Analysis of the Effect of Midwives’ Psychological Care Intervention on the Progress of Labor and Cesarean Rate of Elderly Women in Labor

Objective:To analyze the effect of midwife psychological nursing intervention in the clinical care of elderly women in labor.Methods:According to the order of admission,74 elderly women were divided into the control group and the observation group.In addition to the routine perinatal nursing interventions,the observation group strengthened the implementation of midwives’psychological nursing interventions.The duration of labor,mode of delivery,psychological state,and stress response indexes of the two groups were analyzed and compared.Results:The observation group had a shorter duration of all labor stages and total duration of labor than the control group,a lower cesarean section rate than the control group,and a higher degree of improvement in anxiety,depression,and stress response indexes in the 3-day postpartum period as compared to the control group(P<0.05).Conclusion:The implementation of midwife psychological care intervention in perinatal care of elderly women can further shorten the duration of labor,reduce the cesarean section rate,and improve the psychological state and stress indicators,which is worth promoting.

Metabolic Disorders Increase the Risk to Incident Cardiovascular Disease in Middle-aged and Elderly Chinese

Objective The association of metabolic syndrome （MetS） with cardiovascular diseases （CVD） has not been adequately explored in middle-aged and elderly Chinese. This study aimed to investigate MetS＇ prevalence and its impact on the CVD incidence in this specific population group. Methods A data set of a community-based prospective cohort study was analyzed. A total of 2300 subjects aged 40-94 years were followed up for the CVD events. MetS defined according to the JCDCG criteria was assessed at baseline, and the middle-aged and elderly groups were classified by the WHO definition. Results As compared with the middle-aged group, the prevalence of MetS increased by 0.6 times （34.6% vs. 21.3%） and the incidence density of CVD increased by 4.9 times in the elderly group （52.3/1000 person-year vs. 8.9/1000 person-year）. Furthermore, the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group （HR=2.23, P〈0.01） and to elevated blood glucose in the elderly group （HR=1.39, P〈O.01）. Conclusion MetS was highly prevalent in middle-aged and elderly Chinese. MetS significantly increased the risk to OdD incidence in the elderly. All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.

Public Square Dancing Intervention on Subjective Well-Being of Middle-Aged and Elderly People:A Meta-Analysis

Objective:To understand the influence of public square dancing on the subjective well-being of middle-aged and elderly people.Methods:According to the principle of Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,we search Chinese databases,such as CNKI,Wanfang Data,and VIP,and English databases,such as Proquest,Web of Science,Pubmed,Cochrane,and ScienceDirect,and collect relevant articles at home and abroad from 2006 to December 2019 for meta-analysis in January 2020.Result:A total of 10 articles were included.The meta-analysis results showed that the well-being of middle-aged and elderly people in the public square dancing intervention group was significantly higher than that of the other exercise group and control group(both P<0.01).The results of the subgroup analysis showed the following:Different durations of intervention significantly influence the intervention effect(P<0.01).No difference was found between the effect of the mixed-gender intervention and the individual female intervention(P>0.05).No significant difference was found between the groups with weekly intervention frequency(P>0.05).Conclusion:Public square dancing intervention is effective for middle-aged and elderly people’s subjective well-being.Neither mixed intervention nor the times of weekly intervention have an impact on the intervention effect.However,the length of duration of intervention influences the intervention effect.

Relationship between platelet-lymphocyte ratio and carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus

Objective:To investigate the relationship between platelet-lymphocyte ratio(PLR)and carotid atherosclerosis(CAS)in middle-aged and elderly patients with T2DM.Methods:A total of 420 middle-aged and elderly patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2018 to September 2020 and were examined by ultrasound were selected as the subjects.The carotid artery intima-media thickness(CIMT)was examined by color Doppler ultrasonography,including normal CIMT group(n=111),CIMT thickening group(n=103)and CAS plaque group(n=206).The differences of serum PLR levels among the three groups were compared.Multivariate Logistic regression was used to analyze the relationship between PLR and CAS plaque formation.The receiver operating curve(ROC)was used to evaluate the value of multivariate Logistic regression model(Logit P)in the diagnosis of CAS lesions.Results:The mean value of PLR in CAS plaque group(127.86±48.54)was significantly higher than that in CIMT normal group(109.15±48.35).Multivariate Logistic regression analysis showed that after adjusting for other confounding factors,the increase of PLR was an independent risk factor for the occurrence of CAS plaque.ROC showed that the efficacy of multivariate Logit P model in the diagnosis of CAS plaque was(AUC=0.807,95%CI=0.759-0.858).Conclusions:PLR is one of the important risk factors for the occurrence of CAS lesions.At the same time,the multivariate Logistic regression model established in this study has clinical reference value in predicting CAS lesions in middle-aged and elderly patients with T2DM.

Health and widowhood: Meanings and experience of elderly women in Chile

Aging and widowhood signal a real and symbolic landmark of change toward new vital experiences of elderly people. In the aging experience of women, there are three social age markers that participate directly in the construction of their identity as women during old age: menopause, work and widowhood. The present paper reports the results of a research on widowhood in old age and the experience of aging in elderly women in Chile. Through a qualitative methodological strategy, in depth biographic interviews were held with elderly people who were widowed after reaching 60 years of age, centering the analysis on its meanings on the body, health and death in old age, highlighting sociocultural aspects of the aging and widowing processes. Approaching widowhood in old age shows us not only a person who has lost a husband, but also what it means to be an elderly woman in a life experience continuum that also brings about key changes to understand the aging process of people, because marital relations can get to be determining factors for the construction of the identity of women and their experience of the aging process.

The Moderating Effect of Health on the Relationship between Involvement in Housework of Parents’ and Parents-in-Law’s Families and Happiness of Middle-Aged Women in Taiwan

Background: This study aims to investigate the moderating effect of family health status on the relationship between involvement in housework of two-side parents’ families and happiness of middle-aged women in Taiwan. Methods: The data used in this study were gathered from the Ministry of Science and Technology’s program—“Intergenerational expectation and collaboration: an inquiry on a new mechanism of continued tradition across generations”. The subjects (n = 512) were restricted to aged 45 - 64 years old who live with spouses and have children, and one of whose parent or parent-in-law is still alive. Multiple regression analysis was used to investigate how family health status moderates the relationship between involvement in housework of parents’ families and parents-in-law’s families and the happiness of middle-aged women. Results: 1) Family health status is positively correlated with their happiness. 2) The parents’ health status can moderate the relationship between involvement in housework of parents’ families and happiness of the middle-aged women. 3) The middle-aged women’s health status can moderate the relationship between involvement in housework of parents-in-law’s families and those women’s happiness, and fathers-in-law’s health status can moderate the relationship between husbands’ involvement in housework of the women’s parents-in-law’s families and women’s happiness. Conclusions: In future, when policies and programs related to the well-being of middle-aged women are being planned, the effect of women’s health and family health status shall be considered as a key to improve those women’s quality of life.

Associations of short-term ambient temperature exposure with lung function in middle-aged and elderly people:A longitudinal study in China

The short-term associations of ambient temperature exposure with lung function in middle-aged and elderly Chinese remain obscure.The study included 19,128 participants from the Dongfeng-Tongji cohort's first(2013)and second(2018)follow-ups.The lung function for each subject was determined between April and December 2013 and re-assessed in 2018,with three parameters(forced vital capacity[FVC],forced expiratory volume in 1 s[FEV1],and peak expiratory flow[PEF])selected.The China Meteorological Data Sharing Service Center provided temperature data during the study period.In the two follow-ups,a total of 25,511 records(average age:first,64.57;second,65.80)were evaluated,including 10,604 males(41.57%).The inversely J-shaped associations between moving average temperatures(lag01–lag07)and FVC,FEV1,and PEF were observed,and the optimum temperatures at lag04 were 16.5C,18.7C,and 16.2C,respectively.At lag04,every 1C increase in temperature was associated with 14.07 mL,9.78 mL,and 62.72 mL/s increase in FVC,FEV1,and PEF in the lowtemperature zone(<the optimum temperatures),whereas 5.72 mL,2.01 mL,and 11.64 mL/s decrease in the high-temperature zone(the optimum temperatures),respectively(all P<0.05).We observed significant effect modifications of gender,age,body mass index,body surface area,smoking status,drinking status,and physical activity on the associations(all Pmodification<0.05).Non-optimal temperatures may cause lung function decline.Several individual characters and lifestyles have effect modification on the temperature effects.

Parity and carotid atherosclerosis in elderly Chinese women

Background The relationship between parity and atherosclerosis has been reported in some ethnic populations.However,results regarding Chinese women are still lacking.This study aimed to investigate the association of parity and carotid atherosclerosis,which has a predictive value of subsequent atherosclerotic events in elderly Chinese women.Methods A total of 2,052 participants from the medical examination center of the Third Xiangya Hospital were enrolled in the study.A standardized,structured questionnaire was administered to collect information on subjects’demographic characteristics,socioeconomic status,and cardiovascular risk factors.High-resolution ultrasound was used to examine carotid plaques and carotid intima-media thickness(IMT).Results The mean age of participants was 66.1±5.5 years.Women with more birth appeared to have a higher risk of carotid artery plaques.A multivariate-adjusted model yielded an odds ratio of 1.38(95%CI:12%-70%,P=0.003)per birth.A positive association was observed between parity and common carotid IMT(β±SE:0.029±0.006,P<0.001),and internal carotid IMT(β±SE:0.011±0.005,P=0.03)in a univariate model;however,these associations became non-significant in multivariate-adjusted models.When common carotid IMT was classified into an IMT≥1 mm group and an IMT<1 mm group,higher parity was associated with more obvious thickening both in the unadjusted model(OR=1.61,95%CI:1.29-2.00,P<0.001)and in the fully adjusted model(OR=1.43,95%CI:1.09-1.88,P=0.01).Conclusions There is a positive association between parity and risk of carotid plaques,as well as between parity and risk of obvious thickening for common carotid IMT in elderly Chinese women,indicating multiparous women might experience more atherosclerotic challenges.

Modified Gant procedure for treatment of internal rectal prolapse in elderly women

BACKGROUND Although rectal prolapse is not a life-threatening condition,it can cause defecation disorders,anal incontinence,sensory abnormalities,and other problems that can seriously affect quality of life.AIM To study the efficacy of the modified Gant procedure for elderly women with internal rectal prolapse.METHODS Sixty-three elderly female patients with internal rectal prolapse underwent the modified Gant procedure.The preoperative and postoperative anal symptoms,Patient Assessment of Constipation Quality of Life(PAC-QOL),Wexner incontinence score,incontinence quality of life score,and complications(massive hemorrhage,infection,anorectal stenosis,and anorectal fistula)were compared.RESULTS The improvement rates of postoperative symptoms were defecation disorders(84.5%),anal distention(69.6%),defecation sensation(81.4%),frequent defecation(88.7%),and anal incontinence(42.9%)(P<0.05).All dimensions and total scores of the PAC-QOL after the procedure were lower than those before the operation(P<0.05).The postoperative anal incontinence score and Wexner score were significantly lower than those before the procedure(P<0.05).The quality of life and total scores of postoperative anal incontinence were significantly higher than those before the procedure(P<0.05).There were no serious complications and no deaths.CONCLUSION The modified Gant procedure has significant advantages in the treatment of elderly women with internal rectal prolapse.

Clinical outcome analysis of 98 elderly women with early-stage breast cancer undergoing modified radical mastectomy or simple mastectomy

Objective: The aim of our study was to analyze the clinical results and prognosis for early elderly patients after surgery and to explore the rational treatment. Methods: Between January 1992 and December 2008, 98 early elderly breast cancer patients aged ≥ 65 years were treated with surgery, of which 52 patients received modified radical mastectomy and 46 patients received simple mastectomy. Results: Sixty-four (65.3%) patients had comorbidities including coronary heart disease, hypertension, diabetes, etc. After a median follow up of 56 months (21 to 280 months), the 5-year cumulative survival rate of breast modified radical mastectomy group and mastectomy group were 84.0% and 82.7%, separately (P = 0.653). The 5-year recurrence rate were 3.8% and 8.1%, separately (P = 0.504). Conclusion: The simple mastectomy is suitable for the treatment of early elderly breast cancer patients for its lower complication and recurrence rate. Early old women with breast cancer may be safely treated by simple mastectomy. Our findings suggest that modified radical mastectomy does not significantly increase the overall survival.

Healthcare Providers' Perceptions of the Sexual and Reproductive Health Needs (Including Family Planning) of Elderly Women from Selected Sites in Botswana

Much of the sexual and reproductive health services and service delivery including family planning target women of child bearing ages (15 - 49 years) and sometimes men. Hardly are there programmes/interventions that specifically target the needs of the elderly women (50 years and above), yet this group has serious sexual and reproductive health needs as many of them are still sexually active. This cross-sectional study obtained the views of a stratified random sample of 169 healthcare providers (doctors, nurses and pharmacists) from four selected sites, Gaborone, Selibe Phikwe, Barolong and Kweneng East health districts in Botswana on how the healthcare system in the selected sites is meeting the SRH/FP needs of the elderly women. The study found out that while overwhelming majority of the healthcare providers feltthat the healthcare system has no programme that specifically target the SRH/FP needs of this significant others and their SRH/FP needs are not being met ,less than 15% indicated that Pap smear screening as well as screening of cervical cancer were on-going. Although there are SRH/FP services available in the healthcare system, the elderly women are minimally accessing these services. Only condom, combined oral contraceptives, progestogen-only pills, treatment of STIs, screening for HIV/AIDS and screening for cervical cancer are accessed and information is also limited to these services. Reasons given by the healthcare providers for the non-accessibility of these services were cultural diversity (80%), people's sexual behavior and perceptions about sex (79%), lack of knowledge about the desired SRH/FP services (76%), religion (73%) and gender issues (62%). The study, advocates as part of policy options to mitigate the obstacles to accessing SRH/FP services, the expansion of counseling programmes, screening and treatment for breast cancer, public awareness campaigns, production and circulation of appropriate educational materials, effective training of healthcare providers and the establishment of separate clinic days for the elderly women' SRH/FP services.

Characteristics of Body Composition and Relationship between Muscle Mass and Muscle Strength among Elderly Women in Different Age Groups

Age-related changes in the body composition of older adults differ among age groups. The purpose of the present study was to clarify the characteristics of body compositions in young (age, 65 - 74 years;yE group) and old (age, ≥75 years;oE group) elderly women, and compare the relationship between muscle mass and strength in elderly women with that in young women for preventing motor function loss in older adults. A total of 30 elderly and 45 young women aged ≥ 65 and 19 - 22 years, respectively, participated in this study. The participants underwent body composition measurement via bioelectrical impedance analysis and examinations of handgrip and leg muscle strength. The age-related body composition changes varied among age groups. Compared with young women, fat-free mass (FFM) in the yE group did not decrease significantly;however, fat mass (FM) and waist-hip ratio (WHR) were significantly greater. Compared with the yE group, decreases in FFM, FM, and WHR in the oE group were significant;furthermore, the decrease in FM measurements was attributed to the loss of FM in the trunk and limbs (upper and lower). The measurement results suggested that the greater FM decrease in the oE group was characterized by decreases in both visceral and subcutaneous fat. In the yE group, the muscle mass was comparable to that in young women;however, there was a remarkable reduction in the lower-limb muscle mass (9% - 10%). In the oE group, muscle mass was reduced in all body parts, including upper and lower limbs and trunk. In young women, significant positive correlations between muscle mass and muscle strength in the upper and lower limbs were observed. No such correlations in the lower limbs were found in elderly women, indicating that muscle mass is not proportionally reflected in muscle strength. In conclusion, for improving and maintaining the health of elderly women, especially those above the age of 75 years, it is important to maintain muscle mass, including muscle strength, and prevent the loss of muscle quality.

Exclusive Hormonal Therapy in Breast Cancer in Elderly Women:Clinical Response and Survival over 10 Years

Breast cancer is the first cancer of women in the world and in France.In very elderly patients,the treatment options are often very limited.Neoadjuvant hormone therapy has shown similar or even better results than chemotherapy.This is why we decided to evaluate the clinical response following exclusive hormonal therapy and the 5,then 10 years survival in these very elderly women.This was a retrospective,longitudinal cohort-type study with descriptive and analytical purposes.The study population consisted of 59 patients,with an average age of 85 years.Fifteen(15,25%)of our patients had a complete clinical response after two years of treatment,16(27%)a partial clinical response,23(39%)lesion stabilization and 5(9%)cancer progression.The presence of metastasis at diagnosis increased the risk of cancer progression by 2.84.Overall 5-year survival was 72.5%,and breast cancer mortality 5.88%.The 10-year survival was 27.5%and breast cancer mortality 15%.In the age group 85 and over increased the risk of death by 3.25 in the first 10 years of treatment.The clinical response after 2 years was marked by a low rate of cancer progression.Mortality over 5 and 10 years was mostly related to patient comorbidities.

Practices and Knowledge on the Prevention of Cervical Cancer in Elderly Women

Cancer is a public health problem, primarily in developing countries. Elderly women are more prone to contracting different diseases, including sexual related neoplasms. The aim of this study was to determine the strategies used and knowledge regarding the prevention of cervical cancer in elderly women. This is a cross-sectional observational study. The sample was comprised of elderly women residents from the Brazilian Northeastern city who attended a coexistence group for elder people. After sample, calculation was obtained N of 209 participants. Associations between the independent and dependent variables were analyzed using the chi-squared test, considering p ≤ 0.05 as significant. The following programs were used for statistical analyses: Excel (Microsoft Office?), to tabulate the data and prepare the tables and Bioestat? 5.3 to test the associations. The prevalent age range was 60 to 70 years;most of the subjects were retired and had secondary schooling. Although a large number of those interviewed knew about cervical cancer, their knowledge was insufficient to take preventive measures. It is important that the elderly undergo a Pap smear, since the number of increasing cervical cancer cases is known to increase in this age range. In the coming decades, Brazil will have a significant elderly population, reaffirming the growing need for educational campaigns related to the health of elderly women, encouraging self-care and prevention in old age.

Evaluation of therapeutic effects of self-made pelvic floor muscle rehabilitation on elderly female stress urinary incontinence

Objective:Create a pelvic floor muscle rehabilitation program and explore its effects on stress urinary incontinence(SUI)in elderly women.Methods:Pelvic floor muscle rehabilitation was created based on Kaigl experiment and pelvic floor muscle training methods.20 elderly women aged 65-75 years with SUI were randomly recruited for 10 weeks of pelvic floor muscle rehabilitation.Self-control study was used to compare the 72-hour average frequency of urinary incontinence,the average score of urinary incontinence questionnaire-simple form(ICIQ-SF)of international urinary incontinence advisory committee,the severity index of urinary incontinence and the weight of 1 hour urine pad before and after rehibition.Results:After 10 weeks of pelvic floor muscle rehabilitation training,the 72-hour average frequency of urinary incontinence was 1.02±0.65 times,which was not statistically different from that before training(1.25±0.71,P>0.05).The score of ICIQ-SF was 5.95±1.32,which was significantly lower than that before training(7.0±1.38,P<0.05),and the urinary incontinence severity index was 2.75±0.89,which was significantly lower than that before training(3.95±1.32,P<0.01).The weight of 1 hour urine pad was 6.40±2.29 g and was significantly lower than that before training(P<0.01,8.37±2.24).Conclusion:Self-created pelvic floor muscle rehabilitation had the function of decreasing the quantity of urinary incontinence instead of the frequency of incontinence.

高龄二胎孕妇心理一致感的影响因素分析

目的调查分析高龄二胎孕妇的心理一致感评分及其相关影响因素。方法收集2017年10月至2021年5月我院妇产科收治的842例高龄二胎孕妇的临床资料,通过一般资料问卷、心理一致感量表(SCO-13)进行调查,分析高龄二胎孕妇心理一致感的影响因素。结果842例不同孕周高龄二胎孕妇的SCO-13评分为(58.22±6.18)分。单因素分析发现,不同SCO-13评分高龄二胎孕妇的年龄、体质量、妊娠期并发症、对胎儿性别期待、计划妊娠、孕周比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄≥40岁、体质量≥60 kg、妊娠期并发症、对胎儿性别期待、孕早期为影响高龄二胎孕妇SCO-13评分的危险因素,而有妊娠计划为影响高龄二胎孕妇SCO-13评分的保护因素(P<0.05)。结论高龄二胎孕妇心理一致感处于较低水平,年龄、体质量、妊娠期并发症、对胎儿性别期待、孕周、妊娠计划均为其影响因素。为提高心理一致感水平,临床可根据相关影响因素对高龄二胎孕妇进行针对性干预。

Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China

In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone （TT） and sex hormone-binding globulin （SHBG） were performed, and the aging male symptoms （AMS） questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms （decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido） were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l^-1 for a decreased ability/frequency to perform sex, 12.55 nmol l^-1 for decreased frequency of morning erections, and 14.35 nmol l^-1 for decreased sexual desire. The calculated free testosterone （CFT） thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l^-1, respectively. TT 〈13.21 nmol l^-1 （OR =1.4, 95%Ch 1.0-1.9, P= 0.037） or CFT 〈268.89 pmol l^-1 （OR - 1.5, 95%Ch 1.1-20, P=0.020） was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels 〈13.21 nmol l^-1 and CFT levels 〈268.89 pmol l^-1. Our results may improve the diagnostic accuracy of LOH in older men.

Prevalence and influence factors of self-medication in Chinese middle-aged and elderly people: evidence from 2011, 2013 and 2015 CHARLS panel data

Self-medication is an increasingly frequent phenomenon worldwide and has an important influence on health.In this study,we analyzed the self-medication prevalence rate in Chinese middle-aged and elderly people,and explored the influence factors.The data from China Health and Retirement Longitudinal Study(CHARLS)in 2011,2013 and 2015 were used.Self-medication prevalence was calculated as the number of whole people divided by the number of people taking self-medication.The influence factors of self-medication were analyzed by panel data random effect model.We excluded observations with missing values in our analysis,leaving 16 962,17 876 and 19 572 observations in 2011,2013 and 2015,respectively.The average 3-year self-medication prevalence was 45.52%.Moreover,11.70%of respondents practiced self-medication with prescription medicine in 2011,2013 and 2015.Respondents living in non-rural areas(P=0.009)and western region(P=0.000)took more self-medication.Self-medication was a common phenomenon among middle-aged and elderly population in China.The government should strengthen the guidance for the middle-aged and elderly people who took more self-medication,such as those living in urban and western region.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China:results from a national survey

This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.

Prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes

Background Stroke is now the most prevalent and debilitating disease affecting diabetic population in China. The study aimed to investigate the prevalence of stroke and metabolic disorders in the middle-aged and elderly Chinese with type 2 diabetes. Methods A total of 4 629 subjects with type 2 diabetes （males： 1 917; females： 2 712） aged ≥ 40 years from Shijingshan district, Beijing, China from November 2011 to August 2012 were included in the study. Data on demographic information, lifestyle, history of diabetes mellitus, stroke, coronary heart disease, hypertension, and dyslipidemia were collected. The oral glucose tolerance test or a standard meal test was performed. Non-fatal stroke was reported by the subjects. The 2-tailed test was used, and P 〈0.05 was regarded as statistically significant. Results Prevalence of stroke in the subjects with type 2 diabetes was 5.5%. The prevalence of smoking, overweight or obesity, hypertension, and dyslipidemia was 41.0%, 65.8%, 67.4%, and 52.0% in males, and 2.2%, 65.5%, 69.5%, and 57.6% in females. Multivariate Logistic regression analysis showed that increased age, hypertension, diabetic duration, and overweight or obesity were positively correlated with stroke in the population with type 2 diabetes, whereas high- density lipoprotein cholesterol level was negatively correlated with stroke. After adjustment for age and gender, the odds ratio values of stroke in subjects having 1,2 or ≥3 of 4 risk factors, including smoking, overweight or obesity, hypertension and dyslipidemia, were 2.302 （95% CI： 0.789-6.712）, 4.089 （95% CI： 1.470-11.373）, 6.023 （95% CI： 2.176-16.666）, compared with subjects without any of the above 4 risk factors. Conclusions The prevalence of stroke was higher in middle-aged and eldedy Chinese with type 2 diabetes than that in the general population. With the aggregation of risk factors, the prevalence of stroke increased.