Kaili Yang

Development and evaluation of a risk score for type 2 diabetes mellitus among middle-aged Chinese rural population based on the RuralDiab Study

The purpose of this study was to establish a simple and effective risk score for type 2 diabetes mellitus (T2DM) in middle-aged rural Chinese. Total of 5453 participants aged 30–59 years from the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study were recruited for establishing the RuralDiab risk score by using logistic regression analysis. The RuralDiab risk score was validated in a prospective study from Henan Province of China, and compared with previous risk scores by using the receiver-operating characteristics cure. Ultimately, sex, age, family history of diabetes, physical activity, waist circumference, history of dyslipidemia, diastolic blood pressure, body mass index were included in the RuralDiab risk score (range from 0 to 36), and the optimal cutoff value was 17 with 67.9% sensitivity and 67.8% specificity. The area under the cures (AUC) of the RuralDiab risk score was 0.723(95%CI: 0.710–0.735) for T2DM in validation population, which was significant higher than the American Diabetes Association score (AUC: 0.636), the Inter99 score (AUC: 0.669), the Oman risk score (AUC: 0.675). The RuralDiab risk score was established and demonstrated an appropriate performance for predicting T2DM in middle-aged Chinese rural population. Further studies for validation should be implemented in different populations.

Sex-specific associations of serum uric acid with metabolic syndrome in Chinese rural population: The RuralDiab study

BACKGROUND We explored the association between serum uric acid (SUA) and metabolic syndrome (MetS) in Chinese rural adults. METHODS A total of 16,577 subjects (6354 men and 10,223 women) were from the RuralDiab study. SUA concentration was measured by the enzymatic colorimetric method. A meta-analysis including 12 eligible studies focused on SUA and MetS was preformed to confirm the findings of the cross-sectional study. RESULTS After adjustment for age, educational level, and other covariates, the odds ratio (ORs) for MetS increased smoothly with the increasing SUA concentration in both sexes (P for no-linear trend > 0.05). The adjusted ORs of MetS comparing the fourth and firstly quartiles were 3.11 [95% CI: 2.58-3.74] in men and 3.64 [95% CI: 3.22-4.11] in women (Ptrend < 0.001). In continuous analysis, each 1 mg/dl increment in SUA concentration was significantly associated with a 41% increased risk of MetS in men and 62% in women. The meta-analysis validated the positive association between SUA and MetS (pooled OR: Men, 1.80 [95% CI: 1.57-2.07]; Women, 2.46 [95% CI: 1.95-3.12]). CONCLUSION SUA concentration was positively with the prevalence of MetS in Chinese rural population, and more studies are needed to explore the mechanisms of the relationship. WHAT IS ALREADY KNOWN ON THIS TOPIC?: Previous studies have explored the association between serum uric acid and metabolic syndrome, but evidence on the strength and consistency of the association remains uncertain and limited, especially in rural population. In addition, the epidemiological research and meta-analysis on the association have not been reported. WHAT DOES THIS STUDY ADD?: The results of this study showed that serum uric acid was significantly associated with metabolic syndrome and its components in Chinese rural population. Furthermore, the findings demonstrated that the significant associations varied across sex. In addition, the results of epidemiological research were similar with the meta-analysis, which demonstrates the credible of the results of the epidemiology research.

The “T” allele of apolipoprotein A5 rs2075291 is significantly associated with higher total cholesterol and triglyceride and lower high-density lipoprotein cholesterol levels in Asians: a meta-analysis

Previous studies have discussed the association between apolipoprotein A5 (APOA5) gene rs2075291 polymorphism and lipid levels, but the results were inconsistent. The meta-analysis was performed to evaluate the reported effects of rs2075291 polymorphism on blood lipid levels, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in Asians. A literature search was performed in six databases from January 1, 2001 to March 1, 2017. A standardized mean difference (SMD) with 95% confidence interval (95% CI) was computed to estimate the effect value. Overall, 10 articles with 19 reports were included and most of them were from Chinese institutions. Pooled results indicated significant effects of rs2075291 on lipid levels in Asians; the carriers of T allele had higher TC and TG levels but lower HDL-C level than the non-carriers, and the corresponding SMD (95% CI) were 0.20 (0.04-0.36), 0.74 (0.54-0.94), and -0.17 (-0.33 to -0.00), respectively. No significant difference was found for the LDL-C level: P = .172. Although results from the meta-analysis suggest that the T allele of the APOA5 rs2075291 is associated with higher TC and TG levels and lower HDL-C levels, large-scale studies considering the gene-gene and gene-environment interaction are needed to further explore the effects of rs2075291 polymorphism on blood lipid levels in different ethnicities.

The burden, management rates and influencing factors of high blood pressure in a Chinese rural population: the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study

The aim of the present study was to examine the prevalence, awareness, treatment, control, and potentially influencing factors of high blood pressure (HBP) in Chinese rural adults based on a cross-sectional study. Using data from the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study, a total of 30,834 participants aged 18–74 years were enrolled for the epidemiological study. The multivariate logistic regression model including all selected potentially influencing factors was carried out for the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Overall, a total of 9872 individuals were diagnosed as HBP (32.02%) with substantial imparity between men and women (32.87% vs. 30.58%), and the corresponding age-standardized prevalence of HBP were 19.50% (20.94% in men and 18.85% in women). Among the HBP patients, 6654 were aware of the diagnosis (67.40%), 5391 were taking medication (54.61%), and 2572 had their blood pressure controlled (26.05%).The corresponding age-adjusted awareness, treatment, and control of HBP were 59.35%, 45.91%, and 23.87%, respectively, and the corresponding rates were higher in women than those in men. The age-specific prevalence and management rates of HBP displayed increased trends with aging in both sexes(Ptrend < 0.05). Aging, low level of education, unhealthy lifestyle, positive family history of hypertension, overweight, obesity, diabetes, and dyslipidemia were associated with the prevalence, awareness, treatment, and control of HBP. In conclusion, uncontrolled HBP was common with high prevalence in Chinese rural residents. Strengthening the primary prevention through lifestyle modifications is necessary for reducing the disease burden and improving the management rates of HBP.

Independent and combined effects of resting heart rate and pulse pressure with metabolic syndrome in Chinese rural population: The Henan Rural Cohort study.

BACKGROUND We examined the independent and cumulative associations of resting heart rate and pulse pressure with metabolic syndrome in Chinese rural population based on epidemiological research. METHODS A total of 38,708 participants were derived from the Henan Rural Cohort study. Restricted cubic splines and logistic regression model were used to estimate the odds ratios and 95% confidence intervals of metabolic syndrome risk in relation to resting heart rate and pulse pressure. RESULTS After adjusting for potential confounders, the odds ratio (95% confidence intervals) of resting heart rate and pulse pressure in the highest quartile with the risk of metabolic syndrome were 1.59 (1.48-1.70) and1.81 (1.67-1.95), respectively. Simultaneously, the cumulative effect analysis indicated that the adjusted the odd ratio of resting heart rate and pulse pressure in the highest quartile was 2.89 (2.40-3.47). Furthermore, there was a significantly additive interaction between resting heart rate and pulse pressure on the risk of metabolic syndrome. CONCLUSION Increased resting heart rate and pulse pressure are associated with the higher risk of metabolic syndrome as well as the influences of resting heart rate with pulse pressure might cumulatively increase the risk of metabolic syndrome. However, the potential clinical application remains to be determined.

The Dynamics of Type 2 Diabetes Mellitus Prevalence and Management Rates among Rural Population in Henan Province, China

The aim of this study was to estimate the dynamics of type 2 diabetes mellitus (T2DM) prevalence and management rates based on a rural cohort study in Henan Province of China. The rural prospective study was conducted for 20194 Chinese population ≥18 years in 2007-2008 and followed during 2013-2014. A total of 14009 individuals were recruited for the prospective analysis ultimately. Over 5.74 years of follow-up, the age-standardized prevalence, awareness, treatment, and control of T2DM increased from 6.18%, 44.41%, 34.39%, and 19.08% at baseline to 7.87%, 59.64%, 52.17%, and 26.52% at follow-up in total population, respectively. Similar changes were found in men and women except the age-standardized control in men. The four parameters of T2DM were higher among various factors at follow-up than those at baseline. There was no statistical difference in awareness (P = 0.089) and treatment (P = 0.257) in the newly diagnosed T2DM compared with the rates at baseline. The current study indicated that the prevalence, awareness, treatment, and control of T2DM displayed chronological increasing trends while the awareness, treatment, and control of T2DM were still disproportionally low in central China. More works are needed urgently to popularize public health education and improve the quality of medical care in T2DM.