Predictive Values of Body Mass Index and Waist Circumference for Risk Factors of Certain Related Diseases in Chinese Adults - Study on Optimal Cut-off Points of Body Mass Index and Waist Circumference in Chinese Adults

Objective For prevention of obesity in Chinese population, it is necessary to definethe optimal range of healthy weight and the appropriate cut-off points of BMI and waistcircumference for Chinese adults. The Working Group on Obesity in China under the supportof International Life Sciences Institute Focal Point in China organized a meta-analysis on therelation between BMI, waist circumference and risk factors of related chronic diseases (e. g.,high diabetes, diabetes mellitus, and lipoprotein disorders). Methods 13 population studiesin all met the criteria for enrollment, with data of 239 972 adults (20-70 year) surveyed inthe 1990s. Data on waist circumference was available for 111411 persons and data on serumlipids and glucose were available for more than 80 000. The study populations located in21provinces, municipalities and autonomous regions in China's Mainland as well as inTaiwan. Each enrolled study provided data according to a common protocol and uniformformat. The Center for data management in Department of Epidemiology, Fu Wai Hospitalwas responsible for statistical analysis. Results and conclusion The prevalence ofhypertension, diabetes, dyslipidemia and clustering of risk factors all increased withincreasing levels of BMI or waist circumference. BMI at 24 with best sensitivity andspecificity for identification of the risk factors, was recommended as the cut-off point foroverweight, BMI at 28 which may identify the risk factors with specificity around 90 % wasrecommended as the cut-off point for obesity. Waist circumference beyond 85 cm for menand beyond 80 cm for women were recommended as the cut-off points for central obesity.Analysis of population attributable risk percent illustrated that reducing BMI to normalrange (<24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons(BMI≥28)with drugs could prevent 15%-17% clustering of risk factors. The waistcircumference controlled under 85 cm for men and under 80 cm for women, could prevent47%-58% clustering of risk factors. According to these, a classification of overweight andobesity for Chinese adults is recommended.

Blood Lipid Profile and Prevalence of Dyslipidemia in Chinese Adults

To investigate the plasma lipid levels in a national representative sample of subjects and to determine the prevalence of dyslipidemia in the Chinese population. Methods Plasma lipid profile was analyzed using the data obtained during the Chinese national nutrition and health survey （CNHS） in 2002 which involved 14 252 participants at the age of 18 years or older. Results The mean levels of total cholesterol （TC）, triglyceride （TG） and high density lipoprotein cholesterol （HDL-C） in the participants were 3.81 retool/L, 1.10 mmol/L, and 1.30 mmol/L, respectively. In the groups of participants at the age of 18-44 years, 45-59 years, and over 60 years the mean TC level was 3.70 mmol/L, 4.09 mmol/L and 4.21 mmol/L, respectively, and the mean TG level was 07 mmol/L, 1.21 mmol/L, 1.20 mmol/L, 1.29 mmol/L, 1.33 mmol/L, and 1.33 mmol/L, respectively. The prevalence of dyslipidemia in Chinese adults was 18.6% and 22.2% in males and 15.9% in females. Dyslipidemia prevalence was higher in urban districts than in rural areas （21.0% vs. 17.7%）. The prevalence of hypercholesterolemia, hypertriglyceridemia, and low HDL cholesterol was 2.9%, 11.9%, and 7.4% respectively among the participants. Conclusion Dyslipidemia has become one of the important health risk factors in the Chinese population. There is no significantly difference in the prevalence of dyslipidemia between the groups of participants at the age of 45-59 years and over 60 years. This study provides important lipid profile data for policy making and guideline development for the prevention of dyslipidemia in the Chinese population.

Smoking and Its Relation to Metabolic Status among Chinese Adults： Analysis of a Nationwide Survey

Objective To update the estimated prevalence rates of smoking and examine major metabolic diseases associated with smoking status in Chinese adults. Methods Using a complex, multistage, probability sampling design, we recruited a nationally representative sample of 98,658 Chinese adults aged ≥18 years in 2010. Information on current, former, never, and passive smoking status was obtained using a standard questionnaire. All estimates were weighted to represent the overall Chinese adult population. Results The estimated proportion of current smokers was 28.3% for Chinese adults aged _〉18 years. The corresponding values of former and passive smokers were 5.1% and 21.4%, respectively. Additionally, former smokers were found to have a less favorable metabolic risk profile among all categories of smoking status in both men and women. The prevalence of metabolic diseases such as diabetes and hypertension also increased with a greater number of smoking pack-years in men. Conclusion The prevalences of current smoking and passive smoking remain high in Chinese adults.

New formula for predicting standard liver volume in Chinese adults

AIM To obtain a reference range of morphological indices and establish a formula to accurately predict standard liver volume(SLV) in Chinese adults.METHODS Computed tomography(CT)-estimated total liver volume(CTLV) was determined in 369 Chinese adults. Age,sex,body weight,body height,body mass index,and body surface area(BSA) were recorded using CT. Total splenic volume,portal venous diameter(PVD),splenic venous diameter(SVD),and portal venous cross-sectional area(PVCSA) were also measured by CT. Stepwise multiple linear regression analysis was performed to evaluate the impact of each parameter on CTLV and to develop a new SLV formula. The accuracy of the new formula was compared with the existing formulas in a validation group.RESULTS The average CTLV was 1205.41 ± 257.53 cm3(range,593.80-2250.10 cm3). The average of PVD,SVD and PVCSA was 9.34 ± 1.51 mm,7.40 ± 1.31 mm and 173.22 ± 48.11 mm2,respectively. The CT-estimated splenic volume of healthy adults varied markedly(range,46.60-2892.30 cm3). Sex,age,body height,body weight,body mass index,and BSA were significantly correlated with CTLV. BSA showed the strongest correlation(r = 0.546,P < 0.001),and was used to establish a new model for calculating SLV: SLV(cm3) = 758.259 × BSA(m2)-124.272(R2 = 0.299,P < 0.001). This formula also predicted CTLV more accurately than the existing formulas,but overestimated CTLV in elderly subjects > 70 years of age,and underestimated liver volume when CTLV was > 1800 cm3.CONCLUSION Our new BSA-based formula is more accurate than other formulas in estimating SLV in Chinese adults.

Dietary Patterns Associated Metabolic Syndrome in Chinese Adults

Dietary pattern has been revealed to be associated with metabolic syndrome. However, the association was not well documented in Chinese due to the complexity of Chinese foods. We mainly assessed the dietary patterns and examined their effects on metabolic syndrome among Chinese adults. Four dietary patterns including ＇Refined Grains ＆ Vegetables＂ Pattern, ＇Dairy ＆ Eggs＇ Pattern, ＇Organ Meat ＆ Poultry＇ Pattern, and ＇Coarse Grains ＆ Beans＇ Pattern were extracted. ＇Dairy ＆ Eggs＇ Pattern was associated with a decreased odds of metabolic syndrome in women, and ＇Coarse Grains ＆ Beans＇ Pattern was associated with a decreased odds of hypertension in men. These results provided a scientific basis for future research and dietarv euideline Perfection.

Association of Metabolic Syndrome with Inflammation in Chinese Adults with Different Kidney Function

Chronic kidney disease （CKD） has become a worldwide public health problem, and currently, it affects approximately 10% of adults in the United States[I]. Meanwhile, it also has emerged as an important social challenge in China[2]. CKD has been reported to be a major risk factor for cardiovascular diseases, premature death, and end-stage renal diseaseTM. Thus, it is necessary to determine the risk factors for CKD.

Calcium requirements for Chinese adults by cross-sectional statistical analyses of calcium balance studies： an individual participant data and aggregate data meta-regression

Background Chinese dietary reference intakes for calcium are largely based on foreign studies. We undertook meta- regression to estimate calcium requirements for Chinese adults derived from calcium balance data in Chinese adults. Methods We searched PubMed, Cochrane CENTRAL, and SinoMed from inception to March 5, 2014, by using a structured search strategy. The bibliographies of any relevant papers and journals were also screened for potentially eligible studies. We extracted a standardized data set from studies in Chinese adults that reported calcium balance data. The relationship between calcium intake and output was examined by an individual participant data （IPD） and aggregate data （AD） meta-regression. Results We identified 11 metabolic studies in Chinese adults within 18-60 years of age. One hundred and forty-one IPD （n=35） expressed as mg/d, 127 IPD （n=32） expressed as mg.kg body wt-l-d-1, and 44 AD （n=132） expressed as mg/d were collected. The models predicted a neutral calcium balance （defined as calcium output （Y） equal to calcium intake （C）） at intakes of 460 mg/d （Y=0.60C＋183.98） and 8.27 mg.kg body wt-l.d-1 （Y=0.60C＋3.33） for IPD, or 409 mg/d （Y=0.66C＋139.00） for AD. Calcium requirements at upper intakes were higher than that at lower intakes in all these models. Conclusion Calcium requirement for Chinese adults 18-60 years of age approximately ranges between 400 mg/d and 500 mg/d when consuming traditional plant-based Chinese diets.

The associations of lens power with age, axial length and type 2 diabetes mellitus in Chinese adults aged 50 years and above

Background:To investigate the associations of lens power with age,axial length(AL),and type 2 diabetes mellitus(DM)inChineseadultsaged5oandabove.Methods:Random clustering sampling was used to identify adults aged 50 years and above in urban regions of Shanghai.The participants underwent a comprehensive ophthalmic examination including subjective refraction,autorefraction,and IOL-Master.The crystalline lens power was calculated using Bennett's formula.Results:A total of 4177 adults were included.A linear decrease in lens power was observed both with age and with AL,followed by a stop of lens power loss after the age of 70 or when AL≥25 mm,respectively.Participants with type 2 DM presented higher lens power(0.43 diopter(D),P<0.001)and thicker lens thickness(0.06 mm,P<0.001).In multivariate regression models,there was a positive correlation between lens power and type 2 DM when age<75 years(P<0.001)or AL<25 mm(P<0.001)after adjusting for other factors,while no significant association was found in participants aged≥75 years(P=0.122)or with AL≥25 mm(P=0.172).Conclusions:The lens power in adults aged 50 and above exhibited two stages with age and with AL.Type 2 DM caused an increase in lens power,which was not seen in participants aged≥75 years or with AL≥25 mm.

The associations of lens power with age,axial length and type 2 diabetes mellitus in Chinese adults aged 50 and above

Background:To investigate the associations of lens power with age,axial length(AL),and Type 2 diabetes mellitus(DM)in Chinese adults aged 50 and above.Methods:Random clustering sampling was used to identify adults aged 50 years and above in urban regions of Shanghai.The participants underwent a comprehensive ophthalmic examination including subjective refraction,autorefraction,and IOL-Master.The crystalline lens power was calculated using Bennett’s formula.Results:A total of 4177 adults were included.A linear decrease in lens power was observed both with age and with AL,followed by a stop of lens power loss after the age of 70 or when AL≥25 mm,respectively.Participants with Type 2 DM presented higher lens power(0.43 diopter(D),p<0.001)and thicker lens thickness(0.06 mm,p<0.001).In multivariate regression models,there was a positive correlation between lens power and Type 2 DM when age<75 years(p<0.001)or AL<25 mm(p<0.001)after adjusting for other factors,while no significant association was found in participants aged≥75 years(p=0.122)or with AL≥25 mm(p=0.172).Conclusions:The lens power in adults aged 50 and above exhibited two stages with age and with AL.Type 2 DM caused an increase in lens power,which was not seen in participants aged≥75 years or with AL≥25 mm.

Basal Energy Expenditure of Chinese Healthy Adults:Comparison of Measured and Predicted Values

Objective This study aimed to measure the basal energy expenditure(BEE)of Chinese healthy adults and establish an accurate predictive equation for this population.Methods In total,470 Chinese healthy adults had their BEE measured using the Cosmed K4b2 portable metabolic system.Multiple linear regression analysis was applied to develop new optimal equations for predicting BEE.The bias,accuracy rate,concordance correlation coefficient(CCC),and root mean square error(RMSE)were used to evaluate the accuracy of the predictive equations.Results There was a significant difference in BEE between males and females,with 5,954 kJ/d and 5,089 kJ/d,respectively.People living in rural areas expended significantly higher BEE(5,885 kJ/d)than those in urban areas(5,279 kJ/d).Previous equations developed by Henry,Schofield,Harris-Benedict(HB),and Liu overestimated the BEE of Chinese healthy adults.The new equations derived from the present study displayed the smallest average bias and RMSE from the measured basal energy expenditure(mBEE).The CCC of the new equations was higher than other predictive equations,but it was lower than 0.8.There was no significant difference in the accuracy rate among all predictive equations.Conclusions Sex and regional differences in BEE were observed in Chinese healthy adults.Neither the widely used previous predictive equations nor the one derived in the present study were accurate enough for estimating the BEE of Chinese healthy adults.Further study is required to develop more accurate equations for predicting the BEE of Chinese healthy adults aged between 20–45 years.

Healthcare needs and access in a sample of Chinese young adults in Vancouver, British Columbia: A qualitative analysis

Objectives: Immigrants of Chinese ethnicity and young people (between 18 and 30 years of age) are known to access health services less frequently and may be at greater risk for experiencing unmet health needs. The purpose of this study was to examine the health beliefs, health behaviors, primary care access, and perceived unmet healthcare needs of Chinese young adults.Methods: Semi-structured in-depth interviews were carried out with eight Chinese young adults in Vancouver, Canada. Results: A content analysis revealed that these Chinese young adults experienced unmet healthcare needs, did not have a primary care provider, and did not access preventive services. Cultural factors such as strong family ties, filial piety, and the practice of Traditional Chinese Medicine influenced their health behaviors and healthcare access patterns. Conclusion: Chinese young adults share similar issues with other young adults in relation to not having a primary care provider and accessing preventive care but their health beliefs and practices make their needs for care unique from other young adults.

Prediction of 10-year Atherosclerotic Cardiovascular Disease Risk among Adults Aged 40-79 Years in China:a Nationally Representative Survey

Objective To establish the distribution of 10-year atherosclerotic cardiovascular disease （ASCVD） risk among Chinese adults. Methods We estimated the 10-year ASCVD risk by applying the 2013 American College of Cardiology/ American Heart Association pooled cohort equations （PCEs） to the data obtained from the 2010 China Chronic Disease and Risk Factor Surveillance that involved 61,541 participants （representing 520,158,652 Chinese adults） aged 40-79 years. We also compared the ASCVD risk with the 10-year ischemic cardiovascular disease （ICVD） risk, which was calculated using the simplified scoring tables recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases （Chinese model）. Results Based on the PCEs, the average 10-year ASCVD risk among adults without self-reported stroke or myocardial infraction was 12.5%. Approximately 247 million （47.4%） and 107 million （20.6%） adults had 〉 7.5% and 〉 20% 10-year ASCVD risks, respectively. The 10-year ASCVD risk 〉 20% was higher among men, less educated individuals, smokers, drinkers, and physically inactive individuals than among their counterparts. Overall, 29.0% of adults categorized using the Chinese model were overclassified with the PCEs. Conclusion Our results define the distribution of 10-year ASCVD risk among Chinese adults. The 10-year ASCVD risk predicted by the PCEs was higher than the ICVD risk predicted by the Chinese model.

Association between Adiponectin and Metabolic Syndrome in Older Adults from Major Cities of China

Objective To investigate the association between adiponectin and metabolic syndrome （MetS） and related diseases in older adults from major cities of China. Methods A total of 2 049 adults at the age of 60-96 years from18 major cities of China were enrolled in the study. Plasma adiponectin and insulin concentrations were measured. Insulin resistance was assessed by homeostasis model assessment of insulin resistance （HOMA-IR）. The definitions proposed by International Diabetes Federation （IDF） and American Heart Association/National Heart, Lung, and Blood/nstitute （AHA/NLHBI） were used to identify MetS. Results The adiponectin concentration increased with the advance of age and was higher in women than in men. The sex specific adiponectin concentration was inversely correlated with body mass index （BMI）, waist circumference, diastolic blood pressure, triglycerides, glucose and fasting blood insulin, and positively correlated with HDL-C （P〈0.001）. The adiponectin concentration decreased with increasing MetS components. Compared with the 4th sex-specific adiponectin quartile, the odds ratio （OR） for prevalent MetS-IDF and MetS-AHA/NLHBI in subjects of the 1st quartile group was 3.25 （95% CI： 2.24, 4.71） and 3.21 （95% CI： 2.26, 4.55）, respectively. The association was independent of age, sex, life-style factors, medication, family history of chronic diseases, BMI, and HOMA-IR, The OR for MetS was much higher than those of MetS components and its related diseases. Conclusion Adiponectin is strongly associated with MetS independent of insulin resistance and obesity in older adults from major cities in China. The adiponectin concentration is a useful predictor for the risk of MetS.

Identification of Two Novel Mitochondrial DNA Deletions Induced by Ionizing Radiation

Abstract Objective We identify ionizing radiation-induced mitochondrial DNA （mtDNA） deletions in human lymphocytes and their distribution in normal populations. Methods Long-range polymerase chain reactions （PCR） using two pairs of primers specific for the human mitochondrial genome were used to analyze the lymphoblastoid cell line following exposure to 10 Gy 6~Co y-rays. Limited-condition PCR, cloning and sequencing techniques were applied to verify the mtDNA deletions detected with long-range PCR. Human peripheral blood samples were irradiated with 0, 2 and 6 Gy ^60Co y-rays, and real-time PCR analysis was performed to validate the mtDNA deletions. In order to know the distribution of mtDNA deletions in normal population, 222 healthy Chinese adults were also investigated. Results Two mtDNA deletions, a 7455-bp deletion （nt475-nt7929 in heavy strand） and a 9225-bp deletion （nt7714 -nt369 in heavy strand）, occurring between two 8-bp direct repeats, were identified in lymphoblastoid cells using long-range PCR, limited-condition PCR and sequencing. These results were also observed for ^60Co y-rays irradiated human peripheral blood cells. Conclusion Two novel mtDNA deletions, a 7455-bp deletion and a 9225-bp deletion, were induced by ionizing radiation. The rate of the mtDNA deletions within a normal population was related to the donors＇ age, but was independent of gender.

Evaluation of the Factorial Method for Determination of Energy Expenditure in 16 Young Adult Women Living in China

Objective The present study aimed to evaluate the accuracy of the factorial method for estimating energy needs in individuals living in China.Methods Sixteen healthy female adults aged 22.1±1.2 years with a body mass index （kg/m 2） of 20.4±1.7 were selected as subjects.In free-living conditions,energy expenditure （EE） was determined by using the factorial method.At the same time,the doubly labeled water method （DLW） was also used to measure energy expenditure of the subjects and served as the criterion method.EE predicted by the factorial method （EE factorial） was compared with the simultaneous measurement of EE by the validated DLW method （EE DLW）.Results There was excellent agreement between EE factorial （7.46±0.59 MJ/d） and EE DLW （7.64 ± 0.49 MJ/d）,with a difference of-2.6±4.9% （-0.18±0.36 MJ/d）.No significant differences were found between the two methods.EE factorial was highly correlated with EE DLW （r=0.795,P0.001） and a good agreement for individuals was found by using the Bland and Altman test.Conclusion The factorial method gives satisfactory estimates of EE for both groups and individuals living in China.

Chinese Compilation of Physical Activities in healthy adults aged 18-64:Categories and metabolic intensities

A Chinese Compilation of Physical Activities was compiled to estimate the energy costs of physical activities(PAs)using data on adults aged 18–64.Data were obtained from published articles and laboratory measurements.Databases,including PubMed,Embase,Scopus,Ebsco,Web of Science,Chinese National Knowledge Infrastructure,Wan Fang Data,National Science and Technology Report Service,Public Health Scientific Data were searched to collect data from inception to January 2022,on energy expenditure associated with PA in the healthy Chinese population.Two reviewers independently screened the literature and extracted,classified,and summarized data.Data were measured for 36 PAs using indirect calorimetry.Detailed descriptions of specific activities and metabolic equivalent values were provided by summarizing 241 physical activities in 13 categories.The first edition of the Chinese Compilation of PAs in Healthy Adults Aged 18–64(CCPA)was created.It provides valuable resources for people who regularly engage in physical exercise,researchers,educators,fitness professionals,and health or commercial sectors to quickly obtain various PA MET intensities.In the future,the energy expenditure of various PAs of different ages within the Chinese population can be measured based on the CCPA.

Acoustic characteristics of stop consonants in fluent reading Chinese Putonghua speech of adult stutterers

This study investigated whether adults who stutter and normal adult speakers differ in the production of stop consonants in fluent reading Chinese Putonghua speech.Voice onset time（VOT） was measured and the spectral moments at the stop burst were calculated for the stutterers（both before and after the speech therapy） and also for the nonstutterers. The statistical results showed that there were no significant differences in VOT between the nonstutterers and stutterers either prior to or after therapy,although the mean VOT of the stutterers was slightly greater than that of the nonstutterers.The results also indicated that both the obstruction place and the subsequent syllabic final exhibited an influence to a greater extent on VOT for the stutterers.In the spectral domain,the spectral mean of the stuttering participants before therapy was significantly different from that of the normal participants, whereas the group difference became insignificant after the therapy session.The smaller spectral mean for the stutterers might be interpreted as a more posterior occlusion in the oral cavity when producing alveolars and velars.In addition,productions of the stutterers scattered with a wider range in the space of spectral moments.Furthermore,the smaller main effect of syllabic finals on the mean spectral frequency of the burst suggested that the stutterers exhibited weaker anticipatory coarticulation than the nonstutterers.

The relationship of internal migration and depressive symptoms as well as its mechanisms:evidence from China

An increasing interest has been focused on the association of internal migration with depressive symptoms in China.However,very few of those studies investigated the possible mechanisms underlying that association.This study aims to examine the relationship between internal migration and depressive symptoms and various mechanisms behind this relationship among Chinese middle-aged and older adults.The data was drawn from the national China Health and Retirement Longitudinal Study(CHARLS)2011.The depressive symptoms were defined by the 10-item Center for Epidemiologic Studies Depression Scale(CES-D-10).Within the broader definition of internal migration,we divided migration status into multiple types based on individuals’hukou information.Structural equation models(SEMs)were adopted to examine the association between different types of migration and depressive symptoms and disaggregate the relationship between internal migration and depressive symptoms into direct and mediation pathways.After considering selection features related to migration processes,we found strong relationships between multiple types of internal migration and depressive symptoms.Compared with rural non-migrants,rural-to-urban migrants with urban hukou,urban-to-urban migrants,and urban non-migrants had fewer depressive symptoms(β=-0.75,95%CI:-1.02,-0.49;β=-1.21,95%CI:-1.68,-0.73;andβ=-0.39,95%CI:-0.49,-0.29,respectively).Post-migration experiences,such as living conditions,household income per capita and social participation,mediated the relationship between internal migration and depressive symptoms.These findings of the mechanisms underlying the link between internal migration and depressive symptoms offer evidence for developing mental health interventions for migrants during the rapid progress of urbanization in China.

The impact of social participation on older people’s death risk:an analysis from CLHLS

This study uses nested Cox proportional hazard models to analyze data from five waves(2002,2005,2008,2011,2014)of the Chinese Longitudinal Healthy Longevity Survey.We found that secular social participation and religious participation both contributed to statistically lower death risk among older respondents.These associations still held after controlling for a wide range of covariates.In particular,secular social participation predicted a greater decrease in death risk and had interactive effects with gender and age-group.Female and young-old adults enjoyed more health benefits from participating in secular social activities than their male or old-old counterparts,respectively.This interactive effect was not observed regarding the impact of religious participation on death hazard.