Folic Acid Supplementation in Chinese Peri-conceptional Population: Results from the SPCC Study

Objective To determine the prevalence and determinants of folic acid(FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.Methods This was a cross-sectional study based on the Shanghai Pre Conception Cohort(SPCC) study.Data on FA supplementation and socio-demographic features were collected using questionnaires.Couples visiting clinics for pre-pregnancy examination and pregnant women at 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018.Results Among the pregnancy planners, 42.4%(4,710/11,099) women and 17.1%(1,377/8,045) men used FA supplements, while 93.4%(14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older(RR: 1.13, 95% CI: 1.08–1.18),had higher education(RR: 1.71, 95% CI: 1.53–1.92), and were residing in urban districts(RR: 1.06, 95%CI: 1.01–1.11) of FA supplementation; female pregnancy planners with alcohol consumption(RR: 0.95,95% CI: 0.90–0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level(RR: 1.04, 95% CI: 1.03–1.06), who underwent pre-pregnancy examination(RR: 1.02,95% CI: 1.01–1.03) had higher odds of using an FA supplement; older aged(RR: 0.99, 95% CI: 0.98–0.99),and multigravida(RR: 0.97, 95% CI: 0.96–0.98) had lower odds of FA supplementation.Conclusion Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation.     

Community acceptance,satisfaction, and support for case management of malaria of various degrees in selected rural communities in Ibadan,Oyo-State

ObjectivesThis study aimed to assess communities'' perception and adoption of the evidenced-based malaria diagnosis and case management intervention targeted at under-five children. The effectiveness of trained Volunteer Community Health Workers (VCHWs) to diagnose malaria among under-five children using rapid diagnostic testing kit, provide treatment using Artemisinin Combination Therapy and rectal Artesunate were assessed.DesignA qualitative evaluation study was conducted in October 2015.SettingCommunities in the 6 rural wards in Ona-Ara Local Government Area, Oyo State Nigeria.ParticipantsCaregivers of under-five children, community-based frontline health workers, and community leaders selected using purposively sampling.MethodsNine Focus Group Discussions and 15 Key Informant Interviews were conducted using a pre-tested guide. Data were subjected to thematic analysis.ResultsIt was disclosed that VCHWs promoted people''s access to prompt and appropriate malaria treatment. The communities accepted the VCHWs; the reasons given for this included the following: effectiveness of VCHWs in case management of malaria; good inter-personal relationship with caregivers; and the positive health outcomes associated with services provided by them. In addition, community members expressed satisfaction with the VCHWs and provided them with all the support needed to function throughout the malaria case management intervention. The VCHWs considered the support as a great source of encouragement.ConclusionsThe use of VCHWs to treat malaria was adjudged to be effective and considered acceptable to the communities. The adoption of the intervention and its integration into the primary health system by the government is advocated for in medically underserved rural communities.FundingThis work was supported by UNICEF/UNDP/World Bank/WHO Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland (project ID: A80550 [Nigeria] through funds made available by the European Commission (FP7) for research to improve community access to health interventions in Africa.     

Influence of Built Environment in Hygienic City in China on Self-rated Health of Residents

Objective To assess the subjective perception of residents on the built environment in hygienic cities and its relation to the self-rated health(SRH) status of residents, providing a basis for a better promotion on construction of health-supportive environments.Methods The online survey was adopted with the respondents recruited from residents living in Chaoyang District of Beijing in January 2021. With SRH level as the dependent variable, two-category logistic regression analysis was conducted ...     

Impact of Smoke-Free Legislation on Acute Myocardial Infarction and Subtypes of Stroke Incidence in Shenzhen,China, 2012–2016: An Interrupted Time Series Analysis*

ObjectiveThis study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction (AMI) and stroke in Shenzhen.MethodsData on ischemic (n = 72,945) and hemorrhagic (n = 18,659) stroke and AMI (n = 17,431) incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used. Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.ResultsFollowing the smoke-free legislation, a 9% (95% CI: 3%–15%) immediate reduction was observed in AMI incidence, especially in men (8%, 95% CI: 1%–14%) and in those aged 65 years and older (17%, 95% CI: 9%–25%). The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence, with a 7% (95% CI: 2%–11%) and 6% (95% CI: 4%–8%) decrease per year, respectively. This health effect extended gradually to the 50–64 age group. In addition, neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35–49 age group (P > 0.05).ConclusionSmoke-free legislation was enforced well in Shenzhen, which would generate good experiences for other cities to enact and enforce smoke-free laws. This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.     

Health facility and health worker readiness to deliver new national treatment policy for malaria in Kenya

OBJECTIVE: To evaluate health facility and health worker readiness to deliver new artemether-lumefantrine (AL) treatment policy for uncomplicated malaria in Kenya. DESIGN: Cross-sectional survey. SETTING: Health facilities in four sentinel districts in Kenya. PARTICIPANTS: All government facilities in study districts (n = 211) and all health workers performing outpatient consultations (n = 654). MAIN OUTCOME MEASURES: Availability of antimalarial drugs on the survey day, stock-outs in past six months, presence of AL wall charts, health worker's exposure to in-service training on AL and access to new national malaria guidelines. RESULTS: The availability of any tablets of AL, sulfadoxine-pyrimethamine and amodiaquine was nearly universal on the survey day. However, only 61% of facilities stocked all four weight-specific packs of AL. In the past six months, 67% of facilities had stock-out of at least one AL tablet pack and 15% were out of stock for all four packs at the same time. Duration of stock-out was substantial for all AL packs (median range: 27-39% of time). During the same period, the stock-outs of sulfadoxine-pyrimethamine and amodiaquine were rare. Only 19% of facilities had all AL wall charts displayed, AL in-service training was provided to 47% of health workers and 59% had access to the new guidelines. CONCLUSION: Health facility and health worker readiness to implement AL policy is not yet optimal. Continuous supply of all four AL pack sizes and removal of not recommended antimalarials is needed. Further coordinated efforts through the routine programmatic activities are necessary to improve delivery of AL at the point of care.     

新型冠状病毒肺炎疫情防控环境下皖西南农村居民心理健康状况调查

目的 探究新型冠状病毒肺炎(COVID-19)疫情期间皖西南地区农村居民的心理健康状况及影响因素.方法 采用自编一般情况调查表和90项症状自评量表(SCL-90)于2020年2月1日至5日对皖西南地区766名农村居民进行网络问卷调查.比较不同人口学信息的居民之间心理健康状况的差异,并采用logistic回归分析筛选心理健康的影响因素.结果 发放在线问卷887份,回收有效问卷766份,有效率为86.4％.COVID-19疫情期间皖西南地区农村居民的心理问题发生率为23.2％(178/766),主要表现为强迫(15.1％,116/766)、人际关系敏感(9.0％,69/766)和睡眠与饮食问题(8.5％,65/766).COVID-19疫情期间,农村居民的SCL-90各因子分均低于中国常模,其中躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、偏执、精神病性和"其他"因子分与常模比较差异均有统计学意义(P均<0.01).多因素logistic回归分析显示,年龄(OR=0.977,95％CI 0.965～0.989)、受教育程度(OR=0.693,95％CI 0.497～0.966)、家庭结构完整与否(OR=1.934,95％CI 1.223～3.059)、对疫情知识的了解程度(OR=0.948,95％CI 0.914～0.983)是COVID-19疫情期间农村居民心理健康的影响因素(P均<0.05).结论 COVID-19疫情期间,皖西南地区农村居民的心理健康状况较好,应加强对易感人群的关注,进一步普及疫情相关知识,维护疫情时期农村居民的心理健康.     

Prevalence and Associated Factors of Diabetes Mellitus in a Very Elderly Chinese Population: A Cross-sectional Study

Objectives This paper aimed to investigate the prevalence of diabetes mellitus(DM) and explore the associated risk factors in a very elderly southwest Chinese population.Methods From September 2015 to June 2016, a cross-sectional survey was conducted to obtain a representative sample of 1,326 participants over 80 years old living in Chengdu. The presence of DM was based on fasting plasma glucose(FPG) and 2-h plasma glucose(2-h PG) levels during an oral glucose tolerance test(OGTT). A logistic regression model was used to calculate the odds ratios(ORs) and 95%confidence intervals(CIs) of the potential associated factors.Results The participants' mean age was 83.5 ± 3.1 years. The overall prevalence of DM was 27.4%. The prevalence was higher in males(30.2%) than females(24.7%)(P = 0.02). The prevalence of DM increased with body mass index(BMI) and decreased with aging. The multivariate analysis suggested that male sex(OR = 1.433; 95% CI, 1.116–1.843), hypertension(OR = 1.439; 95% CI, 1.079–1.936), overweight or obesity(OR = 1.371; 95% CI, 1.023–1.834), high heart rate(≥ 75 beats/min; OR = 1.362; 95% CI,1.063–1.746), and abdominal obesity(OR = 1.615; 95% CI, 1.216–2.149) were all significantly positively correlated with DM. However, age was negatively correlated with DM(OR = 0.952; 95% CI,0.916–0.989).Conclusions The prevalence of DM and newly diagnosed DM in a very elderly southwest Chinese population was high. OGTT screening should be performed regularly in people aged ≥ 80 years to ensure timely diagnosis of DM.     

Malaria rapid diagnostic test in children: The Zamfara,Nigeria experience

Background:

Malaria remains a major cause of under-five morbidity and mortality in Nigeria, and prompt diagnosis occupies a strategic position in its management. Malaria rapid diagnostic test (RDT), a nontechnical, easy to perform test promises to meet this need. It is important to locally document the usefulness of the use of RDT in making prompt malaria diagnosis in children.

Objective:

To determine the prevalence of malaria and evaluate the diagnostic performance of malaria RDT kit in febrile under-five children presenting to a Tertiary Health Facility in Gusau, North-Western Nigeria.

Materials and Methods:

A cross-sectional study of children aged 6-59 months, evaluated for malaria in a tertiary health facility from August 2012 to January 2013. Information was obtained from care providers of all subjects with fever and a presumptive diagnosis of malaria. All subjects were investigated using Giemsa stain microscopy and Carestart™ malaria RDT.

Results:

The prevalence of malaria in 250 febrile under-five children was 54%. Three-quarter (79%) of the children received inappropriate nonrecommended antimalaria prior to their presentation, including 20% who received chloroquine. The overall sensitivity of RDT was 40.3%. The specificity, positive and negative predictive values were 89.6%, 81.8%, and 56.5%, respectively.

Conclusion:

Use of RDT should be encouraged for screening and diagnosis using a protocol such that febrile children with positive RDT results are confirmed as having malaria while those with negative results are further evaluated using microscopy.     

Effect of Body Mass Index on the Associations between Parity and Metabolic Syndrome and its Components among Northern Chinese Women

Objectives The aims of this study were to assess the associations between parity and metabolic syndrome(Met S) and its components and to evaluate the effects of body mass index(BMI) on these associations.Methods A total of 5,674 women were enrolled from Jidong and Kailuan communities(Tangshan,Hebei) in Northern China. All participants completed standardized questionnaires, physical examination,and biochemical measurements. Logistic regression analysis was used to test the associations.Results Compared with women with parity of one, nulliparous women had decreased odds ratios(ORs); those with parity of two had odds of abdominal obesity [OR = 1.45, 95% confidence interval(CI)1.17–1.81, P 0.001], high blood pressure(OR = 1.26, 95% CI: 1.03–1.54, P = 0.025), elevated fasting glucose levels(OR = 1.36, 95% CI: 1.03–1.79, P = 0.029), and Met S(OR = 1.39, 95% CI: 1.13–1.73, P =0.002); and those with parity of three or more had increased odds of elevated triglyceride levels(OR =1.42, 95% CI: 1.04–1.94, P = 0.027) and Met S(OR = 1.50, 95% CI: 1.10–2.05, P = 0.011) after complete adjustment for confounders. Furthermore, BMI and age subgroups partially modified the associations between parity and Met S and its components.Conclusions Parity is positively associated with Met S and select components in women. BMI is an important modifier involved in the associations between parity and MetS.     

Association between Selenium in Soil and Diabetes in Chinese Residents Aged 35–74 Years: Results from the 2010 National Survey of Chronic Diseases and Behavioral Risk Factors Surveillance

Objective To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35–74 years.Methods Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey. Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China. A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes, with participants nested within districts/counties.Results A total of 69,332 participants aged 35–74 years, from 158 districts/counties were included in the analysis. Concentrations of selenium in soil varied greatly across the 158 districts/counties, with a median concentration of 0.219 mg/kg(IQR: 0.185–0.248). The results showed that both Quartile 1(0.119–0.185 mg/kg) and Quartile 4(0.249–0.344 mg/kg) groups were positively associated with diabetes compared to a soil selenium concentration of 0.186–0.219 mg/kg(Quartile 2), crude odds ratios(ORs)(95% CI) were 1.227(1.003–1.502) and 1.280(1.048–1.563). The P values were 0.045 and 0.013, for Quartile 1 and Quartile 4 groups, respectively. After adjusting for all confounding factors of interest, the Quartile 1 group became non-significant, and the Quartile 4 group had an adjusted OR(95% CI) of 1.203(1.018–1.421) relative to the reference group(Quartile 2), the P values was 0.030. No significant results were seen for the Quartile 3 group(0.220–0.248 mg/kg) compared to the reference group.Conclusion Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35–74 years.     

The Ability of Baseline Triglycerides and Total Cholesterol Concentrations to Predict Incidence of Type 2 Diabetes Mellitus in Chinese Men and Women: A Longitudinal Study in Qingdao,China

ObjectivesThe purpose of this study was to assess the association between triglycerides (TG), total cholesterol (TC) at baseline, and type 2 diabetes mellitus (T2DM) incidence in a general Chinese population. Further, it aimed to evaluate the ability of TG and TC to predict T2DM incidence.MethodsQingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012–2015. TG, TC, and T2DM status were measured. Cox proportional hazards models were used to estimate the association between TG, TC, and T2DM incidence. The receiver operating characteristic (ROC) curve was used to evaluate the ability of TG and TC to identify T2DM participants.ResultsThe incidence of T2DM significantly increased with TG in women and TC in both men and women (P_trend < 0.05). Univariate Cox regression indicated that higher TG {borderline high TG [hazards ratio (HR): 2.05; 95% confidence interval (CI): 1.40, 3.00] and hypertriglyceridemia [HR: 2.64; 95% CI: 1.68, 4.15]} and TC [hypercholesterolemia (HR: 2.05; 95% CI: 1.43, 2.95)] were significantly associated with increased risk of T2DM incidence in women but not in men. Multivariate Cox regression showed that hypertriglyceridemia in women (HR: 1.78, 95% CI: 1.07, 2.97), borderline high TC in men (HR: 1.61, 95% CI: 1.04, 2.48), and hypercholesterolemia in women (HR: 1.68, 95% CI: 1.81, 2.61) had a higher significant risk of T2DM incidence. The optimal cutoff values of TG were > 1.15 and > 1.23 mmol/L in men and women, respectively. For TC, they were > 5.17 and > 5.77 mmol/L in men and women, respectively. The area under the ROCs of TG and TC were 0.54 (0.51–0.57) and 0.55 (0.52–0.58), respectively, in men, and 0.60 (0.58–0.62) and 0.59 (0.56–0.61), respectively, in women.ConclusionElevated TG and TC were risk factors for T2DM incidence. However, no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women. Hence, TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.     

Global Burden of Cardiovascular Disease Attributable to High Temperature in 204 Countries and Territories from 1990 to 2019

Objective This study aimed to estimate spatiotemporal variations of global heat-related cardiovascular disease(CVD) burden from 1990 to 2019.Methods Data on the burden of heat-related CVD were derived from the Global Burden of Disease Study 2019. Deaths and disability-adjusted life years(DALYs) were used to quantify heat-induced CVD burden. We calculated the age-standardized mortality rate(ASMR) and DALY rate(ASDR) per 100,000population to compare this burden across regions. Generalized linear m...     

Ambient Fine Particulate Matter Exposure and Blood Pressure:Evidence from a Large Chinese Multiple Follow-Up Study

Objective This study aimed to investigate the association of ambient PM_2.5 exposure with blood pressure(BP) at the population level in China.Methods A total of 14,080 participants who had at least two valid blood pressure records were selected from the China Health and Retirement Longitudinal Survey during 2011–2015. Their long-term PM_2.5 exposure was assessed at the geographical level, on the basis of a regular 0.1° × 0.1° grid over China. A mixed-effects regression model ...     

A cross-sectional study on factors associated with health seeking behaviour of Malawians aged 15+ years in 2016

IntroductionHealth seeking behaviour (HSB) refers to actions taken by individuals who are ill in order to find appropriate remedy. Most studies on HSB have only examined one symptom or covered only a specific geographical location within a country. In this study, we used a representative sample of adults to explore the factors associated with HSB in response to 30 symptoms reported by adult Malawians in 2016.MethodsWe used the 2016 Malawi Integrated Household Survey dataset. We fitted a multilevel logistic regression model of likelihood of ‘seeking care at a health facility’ using a forward step-wise selection method, with age, sex and reported symptoms entered as a priori variables. We calculated the odds ratios (ORs) and their associated 95% confidence intervals (95% CI). We set the level of statistical significance at P < 0.05.ResultsOf 6909 adults included in the survey, 1907 (29%) reported symptoms during the 2 weeks preceding the survey. Of these, 937 (57%) sought care at a health facility. Adults in urban areas were more likely to seek health care at a health facility than those in rural areas (AOR = 1.65, 95% CI: 1.19–2.30, P = 0.003). Females had a higher likelihood of seeking care from health facilities than males (AOR = 1.26, 95% CI: 1.03–1.59, P = 0.029). Being of higher wealth status was associated with a higher likelihood of seeking care from a health facility (AOR = 1.58, 95% CI: 1.16–2.16, P = 0.004). Having fever and eye problems were associated with higher likelihood of seeking care at a health facility, while having headache, stomach ache and respiratory tract infections were associated with lower likelihood of seeking care at a health facility.ConclusionThis study has shown that there is a need to understand and address individual, socioeconomic and geographical barriers to health seeking to increase access and appropriate use of health care and fast-track progress towards Universal Health Coverage among the adult population.     

宁波市鄞州区大气可吸入颗粒物暴露与冠心病就诊人数的时间序列分析

目的研究大气中可吸入颗粒物（PM）的浓度与冠心病门诊人数的关系。方法收集宁波市鄞州区卫生信息系统2014年1月至2015年6月冠心病患者的就诊信息,同期收集宁波市环境监测中心的大气PM浓度以及宁波市气象局的气象监测资料。采用时间序列的类泊松—广义相加模型,控制长期趋势、气象因素、星期几效应等因素的影响,分析在研究期间宁波市鄞州区PM浓度与冠心病就诊数之间的关系。结果大气PM _2.5浓度每升高一个四分位数间距（IQR）,冠心病门诊数增加1.98%（95% CI：-0.59%～4.63%）。在女性和年龄≥75岁老年人群中,PM _2.5暴露与冠心病就诊人数具有统计学关联, ER值分别为2.70%（95% CI：0.01%～5.47%）和3.35%（95% CI：0.12%～6.69%）。在校正了PM _2.5后,粗颗粒物（PM _2.5~10）对冠心病就诊数的影响降低。 结论宁波市鄞州区大气PM _2.5与冠心病门诊数短期内存在一定关联,尤其在女性和老年人群中两者的关联更加明显。     

中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值诊断强直性脊柱炎的价值

目的 评估中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）在强直性脊柱炎（AS）诊断中的价值。方法 纳入海军军医大学（第二军医大学）长海医院收治的AS患者80例（AS组）及健康体检者100例（健康对照组）作为研究对象。采集研究对象清晨空腹静脉血进行血常规检查并计算NLR和PLR,比较两组NLR和PLR的差异,采用受试者工作特征（ROC）曲线评价NLR、PLR诊断AS的灵敏度和特异度并进行联合诊断试验。结果 与健康对照组相比,AS组NLR、PLR均增高,差异均有统计学意义[2.25（1.66,3.35）vs 1.50（1.23,2.09）,P<0.01;147.94（104.11,188.80）vs 105.75（89.55,148.02）,P<0.01]。ROC曲线分析显示,NLR诊断AS的曲线下面积（AUC）为0.694[95%置信区间（CI）：0.615~0.772,P<0.01],以最佳截断值（1.64）为诊断标准时其灵敏度和特异度分别为77.5%和58.0%;PLR诊断AS的AUC为0.662（95%CI：0.580~0.756）,以最佳截断值（120.91）为诊断标准时其灵敏度和特异度分别为66.2%和63.0%。联合诊断试验结果显示,NLR与PLR并联试验（NLR/PLR）诊断AS的灵敏度和特异度分别为83.8%和50.0%,NLR与PLR串联试验（NLR+PLR）诊断AS的灵敏度和特异度分别为61.2%和75.0%。结论 NLR和PLR对AS具有一定的诊断价值,二者联合诊断可提高诊断的灵敏度和特异度。     

Evaluation of alternative diagnostic techniques for diagnosis of cerebral malaria in a tertiary referral hospital in Bangladesh

Five alternative techniques for diagnosis of malaria were evaluated in 124 clinically diagnosed cerebral malaria cases admitted in a tertiary hospital in Bangladesh. Clinical diagnosis of cerebral malaria was done by WHO criteria. The tests were conventional routine malaria microscopy; prolonged microscopy; dipstick antigen capture assay (Para Sight TM-F test); pigments in peripheral leucocytes and routine microscopy repeated at 12 hours interval. First four tests were done at 0 hours of hospital admission and repeat routine microscopy was added at 12 hours interval. Diagnostic capability of the test was 64%, 65%, 69%, 27% and 63% respectively. None of the tests except pigments in peripheral leucocytes was superior at initial evaluation. Only the dipstick test added 5% more diagnostic possibility compared with routine microscopy as standard. Stratification of diagnostic capability in different ways improved diagnosis 15% and 11% in smear negative cases by dipstick and prolonged microscopy respectively. It was increased by 50% (5/10 patients) with dipstick test in the smear negative patients with history of anti-malarials prior to hospital admission.     

2型糖尿病患者一相胰岛素分泌功能特点与糖尿病微血管病变的相关性

目的 利用精氨酸刺激试验探讨2型糖尿病（T2DM）患者一相胰岛素分泌功能特点与糖尿病微血管病变的相关性。方法 招募于南通大学附属医院住院治疗的T2DM患者67例,其中男42例、女25例,年龄为（56.4±14.2）岁。根据是否存在微血管病变将患者分为微血管病变组（病例组,n=23）和无微血管病变组（对照组,n=44）。收集两组患者的身高、体质量、糖尿病病程、肾功能、血脂、尿微量白蛋白与尿肌酐等资料,计算体质量指数（BMI）、尿微量白蛋白/肌酐比值（UACR）、估计的肾小球滤过率（eGFR）。空腹状态下进行精氨酸刺激试验,检测空腹和注射精氨酸后2、4、6 min血浆葡萄糖水平和血清胰岛素、C肽水平。计算并比较两组患者的一相胰岛素分泌功能特征,包括急性胰岛素反应（AIR）指数、急性C肽反应（ACR）指数、胰岛素曲线下面积（INS_AUC）、稳态模型评估胰岛素抵抗（HOMA-IR）指数等,并分析其与糖尿病微血管病变的相关性。结果 病例组患者的糖尿病病程长于对照组,差异有统计学意义（P=0.030）。病例组患者的血清肌酐水平,UACR,空腹和注射精氨酸后2、4、6 min胰岛素和C肽水平,AIR指数,INS_AUC,HOMA-IR指数均高于对照组,eGFR低于对照组,差异均有统计学意义（P均<0.05）。校正年龄、BMI后的logistic回归分析结果显示,糖尿病病程、AIR指数是T2DM合并微血管病变的危险因素[比值比（OR）=1.099,95%置信区间（CI）：1.011~1.194,P=0.026;OR=1.049,95% CI：1.007~1.092,P=0.021]。结论 T2DM微血管病变与糖尿病病程延长、精氨酸刺激后的AIR指数升高相关。     

艾灸干预亚健康阳虚质随机对照试验的系统综述

[目的]应用循证医学方法评价艾灸干预亚健康阳虚质临床疗效与安全性,为艾灸干预亚健康阳虚质提供循证证据.[方法]检索中国知网(CNKI)、维普数据库(VIP)、万方数据库(WANFANG DATA)、中国生物医学文献服务系统(SinoMed)4个中文数据库2011年1月1日—2019年12月31刊载的文献,纳入干预措施为...     

Childhood BMI and Adult Obesity in a Chinese Sample:A 13-Year Follow-up Study

Objective Obesity is recognized as a significant risk factor for diabetes and hypertension. The present study aimed to examine the associations between adults' obesity risk and childhood and parental obesity. Methods A total of 204 children aged 6-17 years were recruited in 2002 with an average follow-up period of 13.2 years. Height and body weight were measured by trained staffs. Overweight and obesity were defined based on the Chinese standard for children and adults. T-test, analysis of variance, and Chi-square analysis were used for single factor analysis. Multiple linear and logistic regression analyses were used to perform multifactor analysis. Results The percentage of non-obese children who grew up to be non-obese adults was 62.6%, and that of obese children who grew up to be obese adults was 80.0%. There was a significant association between childhood body mass index(BMI) and adulthood BMI with a β regression coefficient of 3.76 [95% confidence interval(CI): 1.36-6.16], and between childhood obesity and adulthood obesity with an odds ratio of 5.76(95% CI: 1.37-24.34). There was no statistical difference between parental obesity at baseline and children's adulthood obesity, after adjustment of confounders. Male participants and those aged 10.0-13.0 years had a higher risk of adulthood obesity with odds ratios of 2.50(95% CI: 1.12-5.26) and 3.62(95% CI: 1.17-11.24), respectively. Conclusion Childhood obesity is an important predictor of adulthood obesity.