Epidemiologic surve of Overweight and obesity among residents aged≥60 years in ronggui community

Objectives To investigate prevalence of overweight and obesity among residents aged 3≥60 years in ronggui community.Methods 1372 ones(570 males,802 females,68.03±6.62 years) Of total 1503 residents aged≥60 years in the 2 villages which were randomly exampled in rong-gui community were investigated.857 ones aged among 60-69 years(62.5%),416 ones aged among 70-79 years (30.3%),99 ones aged≥60 years(7.2%).Investigative items included age,sex,body height,body weight,waist circumference(WC),hip circumference(HC)、fasting plasma glucose(FG),total cholesterol(TC),triglyceride(TG),blood pressure,history of past illness,body mass index(BMI),waist hip ratio(WHR) and waist height ratio(WHtR).Results (1)Of total 1372 residents,the combined prevalence of overweight and obesity was 39.4%.Prevalence of overweight, obesity were 29.4%,10.0%respectively.Prevalence of overweight, obesity of male were 30.8%,6.0%,and female, 28.5%,12.8%respectively.Prevalence of overweight,obesity of residents aged 60-69 years were 31.2%,11.3%,70-79 years were 27.0%,9.1%and≥80 years were 25.2%,2.0% respectively.The difference between male and female、among three age groups were not significant.(2)Of total 1372 residents, prevalence of central adiposity were 34.6%,male was 15.9%and female was 52.4%,female signifleanfly higher than male(P<0.01).(3)The FG^TG.SBP^DBP of residents with overweight、obesity or central adiposity were higher than residents with normal weight or WC(P<0.01).(4)By Pearson correlation analysis,we found that overweight、obesity and central adiposity were obviously correlated with FG、TG、SBP、DBP(P<0.01),were not correlated with TC(P>0.05). Conclusions(1)Of total 1372 residents,the combined preva- lence of overweight and obesity was 39.4%,prevalence of overweight,obesity were 29.4%,10.0%respectively,prevalence of central adiposity were 34.6%,female was 52.4%, female signifleanfly higher than male.(2)overweight.obesity and central adiposity were obviously correlated with FG,TG, SBP,DBP.     

Central obesity in Yemeni children: A population based cross-sectional study

AIM: To establish percentile curves and to explore prevalence and correlates of central obesity among Yemeni children in a population based cross-sectional study.METHODS: A representative sample of 3114 Yemeni children(1564 boys,1550 girls) aged 6-19 years participating in the HYpertension and Diabetes in Yemen study was studied.Data collection was conducted at home by survey teams composed of two investigators of both genders.Study questionnaire included questions about demographics,lifestyle,and medical history.Anthropometric measurements included body weight,height,waist circumference(WC) and hip circumferences.Waist to hip ratio(WHR) and waist-toheight ratio(WHtR) were then calculated.Age and gender specific smoothed percentiles of WC,WHR,and WHtR were obtained using lambda-mu-sigma parameters(LMS method).The independent predictors of central obesity defined as(1) WC percentile ≥ 90th;(2) WHtR ≥ 0.5;or(3) WC percentile ≥ 90thand WHtR ≥ 0.5,were identified at multivariate logistic regression analysis adjusted for age,gender,urban/rural location,years of school education,sedentary/active life-style.RESULTS: Percentile curves for WC,WHR and WHtR are presented.Average WC increased with age for both genders.Boys had a higher WC than girls until early adolescence and thereafter girls had higher values than boys.WHR decreased both in boys and girls until early adolescence.Thereafter while in boys it plateaued in girls it continued to decrease.Mean WHtR decreased until early adolescence with no gender related differences and thereafter increased more in girls than in boys towards adult age.Prevalence of central obesity largely varied according to the definition used which was 10.9% for WC ≥ 90thpercentile,18.3% for WHtR ≥ 0.5,and 8.6% when fulfilling both criteria.At adjusted logistic regression WC ≥ 90thpercentiles and WHtR ≥ 0.5 were less prevalent in rural than in urban areas(OR = 0.52,95%CI: 0.41-0.67 and 0.66,0.54-0.79 respectively),being more prevalent in children with sedentary lifestyle rather than an active one(1.52,95%CI: 1.17-1.98 and 1.42,95%CI: 1.14-1.75,respectively).CONCLUSION: Yemeni children central obesity indicespercentile curves are presented.Central obesity prevalence varied according to the definition used and was more prevalent in urban sedentary subjects.     

社区老人群血脂1401例现况调查

目的了解顺德容桂地区1401例老年人血脂现况。方法对顺德区容桂街道整群随机抽样,随机抽取2个村。对村中60岁以上的常住人口全部进行调查。总人数1503人,被调查且资料完整的1401人(68.12±6.64)岁其中男性579人,女性822人,60～69岁867人(占61.9%),70～79岁430人(占30.7%),80岁以上104(占7.4%)。调查的项目有年龄、性别、总胆固醇(TC)、甘油三酯(TG)、身高、体重、腰围(WC)、臀围(HC)、空腹血糖(FC)、血压、既往史,并计算出体重指数(BMI)、腰臀围比(WHR)和腰围身高比(WHtR)。结果 (1)高脂血症现患率42.8%,男女之间差异明显(P<0.01),女性高于男性,各年龄组间差异不明显。高脂血症加上血脂边缘升高的1 122人,占总数的80.1%。(2)与正常血脂者相比,高脂血症者FG、BMI、SBP、DBP、WC、WHR、WHtR更高(P<0.05)。(3)Pearson相关性分析发现,高脂血症与FG、BMI、WC、WHR、WHtR、SBP、DBP明显相关(P<0.01)。结论 (1)顺德容桂地区1401例老年人群高脂血症现患率42.8%,女性高于男性。(2)高脂血症与高FG、BMI、WC、WHR、WHtR、SBP、DBP相关。     

社区老人群血脂1401例现况调查

目的了解顺德容桂地区1401例老年人血脂现况。方法对顺德区容桂街道整群随机抽样,随机抽取2个村。对村中60岁以上的常住人口全部进行调查。总人数1503人,被调查且资料完整的1401人(68.12±6.64)岁其中男性579人,女性822人,60～69岁867人(占61.9%),70～79岁430人(占30.7%),80岁以上104(占7.4%)。调查的项目有年龄、性别、总胆固醇(TC)、甘油三酯(TG)、身高、体重、腰围(WC)、臀围(HC)、空腹血糖(FC)、血压、既往史,并计算出体重指数(BMI)、腰臀围比(WHR)和腰围身高比(WHtR)。结果 (1)高脂血症现患率42.8%,男女之间差异明显(P<0.01),女性高于男性,各年龄组间差异不明显。高脂血症加上血脂边缘升高的1 122人,占总数的80.1%。(2)与正常血脂者相比,高脂血症者FG、BMI、SBP、DBP、WC、WHR、WHtR更高(P<0.05)。(3)Pearson相关性分析发现,高脂血症与FG、BMI、WC、WHR、WHtR、SBP、DBP明显相关(P<0.01)。结论 (1)顺德容桂地区1401例老年人群高脂血症现患率42.8%,女性高于男性。(2)高脂血症与高FG、BMI、WC、WHR、WHtR、SBP、DBP相关。     

Waist circumference cutoff points for Chinese adults with metabolic syndrome defined by the International Diabetes Federation

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344 Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P<0.05). 2)The prevalence of elevated TG, reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P<0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2 were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.     

Nonalcoholic fatty liver disease and microvascular complications in type 2 diabetes

AIM:To evaluate the correlation between nonalcoholic fatty liver disease(NAFLD) and microvascular complications in type 2 diabetes mellitus(T2DM).METHODS:Data were obtained from 1217 inpatients with T2DM(757 females,460 males;aged 63.39 ± 12.28 years).NAFLD was diagnosed by hepatic ultrasonography.Diabetic nephropathy(DN),diabetic peripheral neuropathy(DPN),and diabetic retinopathy(DR) were diagnosed according to their respective criteria.The prevalence of NAFLD and the independent correlations of clinical characteristics with NAFLD were determined by cross-tabulation and logistic regression,respectively.RESULTS:Approximately 61% of inpatients with T2DM in Qingdao,China had NAFLD,which decreased significantly with increase in age and prolonged course of diabetes.The prevalence of NAFLD in patients presenting with DN,DPN and DR was 49.4%,57.2% and 54.9%,respectively.These rates were significantly lower than those of patients without DN,DPN and DR(65.9%,65.6% and 66.1%,respectively,P < 0.05).Participants with NAFLD had greater body weight,waist circumference(WC),body mass index(BMI),fasting blood glucose(FBG),hemoglobin A1c,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,blood pressure,as well as triglyceride(TG) levels and lower high-density lipoprotein(HDL) concentration than those without NAFLD(P < 0.05).NAFLD was positively correlated with BMI,WC,TG,FBG,diastolic blood pressure,and systolic blood pressure but negatively correlated with the duration of diabetes,DR,DPN,DN,and HDL.CONCLUSION:Despite the benign nature of NAFLD,efforts should be directed toward early diagnosis,intensive blood glucose and blood pressure control,and effective dyslipidemia correction.     

Association of late-life changes in blood pressure and cognitive status

Background Disagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to examine whether 4-year changes in systolic and diastolic blood pressure (SBP and DBP) are associated with cognitive status in a representative sample of older men and women. Methods Analysis of longitudinal data from 854 participants of a population-based German sample (aged 60-87 years) was performed with standard cognitive screening and blood pressure measurements. Effects of changes in SBP and DBP (10 mmHg and 5 mmHg respectively as unit of regression effect measure) on cognitive status were evaluated using non-parametric and linear regression modeling. Results No clear associations were seen between changes in SBP or in DBP and cognitive scores. Small effects were found after stratification for sex and hypertension awareness. Specifically, larger decreases in SBP were associated with higher cognitive scores in those men aware of their hypertension (10 mmHg decrease in SBP, β = -0.26, 95% CI: -0.51 to 0.02) and men with controlled hypertension (10 mmHg decrease in SBP, β = -0.44, 95% CI: -0.92 to -0.03). Additionally larger increases in DBP were associated with higher cognitive scores in men with controlled hypertension (5 mmHg increase in DBP, β = 0.67, 95% CI: 0.19-1.15). For women aware of their hypertension, larger decreases in DBP were associated with higher cognitive scores (5 mmHg decrease in DBP, β ?= -0.26; 95%CI: -0.51 to -0.01). Conclusions Changes in blood pressure were only weakly associated with cognitive status. Specifically, decreases in SBP were associated with higher cognitive scores in men aware of their hypertension and especially those that were medically controlled.     

Change of plasma visfatin level in the population with different glucose tolerances

Objective To investigate the change of plasma visfatin level and the relationship of plasma visfatin level to body mass index (BMI) , waist hip ratio (WHR) , blood glucose, plasma insulin levels as well as other factors in the subjects with different glucose tolerances. Methods Fasting and glucose loading 2 h plasma visfatin levels were assayed by ELISA in patients with type 2 diabetes     

Factors associated with visceral fat accumulation in the general population in Okinawa,Japan

AIM:To investigate the clinical and biochemical factors associated with visceral fat accumulation in the general population.METHODS:We enrolled 1004 subjects who underwent a medical health checkup between April 2008 and March 2009.The medical health checkup included the following tests:Height,body weight,waist circumference(WC),systolic blood pressure,diastolic blood pressure,urinalysis,blood-cell counts,blood chemistry,electrocardiography,chest radiography,and abdominal computed tomography(CT)for visceral fat accumulation.The patients’medical history and lifestyle factors were collected privately by nurses using a selfadministered questionnaire,and they included questions regarding physical activity,sleep duration,dietary habits,smoking,and alcohol consumption.visceral fat area(VFA)was defined as the sum of the intraperitoneal fat area at the level of the umbilicus with CT density in the range of-150 to-50 Hounsfield units.RESULTS:The mean age and body mass index(BMI)of the study subjects were 57.0 years and 24.4 kg/m2.In both male and females,v FA was significantly andpositively correlated with WC(r=0.532,P0.01;r=0.612,P0.01).Subjects with high levels of v FA were primarily male with significantly higher age,height,body weight,BMI,systolic blood pressure(BP),diastolic BP,and hemoglobin in all subjects(P0.05).A multivariate logistic regression analysis revealed that vF A had a positive relationship with age≥56,BMI≥25 kg/m2,and triglyceride level≥149 in males(P0.05),whereas it had a positive relationship with age≥58,BMI≥24.4 kg/m2,high-density lipoprotein cholesterol level40 mg/d L,and current drinking in females(P0.05).CONCLUSION:These results suggest that gender differences exist in the clinical and biochemical parameters associated with visceral fat accumulation.     

Association between UCP3 gene polymorphisms and nonalcoholic fatty liver disease in Chinese children

AIM:To confirm the hypothesis that polymorphisms of the uncoupling protein 3(UCP3)gene are associated with the occurrence of nonalcoholic fatty liver disease(NAFLD).METHODS:A total of 250 NAFLD patients(147 malesand 103 females)and 200 healthy individuals who served as controls(control,109 males and 91 females),aged between 6 and 16 years were enrolled in this study.The four non-synonymous single nucleotide polymorphisms(SNPs)in the UCP3 gene polymorphisms of rs1726745,rs3781907,rs11235972 and rs1800849,were genotyped using MassArray.Body mass index(BMI),waist and hip circumference,blood pressure(BP),fasting blood glucose(FBG),insulin and lipid profiles were measured and B-ultrasound examination was performed in all subjects.RESULTS:NAFLD patients showed risk factors for metabolic syndrome:elevated BMI,waist-to-hip ratio,BP,FBG,homeostasis model assessment-estimated insulin resistance,total triglyceride,total cholesterol and low-density lipoprotein-cholesterol,while decreased high-density lipoprotein-cholesterol level compared with the control group.The GG genotype distributions of rs11235972 in the NAFLD group differed significantly from that in the control group.We found that waist circumference between CC(58.76±6.45 cm)and CT+TT(57.00±5.59 cm),and hip circumference between CC(71.28±7.84 cm)and CT+TT genotypes(69.06±7.75 cm)were significantly different with and without rs1800849 variation(P<0.05).CONCLUSION:A higher prevalence of rs11235972 GG genotype was observed in the NAFLD group compared with the control group.No differences were observed for the other SNPs.However,there was a significant difference in body height in addition to waist and hip circumference between the CC(mutant type group)and CT+TT group with and without rs1800849 variation.     

Anthropometric parameter-based assessment for cardiovascular disease predisposition among young Indians

AIM:To assess the predisposition for cardiovascular diseases among young Asian Indians by anthropometric data analysis.METHODS:One hundred and thirty males and 329 females aged between 15 and 26 years,attending health care check-ups at VIT University,were included in this study.Their body mass index,systolic and diastolic blood pressure,waist circumference,waist-to-hip ratio,pulse rate and pressure,along with mean arterial pressure,were measured and the data analyzed as per World Health Organization guidelines.RESULTS:Based on the analysis,54% of the male population was found to be predisposed to cardiovascular disease.Of these,approximately 40% were at highest possible risk,with greater than threshold values of body mass index,waist circumference and waist-to-hip ratio.Females were found to have lower risk.Both genders showed significant correlation(P < 0.0001) between body mass index and waist circumference.Waist-to-hip ratio correlated significantly only in males with the former index whereas it correlated significantly with waist circumference in both genders.Receiver operating curve analysis,when performed,showed optimal sensitivity and specificity for body mass index and waist circumference.CONCLUSION:The above results indicate that seeds of cardiovascular disease may have been sown at a young age in Asian Indian populations.Interventional measures are advised to prevent accelerated atherosclerosis leading to premature cardiovascular disease.     

Clinical characteristics, target organ damage and associate risk factors of resistant hypertension determined by ambulatory blood pressure monitoring in patients aged ≥80 years

Objectives: We investigated clinical characteristics, target organ damage, and the associated risk factors of the patients aged ≥80 years with true resistant hypertension (RH) admitted to Chinese PLA general hospital. Methods: Patients aged ≥80 years with hypertension (n=1163) were included in this study. The included participants attended a structured clinical examination and an evaluation of RH was carried out. The prevalence, clinical characteristics and target organ damage of patients with RH were assessed. The associated clinical risk factors were analyzed by using logistic regression. Results: The prevalence of RH diagnosis by ABPM assessment was 21.15% of patients with hypertension. LVIDd,LVMI as well as prevalence of LVH were significantly greater in patients with RH than control group. The common carotid artery intimal media thickness,carotid walls thickness, CCA diameter and RWT were significant greater in the RH group than in controls. A relatively higher level of creatinine, eGFR, and microalbuminuria and retinal changes was found in the RH group than control group. A multivariate analysis showed that patients with a history of diabetes, higher BMI and lipid profiles were independent risk factors of RH. Conclusions: The prevalence of RH in patients aged≥80 years was within the range of reported rates of the general population. Subjects with RH diagnosis showed a higher occurrence of target organ damage than patients with well controlled blood pressure. Patients with diabetes, higher BMI and serum lipid profiles were independent risk factors for RH in patients aged ≥80 years.     

The relationship of body mass index and hyperuricemia in hypertensive adults over 80 years

Background Hyperuricemia (HUA) and hypertension are associated with the increasing risk and mortality of cardiovascular disease (CVD) . However,the relationship between body mass index (BMI) and HUA in hypertensive adults over 80 years remains uncertain. Methods Observational trial was designed and 308 patients who were newly diagnosed as essential hypertension without anti-hypertensive therapy were enrolled into our study. According to the cut-off value of serum UA,participants were stratified into normal (420 μmol/L for men and 360 μmol/L for women) and increased UA groups (≥420 μmol/L for men and ≥360 μmol/L for women) . Serum UA level,blood pressure and other baseline characteristics were compared,logistic regression analysis and receiver operating characteristic curve (ROC) were performed. Results The mean (SD) serum uric level was 382.2 (108.7) μmol/L and the prevalence of hyperuricemia was 45% among men and 50% among women.BMI was significantly higher (22.6 vs. 24.0 kg/m~2,P=0.003) and FBG was lower (5.13 vs. 4.98 mmol/L,P=0.025) in increased UA group among aged women,and BMI and FBG were found the independent determinants for UA increase in female subjects according to logistic regression analysis,and the odd ratio were 1.154 (95% interval confidence 1.058-1.259,P=0.001) and 0.646 (95% interval confidence 0.44-0.949,P=0.026),respectively.Moreover,evaluation of receiver operating characteristic curve (ROC) showed that area under the curve for BMI to predict UA increase was 0.627+0.039,P=0.001 in women. However,the results mentioned above were only found in elderly women,not in men. Conclusions Our study indicates that aged women have higher prevalence of HUA than men,and that BMI is independently associated with serum uric acid level for hypertensive women but not for men over 80 years old. Therefore,BMI is a useful predictor of serum uric acid level in elderly women with hypertension.     

Gender differences in risk factors and patients' awareness,treatment and control of hypertension

正Objective To investigate gender differences in the risk factors and awareness,treatment,and control of hypertension.Methods The subjects were selected among local residents aged≥18 years old,by multi-stage stratified-random sampling method.All participants accepted physical examinations including blood tests for lipids,     

Risk factors for prehypertension in Xinjiang Uygur population

Objective To assess the risk factors for prehypertension in Xinjiang Uygur population. Methods A cross-section study was conducted in a Xinjiang Uygur population（438 males and 716 females,aged 30 to 70 years）.The fasting lipid profiles,serum glucose,insulin,and uric acid were determined.Homeostasis model assessment of insulin resistance（HOMA-IR）index was used to assess insulin resistance（IR）.Binary logistic regression analysis was performed to determine risk factors for prehypertension.Blood pressure levels ofnormotensives and prehypertensives in different body mass index（BMI）categories were compared. Results Binary logistic regression analysis performed after adjustment for gender,lipids profiles,waist-to-hip ratio,uric acid,HOMA-IR,and lifestyle（alcohol drinking and smoking）showed a significantly increasing prevalence of prehypertension with BMI.The odds ratios for prehypertension against the lowest BMI group（separated by 24 and 28）were 1.934 and 2.490（95% confidence interval：1.435-2.606 and 1.825-3.399,respectively）.Age was independently correlated to the increasing prevalence of prehypertension.HOMA-IR was not associated with prehypertensive.The mean diastolic blood pressure（DBP）was significantly increased with BMI categories in either normotensives or prehypertensives（P〈0.001）while the mean systolic blood pressure（SBP）was significantly increased with BMI only in normotensives（P〈0.001）. Conclusions In Xinjiang Uygurs,BMI and age was the risk factors for prehypertension.DBP is significantly increased with BMI.IR is not associated with prehypertension.These findings emphasize the importance of management of obesity for the control of blood pressure and other cardiovascular complications.     

80岁及以上高血压患者血压与心脑事件和季节性变化研究

目的 观察80岁及以上老年高血压患者血压和心脑血管事件的季节性变化. 方法监测67例年龄80～92岁的高血压患者2年间的家庭自测血压、诊室测血压和每季度1次的24 h时动态血压,记录期间发生的心脑血管事件. 结果高血压患者夏季的收缩压、舒张压最低(P＜0.01).冬季的收缩压最高(P＜0.01),冬季舒张压高于夏季(P＜0.01).春季和秋季的收缩压、舒张压差异无统计学意义.心脑血管事件的发病率在夏季和冬季明显高于春季和秋季(P＜0.05).发生心血管事件的相关因素为:季节(OR=1.525,P=0.001)、体质指数(OR=1.145,P=0.018)、心功能(OR=2.037,P=0.01),发生缺血性脑血管事件的相关因素为季节(OR=1. 604,P=0.001)、脑血管病史(OR=1.598,P=0.034)、诊室测收缩压(OR=0.960,P=0.013)、动态血压的舒张压(OR=0.936,P=0.008). 结论 80岁及以上老人通过3种方式测得的血压结果显示,夏季的收缩压、舒张压为全年最低;冬季的收缩压全年最高,舒张压高于夏季;春季和秋季的血压水平无明显差异.心脑血管事件的发生率在冬季和夏季明显高于春季和秋季.

Abstract：

Objective To investigate the effect of seasonal variation of blood pressure (BP) on the incidence of cardiovascular and cerebrovascular events in the elderly aged 80 years and over.Methods The 67 patients (aged 80-86 years) with essential hypertension were enrolled, the BP were measured at home, in consulting room, and by 24-h ambulatory BP monitor in every season for 2 years. The incidences of cardiovascular and cerebrovascular events were recorded in the meantime.Results Both systolic BP (SBP) and diastolic BP (DBP) were lower in summer than in any other season (P＜0. 01 ). SBP was higher in winter than in any other season. (P＜0.01), DBP was higher in winter than in summer(P＜0. 01). There were no significant differences in SBP and DBP between spring and autumn. The incidence of cardiovascular and cerebrovascular events were higher in winter and summer than in spring and autumn (P＜0.05). The season (OR= 1. 525, P=0. 001), BMI (OR =1.145, P=0.018) and heart function (OR= 2. 037, P=0.01) were related to the incidence of cardiovascular events. And the season (OR = 1. 604, P= 0. 001 ), history of cerebrovascular disease (OR= 1. 598, P=0. 034), office-measured SBP (OR=0.960, P=0.013) and ambulatory DBP (OR =0. 936, P = 0. 008) were related to the incidence of cerebrovascular events.Conclusions The blood pressure measured by three methods in the elderly aged 80 and over shows that both SBP and DBP are at the lowest in summer; SBP is at the highest in winter, DBP is higher in winter than in summer. There are no significant differences in BP between spring and autumn. The incidences of cardiovascular and cerebrovascular events are significantly higher in winter and summer than in spring and autumn.     

健康体检人群不同肥胖指标与糖尿病及空腹血糖受损的关系研究

目的探讨不同肥胖指标与糖尿病及IFG的关系。方法采用横断面研究方法,以开滦集团有限责任公司2006~2007年度健康体检且与本研究相关体检数据完整的87757名对象作为观察队列,分别以BMI、WC、WHR及腰围身高比值(WHtR)分组,比较各组FPG水平、糖尿病和IFG的检出率。多因素Logistic回归分析影响糖尿病和IFG的因素。结果不同性别组FPG水平、糖尿病和IFG的检出率随BMI、WC、WHR和WHtR值增加而逐渐升高。校正年龄、血压和血脂因素后,Logistic回归分析显示,男性以WHtR预测糖尿病风险的OR值最高(1.649),女性以WC的OR值最高(2.495),BMI的OR值在两性中均最低(1.396/1.429);男性以BMI预测IFG风险的OR值最高(1.208),女性以WC的OR值最高(1.348)。结论BMI、WC、WHR和WHtR值越大,糖尿病和IFG的检出率越高,WC、WHR和WHtR对糖尿病风险的预测优于BMI。     

Predictors for difficult cecal insertion in colonoscopy: The impact of obesity indices

AIM To identify the factors influencing cecal insertion time(CIT) and to evaluate the effect of obesity indices on CIT. METHODS We retrospectively reviewed the data for participants who received both colonoscopy and abdominal computed tomography(CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices [body mass index(BMI), waist-to-hip circumference ratio(WHR), waist circumference(WC), visceral adipose tissue(VAT)volume and subcutaneous adipose tissue(SAT) volume on abdominal CT], history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed. CIT was categorized as longer than 10 min(prolonged CIT) and shorter than or equal to 10 min, and then the factors that required a CIT longer than 10 min were examined.RESULTS A total of 1678 participants were enrolled. The mean age was 50.42 ± 9.931 years and 60.3% were men. The mean BMI, WHR, WC, VAT volume and SAT volume were 23.92 ± 2.964 kg/m2, 0.90 ± 0.076, 86.95 ± 8.030 cm, 905.29 ± 475.220 cm3 and 1707.72 ± 576.550 cm3, respectively. The number of patients who underwent abdominal surgery was 268(16.0%). Colonoscopy was performed by an attending physician alone in 61.9% of cases and with the involvement of a fellow in 38.1% of cases. The median CIT was 7 min(range 2-56 min, IQR 5-10 min), and mean CIT was 8.58 ± 5.291 min. Being female, BMI, VAT volume and involvement of fellow were significantly associated with a prolonged CIT in univariable analysis. In multivariable analysis, being female(OR = 1.29, P = 0.047), lower BMI( 23 kg/m2)(OR = 1.62, P = 0.004) or higher BMI(≥ 25 kg/m2)(OR = 1.80, P 0.001), low VAT volume( 500 cm3)(OR = 1.50, P = 0.013) and fellow involvement(OR = 1.73, P 0.001) were significant predictors of prolonged CIT. In subgroup analyses for gender, lower BMI or higher BMI and fellow involvement were predictors for prolonged CIT in both genders. However, low VAT volume was associated with prolonged CIT in only women(OR = 1.54, P = 0.034).CONCLUSION Being female, having a lower or higher BMI than the normal range, a low VAT volume, and fellow involvement were predictors of a longer CIT.     

Treating blood pressure to prevent strokes: The age factor

The importance of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), on the incidence of coronary heart disease (CHD) and stroke are known. However, the importance of blood pressure (BP)-age shifts regarding the stroke incidence is not clearly known. The BP changes with the advancement of age from the predominance of DBP in the young to the predominance of SBP in the old. This change is due to the stiffening of the large arteries as a result of the aging process and the replacement of the elastic fibers with collagen fibers. This change results in the loss of compliance and the elastic recoil of these vessels leading to increase in pulse wave velocity, central SBP and widening of pulse pressure leading to an increased incidence of CHD and strokes. It has been demonstrated epidemiologically that the SBP rises linearly with age, whereas the DBP rises up to the age of 45-50 years, and then begins to decline after the age of 60 years leading to a progressive widening of PP. Several studies have shown an inverse relationship between DBP and CHD, whereas no such relationship has been demonstrated for stroke. However, a recent study showed an inverse relationship with DBP and stroke when it dropped below 71 mmHg in subjects 50 years of age or older. In contrast, there was a positive association between BP and stroke when both SBP and DBP were ≥ 71 mmHg. These findings suggest that intreating systolic hypertension in the elderly to reduce stroke risk, attention should be paid on the potential harm of low DBP and the widening of PP regarding CHD and stroke. The implications of BP shifts with age and the potential risks of low DBP regarding the risk of stroke will be discussed in this concise review.     

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

BACKGROUND Periodontitis is a chronic inflammation of periodontal tissues. The effect of periodontitis on the development of inflammatory bowel disease(IBD) remains unclear.AIM To assessed the risk of IBD among patients with periodontitis, and the risk factors for IBD related to periodontitis.METHODS A nationwide population-based cohort study was performed using claims data from the Korean National Healthcare Insurance Service. In total, 9950548 individuals aged ≥ 20 years who underwent national health screening in 2009 were included. Newly diagnosed IBD [Crohn's disease(CD), ulcerative colitis(UC)] using the International Classification of Disease 10 th revision and rare intractable disease codes, was compared between the periodontitis and nonperiodontitis groups until 2017.RESULTS A total of 1092825 individuals(11.0%) had periodontitis. Periodontitis was significantly associated with older age, male gender, higher body mass index, quitting smoking, not drinking alcohol, and regular exercise. The mean age was 51.4 ± 12.9 years in the periodontitis group and 46.6 ± 14.2 years in the nonperiodontitis group(P 0.01), respectively. The mean body mass index was 23.9 ± 3.1 and 23.7 ± 3.2 in the periodontitis and non-periodontitis groups, respectively(P 0.01). Men were 604307(55.3%) and 4844383(54.7%) in the periodontitis and non-periodontitis groups, respectively. The mean follow-up duration was 7.26 years. Individuals with periodontitis had a significantly higher risk of UC than those without periodontitis [adjusted hazard ratio: 1.091; 95% confidence interval(CI): 1.008-1.182], but not CD(adjusted hazard ratio: 0.879; 95% confidence interval: 0.731-1.057). The risks for UC were significant in the subgroups of age ≥ 65 years, male gender, alcohol drinker, current smoker, and reduced physical activity. Current smokers aged ≥ 65 years with periodontitis were at a 1.9-fold increased risk of UC than non-smokers aged ≥ 65 years without periodontitis.CONCLUSION Periodontitis was significantly associated with the risk of developing UC, but not CD, particularly in current smokers aged ≥ 65 years.