Usefulness of cardiometabolic index for the estimation of diabetes risk among general population in rural China: a community-based study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
HY Wang ◽  
WR Shi ◽  
YX Sun

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiometabolic index (CMI) defines adiposity based on triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and waist-to-height ratio (WHtR). This newly proposed metric has been used to detect multiple cardiovascular risk factors, but data relative to diabetes in the general population are lacking. This study aims to validate CMI’s utility of discriminating diabetes and compares it with other indexes among general Chinese population. Methods Analyses were based on a cross-sectional study of 11,478 participants that underwent assessment of metabolic and anthropometric parameters in rural areas of northeastern China in 2013. CMI was calculated by TG/HDL-C × WHtR. Multivariate logistic regressions were performed to clarify CMI’s association with diabetes, ROC analyses were engaged to investigate CMI’s discriminating ability for diabetes. Results The prevalence of diabetes was 9.93% in males while 10.76% in females, and increased with CMI’s increment. After full adjustment, each SD increment of CMI had odds ratios (ORs) for diabetes of 1.471 (1.367–1.584) and 1.422 (1.315–1.539) in females and males, respectively. Compared with bottom categories of CMI, the top quartiles had ORs of 3.736 (2.783–5.015) in females and 3.697 (2.757–4.958) in males. The ROC results showed an excellent discriminating power of CMI (AUC: 0.702 for females, 0.664 for males). Conclusions An increasing CMI was correlated with higher odds of diabetes, supporting CMI as a useful and economic measure to screen and quantify diabetes in general Chinese population. Monitoring and promoting achievement of dyslipidemia and abdominal obesity based on CMI may improve subclinical and cardiovascular outcomes. Abstract Figure.

2020 ◽  
Author(s):  
Juping Liu ◽  
Jie Hao ◽  
Kai Cao ◽  
Ye Zhang ◽  
Yuanbo Liang ◽  
...  

Abstract Background Body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist/hip/height ratio (WHHR), sagittal abdominal diameter (SAD), and SAD/height ratio (SADHR) are all anthropometric tools used to categorize obesity status. This study aimed to determine associations between different anthropometric indices and the risk of cardiovascular disease (CVD) in Chinese rural areas. Methods The Handan Eye Study is a population-based, longitudinal study. In total, 6830 participants, aged 30 years or older, participated in the baseline study (HES-1). Among them, 5394 subjects of the 6323 survivors (follow-up rate: 85.3%) took part in the 6-year follow-up study (HES-2). As a new anthropometric parameter, SAD was added into HES-2. Meanwhile total cholesterol, high-density lipoprotein protein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and other biochemical data were recorded. This cross-sectional study analyzed these anthropometric obesity indices and correlations with CVD. Prevalence of metabolic syndrome (MS) was used as the indicator of CVD. Results Among the 5394 patients in this study, multivariate analysis revealed higher BMI and WC in women compared to men (24.61 vs. 23.66, p < 0.0001). SAD, WHR, and WHHR showed a smaller correlation to CVD risk factors when compared with other anthropometric parameters. WC and SADHR were more effective predictors of CVD and MS. In men, BMI exhibited a greater proportionality to high-TG (0.693) and hypertension (0.593) and SADHR showed a correlation to low-HDL (0.561) as well as high-glucose (0.664). WC and SADHR were the most effective diagnostic parameters in women. Conclusions Within a rural Chinese population, women were observed to be comparatively more overweight than men. SADHR and BMI serve as effective indicators of CVD and MS in men, whereas SADHR and WC are more effective indicators of CVD and MS in women. Age and gender affect anthropometric obesity indices and correlations with CVD.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031443
Author(s):  
Jianwei Xu ◽  
Jixiang Ma ◽  
Xiaorong Chen ◽  
Liuxia Yan ◽  
Xiaoning Cai ◽  
...  

ObjectiveMicroalbuminuria (MAU) has been described as a risk factor for metabolic syndrome (MetS). However, the association between MetS components with MAU and 24-hour urinary albumin excretion (UAE) has not been clearly explained in the general Chinese population. We aimed to analyse the associations between MAU and high–normal 24-hour UAE with MetS and its components.DesignCross-sectional observational study.SettingFour selected counties/districts in China’s Shandong and Jiangsu Provinces.ParticipantsA total of 2261 participants aged 18–69 years were included in this study. Participants with missing physical examination data or incomplete urine collection were not included in the analysis.ResultsThe prevalence of MAU was 9%, and the mean 24-hour UAE was 18 mg/d. The prevalence of MAU was significantly higher for the MetS, high blood pressure (BP), high triglyceride (TG) levels, low high-density lipoprotein cholesterol (HDL-C) and hyperglycaemia groups but not for the central obesity group. Both MAU and mean 24-hour UAE were significantly increased in association with a number of MetS components. The adjusted prevalence OR (POR) for MetS with MAU was 2.95 (95% CI 2.15 to 4.04) compared with those without MAU. MAU was significantly associated with three components of MetS: high BP (POR=1.86, 95% CI 1.31 to 2.64), high TG levels (POR=1.80, 95% CI 1.31 to 2.46) and hyperglycaemia (POR=1.84, 95% CI 1.34 to 2.53). No significant association between MAU and central obesity or low HDL-C was found. The presence of MetS gradually increased according to the normal-range 24-hour UAE quartiles: POR=1.00, POR=1.22, POR=1.14 and POR=2.02, respectively. Hyperglycaemia also increased significantly according to the normal-range 24-hour UAE quartiles.ConclusionsMAU and elevated 24-hour UAE within the normal range were closely associated with MetS in the Chinese population, which may provide a basis for the development of early interventions to decrease the effects of MetS.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e038671
Author(s):  
Feng-E Li ◽  
Fu-Liang Zhang ◽  
Peng Zhang ◽  
Dong Liu ◽  
Hao-Yuan Liu ◽  
...  

ObjectivesLow levels of income and education are risk factors for metabolic syndrome in the population of Northeast China, which has a high incidence of metabolic syndrome and cardiovascular diseases. This study aimed to determine sex-based differences associated with the prevalence of and risk factors for metabolic syndrome among people older than 40 years in Northeast China; this has not been previously investigated.DesignThis study analysed a portion of the large sample data of the national cross-sectional screening of China from 2016. Metabolic syndrome was defined as the presence of any three of the following five risk factors: abnormal waist circumference; high levels of triglycerides, high-density lipoprotein cholesterol or fasting plasma glucose; and elevated blood pressure. Multiple regression analysis was used to investigate sex-based differences in the prevalence of, and risk factors for metabolic syndrome.SettingThe study was conducted in Dehui City, Jilin Province, China.ParticipantsA total of 4052 participants with complete questionnaire information and laboratory examination results were included.ResultsThe prevalence of metabolic syndrome was 50.1% overall (38.4% in men and 57.9% in women; p<0.001). High body mass index and hip circumference were associated with metabolic syndrome in both sexes. In addition, physical inactivity (OR and 95% CI 1.44 (1.06 to 1.97); p=0.022) in men and advanced age (OR and 95% CI 1.54 (1.15 to 2.04); p=0.003) in women were factors associated with metabolic syndrome. Women with junior high school education or above and living in rural areas were less likely to have metabolic syndrome. For men, education and rural or urban living had no association with metabolic syndrome.ConclusionsThe risk factors for metabolic syndrome have similarities and differences in different sexes; thus, the prevention and treatment of metabolic syndrome should be based on these sex differences.


2008 ◽  
Vol 126 (5) ◽  
pp. 274-278 ◽  
Author(s):  
Iúri Amorim de Santana ◽  
Gustavo Souza Moura ◽  
Nivaldo Farias Vieira ◽  
Rosana Cipolotti

CONTEXT AND OBJECTIVE: Prostate cancer (PCa) is the second most common cancer among men in Brazil. Recently, several studies have hypothesized a relationship between PCa and metabolic syndrome (MS). The aim here was to identify an association between MS and PCa. DESIGN AND SETTING: Cross-sectional study, Fundação de Beneficência Hospital de Cirurgia (FBHC) and Universidade Federal de Sergipe. METHODS: Laboratory and anthropometric parameters were compared between PCa patients (n = 16) and controls (n = 16). RESULTS: The PCa patients showed significantly greater frequency of MS than did the controls (p = 0.034). Serum glucose was higher and high-density lipoprotein-cholesterol was lower than in the controls, although without significant differences. There were significant differences in blood pressure (p = 0.029) and waist-to-hip ratio (p = 0.004). Pearson linear correlation showed a positive association between waist-to-hip ratio and prostate specific antigen (r = 0.584 and p = 0.028). Comparing subgroups with and without MS among the PCa patients, significant differences (p < 0.05) in weight, height, body mass index, hip circumference and lean body mass were observed, thus showing higher central obesity in those with MS. The serum glucose values were also higher in MS patients (p = 0.006), thus demonstrating that insulin resistance has a role in MS physiopathology. CONCLUSIONS: Our study suggests that MS may exert an influence on the development of PCa. However, it would be necessary to expand the investigation field with larger sample sizes and cohorts studied, to test the hypothesis generated in this study.


2021 ◽  
Vol 18 ◽  
Author(s):  
Feng-E Li ◽  
Yi Yang ◽  
Zhen-Ni Guo ◽  
Yun Luo ◽  
Fu-Liang Zhang ◽  
...  

Background: Cardiometabolic index (CMI) is associated with several risk factors for stroke; however, few studies have assessed the role of CMI in stroke risk. Objective: This study aimed to assess the association between CMI and stroke in a population-based cross-sectional study. Methods: This study included 4445 general residents aged ≥40 years selected by multistage stratified random cluster sampling. CMI was calculated as the product of the ratio of waist circumference to height (WHtR) and the ratio of triglyceride levels to high-density lipoprotein cholesterol levels (TG/HDL-C). Participants were categorized according to CMI quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to assess the association between CMI and stroke. Results: A total of 4052 participants were included in the study, with an overall stroke prevalence of 7.2%. The prevalence of stroke increased with CMI quartiles, ranging from 4.4% to 9.2% (p for trend <0.001). Compared with Q1, stroke risk for Q2, Q3, and Q4 were 1.550-, 1.693-, and 1.704- fold, respectively. The area under the ROC curve (AUC) [95% CI] was (0.574 [0.558−0.589]) for CMI, 0.627 [0.612−0.642]) (p=0.0024) for WHtR, 0.556 [0.540−0.571]) (p<0.0001) for TG/HDL-C. CMI was inferior to WHtR, but CMI had marginal advantage over TG/HDL-C in terms of its stroke discrimination ability. Conclusion: Although there was a strong and independent association between CMI and stroke in the general population, CMI had limited discriminating ability for stroke. Thus, new parameters should be developed.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Qun Ma ◽  
Zhao Li ◽  
Xiaofan Guo ◽  
Liang Guo ◽  
Shasha Yu ◽  
...  

Abstract Background Corrected QT (QTc) interval has been correlated with total and CVD mortality. Although much is known about the relation between prolonged QTc interval and clinical outcome, there is no information on the prevalence and specific risk factors of QTc prolongation in general Chinese population. We evaluated the prevalence of prolonged QTc interval and its risk factors in general Chinese population, aiming to fill in the gaps in the literature and provide evidence for potential CVD risk prediction and disease burden estimate in community. Methods A population-based survey was conducted on 11,209 participants over the age of 35 in rural areas of Liaoning Province from 2012 to 2013. Twelve-lead ECGs and automatic analysis were performed on all participants. Logistic regression adjustments were made by using the Bazett’s formula to correlate specific risk factors with prolonged QTc intervals (> 440 ms) for potential confounders. Results The overall prevalence of prolonged QTc interval was 31.6%. The prevalence increased significantly with age (24.1% among those aged 35–44 years; 28.3%, 45–54 years; 35.2%, 55–64 years; 43.4%, ≥65 years, P < 0.001). Participants with a history of CVD had a higher prevalence of QTc prolongation (40.7% vs. 30.0%). In the fully adjusted logistic regress model, older age, abdominal obesity, hypertension, diabetes, hypokalemia and any medicine used in the past two weeks were associated independently with increased risk for prolonged QTc interval (All P < 0.05). We found no significant differences between general obesity, hypocalcemia and hypomagnesemia with prolongation of QTc interval. Female sex showed opposite results after applying clinical diagnostic criteria, and high physical activity could reduce the risk of prolonged QTc interval. Conclusions The prevalence of prolonged QTc interval was relatively high in general Chinese population and listed relevant factors, which would help identify patients at risk in pre-clinical prevention and provide evidence for estimating potential CVD burden and making management strategies in community.


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e021820
Author(s):  
Xiaoshuang Xia ◽  
Xiaolin Tian ◽  
Tianli Zhang ◽  
Peilu Wang ◽  
Yanfen Du ◽  
...  

ObjectivesStroke survivors require assistance and support in their daily lives. This survey aims to investigate the needs and rights awareness in Chinese stroke survivors and caregivers in rural and urban settings.SettingThis survey was adapted from the one created by the World Stroke Organization. The questionnaire included demands for psychological support, treatment and care, social support and information. From January 2015 to January 2016, the survey was pilot tested with urban and rural-dwelling stroke survivors and caregivers from 12 hospitals. Stroke survivors were invited to participate if they were over 18 years old and had experienced a stroke. Exclusion criteria were patients who had disorders of consciousness, significant cognitive impairment, aphasia, communication difficulties or psychiatric disorders. Only caregivers who were family members of the patients were chosen. Paid caregivers were excluded.ParticipantsOne thousand, one hundred and sixty-seven stroke survivors and 1119 caregivers were enrolled.Primary outcome measuresThe needs of stroke survivors and caregivers in rural and urban areas were compared. The correlations between needs of rural and urban stroke survivors and caregivers and potential effect factors were analysed, respectively.ResultsAmong the cohort, 93.5% reported the need for psychological support, 88.6% for treatment and care, 84.8% for information and 62.7% for social support. The total needs and each aspect of needs of stroke survivors in urban settings were greater than of those in rural settings (p<0.01). In rural areas, total needs and each aspect of needs were positively correlated with education level (p<0.01).ConclusionsNeeds and rights awareness of stroke survivors should also be recognised in both urban and rural China. According to the different needs of patients and their caregivers, regional and individualised services were needed by stroke survivors and their caregivers.


Author(s):  
Yiqing MAO ◽  
Zhanchun FENG ◽  
Shangfeng TANG ◽  
Tailai WU ◽  
Ruoxi WANG ◽  
...  

Background: This study aimed to identify the characteristics of item nonresponse and examine the factors affecting the refusal or failure to respond of patients with chronic disease in rural China. Methods: A cross-sectional survey data from patients with chronic disease from rural China were analyzed. A total of 1,099 patients were enrolled. Chi-square test and cumulative logistic regression determined the predictors of having item nonresponse. Results: The respondents in central provinces (OR = 2.311, 95%CI = 0.532~1.144, P < 0.001) with over eight household members (OR = 0.067, 95%CI = -1.632~-0.349, P = 0.002), multiple chronic diseases (OR = 0.301, 95%CI = -1.673~-0.727, P < 0.001), and low health knowledge level (OR = 2.112, 95%CI = 0.405~1.090, P < 0.001) had more item nonresponse numbers. Compared with the participants with high school education level and above, the item nonresponse number seemed to increase when the participants were illiterate (OR = 2.159, 95%CI = 0.254~1.285, P = 0.003), had primary school education (OR = 2.161, 95%CI = 0.249~1.294, P = 0.004) and junior school education (OR = 2.070, 95%CI = 0.160~1.296, P = 0.012). Conclusion: This study indicates the influencing factors of the item nonresponse in survey of patients with chronic disease in rural China. This study contributes to investigation practice and highlights that health institutions should improve the quality of follow-up services. Moreover, the government should pay more attention to the care of vulnerable groups, especially patients with chronic disease in rural areas.


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