Differential educational patterning of cardiometabolic risks between women and men among community-dwelling Chinese adults in Hong Kong: the mediating role of obesity

2021 ◽  
pp. 1-33
Author(s):  
Gary K.K. Chung ◽  
Francisco T.T. Lai ◽  
Heidi Hung ◽  
Eng-Kiong Yeoh ◽  
Roger Y. Chung
Keyword(s):  
Hong Kong ◽  
Clinical Data ◽  
Abdominal Obesity ◽  
Education Level ◽  
Community Dwelling ◽  
Binary Logistic Regression Analysis ◽  
Health Examination ◽  
Educational Inequalities ◽  
Anthropometric Measures ◽  
Cross Sectional

Abstract Objectives: Educational inequalities in cardiometabolic diseases (CMD) are globally recognised; nonetheless, evidence on potential explanatory mechanisms and effective strategies for CMD prevention and inequality reduction is relatively scarce in Asia. Therefore, this study examined the extent and potential mediators of the association of education level with CMD conditions (i.e., hypertension and diabetes) in an advanced economy in Asia. Design: A cross-sectional study. Setting: This territory-wide cross-sectional Population Health Survey in 2014/15 was performed in Hong Kong. Demographic, socioeconomic, and lifestyle factors were collected via questionnaire, while clinical data on blood pressure and glucose levels, lipid profiles, and anthropometric measures were obtained during health examination. Hypertension and diabetes statuses were objectively defined by both clinical data and the use of relevant medications. Participants: 2297 community-dwelling adults aged between 15-84 years recruited via systematic replicated sampling of living quarters. Results: Multivariable binary logistic regression analysis showed that lower education level was significantly associated with hypertension among women but not men, whereas similar pattern was also observed for diabetes and other related clinical risk factors. Also, general and abdominal obesity were independently associated with hypertension and diabetes among both women and men, and substantially mediated the observed inequalities across education levels among women. Specifically, abdominal obesity was a particularly strong risk factor and mediator for diabetes. Conclusion: Educational patterning of CMD was more apparent among women in Hong Kong. Obesity control appears to be important for both overall CMD prevention and reduction of educational inequalities in CMD among women.

scholarly journals Association of Dental Caries and Anthropometric Measures among Primary School Children

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 223
Author(s):  
Wajiha Anzar ◽  
Ambrina Qureshi ◽  
Ashar Afaq ◽  
Hiba F. Kattan ◽  
Basil Almutairi ◽  
...  
Keyword(s):  
Dental Caries ◽  
Primary School ◽  
Clinical Data ◽  
School Children ◽  
Low Income ◽  
Primary School Children ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Height For Age ◽  
Weight For Age

Aim: This study aimed to investigate an association between dental caries status and anthropometric measures in primary school children. Methods and Materials: An analytical cross-sectional study (n = 376) was conducted among primary school children (age range = 6–9 years) registered in private schools. Non-clinical data was gathered from parents of participating children through a self-administered structured questionnaire as well as from the children through an interviewer-administered questionnaire. Clinical data included the examination of dental caries using dmft/DMFT index and anthropometric measures including calculated z-scores of height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BAZ), and physical examination. Inferential statistics included Kruskal Wallis and linear regression for univariate and multivariate analysis respectively. Results: The proportion of dental caries in primary and secondary dentition was 67.6% and 8.2% respectively. A significant association was observed between dental caries status and HAZ, WAZ, and BAZ (p < 0.001). An inverse relation was found between low, medium, and high dental caries categories and anthropometric measures. Conclusions: In the primary dentition, dental caries were significantly and inversely related to weight-for-age, height-for-age, and BMI-for-age. Hence, it can be concluded that among the low-income population dental caries is associated with lower anthropometric outcomes in children and therefore caries management should be considered an approach impacting overall health and quality of life.

Maternal educational inequalities about adverse pregnancy outcomes observed in a rural area of a province of China during a time period (2010–2018)

2022 ◽  
pp. jech-2021-217754
Author(s):  
Lixin Li ◽  
Yanpeng Wu ◽  
Yao Yang ◽  
Ying Wu ◽  
Yan Zhuang ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Maternal Education ◽  
Rural China ◽  
Education Level ◽  
Adverse Pregnancy Outcomes ◽  
Secondary Outcome ◽  
Health Examination ◽  
Educational Inequalities ◽  
Increased Risk ◽  
Adverse Pregnancy

BackgroundThe relationship between maternal education and adverse pregnancy outcomes is well documented. However, limited research has investigated maternal educational disparities in adverse pregnancy outcomes in China. This study examined maternal educational inequalities associated with adverse pregnancy outcomes in rural China.MethodsWe conducted a population-based cohort study using participants enrolled in the National Free Preconception Health Examination Project in Yunnan province from 2010 to 2018. The primary outcome was stillbirth, and the secondary outcome was adverse pregnancy outcomes, defined as a composite event of stillbirth, preterm birth or low birth weight. The study was restricted to singleton births at 20–42 weeks’ gestation. Univariate and multivariate log-binomial regression models were performed to estimate crude risk ratios (RRs) and confounding-adjusted RRs (ARRs) for stillbirth and adverse pregnancy outcomes according to maternal education level.ResultsA total of 197 722 singleton births were included in the study. Compared with mid-educated women, low-educated women were at a significantly increased risk of stillbirth (ARR, 1.20; 95% CI, 1.05 to 1.38) and adverse pregnancy outcomes (ARR, 1.11; 95% CI, 1.07 to 1.16). However, the risk of stillbirth (ARR, 1.16; 95% CI, 1.01 to 1.35) was significantly higher for high-educated women compared with mid-educated women.ConclusionCompared with women with medium education level, women with lower education level were more likely to experience adverse pregnancy outcomes, including stillbirth, and women with higher education level were more likely to experience stillbirth.

scholarly journals Prevalence of Untreated Early Childhood Caries of 5-Year-Old Children in Hong Kong: A Cross-Sectional Study

2021 ◽  
Vol 18 (22) ◽  
pp. 11934
Author(s):  
Faith Miaomiao Zheng ◽  
Iliana Gehui Yan ◽  
Duangporn Duangthip ◽  
Sherry Shiqian Gao ◽  
Edward Chin Man Lo ◽  
...  
Keyword(s):  
Early Childhood ◽  
Hong Kong ◽  
Oral Health ◽  
Early Childhood Caries ◽  
Maternal Education ◽  
Education Level ◽  
Demographic Information ◽  
Cross Sectional ◽  
Health Related ◽  
Childhood Caries

This cross-sectional survey investigated untreated early childhood caries (ECC) and its associated factors among 5-year-old children in Hong Kong. Children were recruited using a multistage sampling method. One dentist examined the children in kindergarten to diagnose untreated ECC (dt) at the cavitation level. Each child’s demographic information, snacking behaviour, and oral health-related practice were collected using a parental questionnaire. The relationships between the untreated ECC and demographic information, snacking behaviours, and oral health-–related practice were analysed by zero-inflated negative binomial (ZINB) regression analysis. This survey recruited 404 children. Their dt score was 2.8 ± 3.8. The significant untreated ECC (SiUC) index, which was one-third of the children with the highest dt score, was 7.1 ± 3.6. Their untreated ECC prevalence was 57%, which was associated with the district the child lived in. Most children with untreated ECC (71%, 164/231) had never visited a dentist. Children who brushed without toothpaste had more untreated ECC. Children coming from low-income families and with a lower maternal education level had a higher risk of ECC. In conclusion, untreated ECC was prevalent and unevenly distributed among 5-year-old children in Hong Kong. Its prevalence was associated with toothpaste use, family income, maternal education level and the district they lived in.

scholarly journals Prevalence of Metabolically Obese, Normal-Weight Individuals and Its Dietary Patterns Characteristics: A Cross-Sectional Study in Thai Adults

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1464-1464
Author(s):  
Hung Nguyen Ngoc ◽  
Wantanee Kriengsinyos ◽  
Nipa Rojroongwasinkul ◽  
Wichai Aekplakorn
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Abdominal Obesity ◽  
Dietary Patterns ◽  
Lower Risk ◽  
Normal Weight ◽  
Normal Body Mass Index ◽  
Health Examination ◽  
Cross Sectional ◽  
Metabolically Obese Normal Weight

Abstract Objectives Metabolically obese normal weight (MONW) individuals are subjects who have a normal body mass index (BMI), but manifest obesity-related metabolic syndrome (MetS). Nevertheless, the prevalence and correlation between MONW and dietary patterns have not been fully explored in Thais. This study aimed to investigate the national prevalence of MONW, determine which dietary patterns are consumed in Thai normal-weight adults and to identify whether those patterns were associated with the risk of MetS and its features. Methods Total 6899 Thais ≥18 years with normal BMI (18.5–22.9 kg/m2) were obtained from the Thai National Health Examination Survey IV. Sociodemographic, eating-habits, anthropometric, blood pressure and biochemical parameters were measured. MONW was diagnosed by the National Cholesterol Education Program/Adult Treatment Panel III within normal BMI. Dietary patterns were determined by means of factor analysis, and were evaluated by multiple logistic regressions for its association with MONW. Results Overall, the weighted prevalence of MONW was 9.9% (95% CI: 9.1–10.6%), particularly, the MONW prevalence was 7.2% (95% CI: 6.5–8.0%) and 13.1% (95% CI: 11.6–14.7%) in male and female respectively. Three major dietary patterns were distinguished: “westernized”, “healthy” and “carbohydrate” patterns. After controlling for potential confounders, compared with the lowest quartile, individuals in the highest quartile of the westernized and carbohydrate pattern were connected with the greater risk of MONW (adjusted odds ratio [OR]: 1.64, 95% CI: 1.25–2.17, P &lt; 0.001) and (OR: 1.57, 95% CI: 1.19–2.08, P &lt; 0.05) respectively, whereas subjects in the fourth quartile of healthy pattern reduce the risk of MONW and its components, except for elevated blood pressure and hyperglycemia (OR: 0.68, 95% CI: 0.50–0.92 for MONW, P &lt; 0.05; OR: 0.43, 95% CI: 0.28–0.68 for abdominal obesity, P &lt; 0.001; OR: 0.63, 95% CI: 0.49–0.81 for hypertriglyceridemia, P &lt; 0.001; OR: 0.67, 95% CI: 0.54–0.82 for low high-density lipoprotein cholesterol [HDL-C], P &lt; 0.01). Conclusions In Thai normal-weight adults, high consumption of whole grains, fruits, beans, juices, and dairy products is connected with a lower risk of metabolic syndrome and its features, i.e., lower risk of abdominal obesity, hypertriglyceridemia, and low HDL-C. Funding Sources This research received no funding.

scholarly journals Socioeconomic Differentials in Trends in the Prevalence of Hypertension and Pre-hypertension and Hypertension Awareness, Treatment, and Control in Rural Southwestern China

2020 ◽  
Author(s):  
Luming Fan ◽  
Fang Wang ◽  
Min Zhao ◽  
Wen-Long Cui ◽  
Le Cai
Keyword(s):  
Education Level ◽  
Southwestern China ◽  
Health Examination ◽  
Cross Sectional ◽  
Lower Education Level ◽  
Education Levels ◽  
Hypertension Awareness ◽  
High Level ◽  
Socioeconomic Differentials ◽  
And Control

Abstract Background: This study examines the socioeconomic differentials in trends in the prevalence of hypertension and pre-hypertension and hypertension awareness, treatment, and control in rural Southwestern China.Methods: Two cross-sectional interviews and health examination surveys were administered in rural Yunnan Province, including 6,350 consenting participants in 2009 and 6,359 consenting participants in 2016 (aged ≥ 35 years). Participant demographics, socioeconomic status (SES), and ethnicity, along with information about hypertension awareness, treatment, and control, were collected using similar questionnaires in the two surveys. The participants’ blood pressure levels were also measured.Results: From 2009 to 2016, the prevalence of hypertension substantially increased from 28.4% to 39.5% (P < 0.01), and awareness and control rose from 42.2 and 25.8% to 53.1 (P < 0.01) and 30.6% (P < 0.05), respectively. Although people with a higher education level also had higher awareness and control rates than the lower education level ones, there were no conspicuous differences in the improvement of awareness and control between publics with different education levels over the 7 years studied. Increases were observed in both rates of awareness and control in people with a high level of income (P < 0.01). However, only the awareness rate increased in participants with a low level of income. Furthermore, the prevalence (P < 0.01) and treatment (P < 0.05) of hypertension were higher in the Han people than in ethnic minorities.Conclusions: Individual SES has clear associations with trends in the prevalence, awareness, and control of hypertension. Future interventions to improve hypertension prevention and control should be tailored to address individual SES.

scholarly journals The silent epidemic of obesity in The Gambia: evidence from a nationwide, population-based, cross-sectional health examination survey

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e033882 ◽  
Author(s):  
Bai Cham ◽  
Shaun Scholes ◽  
Linda Ng Fat ◽  
Omar Badjie ◽  
Nora Ellen Groce ◽  
...  
Keyword(s):  
Higher Education ◽  
Abdominal Obesity ◽  
The Gambia ◽  
Older Age ◽  
Secondary Outcome ◽  
Outcome Variable ◽  
Health Examination ◽  
Obesity Prevalence ◽  
Urban Residence ◽  
Cross Sectional

ObjectivesNon-communicable diseases account for 70% of global deaths; 80% occur in low-income and middle-income countries. The rapid increase of obesity in sub-Saharan Africa is a concern. We assessed generalised and abdominal obesity and their associated risk factors among adults in The Gambia.DesignNationwide cross-sectional health examination survey using the WHO STEPwise survey methods.SettingThe Gambia.ParticipantsThis study uses secondary analysis of a 2010 nationally representative random sample of adults aged 25–64 years (78% response rate). The target sample size was 5280, and 4111 responded. Analysis was restricted to non-pregnant participants with valid weight and height measurements (n=3533).Primary and secondary outcome measuresThe primary outcome variable was generalised obesity, using WHO body mass index (BMI) thresholds. Analyses used non-response weighting and adjusted for the complex survey design. We conducted multinomial logistic regression analysis to identify factors associated with BMI categories. The secondary outcome variable was abdominal obesity, defined as high waist circumference (using the International Diabetes Federation thresholds for Europeans).ResultsTwo-fifths of adults were overweight/obese, with a higher obesity prevalence in women (17%, 95% CI 14.7 to 19.7; men 8%, 95% CI 6.0 to 11.0). 10% of men and 8% of women were underweight. Urban residence (adjusted relative risk ratio 5.8, 95% CI 2.4 to 14.5), higher education (2.3, 1.2 to 4.5), older age, ethnicity, and low fruit and vegetable intake (2.8, 1.1 to 6.8) were strongly associated with obesity among men. Urban residence (4.7, 2.7 to 8.2), higher education (2.6, 1.1 to 6.4), older age and ethnicity were associated with obesity in women.ConclusionThere is a high burden of overweight/obesity in The Gambia. While obesity rates in rural areas were lower than in urban areas, obesity prevalence was higher among rural residents in this study compared with previous findings. Preventive strategies should be directed at raising awareness, discouraging harmful beliefs on weight, and promoting healthy diets and physical activity.

scholarly journals Hypertriglyceridemic waist phenotype and risk of chronic kidney disease in community-dwelling adults aged 60 years and older in Tianjin, China: a 7-year cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ruping Chen ◽  
Guangshan Sun ◽  
Rui Liu ◽  
Ao Sun ◽  
Yujie Cao ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Waist Circumference ◽  
Kidney Disease ◽  
Community Dwelling ◽  
Health Examination ◽  
Cross Sectional ◽  
Hypertriglyceridemic Waist ◽  
The Cross

Abstract Background The hypertriglyceridemic waist (HTGW) phenotype has been proposed to be related to the occurrence and progression of chronic kidney disease (CKD). The ageing trend of the Chinese population continues to intensify, and elderly individuals are at high risk of CKD. The purpose of this study was to investigate the cross-sectional and longitudinal associations between the HTGW phenotype and the risk of CKD by following community-dwelling adults aged 60 years and older in Tianjin, China, for 7 years. Methods This study was an observational cohort study conducted between 2013 and 2019. Of 2050 participants aged 60 years and older who underwent an annual health examination in 2013, 1605 individuals with complete data were enrolled in the cross-sectional analysis. Among them, 1271 individuals were observed until 2019. Detailed follow-up records were available for 816 participants, of whom 600 participants without CKD at baseline were eligible for inclusion in the retrospective analysis. The HTGW phenotype was defined as a waist circumference of 90 cm or more and triglyceride concentrations of 2.0 mmol/L or more in males or a waist circumference of 85 cm or more and triglyceride concentrations of 1.5 mmol/L or more in females. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and/or proteinuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g). Multivariable logistic regression analyses were performed to evaluate the relationship between the HTGW phenotype and CKD. Results In 2013, the prevalence of CKD among older adults was 31.03%, and the prevalence of CKD in the HTGW phenotype group was 37.81%. Over a 7-year observation period, 195 individuals developed CKD, with an incidence rate of 32.50%. Statistically significant associations were observed between the HTGW phenotype and CKD in older adults in both cross-sectional surveys and retrospective analyses, with odds ratios and 95% confidence intervals of 1.38 (95% CI: 1.03–1.86, P = 0.033) and 2.27 (95% CI: 1.30–3.97, P = 0.004), respectively, after adjustment for confounders. Conclusions In this community-based cohort study, the HTGW phenotype was confirmed to be independently associated with an increased risk of prevalent and incident CKD in older adults aged 60 years and above in Tianjin, China.

scholarly journals Oral health status of community dwelling adults aged 50 years and over in Ireland. A cross-sectional analysis of the Wave 3 TILDA cohort.

2018 ◽  
Vol 1 ◽  
pp. 26
Author(s):  
Amara Naseer ◽  
Jacinta McLoughlin ◽  
Orna Donoghue ◽  
Rose Anne Kenny ◽  
Brian O'Connell
Keyword(s):  
Health Status ◽  
Oral Health ◽  
Oral Health Status ◽  
Community Dwelling ◽  
World Health ◽  
Current Status ◽  
Health Examination ◽  
Root Caries ◽  
Cross Sectional ◽  
The Mean

Background: Little is known about the current oral health status of adults in Ireland. The aim of this study was to measure the oral health status of community dwelling adults aged 50 years and over in Ireland, and to compare the current status to previous surveys of oral health in adults.  Methods: The Irish Longitudinal Study on Ageing (TILDA) Wave 3 provided an opportunity to assess the oral health of a subset of TILDA participants. Respondents attending for health assessments at the TILDA centre were offered an oral health examination. The World Health Organization examination criteria were used. Results: Out of the 3111 people who were offered the oral health assessment (OHA), 2525 were examined. Adults below 50 years of age (n=17) and 4 respondents whose oral health data were unavailable at time of analysis were omitted, giving a final sample of 2504 respondents.  Among the OHA sample, 9.9% (249) were edentate; 11.5% (159) of females and 8% (90) of males. Of those aged 65 years and older, 15.6% were edentate compared with 40.9% in 2000-02. The mean number of teeth present in those aged 65 years or older was 14.9 for males and 14.2 for females compared with 9.9 and 7.4, respectively, in 2000-02. 56.8% of the dentate sample had 10 or more tooth contacts. The mean DMFT of those aged 50 years or more was 18.5 and the Root Caries Index (RCI) was 6.3. For adults aged 65 years and over, the mean DMFT decreased from 25.9 to 20.1 and the Root Caries Index decreased from 11.6 to 9.1, between 2000-02 and 2014-15. Conclusion: The results suggest an improvement in oral health status of community dwelling adults aged 50 years and over in Ireland as compared to the previous Irish survey of 2000-02.

scholarly journals Risk Factors of Dementia in Elderly of Bandung City, Indonesia: A Community-Dwelling Study

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Sarah Fitri Janaris ◽  
Sharon Gondodiputro ◽  
Nita Arisanti
Keyword(s):  
Risk Factors ◽  
Social Participation ◽  
Living Arrangements ◽  
Cognitive Disorders ◽  
Secondary Data ◽  
The Elderly ◽  
Multiple Organ ◽  
Education Level ◽  
Community Dwelling ◽  
Cross Sectional

Background: Multiple organ degenerative processes are parts of a normal biological process in aging. One of the geriatric syndromes is cognitive disorders that range from a mild cognitive impairment to dementia. The aim of this study was to analyze factors contributing to the occurrence of dementia in the elderly. Methods: A cross-sectional analytical study was conducted using secondary data on 306 elderly people who visited the Integrated Health Post (Pos Pembinaan Terpadu, Posbindu) from June to August 2016 in Bandung City, Indonesia. Nine variables were included in this study: age, gender, education level, marital status, occupation, living arrangements, social participation, comorbidity, and dementia. The dementia status was measured by the Mini-Mental State Examination and Mini Cog Assessment instruments. Data were then analyzed statistically using Chi-Square, Fisher Exact, and Kolmogorov-Smirnov tests, as well as using the multivariate logistic regression. Results: Around 35.3% (95%CI=30%–40.6%) of respondents had dementia. There were relationships between dementia and age (p=0.035), level of education (p=0.000), and social participation (p=0.001). Social participation was the most dominant risk factor of dementia (OR=2.703;95%CI=1.491-4.902). Conclusions: Age, education level, and social participation are risk factors that contribute to dementia. The elderly who has less than two times per week of social participation has a 2.7 times higher risk for having dementia compared to the elderly who has more than two times per week of social participation.

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