Epidemiological evidence of increased waist circumference,but not body mass index,associated with impaired baroreflex sensitivity

Although an inverse relationship between body mass index (BMI) and baroreflex sensitivity (BRS) was found, the effect of waist circumference (WC) on BRS is still inconclusive. The contradictory results of previous studies may be related to the heterogeneity and relatively small sample size of the subjects examined. The aim of this population-based study was to investigate whether the influence of increased WC is more detrimental to BRS than BMI. A total of 760 community dwellers were recruited and they were classified into Q1 (n = 189), Q2 (n = 183), Q3 (n = 192) and Q4 (n = 196) groups, based on WC quartiles. Spontaneous BRS was determined by spectral α coefficient method. Valsalva ratio was the longest RR interval after release of Valsalva maneuver divided by the shortest RR interval during maneuver. Cardiac autonomic function was calculated by power spectrum of heart rate in low and high frequency (LF, 0.04–0.15 Hz; HF, 0.15–0.40 Hz), and LF/HF ratio in supine position for five minutes. There were significant differences in spontaneous BRS and Valsalva ratio among different WC groups. In multivariate analysis, obesity was inversely associated with spontaneous BRS and Valsalva ratio. However, these inverse relationships became insignificant after further adjustment for WC quartiles. In contrast, Q4 vs. Q1, Q3 vs. Q1 and Q2 vs. Q1 of WC were inversely related to spontaneous BRS. Q4 vs. Q1 and Q3 vs. Q1 of WC were negatively associated with the Valsalva ratio. In conclusion, increased and even high-normal WC had a stronger adverse effect on BRS than BMI, independent of cardio-metabolic risk factors.     

重视心血管病流行病学研究工作

自 2 0世纪 90年代 ,心血管病已逐渐成为我国城乡居民的第一位死因 ,目前已占总死亡人数的近40 %。心血管病也是造成劳动力损失、生活质量下降、疾病负担增加的主要原因。据不完全统计资料估计 ,我国每年新发冠心病事件 (包括急性心肌梗死、冠心病猝死和慢性冠心病死亡 )约 1 3 0万例次 ,脑卒中约 40 0万例次。全国现有 1 .1亿高血压患者 ,1亿多血脂异常者 ,3 0 0 0万糖尿病患者。人群中有一半以上的人至少具有 1种心血管病危险因素。心血管疾病以其高发病率、高致残率、高病死率及高治疗费用 ,严重制约了我国经济发展和人民生活水平及生存…     

西昌市社区居民中心性肥胖流行特征与影响因素分析

目的 了解四川省西昌市居民的中心性肥胖流行现况与影响因素,为后续当地相关的干预措施的制定提供理论依据与数据支持。方法 综合考虑经济水平、民族构成、地理位置等因素,在西昌市选择6个调查点,根据调查点社区人口数确定抽样比例,采用简单随机抽样的方法抽取18周岁及以上的成年居民进行问卷调查与体格检查,对所得数据进行描述性分析、单因素χ2分析与多因素logistic回归分析。结果 共纳入874名居民,中心性肥胖率为39.24%。单因素分析结果显示,不同饮酒情况（χ2=4.914,P<0.05）、高血压患病情况（χ2=15.869,P<0.001）、BMI（χ2=300.521,P<0.001）的成年居民中心性肥胖率不同。多因素分析结果显示,饮酒者（OR=1.545,95%CI:1.028～2.322）、高血压患者（OR=1.684,95%CI:1.093~2.592）发生中心性肥胖的风险所增加;相较于正常体重（18.5kg/m²≤BMI<23.9kg/m²）的居民,BMI<18.5kg/m²组别人群（OR=0.114,95%CI:0.015~0.843）发生中心性肥胖的风险更低,而BMI≥24.0kg/m²组别人群（OR=12.196,95%CI:8.630~17.234）则风险更高。 结论 西昌市成年居民中心性肥胖率较低。BMI<18.5kg/m²为中心性肥胖的保护因素,而饮酒、高血压患病、BMI≥24.0kg/m²为中心性肥胖的危险因素。     

The association of general obesity,central obesity and visceral body fat with the risk of gestational diabetes mellitus: Evidence from a systematic review and meta-analysis

BackgroundStudies consistently reported that general obesity predicts gestational diabetes mellitus (GDM). However, whether other phenotypes of obesity such as central obesity and visceral adiposity might have differential associations as risk factors of GDM are less known. The objective of this study was to investigate the association of all these obesity phenotypes in developing GDM.MethodsPubMed, CINHAL, Embase, Scopus, Google Scholar and Web of Science were searched. Full-text research articles published in English from 1985 to February 2020 with cohort and cross-sectional studies design and reported an association between obesity and GDM were included. Case-control studies, case reports, conference abstract, women with previous metabolic disorders and articles considered general obesity only were excluded. A bias adjusted-quality effect meta-analysis was conducted to evaluate the association of these obesity phenotypes and GDM risk.ResultsTwenty studies met the inclusion criteria representing data of ∼50 thousand women at the reproductive age with ∼7% prevalence of GDM. Meta-analysis of 14 datasets revealed that the three types of obesity were significantly associated with an increased risk of GDM. In addition, visceral adiposity was a stronger risk factor for GDM than other obesity phenotypes (odd ratio = 3.25, 95% confidence interval = 2.01–5.26) versus (odd ratio = 2.73, 95% confidence interval = 2.20−3.38) for general obesity and (odd ratio = 2.53, 95% confidence interval = 2.04−3.14) for central obesity.ConclusionThe findings of this study suggest that general obesity, central obesity and visceral body fat were associated with an increased risk of GDM. Furthermore, the association with maternal visceral adiposity was more robust compared to general obesity and central obesity.     

海口市7~14岁儿童腰围界值点及其肥胖相关性分析

目的分析海口市7~14岁儿童在超重和肥胖层面的腰围界值点,为儿童超重和肥胖防治策略制定提供科学依据。方法利用2016—2019年“海南省学生健康档案管理系统”,采用PPS抽样方法抽取海口220所中小学校,对学校整群抽样7~14岁儿童调取身高、体重和腰围数据进行整理分析。结果共计分析283054名7~14岁儿童,各年龄组儿童的平均腰围值和百分位点腰围值均低于全国平均腰围,腰围均随着年龄增长而持续增加。各年龄组儿童腰围男生均大于女生(P<0.0001),城市均高于农村(P<0.0001)。在超重层面,男童和女童界值点集中P 75~P 80(56.50~71.75 cm)、P 80~P 85(54.50~68.50 cm)。在肥胖层面,男童7~11岁和12~14岁的界值点分别是P 85(58.5~72.50 cm)、P 90(75.50~79.50 cm),女生7岁和8~14岁的界值点范围在分别是P 85(56.50 cm)和P 90(59.85~71.50 cm)。结论该地区在超重层面,男童和女童的界值点分别为56.50~71.75 cm和54.50~68.50 cm;肥胖层面,男童和女童的界值点分别是58.50~79.50 cm和56.50~71.50 cm。除了男生7岁和女生9岁超重界值点及女生青春期前8~10岁肥胖界值点外,其他各年龄组超重和肥胖界值点与全国的一致。     

身体质量指数及腰臀围比与胆道癌关系的探讨

目的:探讨身体质量指数(BMI)、腰臀围比(WHR)与胆道癌的关系.方法:采用非条件logistic回归模型分析身体质量指数、腰臀围比与胆道癌的关系.结果:与正常BMI组比较,胆囊癌女性20～29岁、30～39岁肥胖组的OR与趋势检验均达到或接近显著水平.与腰臀围比四分位最低组比较,胆囊癌和肝外胆管癌男女性最高四分位组OR和趋势检验均达到显著水平.结论:青年时期肥胖可能会增加胆囊癌的发病风险;腰臀围比也是胆囊癌和肝外胆管癌独立的危险因素.     

应对突发公共卫生事件中建立病例定义值得注意的问题

突发公共卫生事件（emergent events of public health）是指突然发生,造成或者可能造成社会公众健康严重损害的重大传染病疫情、群体性不明原因疾病、重大食物和职业中毒以及其他严重影响公众健康的事件.近年来,各类突发公共卫生事件不断发生,如食物中毒、生物恐怖、严重急性呼吸综合征（SARS）、人感染猪链球菌、人禽流感等,严重危害人民健康,给整个国家或局部地区带来明显影响,甚至影响社会安定,因而探索科学有效的方法应对突发公共卫生事件变得十分重要.应对突发公共卫生事件最重要的方法是开展现场流行病学调查,尽早查明其原因,及时采取措施,控制事件的发展.在开展现场流行病学调查处理的过程中,建立病例定义是关键,是进行病例对照研究探索病因的基础,因此作为流行病学工作者,应知晓突发公共卫生事件应对中病例定义的确定问题,以便在现场处理时能建立一个合适的病例定义,科学应对突发公共卫生事件.     

Energy density,diet quality,and central body fat in a nationwide survey of young Spaniards

ObjectivesTo determine the impact of energy density on diet quality and anthropometric proxy measures for central body fat in young Spaniards.MethodsData were obtained from a representative national sample of 2513 young Spaniards aged 10 to 24 y. Dietary assessment was performed with a 24-h recall. Adherence to the Mediterranean diet was measured by the KIDMED index. Reduced rank regression analysis was used to identify energy-density dietary patterns. Waist circumferences and height were measured.ResultsPastries and sausages showed the strongest loading for the dietary energy density factor score (DED-FS), with fruits and vegetables at the opposite end of the scale. Multiple linear regression analysis showed a positive association (P < 0.01) of dietary energy density (DED) and the DED-FS with waist circumferences regressed on height and age (WC_height+age) and waist-to-height ratio (WHtR). The adjusted odds ratio for elevated WC_height+age and WHtR increased across quartile distribution of DED (P < 0.001) and DED-FS (P < 0.05). Diet quality characterized by the KIDMED index was negatively associated (P < 0.001) with DED and the DED-FS.ConclusionsHigher DED is a risk for increased central fat distribution and is associated with low adherence to the Mediterranean diet.     

Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review

Over the past three decades, the potential effects of lifestyle interventions targeting changes in body weight and composition (weight, body mass index, fat mass, waist circumference) among adults with an intellectual disability (ID) have been examined in various systematic reviews. Nevertheless, since the middle of the 1980s, the potential effects of these interventions for youth with an ID remain an open question. The purpose of this article is to review the effects of lifestyle interventions targeting changes in body weight and composition among youth with an ID. This review will focus on changes in body weight and composition, healthy lifestyle, and secondary health conditions. A systematic review of English- and French-language studies, published between 1981 and 2013, was performed on Academic Search Complete, PsycARTICLES, Medline and Scopus. The nine studies included in this review focused mainly on: a sample with a wide age range (e.g., 7–22 years); males; overweight-obese youth having a mild-to-moderate ID with Down or Prader-Willi syndrome; physical activity interventions; cohort pre- and post-test designs with/without a control group; and changes in body weight and composition. Taken together, results from these studies suggest successful changes in weight, body mass index and fat mass. However, intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive. Given the weaknesses of the reviewed studies, the present findings should be considered preliminary and indicative of the need for future research.