湖南省某乡村成年人群中代谢综合征与慢性肾脏病的关系

目的 研究中国南方某乡村成年人群代谢综合征(MS)和慢性肾脏病(CKD)的关系.方法 在湖南省某乡村采用分层多级随机抽样的方法,抽取18岁以上的常住居民1953人,进行MS组分、肾脏损伤指标及其他相关危险因素的问卷调查和检测.结果 在资料完整的1709名居民中,用年龄、性别及MS组分校正后.有MS的参与者CKD的患病率比没有MS的参与者高(19.3% vs.13.2%,P＜0.001).CKD患病率随MS组分数的增多而升高.MS与CKD之间存在强而独立的关联.不合并高血压和糖尿病的参与者,MS也与CKD有关(OR=1.733,95%CI:1.20～2.41,P=0.004).结论 中国南方某乡村1709名研究对象中,MS与CKD存在关联.     

Prevalence of overweight and weight loss behavior in a metropolitan adult population: the Minnesota Heart Survey experience

Data from two major surveys, conducted in the Minneapolis-St. Paul metropolitan area in 1973-74 and 1980-81, were used to estimate the prevalence of overweight. In 1980-81, weight history and the prevalence of dieting behaviors were also obtained. The prevalence of overweight was greater in the 1980-81 survey than in 1973-74. Increases were observed in all ages in women, but only in the 40-59 year age ranges in men. In 1980-81, dieting to control weight was widely reported by both sexes, even among those who had never been overweight. Of those who reported having been overweight, approximately one-third reported they had successfully reduced. More men than women reported having been overweight, but more women reported having dieted to lose weight. Formal weight reduction programs were used much more by women than men. Although most dieting attempts consisted of balanced, reduced calorie regimens, a significant percentage were "fad" types, whose nutritional safety may be questioned. Overall, contrary to findings based on clinical populations, weight reducing efforts often appear to be successful. Nevertheless, overweight remains a significant public health problem in this community.     

Sex difference in the association of metabolic syndrome with high sensitivity C-reactive protein in a Taiwanese population

Background  

Although sex differences have been reported for associations between components of metabolic syndrome and inflammation, the question of whether there is an effect modification by sex in the association between inflammation and metabolic syndrome has not been investigated in detail. Therefore, the aim of this study was to compare associations of high sensitivity C-creative protein (hs-CRP) with metabolic syndrome and its components between men and women.     

The impact of socioeconomic status on the incidence of metabolic syndrome in a Taiwanese health screening population

Objectives

The purpose of this study was to estimate the incidence of metabolic syndrome (MS) in a 5-year follow-up adult population in Taiwan who were examined at the Major Health Screening Center, and to assess possible socioeconomic determinants of the syndrome in this sample.

Methods

The longitudinal study included 9,389 adults, aged 35?C74?years, who visited the Major Health Screening Center from 1998?C2002, and were followed up for 5?years.

Results

The 5-year cumulative incidence of MS in this sample was 11.37%, and the weighted incidence was 12.46%; 14.95% for men and 9.89% for women, respectively. After adjustment for behavioral and habits, family history, gender and age, education level was associated with the incidence of MS. With middle school and lower as a baseline, the incidence of MS for high school, junior college, and college and above was OR 0.80, 95% CI 0.64?C1.00; OR 0.80, 95% CI 0.62?C1.03 and OR 0.65, 95% CI 0.50?C0.83, respectively.

Conclusions

The standardized cumulative incidence of MS was 12.46%. Lower education level was an important socioeconomic determinant of MS in women.     

Metabolic Syndrome Is Associated with Cataract in a Large Taiwanese Population Study

Cataract is the leading cause of blindness worldwide, and metabolic syndrome (MetS) is a known risk factor. In this study, we investigated the association between the risk of cataract with MetS and its components in a large-scale study. Data were derived from the Taiwan Biobank, and 121,380 individuals were included. The NCEP-ATP III criteria modified for use in an Asian population were used to define MetS and its components. The occurrence of cataract was identified through a standardized interview and self-reported questionnaire. Multivariable analysis showed that MetS (OR, 1.129; 95% CI, 1.0175–1.184; p < 0.001), low high-density lipoprotein (HDL)-cholesterol (OR, 1.057; 95% CI, 1.005–1.113; p = 0.032), and hyperglycemia (OR, 1.162; 95% CI, 1.108–1.218; p < 0.001) were significantly associated with cataract. Furthermore, a stepwise increase in the prevalence of cataract corresponding to the number of MetS components was found. The presence of three MetS components (vs. 0; OR, 1.103; 95% CI, 1.024–1.188; p = 0.010), four MetS components (vs. 0; OR, 1.137; 95% CI, 1.040–1.242; p = 0.005), and five MetS components (vs. 0; OR, 1.208; 95% CI, 1.059–1.378; p = 0.005) were significantly associated with cataract. In conclusion, significant associations were found between a high incidence of cataract with MetS and its components, including low HDL-cholesterolemia and hyperglycemia. Further, a stepwise increase in the prevalence of cataract corresponding to the number of MetS components was also found. The results of this study indicate that MetS may increase the development of cataract in Taiwan.     

Oral contraceptive use and blood pressure in a German metropolitan population

The relationship between blood pressure (BP) and oral contraceptive (OC) use in women has been examined with the data from the Munich Blood Pressure Study (MBS), a cross-sectional study with follow-up of a random sample of 3198 Munich citizens aged 30-69 (response rate 69.3%). Multiple linear and logistic regression analyses were run with BP as the dependent variable and age, OC use, obesity, alcohol consumption, and smoking habit as the independent variables. All second and third order interactions between the independent variables were tested during a backward stepping procedure. OC use appeared as a significant main effect in most of the analyses. The coefficient of the OC variable was about 3 in the linear regression analyses for both systolic BP and diastolic BP, indicating an increase of about 3 mmHg in the systolic and diastolic BP of the OC users. An analysis of the change in BP after one year in relation to change in OC user status has also been made. It was observed that women ceasing to use OC had a clear decrease in BP while those starting to use OC had on average an increase in BP.     

代谢综合征与女性乳腺癌发病风险的前瞻性队列研究

目的研究代谢综合征(MS)与女性乳腺癌发病风险关联。方法基于“开滦女性动态队列”,于2006年5月至2015年12月,纳入25618名开滦集团在职及离退休女性职工为研究对象,并进行随访。采用问卷调查、身体测量和实验室检测的方法收集基线社会人口学特征、身高、体重、血糖、血脂、血压及肿瘤发病结局信息。采用Cox比例风险回归模型分析MS及其组分(体重指数、血压、血糖、血脂)与女性乳腺癌发病风险的关系。结果25618名研究对象年龄为(47.65±12.02)岁,中位随访时间为8.78年;乳腺癌新发病例为235例,发病密度为113.19/10万人年。调整年龄、教育程度、经济收入、吸烟状态、饮酒状态等因素后,与体重指数正常者相比,超重或肥胖者的乳腺癌发病风险较高,HR(95%CI)值为1.47(1.12~1.93);与无MS异常组分相比,具有2个MS异常组分的女性乳腺癌发病风险增加(HR=1.70,95%CI:1.16~2.50);随着MS异常组分个数的增加,乳腺癌发病风险逐渐增加(P趋势<0.05)。结论超重/肥胖、MS异常组分的个数均可增加女性乳腺癌发病风险。     

Management of adult infectious encephalitis in metropolitan France

Infectious encephalitis is a severe disease leading to a high mortality and morbidity. The most frequent causes include Herpes simplex virus, Varicella Zoster virus, Listeria monocytogenes, and Mycobacterium tuberculosis. Urgent treatment is required (anti-infective therapy and nonspecific supportive care). The aim of this study was to define treatment strategy, empirical and after microbiological documentation at 48 hours, through a systematic literature review.     

Insomnia: prevalence and its impact on excessive daytime sleepiness and psychological well-being in the adult Taiwanese population

Objectives  This study examined the national age- and sex-specific prevalence rates of insomnia and excessive daytime sleepiness (EDS), the associations of insomnia symptoms with daytime consequences, and the impact of insomnia on EDS and psychological well-being. Methods  Data of 36,743 men and women aged 18 years and above from the 2005 Survey of Social Development Trends—Health Security in Taiwan were analyzed. Results  Over 25% of the Taiwanese adults experienced insomnia. Difficulty initiating sleep (14.6%) was the most common type of insomnia, followed by early morning awakening (13.9%) and difficulty maintaining sleep (13.4%). The risk of EDS was three times as high for individuals with insomnia as for those without (95% confidence interval of odds ratio: 2.77–3.71). Insomnia status predicted poor psychological well-being even after controlling for sociodemographic factors and health status. Conclusions  Taiwanese adults had a high prevalence of insomnia. Insomnia contributed at least partially to an individual’s psychological well-being.     

代谢综合征--"死亡四重奏"

长期以来,很多流行病与临床研究中发现糖耐量异常、超重或肥胖、血脂紊乱和高血压等临床表现可同时发生在同一个体。1988年,Reaven提出了“X综合征”的概念[1] ,并推断其发病机制可能与胰岛素抵抗(IR)有关,故有学者称之为“IR综合征”。因为它涉及一系列心血管疾病的危险因素,NormanKaplan将其称为“死亡四重奏”。1999年,WHO对其采用了“代谢综合征”(metabolicsyndrome,MS)的名称。一、MS的定义WHO对MS的定义为[2 ] :糖调节损害或空腹血糖损伤或糖尿病,IR(由高胰岛素葡萄糖钳夹技术测定的葡萄糖利用率低于下位1/4位点)。同时包括…     

Hyperuricemia and metabolic syndrome in Taiwanese children

Metabolic fitness in childhood is of increasing concern in transitional and advanced economies as the metabolic syndrome (MS) is recognized more often in this age group. As the MS appears, so also does hyperuricemia. Studies in Taiwan have identified both indigenous and Chinese with high prevalence of hyperuricemia. Data (1227 boys and 1057 girls, aged 6-12) from the Nutrition and Health Survey in Taiwan Elementary School Children (NAHSIT Children 2001-2002) were used to appraise the association between uric acid (UA) and MS in children. Mean serum urate increases by age, ranging from 5.69 mg/dL to 7.11 mg/dL for boys and 5.61 mg/dL to 6.13 md/dL for girls. Boys have higher UA concentrations (6.07 mg/dL vs. 5.74 mg/dL) and hyperuricemia (UA > or = 7 mg/dL) rate (26.5% vs. 18.8%) than girls. Children of Mountain areas have higher rates of hyperuricemia (boys: 39.2%, girls: 30.1%). 5.56% of boys and 6.39% of girls were classified as having the MS by ATP III criteria. Serum urate was closely correlated with the MS parameters, and waist circumference (WC) in particular (r=0.387). WC alone accounted for 18% of variance of serum urate concentration. Both serum urate and hyperuricemia are significant risk factors for the MS (serum urate in mg/dL, OR: 1.54, 95% CI: 1.36-1.74; hyperuricemia, OR: 3.73, 95% CI: 2.47-5.62). Adjustment for age and region accentuate these relationships. Not only abdominal fatness, but also uric acid status, or both together may be of interest to public health workers and clinicians in regard to the transitional health problem of MS.     

Reevaluating the Diagnostic Criteria for Metabolic Syndrome in the Taiwanese Population

Objective: Metabolic syndrome (MS) represents a constellation of conditions, which, taken together, increase an individual's risk for the development of type 2 diabetes and cardiovascular disease. Numerous guidelines have been suggested; however, increasing evidence has suggested that universal recommendations are not applicable across different ethnic groups. To date, no specific screening recommendations exist for the Taiwanese population.

Materials and Methods: A total of 8913 Taiwanese (>18 years) were enrolled and evaluated for MS based on the International Diabetes Federation (IDF) criteria established for the Asian population, in an attempt to reevaluate the appropriate guidelines for diagnosing MS in the Taiwanese population.

Results: Among the risk factors assessed, hypertension (24.72%), hyperglycemia (6.86%), and elevated triglycerides (18.50%) were significantly more prevalent among men (p < 0.01). Low high-density lipoprotein was not significantly different between genders. The prevalence of MS was 24.83% (1171/4716) for men and 15.48% (650/4197) for women. When modified cutoff points for waist circumference (WC) were analyzed (≥86.0 cm for men, ≥76.0 cm for women), the prevalence of MS increased to 40.88% (1928/4716) for men and 27.88% (1170/4197) for women. Not unexpectedly, the odds ratio for developing MS increased with an increasing WC, as well as with an increasing number of risk factors for MS.

Conclusions: The suggested IDF guidelines for defining MS in the Asian population, including WC, seem appropriate for use in the Taiwanese population but need modification. Further studies are warranted to identify other anthropometric measures specific to the population that would enhance the ability to diagnose MS.     

Metabolic syndrome screening using visceral adipose tissue (VAT) from opportunistic MRI locations in a multi-ethnic population

ObjectiveTo determine if visceral adipose tissue (VAT) area measured through MRI can be used opportunistically to assess the presence of cardiometabolic risk factors and compare its performance to simpler adiposity measures.MethodsA cross-sectional analysis was carried out on a subset of 1683 participants (856 women) from the Adiposity Phenotype Study (mean age = 69.2y; range 59.9–77.4). The association of total VAT area (sum of four cross sections, L1–L2, L2–L3, L3–L4, L4–L5) and each location, as well as BMI and body fat % (per SD) with the metabolic syndrome (MetSx) or its components was evaluated through logistic regression analysis.ResultsTotal VAT can be accurately predicted using all sites evaluated (R² range = 0.82?0.96). In men, VAT did not show a superior association to MetSx compared to BMI in men. However, in women, VAT was consistently superior to BMI and body fat % in its association to MetSx, independent of ethnicity [odds ratio for BMI, body fat %and total VAT area = 2.25 (95% CI: 1.93–2.62); 1.66 (95% CI: 1.36–2.03); 6.20 (95% CI: 4.69–8.21) respectively in all women]. Ethnic-specific odds ratios to MetSx in women ranged from 5.38 to 8.63 for total VAT area and 2.12–4.08 for BMI.ConclusionTotal VAT area can be accurately predicted from individual VAT regions in men and women and offers superior association to BMI for MetSx in women but not in men for five ethnicities. Therefore, opportunistic screening for elevated VAT area in women may be warranted across multiple ethnic groups.