对北京市房山区张坊村中老年人握力及高血压患病率的影响

目的探讨蛋白质摄入量对中老年人握力及高血压患病率的影响。方法抽取北京市房山区张坊村中老年村民134例,根据蛋白质摄入量将受试者分为蛋白质摄入较高组和蛋白质摄入较低组,使用24 h膳食回顾法进行膳食调查,计算产能营养素和能量的摄入量;分别应用握力计、电子血压计和血糖仪测定受试者的握力、血压和即刻血糖;同时收集人体测量指标并调查受试者睡眠和体力活动情况等生活习惯。采用t检验或χ2检验分析2组中老年人的握力、运动情况、人体测量指标、产能营养素和能量摄入量、膳食摄入习惯、高血压病和血糖异常情况的差异。结果高蛋白质摄入组握力和上臂肌围显著高于低蛋白质摄入组,高蛋白质摄入组对主食类、蔬果类、鱼肉类、蛋类、豆腐类及食用油的摄入均显著多于低蛋白质摄入组,在营养素摄入方面,高蛋白质摄入组人群碳水化合物、脂肪、膳食纤维和能量摄入均高于低蛋白质摄入组。在疾病患病率方面,高蛋白质组高血压病患病率低于低蛋白质摄入组。结论北京市房山区张坊村中老年人膳食模式不均衡,蛋白质摄入过少,可能与握力降低有关,同时也可能与高血压患病率增加有关。改善该村村民的膳食结构,适当增加蛋白质摄入量可能在一定程度上会增加握力和降低高血压患病率。     

Waist Circumference Measurement Diffusion in Primary Care

This sequential explanatory mixed-methods study, informed by the Diffusion of Innovations theory, aimed to gain a deeper understanding of waist circumference measurement rejection in primary care. A convenience sample of primary-care practices generated the quantitative sample. A purposeful selection of providers, sampled from the quantitative sample, comprised the qualitative sample. Waist circumference measurement did not diffuse into practice. Provider characteristics did not correlate with measurement use. Barriers of practice norms, time, provider discomfort, and perceived patient discomfort influenced rejection. To promote adoption of waist circumference measurement, findings that refute barriers need to reach providers via reliable, convenient means.