Waist circumference and impaired fasting glucose screening in a Mediterranean population

We evaluate the merits of routine waist circumference measurements for screening of impaired fasting glucose (IFG). Waist circumference and body mass index showed a strong association with the risk of IFG. The present data indicate the need for routine anthropometric measurements in clinical practice screening for IFG.     

Metabolic syndrome and anthropometric factors in Japanese patients with chronic kidney disease

A necessary condition for establishing new criteria for the metabolic syndrome (MetS) in Japan is waist circumference (WC), which varies among races. In the present study, we measured WC and visceral fat area (VFA) in patients with chronic kidney disease (CKD) and assessed the features of new MetS criteria in Japan. Two hundred and seventeen patients (M/F: 116/101, age: 59.1 ± 13.0 years, body mass index: 24.1 ± 3.9 kg/m²) who received abdominal computed tomography (CT) examinations were analyzed, and 93 subjects met the criteria for MetS. Average VFA was significantly larger in subjects with MetS (193.6 ± 52.4 cm² versus 96.9 ± 50.2 cm², P < 0.001). WC and VFA correlated significantly in both males (r = 0.71, P < 0.001) and females (r = 0.79, P < 0.001). Male and female CKD patients whose VFAs exceed 125 cm² have significantly more components of MetS, and the corresponding WC is 81.2 cm for males and 81.6 cm for females. From the ROC curve, 84 cm for males and 83 cm for females seemed to be suitable cut-off values in CKD patients. In conclusion, we propose suitable cut-off values of WC in Japanese CKD patients, with a high sensitivity for detecting the MetS, to be 84 cm for males and 83 cm for females. Further prospective analysis is required to validate these criteria and the clinical significance of MetS in Japanese CKD patients.     

糖调节受损人群胰岛素早期分泌相的变化及影响因素

目的 探讨糖调节受损人群胰岛素早期分泌相的变化及影响因素。方法　整群抽取1024名作为研究对象，所有研究对象均测量腰围、行口服葡萄糖耐量试验。根据口服葡萄糖耐量试验结果对糖耐量状态进行分组:糖耐量正常组、空腹血糖受损组、糖耐量低减组、空腹血糖受损伴糖耐量低减组、糖尿病组。计算早期胰岛素分泌指数。结果　与糖耐量正常组1.96±1.03比较，空腹血糖受损组1.79±0.91 （P=0.007）、糖耐量低减组1.81±0.97（P=0.007）、空腹血糖受损伴糖耐量低减组1.59±0.85 （P=0.005）、糖尿病组1.30±0.60（P=0.004）早期胰岛素分泌指数逐渐下降。Logistic回归分析显示腰围是早期胰岛素分泌指数的重要影响因素（β=0.716，P=0.000）。结论　在糖调节受损阶段，早期胰岛素分泌指数已明显下降，腰围可作为评估早期胰岛素分泌指数的指标。     

手舟骨腰部骨折3种内固定方式的有限元分析

目的　通过建立手舟骨腰部骨折三维模型来比较3种不同内固定方式的生物力学差异,为临床内固定方式的选择提供依据。 方法　选取健康志愿者的腕关节CT数据,应用软件建立舟骨腰部骨折的3种内固定方式模型：克氏针固定组、Herbert螺钉固定组、钉脚固定器组。分别在中立握拳位和腕背伸桡偏位施加载荷,并分析舟骨变形量、内固定器械的应力。 结果　在3种内固定装置下舟骨的变形量,克氏针最大,钉脚固定器最小。在两种工况下,舟骨变形量和固定装置的最大应力值不等,但趋势相同,均为钉脚固定器的舟骨变形量最小、所受的最大应力最小。钉脚固定器存在偏心效应,当载荷达到临界值时,易使舟骨愈合面出现开裂或不对称偏心现象。 结论　克氏针固定效果最差,钉脚固定器的固定效果最佳,钉脚固定器术后应适当限制手部负重。     

Associations of self-reported and actigraphy-assessed sleep characteristics with body mass index and waist circumference in adults: moderation by gender

ObjectivesSelf-reported sleep duration has been linked to body mass index (BMI) and waist circumference in previous work; however, data regarding if these associations are stronger in men or women have been mixed, and few studies have objectively measured sleep. We investigated self-reported and actigraphy-assessed sleep characteristics in relation to BMI and waist circumference and examined the extent to which these associations differ by gender.DesignArchived cross-sectional data collected from 2004 to 2006 from the National Survey of Midlife Development in the United States (MIDUS) Biomarkers Study were used. Participants included 1248 adults (43% men) who reported their habitual sleep duration, and a subset of participants (N = 441; 40% men) who underwent seven nights of wrist actigraphy.ResultsSelf-reported total sleep time (TST), actigraphy-assessed TST, and actigraphy-assessed sleep efficiency (SE) were inversely associated with BMI in the full sample of both men and women. Gender moderated associations between actigraphy assessments of sleep and anthropometric variables; however, TST and SE were related to BMI and waist circumference in women only. Associations between sleep and waist circumference were independent of BMI.ConclusionsSleep duration and sleep continuity are associated with body weight and distribution of body fat, but these associations were stronger or were only present in women.     

急性心肌梗死118例临床分析

目的 了解我院急性心肌梗死的发病及临床相关情况。方法 对2004年1月至2006年12月住院的118例急性心肌梗死病例进行回顾性分析。结果 心肌梗死部位最多的见于前壁、前间壁及广泛前壁。发生心律失常的103例，发生率87．29％。死亡16例，死亡率13．6％。结论 急性心肌梗死的发病男性明显高于女性；城市发病高于农村；发病以60～79岁年龄段最多；住院1周内死亡发生率最高，占81．25％。死亡原因主要见于心源性休克、急性左心衰、心脏骤停。     

Measures of Abdominal Adiposity and Risk of Stroke：A Dose-Response Meta-analysis of Prospective Studies

ObjectiveWaist circumference, waist-to-hip ratio and waist-to-height ratio, which are the indicators or measures of abdominal adiposity, have long been hypothesized to increase therisk of stroke; yet evidence accumulated till date is not conclusive. Here, we conducted a dose-response meta-analysis to summarize evidences of the association between these measures of abdominal adiposity and the risk of stroke. MethodsPubMed and Web of Science databases were searched from inception to May 2015. Two investigators independently conducted the study selection and data extraction. Dose-response relationships were assessed by the generalized least squares trend estimation, while the summaryeffect estimates were evaluated by the use of fixed- or random-effect models. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Publication biasof the literaturewas evaluated usingBegg’s and Egger’s test. ResultsAltogether 15 prospective cohort studies were identified in this study. The summary of relative risks (95% confidence intervals) of stroke for the highest versus the lowest categories was 1.28 (1.18-1.40) for waist circumference, 1.32 (1.21-1.44) for waist-to-hip ratio, and 1.49 (1.24-1.78) for waist-to-height ratio. For a 10-cm increase in waist circumference, the relative risk of stroke increased by 10%; for a 0.1-unit increase in waist-to-hip ratio, the relative risk increased by 16%; and for a 0.05-unit increase in waist-to-height ratio, the relative risk increased by 13%. There was evidence of a nonlinear association between waist-to-hip ratio and stroke risk,Pnonlinearity=0.028. ConclusionFindings from our meta-analysis indicated that waist circumference, waist-to-hip ratio, and waist-to-height ratio were positively associated with the risk of stroke, particularly ischemic stroke.     

Trends in general and abdominal obesity among Korean adults: findings from 1998, 2001, 2005, and 2007 Korea National Health and Nutrition Examination Surveys

We examined trends in obesity among Korean adults, using body mass index (BMI) and waist circumference (WC) as reported in national surveys. Data (10,043 men and 12,758 non-pregnant women) were derived from four waves of the Korea National Health and Nutrition Examination Survey conducted in 1998, 2001, 2005, and 2007. Between 1998 and 2007, the distribution of BMI and WC showed shifts toward the right among men. Mean values of BMI and WC and the corresponding overweight (includes obesity) and obesity prevalences showed increasing trends in men but not in women. Women aged 60+ showed significant increases in obesity measures, including mean BMI and WC, and the associated prevalences. Among women aged 20-39, the prevalence of underweight increased significantly between 1998 and 2007, and BMI showed a decreasing tendency. These time trends in young women were the reverse of the trends in young men. In conclusion, policy efforts to abate overweight and obesity trends need to be exercised among men and older women. In addition, more national studies regarding potential increases in underweight among young women are warranted.     

北京市学龄儿童腰围、腰围身高比分类标准对心血管代谢危险因素的筛查效度

目的在心血管代谢危险因素单一患病率和聚集水平评估的基础上,验证和提出适合北京市学龄儿童人群腹型肥胖筛查的腰围和腰围身高比分类标准。方法依据北京市儿童青少年代谢综合征研究的现况调查结果,笔者前期研究提出腰围的性别年龄别P80及腰围身高比0.46可作为初步筛查腹型肥胖的界值,但提出上述标准时,心血管危险因素相关指标中血脂、血糖水平是基于指末梢血的检测结果,因此有待于依据准确性更高的静脉血生化指标的检测结果进行验证。本研究从该项目调查人群中非随机选择3525名6~18岁学龄儿童为研究对象,对其进行血压测量和静脉血生化指标检测,对儿童肥胖与脂肪肝研究中1454名7~18岁学龄儿童,除上述检测项目外,行B超检查脂肪肝及肝功能生化检测,筛出非乙醇性脂肪肝儿童,在前期儿童腹型肥胖初筛界值的基础上,提出腰围和腰围身高比的备选分类标准,通过比较各备选标准检出心血管危险因素及其聚集的效率,对腰围、腰围身高比判定学龄儿童腹型肥胖的适宜界值做进一步的研究。结果肥胖、高血压、血脂紊乱及其聚集的检出率均随腰围及腰围身高比的升高逐渐增加。通过比较不同腰围和腰围身高比备选界值检出上述危险因素及其聚集的灵敏度、特异度、阳性预测值及阴性预测值,...