BMI, WC, WHtR, VFI and BFI: Which Indictor is the Most Efficient Screening Index on Type 2 Diabetes in Chinese Community Population

Objective Obesity is a major risk factor for type 2 diabetes, many indexes can be used to describes obesity and predict diabetes. This research attempts to identify the best indicator of obesity to screening diabetes in Chinese population. Methods A cross-sectional data of 8121 subjects aged 35-60 years were included in this research belongs to the Diabetes Appropriate Technology Intervention Study. Anthropometric indicators including body weight, height, waist circumferences （WC）, body fat index （BFI） and visceral fat index （VFI） and blood biochemical indicators after an overnight fast [fasting blood glucose, total cholesterol, high-density lipoprotein （HDL） cholesterol, and triacylglycerol] were measured. BMI （body mass index） and Weight to Height Ratio was calculated. Results Subjects with obesity had a higher risk of physician diagnosed diabetes （0R=2.50, 95% CI 1.83-3.43）, new diagnosed diabetes （0R=4.23, 95% Cl 2.91-6.15） and pre-diabetes （0R=1.75, 95% CI 1.31-2.34） compared to those with normal Body mass index （BMI）. There was a significant trend of increased risk of all diabetes status with increased waist circumference （WC）. The waist-to-height ratio （WHtR） yielded the most significant association with new diagnosed diabetes and physician diagnosed diabetes than other indices. Conclusion Central obesity is significantly correlated with diabetes. VFI was most correlated with pre-diabetes while WHtR is an efficient screening index than BMI and WC in Chinese community diabetes screening.

Hypertension Prevalence,Awareness,Treatment,and Control and Their Associated Socioeconomic Factors in China:A Spatial Analysis of A National Representative Survey

Objective We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China.Methods A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015–2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators.Results Overall, it was estimated that 29.20% of the participants were hypertensive nationwide,among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment,and 7.81% had controlled their condition. Per capita gross domestic product(GDP) was associated with hypertension prevalence(coefficient:-2.95, 95% CI:-5.46,-0.45) and control(coefficient: 6.35, 95% CI:1.36, 11.34) among adjacent provinces and was also associated with awareness(coefficient: 2.93, 95%CI: 1.12, 4.74) and treatment(coefficient: 2.67, 95% CI: 1.21, 4.14) in local province. Beds of internal medicine(coefficient: 2.66, 95% CI: 1.08, 4.23) was associated with control in local province. Old dependency ratio(coefficient:-3.58, 95% CI:-5.35,-1.81) was associated with treatment among adjacent provinces and with control(coefficient:-1.69, 95% CI:-2.42,-0.96) in local province.Conclusion Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.

Gender-specific Association of Sleep Duration with Body Mass Index,Waist Circumference,and Body Fat in Chinese Adults

Objective To examine the association between habitual sleep duration and obesity among Chinese adults. Methods The association of sleep duration and obesity was investigated among 7,094 community-dwelling Chinese adults. Sleep duration was self-reported. In this study, obesity was defined as follows： body mass index （BMI） ≥ 28 kg/m^2, waist circumference （WC） ≥ 85 cm in men and ≥ 80 cm in women, and percent body fat （%BF） ≥ 25 in men and ≥ 35 in women. Logistic and quantile regressions were employed to examine relationships of interest. Results Overall, 6.42% of the participants reported short sleep durations （〈 6 h/d） while 14.71% reported long （≥ 9 h/d） sleep durations. Long sleepers （≥ 9 h/d） represented a greater frequency of women with obesity [odds ratio （OR）： 1.30; 95% confidence interval （CI）, 1.02-1.67] and high body fat （1.43, 1.04-1.96） than those who slept 7-8 h/d. An association between long sleep times and higher BMI estimations was found across the 10th-75th percentile of the BMI distribution. Among men, long sleepers （≥ 9 h/d） presented lower risks of developing abdominal obesity compared with individuals who slept 7-8 h/d （OR = 0.79, 95% CI： 0.44-0.99）. Conclusion Our study suggests that long sleep durations are associated with general obesity in Chinese women but reduced waist circumferences in men. Confirmatory studies are needed to determine the heterogeneous association of sleep time and obesity by gender.

Negative Association of Domestic Activity and Active Commuting with Metabolic Syndrome in a Chinese Population Aged 35-64 Years

Objective To understand the associations of physical activity domains with metabolic syndrome among a middle-aged Chinese population. Methods In all, 3326 professional adults aged 35-64 years from Beijing and Zhejiang province were recruited with a cluster random sampling method. The Global Physical Activity Questionnaire was modified, and the recommended Asia-Pacific cut-offs of waist circumstance were introduced into the criteria for metabolic syndrome from the Adult Treatment Panel III. A binary logistic regression model was applied to examine the association of all physical activity domains with the risk of the syndrome. Results Participants who engaged in domestic activity for 〉1176 MET-min/week had a 41.6% less chance of having metabolic syndrome [odds ratio （OR）, 0.584; 95% confidence interval （CI）, 0.480-0.710] than those without this activity. In adjusted models, adults who actively commuted for 〉33 MET-rain/week but 〈52g MET-min/week had a 25% less chance of having the syndrome （OR, 0.750; 95% CI, 0.582-0.966） than those who did not. No interaction was detected between the two domains of activity and the syndrome. Conclusion This study highlighted the independently negative association of traffic and house activity with the prevalence of the syndrome in this sample with a generally low level of moderate activity.

胰腺结核合并梗阻性黄疸1例并文献复习

目的通过报道1例胰头结核误诊为恶性肿瘤的病例结合文献复习,探讨胰腺结核的临床特点、影像学表现,以提高对该病的认知和诊断水平。方法分析1例胰头结核患者的临床资料、诊断过程并结合相关文献进行检讨分析。结果该例被误诊为胰头恶性肿瘤,最终行胰十二指肠切除手术。结论胰腺结核是一种临床罕见疾病,症状及影像学表现缺乏特异性,鉴别诊断困难,对于年轻的梗阻性黄疸患者,尤其不伴有肿瘤标志物升高的孤立胰腺占位,应把胰腺结核考虑在内,完善相关实验室检查,在术前可通过穿刺活检帮助鉴别诊断;患者经过及时、正规的抗结核治疗多能获得良好的疗效。