Research progress of 24-hour movement behaviors in chronic non-communicable disease

Chronic non-communicable diseases(NCDs)represent a significant impediment to improve life expectancy and remain a focal point in global public health and disease prevention efforts.24-hour movement behaviors,which include sleep,sedentary behavior(SED),and physical activity,underscore the inherent connections between different daily activities and the comprehensive impact of overall movement patterns on health.Evidence suggested that modifying patterns of 24-hour movement behaviors can aid in preventing and attenuating the progression of NCDs.This study systematically delineated the concept,evolution,analytical methods,and intrinsic associations of 24-hour movement behaviors,emphasizing their pivotal role in the prevention and management of NCDs such as obesity,mental disorders,cardiovascular diseases,diabetes,and renal diseases.Future research endeavors should focus on refining methodologies,broadening study populations,developing research tools,and exploring precise intervention strategies and interdisciplinary approaches to comprehensively enhance the effectiveness of NCDs prevention and management from a temporal perspective.Such efforts are poised to provide substantive guidance and support for public health practices.

Surveillance Report of the Prevalence and Risk Factors of Chronic Non-Communicable Diseases in Tinghu District,Yancheng City,2021

Objective:To comprehensively understand the changes and prevalence of major chronic diseases among residents of Tinghu District,Yancheng City,in 2021,and to analyze the trends of the major risk factors for the onset of chronic diseases in the region.Methods:Chronic diseases and their risk factors in Tinghu District in 2021 were monitored among the resident population who had lived in the district for five years or more and were aged 18 years or older.The survey was conducted using random cluster sampling,with 7,130 questionnaires collected.After data processing,7,012 valid questionnaires were obtained,resulting in a qualification rate of 98.35%.Results:Among the chronic diseases reported in the survey population,hypertension had the highest prevalence at 37.61%,followed by dyslipidemia at 37.19%.Other chronic diseases were ranked in order of prevalence from highest to lowest.Regardless of gender,the top three chronic diseases were hypertension,diabetes,and hyperlipidemia.Multifactorial regression analysis identified both non-preventable risk factors(such as family history,gender,and age)and preventable risk factors(such as smoking,sedentary behavior,overweight,and obesity)as significant contributors to the major chronic diseases in Tinghu District.Conclusion:Analyzing the trends in the main risk factors for chronic disease incidence in Tinghu District,Yancheng City,provides a basis for developing a new comprehensive chronic disease prevention and control plan to address chronic disease prevention and management.

Prevalence of Risk Factors for Chronic Non-Communicable Diseases to the National Teaching Hospital “HKM” of Cotonou

Background: In 2008 Non-communicable diseases (NCDs) were responsible for 63% of deaths worldwide and 80% of these deaths occurred in developing countries. Four of them were responsible for more than 80% of mortality from NCDs, which were cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. They shared the same risk factors. Objective: To determine the prevalence of NCD risk factors in patients admitted to consult in the outpatient unit of the National Teaching Hospital of Cotonou. Patients and Methods: This was a transversal, descriptive and analytical study which took place from 15 June 2011 to 16 September 2011. It focused on 1000 subjects found after a recruitment of all patients coming to consult during the study period. The collection technique was a questionnaire followed by physical measures (weight, height, blood pressure and waist) and biological measures (fasting glucose and cholesterol). The data were analyzed with the software Epi-3.3.2 info. Results: The mainly prevalent behavioural risk factors were smoking (10.2%), alcohol consumption (60.3%), insufficient intake of fruits and vegetables (84.2%), and physical inactivity (57.6%). The prevalent physical risk factors were hypertension (47.4%), obesity (27.5%), and overweight (35.3%). The prevalent biological risk factors were diabetes (28.5%), and hypercholesterolemia (10.4%). The level of cardiovascular risk was higher than 40% in 81 people (8.1%). Conclusion: This study shows the importance of risk factors for NCDs in outpatient Unit in the National Teaching Hospital of Cotonou.

Opportunity and challenge of big data in improving chronic non-communicable diseases： by health system engineering approaches

Chronic non-communicable diseases （NCDs） is a sick- state in the complex system of human body. Healthsystems engineering approach can be used to recover health state by many different ways of system adjustments, including physical exercises, nutrition and psychological intervention, and drug therapies. To evaluate and assess the effects of these adjustments, many parameters of the system states have to be monitored （such as molecular high- throughput technologies, physiological, image, etc.）, and estimated at the different levels （such as molecular, cellular, tissue, organ, and system levels） and on the different dimensions （such as metabolic, immune, neural, etc.） for human system. Huge data have been produced during the whole process, and health systems engineering approach will model health and sick state in the human system by detecting and analyzing these multi-dimension and multi- level big-data in order to find personal suitable adjustment method.

Associated Risk Factors of Non-Communicable Disease in Three Sites across Ivory Coast: An Urban (Cocody), Peri-Urban (Abobo) and Rural (Yocoboué) Area

Introduction: The prevalence of Non-communicable diseases (NCDs) has increased so it’s becoming a global public health problem. This problem is also threatening in Sub-Sahara Africa (SSA) country including Ivory Coast. Ivory Coast is a country of 22.6 million people experiencing rapid economic development and social change. All development is typically associated with an increase in non-communicable disease (NCD) risk factors. Our study aimed to determine the prevalence and associated factors of the major risk factors of NCDs among the population of Cocody, Abobo and Yocoboué in the Ivory Coast. Methods: A descriptive and analytical cross-sectional study was conducted and involved 1146 adults of 19 to 60 years from general population in Cocody (urban), Abob (peri-urban) and Yocoboué (rural). The WHO STEPS risk factor survey has been changed a bit and was administered. it contains anthropometric and biochemical measures. Results: The prevalence of NCD risk factors was markedly different across the three sites particularly between urban (Cocody) and rural (Yocoboué) areas. The overall prevalence estimates of the risk factors were 15.2% for current smoking, 57.71% for harmful use of alcohol, 58.84% for low physical activity, 24.71% for sedentariness (sitting at least 7 h), 69.45% for skipping breakfast, 61% for having late dinner and 36% for snacking. Concerning biological risk factor we noticed 40.95% for Overweight/obesity, 52.96% for abdominal obesity, 14.61% for raised blood pressure, 23.37% for raised blood sugar and 18.51 low HDL-C. Being female has an important associated with an increased risk for having abdominal obesity (OR: 25.7) and being overweight or obese (OR: 11.3), suffering from hypertension increased with age, 30 - 39 years (OR 8.45), 40 - 49 years (OR 13.4) and 50 years and above (OR 24.6). Conclusion: Adult residents in the two (Urban and peri-urban) of three different areas are developing high-risk NCDs, particularly Cocody’s population. At the end, we observed among participants that the female gender, living in urban areas and clustering are the most concerned by non-communicable disease risk factors. To reach the goal, preventive and therapeutic interventions are needed among the targeted population.

Targeting mitochondrial phenotypes for non-communicable diseases

The concept that ＂Exercise is Medicine＂ has been challenged by the rising prevalence of non-communicable chronic diseases （NCDs）. This is partly due to the fact that the underlying mechanisms of how exercise influences energy homeostasis and counteracts high-fat diets and physical inactivity is complex and remains relatively poorly understood on a molecular level. In addition to genetic polymorphisms in humans that lead to gross variations in responsiveness to exercise, adaptation in mitochondrial networks is central to physical activity, inactivity, and diet. To harness the benefits of exercise for NCDs, much work still needs to be done to improve health effectively on a societal level such as developing personalized exercise interventions aided by advances in high-throughput genomics, proteomics, and metabolomics. We propose that understanding the mitochondrial phenotype according to the molecular information of genotypes, lifestyles, and exercise responsiveness in individuals will optimize exercise effects for prevention of NCDs.

Potential of Sestrin2 in the prevention and treatment of chronic diseases

The prevalence and lethality of chronic non-communicable diseases are constantly rising,becoming a global public health problem.The occurrence and development of chronic diseases are closely related to the generation of excessive free radicals and active oxygen in the body,and anti-oxidation will become an effective treatment.Sestrin2 protein,as a new stress protein found in mammals in recent years,has unique advantages in antioxidants,and is expected to become an effective biomarker and therapeutic target for chronic diseases.The following is a review of the regulatory role and mechanism of sestrin2 in chronic diseases in order to provide a reference for the research of other scholars.

Community-based intervention of chronic disease management program in rural areas of Indonesia

Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.

Life’s Essential 8 and risk of non-communicable chronic diseases:Outcome-wide analyses

Background:Life’s Simple 7,the former construct of cardiovascular health(CVH)has been used to evaluate adverse non-communicable chronic diseases(NCDs).However,some flaws have been recognized in recent years and Life’s Essential 8 has been established.In this study,we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions(PAFs)of low-moderate CVH scores in the 44 NCDs.Methods:In the UK Biobank,170,726 participants free of 44 common NCDs at baseline were included.The Life’s Essential 8 composite measure consists of four health behaviours(diet,physical activity,nicotine exposure,and sleep)and four health factors(body mass index,non-high density lipoprotein cholesterol,blood glucose,and blood pressure),and the maximum CVH score was 100 points.CVH score was categorized into low,moderate,and high groups.Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition(ICD-10)code using linkage to national health records until 2022.Cox proportional hazard models were used in this study.The hazard ratios(HRs)and PAFs of 44 NCDs associated with CVH score were examined.Results:During the median follow-up of 10.85 years,58,889 incident NCD cases were documented.Significant linear dose-response associations were found between higher CVH score and lower risk of 25(56.8%)of 44 NCDs.Low-moderate CVH(<80 points)score accounted for the largest proportion of incident cases in diabetes(PAF:80.3%),followed by gout(59.6%),sleep disorder(55.6%),chronic liver disease(45.9%),chronic kidney disease(40.9%),ischemic heart disease(40.8%),chronic obstructive pulmonary disease(40.0%),endometrium cancer(35.8%),lung cancer(34.0%),and heart failure(34.0%)as the top 10.Among the eight modifiable factors,overweight/obesity explained the largest number of cases of incident NCDs in endocrine,nutritional,and metabolic diseases(35.4%),digestive system disorders(21.4%),mental and behavioral disorders(12.6%),and cancer(10.3%);however,the PAF of ideal sleep duration ranked first in nervous system(27.5%)and neuropsychiatric disorders(9.9%).Conclusions:Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs.Among CVH metrics,avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases,NCDs in digestive system,mental and behavioral disorders,and cancer.

Klotho in cardiovascular disease:Current and future perspectives

Protein Klotho,beyond its role as a regulator of the phosphatemia,is also involved in the maintaining of the cardiovascular health,being associated its alterations with the development of cardiovascular damage and increased morbi-mortality. For all this,nowadays Klotho is the subject of a thorough research which is focused on uncover its intimate mechanisms of action,and in analyzing the utility of its modulation as a potential strategy with clinical applicability. Molecular mechanisms of Klotho are not well understood but an emerging research area links Klotho deficiency with vascular pathology. Changes in this protein have been associated with cardiovascular-related complications like inflammation,vascular calcification,and endothelial dysfunction. All this is particularly relevant if considering the recent discovery of Klotho expression in vascular tissue.

Satisfaction about Patient-centeredness and Healthcare System among Patients with Chronic Multimorbidity

The aim of the present study was to measure the prevalence of multimorbidity in Bangladesh,India and China,and to assess the relationship between multimorbidity and patient's opinion regarding their involvement in healthcare decision-making and overall satisfaction of healthcare system.Cross-sectional data on 18696 men and women aged 18 and above were collected from the World Health Survey of World Health Organization(WHO).Outcome variables were subjective rating of(1)healthcare system's ability to involve patients in decision-making,and(2)satisfaction with the way healthcare system runs in the country.Self-reported chronic conditions were used to measure the prevalence of multimorbidity.Out of 9 chronic conditions,back pain,arthritis,and chronic cough appeared to be the most prevalent ones among majority of the participants.About one-third of the participants in China(30.7%)and two-thirds in Bangladesh(66.1%)and India(66.6%)reported having at least one chronic illness.Prevalence of multimorbidity was highest in India(34.3%)followed by Bangladesh(28.8%)and China(14.3%).In Bangladesh,India and China,respectively 70.5%,41.7%,61.3%women and 54.5%,42.8%and 58.8%men expressed dissatisfaction regarding the way healthcare system runs in their country.In Bangladesh and India,men who were living with multimorbidity were more likely to rate the patient-centeredness as"bad"than those who had no disease illness.This study suggests that the prevalence of multimorbidity was remarkably high especially in Bangladesh and India.Higher likelihood of dissatisfaction about healthcare system among multimorbid patients might be indicative of inadequacy in the provision of care in qualitative and quantitative terms.

光学相干断层扫描血管成像在慢性肾脏病中的研究进展

肾小球与视网膜脉络膜微血管在发育及结构的相似性为通过观察视网膜血管来无创性研究肾脏微循环提供了机会,近些年来,光学相干断层扫描血管成像(OCTA)这一项眼底血管成像技术在慢性肾脏病(CKD)中的研究开展较多,并且取得了大量研究成果,现就OCTA在CKD研究中所观察到视网膜脉络膜微血管及神经参数等方面的特征性变化进行综述,以期对预测CKD的病程和预后提供新思路,对CKD病人进行及早干预和病情随访提供更多的帮助。

布地奈德联合盐酸氨溴索雾化吸入治疗慢性阻塞性肺疾病急性加重期的临床效果分析

目的探究慢性阻塞性肺疾病(简称慢阻肺)急性加重期患者采取布地奈德联合盐酸氨溴索雾化治疗的临床疗效。方法便利选取2023年3月—2024年3月涟水县中医院收治的慢阻肺急性加重期患者64例为研究对象,以随机数表法分成两组,各32例。对照组给予布地奈德雾化吸入,观察组在对照组基础上结合盐酸氨溴索雾化吸入。对比两组临床效果、肺功能、炎症因子与不良反应。结果观察组临床总有效率(96.88%)高于对照组(81.25%),差异有统计学意义(χ^(2)=4.010,P<0.05)。治疗后,两组肺功能指标水平显著升高,且观察组高于对照组,差异有统计学意义(P均<0.05);两组炎症因子水平显著降低,且观察组低于对照组,差异有统计学意义(P均<0.05)。观察组与对照组不良反应总发生率对比,差异无统计学意义(P>0.05)。结论布地奈德与盐酸氨溴索雾化联合治疗慢阻肺急性加重期的效果可靠,能改善肺功能,减轻炎性反应,且安全性高。

基于N端脑利钠肽前体、D-二聚体及降钙素原和临床病例资料构建AECOPD预后模型

目的:探究重症慢性阻塞性肺疾病急性加重期(AECOPD)患者血清中N端脑利钠肽前体(NT-proBNP)、D-二聚体(D-D)、降钙素原(PCT)的水平以及三者联合评估患者出院1年内预后的预测价值。方法:回顾性分析2018年1月—2022年10月于我院接受住院治疗的AECOPD患者124例的临床资料,患者分为存活组(99例)和死亡组(25例)。多因素Logistic回归模型分析患者出院1年内死亡的独立危险因素。受试者工作特征(ROC)曲线分析三者联合检测评估患者出院1年内预后的预测价值。结果:多因素Logistic回归分析显示,上1年急性加重≥2次、改良版英国医学研究委员会呼吸问卷(mMRC)>2级、铜绿假单胞菌、无长期家庭氧疗(LTOT)、NT-proBNP>1.1g/L、D-D>2.4 mg/L、PCT>0.09g/L以及右心室增大,均为AECOPD患者出院后1年内死亡的独立危险因素(P<0.05)。三者联合预测时曲线下面积(AUC)为0.830(95%CI:0.801~0.859,P<0.001),灵敏度为95.15%,特异度为74.28%,表明联合预测价值较高。风险评分模型将患者分为低(≤77分)、中(>77分且≤89分)、高风险(>89分)3组人群。模型评价提示风险评分模型准确度高。结论:上1年急性加重≥2次、mMRC>2级、铜绿假单胞菌、无LTOT、NT-proBNP>1.1 g/L、D-D>2.4mg/L、PCT>0.09g/L以及右心室增大,均为AECOPD患者出院后1年内死亡的独立危险因素。NT-proBNP、D-D及PCT三者联合检测AECOPD患者出院后1年内预后情况具有的较高预测价值,为临床评估病情和判定预后提供参考。

慢性阻塞性肺疾病患者血浆IL-12的变化及吸入糖皮质激素对其的影响

目的:探讨慢性阻塞性肺疾病(COPD)患者血浆白细胞介素-12(IL-12)的变化和雾化吸入糖皮质激素治疗对其的影响。方法:采用ELISA法分别检测114例COPD患者不同分期、分度及糖皮质激素治疗后血浆IL-12的浓度,以30例健康正常人血浆IL-12的浓度为对照。结果:COPD患者血浆IL-12的浓度显著低于健康对照组(P<0.05),且急性加重期显著低于稳定期(P<0.05)。在68例急性加重期COPD患者中,轻、中、重度、极重度患者其血浆IL-12浓度相互间比较,差异均有统计学意义(P<0.05)。各30例COPD急性加重期和稳定期患者,经吸入舒利迭干粉激素治疗1个月后,血浆IL-12浓度均较治疗前明显升高(P<0.05)。结论:IL-12参与COPD的病理生理过程,并可作为判断COPD患者病变严重程度和疗效观察的指标。

COPD患者D-二聚体和纤维蛋白原检测的临床价值

目的探讨COPD患者血浆D-二聚体和纤维蛋白原检测的临床意义。方法分别检测122例按病情严重程度分期、分度的COPD患者和30例健康对照组血浆D-二聚体和纤维蛋白原含量,分析比较各组间血浆D-二聚体和纤维蛋白原含量的差异。结果 COPD患者血浆D-二聚体和纤维蛋白原含量明显高于健康对照组(P<0.05),且急性加重期明显高于稳定期(P<0.05)。在75例急性加重期COPD患者中,轻、中、重、极重度患者其血浆D-二聚体和纤维蛋白原含量间相互比较(P<0.05)。结论 COPD患者存在血液高凝状态,且随着病情的加重而加重,对其监测和预防性使用抗凝、溶栓剂是非常必要的。

穴位埋线对COPD稳定期患者免疫功能及生活质量的影响

目的:探讨穴位埋线改善慢性阻塞性肺疾病稳定期患者临床症状及对免疫功能的影响。方法:40例COPD稳定期患者随机分为对照组、治疗组,两组均接受常规西医治疗,治疗组在西医治疗的基础上加用穴位埋线治疗,两组疗程均为2个月。比较两组治疗前后中医证候积分及检测反应机体免疫功能的T淋巴细胞亚群指标。结果:治疗组治疗后中医证候咳嗽、胸闷症状积分均低于对照组,差异有统计学意义(P<0.05);治疗组治疗后CD3、CD4、CD4/CD8上升、CD8减低,免疫指标较治疗前改善,治疗前后比较差异显著(P<0.05),与对照组治疗后比较,差异亦有统计学意义(P<0.05)。结论:穴位埋线治疗能改善咳嗽、咳痰、胸闷等症状,提高生活质量,并能提高机体免疫功能。

运动、体力活动与慢性疾病预防

体力活动不足和静坐少动的生活方式成为当今慢性疾病发生的第一独立危险因素。为了进一步认识运动、体力活动对慢性非传染性疾病的作用,对近年的相关文献进行综述与分析。结果表明,适当的体力活动和运动不仅能有效地预防慢性非传染性疾病,并且在延缓疾病进程、治疗疾病、减少疾病并发症和降低疾病死亡率方面也有重要作用。美国、英国、加拿大、中国等多个国家推出了"体力活动指南",近10年来中国体育科研中加强了运动与慢性疾病的相关研究,有效地促进了科学健身发展。每周150-300分钟中等至较大强度的有氧运动,2-3次力量练习及适当的柔韧性练习是预防慢性非传染性疾病的有效运动量。

益气活血纳肾方对慢性阻塞性肺病稳定期患者BODE指数的影响

目的探讨益气活血纳肾法改善慢性阻塞性肺疾病稳定期患者BODE指数的影响,从而判断益气活血纳肾法对慢性阻塞性肺疾病患者预后作用。方法 40例COPD稳定期患者随机分为对照组、治疗组,两组均接受常规西医治疗,治疗组在西医治疗的基础上加服益气活血纳肾方,治疗3疗程后比较两组治疗前后BODE综合指数、MMRC、BMI、FEV1占预计值百分比、6 min步行距离。结果治疗组治疗后BODE综合指数、MMRC、FEV1占预计值百分比、6 min步行距离评分治疗前后比较差异有统计学意义(P<0.05),与对照组治疗后比较,差异亦有统计学意义(P<0.05),但对体重指数改善不明显。结论益气活血纳肾方能改善COPD稳定期患者临床证候和预后,起到既病防变的作用。

加味定喘汤联合补肺汤治疗慢性阻塞性肺疾病急性加重期疗效观察

目的观察加味定喘汤联合补肺汤对慢性阻塞性肺疾病急性加重期患者的临床疗效。方法将120例慢性阻塞性肺疾病加重期患者随机分为治疗组和对照组。对照组60例常规给予吸氧、解痉平喘、抗感染等治疗。治疗组60例在对照组治疗的基础上给予加味定喘汤联合补肺汤治疗,两组疗程均为2周。疗程结束后检测两组肺功能变化、血气分析、临床症状、中医证候积分、生存质量评分。结果 2周后治疗组患者肺功能、血气分析、临床症状、中医证候积分、生存质量评分均较治疗前显著改善(均P<0.05),治疗组与对照组比较差异有统计学意义(P<0.05)。结论加味定喘汤联合补肺汤能改善慢性阻塞性肺疾病患者肺功能,提高血氧饱和度,控制临床症状,有效提高患者生存质量,缓解复发率。