Yongcheng Ren

Prevalence of Metabolically Healthy Obese and Metabolically Obese but Normal Weight in Adults Worldwide: A Meta-Analysis.

The objective of the present study was to summarize the prevalence and influencing factors of metabolically healthy obese (MHO) and metabolically obese but normal weight (MONW) among people ≥ 18 years old in the general population worldwide. We searched for studies of the prevalence of MHO and MONW published in English and Chinese up to October 2013. Pooled prevalence estimates were calculated by a random-effects model according to a Q test. The effects of gender, region, age, sample size, smoking, and alcohol consumption on MHO and MONW were analyzed. Differences between subgroups were assessed by chi-square test. Publication bias was estimated by Eggers test. Studies of MHO and MONW showed heterogeneity (I(2)=99.4% and I(2)=99.7%, respectively). The overall prevalence of MHO and MONW was 7.27% (95% CI 5.92-8.90%) and 19.98% (95% CI 16.54-23.94%), respectively. American populations had the highest MHO prevalence and European populations the highest MONW prevalence. Different patterns of MHO and MONW were observed in the subgroup analysis with respect to gender, age, sample size, smoking, alcohol consumption, and metabolically healthy criteria. The prevalence of both MHO and MONW were affected by gender, region, age, sample size, smoking, alcohol consumption, and metabolically healthy criteria, but studies showed high heterogeneity.

Prevalence, awareness, treatment, control of type 2 diabetes mellitus and risk factors in Chinese rural population: the RuralDiab study.

The study aimed to investigate prevalence, awareness, treatment and control of type 2 diabetes mellitus (T2DM), and to explore potential risk factors in rural areas of China. A total of 16413 individuals aged 18–74 years in rural districts were recruited from the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study for the epidemiological research. Meanwhile, a meta-analysis including 7 published studies was conducted to validate the result of the cross-sectional study. The rates of crude and age-standardized prevalence, awareness, treatment and control of T2DM were 12.19%, 67.00%, 62.35%, 22.20% and 6.98%, 60.11%, 54.85%, 18.77%, respectively. The prevalence, awareness, treatment and control of T2DM displayed increased trends with age (Ptrend < 0.01) and were strongly associated with education, drinking, more vegetable and fruit intake, physical activity, family history of diabetes, body mass index (BMI). The results of this meta-analysis showed that the pooled prevalence, awareness, treatment and control of T2DM in China countryside were 7.3% (5.3–9.4%), 57.3% (36.9–77.6%), 48.4% (32.4–64.5%) and 21.0% (9.9–32.1%), respectively. The prevalence of T2DM was high with inadequate awareness, treatment and control of T2DM in China rural areas. Healthy lifestyles should be advocated to reduce prevalence and improve awareness, treatment, and control of T2DM in Chinese rural residents.

Dose–Response Association Between Physical Activity and Incident HypertensionNovelty and Significance: A Systematic Review and Meta-Analysis of Cohort Studies

Despite the inverse association between physical activity (PA) and incident hypertension, a comprehensive assessment of the quantitative dose–response association between PA and hypertension has not been reported. We performed a meta-analysis, including dose–response analysis, to quantitatively evaluate this association. We searched PubMed and Embase databases for articles published up to November 1, 2016. Random effects generalized least squares regression models were used to assess the quantitative association between PA and hypertension risk across studies. Restricted cubic splines were used to model the dose–response association. We identified 22 articles (29 studies) investigating the risk of hypertension with leisure-time PA or total PA, including 330 222 individuals and 67 698 incident cases of hypertension. The risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92–0.96) with each 10 metabolic equivalent of task h/wk increment of leisure-time PA. We found no evidence of a nonlinear dose–response association of PA and hypertension (Pnonlinearity=0.094 for leisure-time PA and 0.771 for total PA). With the linear cubic spline model, when compared with inactive individuals, for those who met the guidelines recommended minimum level of moderate PA (10 metabolic equivalent of task h/wk), the risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92–0.97). This meta-analysis suggests that additional benefits for hypertension prevention occur as the amount of PA increases.

Development and Validation of a Risk-Score Model for Type 2 Diabetes: A Cohort Study of a Rural Adult Chinese Population

Some global models to predict the risk of diabetes may not be applicable to local populations. We aimed to develop and validate a score to predict type 2 diabetes mellitus (T2DM) in a rural adult Chinese population. Data for a cohort of 12,849 participants were randomly divided into derivation (n = 11,564) and validation (n = 1285) datasets. A questionnaire interview and physical and blood biochemical examinations were performed at baseline (July to August 2007 and July to August 2008) and follow-up (July to August 2013 and July to October 2014). A Cox regression model was used to weigh each variable in the derivation dataset. For each significant variable, a score was calculated by multiplying β by 100 and rounding to the nearest integer. Age, body mass index, triglycerides and fasting plasma glucose (scores 3, 12, 24 and 76, respectively) were predictors of incident T2DM. The model accuracy was assessed by the area under the receiver operating characteristic curve (AUC), with optimal cut-off value 936. With the derivation dataset, sensitivity, specificity and AUC of the model were 66.7%, 74.0% and 0.768 (95% CI 0.760–0.776), respectively. With the validation dataset, the performance of the model was superior to the Chinese (simple), FINDRISC, Oman and IDRS models of T2DM risk but equivalent to the Framingham model, which is widely applicable in a variety of populations. Our model for predicting 6-year risk of T2DM could be used in a rural adult Chinese population.

Glucagon gene polymorphism modifies the effects of smoking and physical activity on risk of type 2 diabetes mellitus in Han Chinese.

Few genome-wide association studies have considered interactions between multiple genetic variants and environmental factors associated with disease. The interaction was examined between a glucagon gene (GCG) polymorphism and smoking, alcohol consumption and physical activity and the association with risk of type 2 diabetes mellitus (T2DM) in a case-control study of Chinese Han subjects. The rs12104705 polymorphism of GCG and interactions with environmental variables were analyzed for 9619 participants by binary multiple logistic regression. Smoking with the C-C haplotype of rs12104705 was associated with increased risk of T2DM (OR=1.174, 95% CI=1.013-1.361). Moderate and high physical activity with the C-C genotype was associated with decreased risk of T2DM as compared with low physical activity with the genotype (OR=0.251, 95% CI=0.206-0.306 and OR=0.190, 95% CI=0.164-0.220). However, the interaction of drinking and genotype was not associated with risk of T2DM. Genetic polymorphism in rs12104705 of GCG may interact with smoking and physical activity to modify the risk of T2DM.

Secular trends in the prevalence of type 2 diabetes in adults in China from 1995 to 2014: A meta‐analysis

The aim of the present study was to estimate trends in the prevalence of type 2 diabetes mellitus (T2DM) in adults in China.

Polymorphisms in Four Genes (KCNQ1 rs151290, KLF14 rs972283, GCKR rs780094 and MTNR1B rs10830963) and Their Correlation with Type 2 Diabetes Mellitus in Han Chinese in Henan Province, China.

Genetic variants at KCNQ1 rs151290, KLF14 rs972283, GCKR rs780094 and MTNR1B rs10830963 have been associated with type 2 diabetes mellitus (T2DM), but the results are contradictory in Chinese populations. The aim of the present study was to investigate the association of these four SNPs with T2DM in a large population of Han Chinese at Henan province, China. Seven-hundred-thirty-six patients with T2DM (cases) and Seven-hundred-sixty-eight healthy glucose-tolerant controls were genotyped for KCNQ1 rs151290, KLF14 rs972283, GCKR rs780094 and MTNR1B rs10830963. The association of genetic variants in these four genes with T2DM was analyzed using multivariate logistic regression. Genotypes and allele distributions of KCNQ1 rs151290 were significantly different between the cases and controls (p < 0.05). The AC and CC genotypes and the combined AC + CC genotype of rs151290 in KCNQ1 were associated with increases risk of T2DM before (OR = 1.482, 95% CI = 1.062–2.069; p = 0.021; OR = 1.544, 95% CI = 1.097–2.172, p = 0.013; and OR = 1.509, 95% CI = 1.097–2.077, p = 0.011, respectively) and after (OR = 1.539, 95% CI = 1.015–2.332, p = 0.042; OR = 1.641, 95% CI = 1.070–2.516, p = 0.023; and OR = 1.582, 95% CI = 1.061–2.358, p = 0.024; respectively) adjustment for sex, age, anthropometric measurements, biochemical indexes, smoking and alcohol consumption. Consistent with results of genotype analysis, the C allele of rs151290 in KCNQ1 was also associated with increased risk of T2DM (OR = 1.166, 95% CI = 1.004–1.355, p = 0.045). No associations between genetic variants of KLF14 rs972283, GCKR rs780094 or MTNR1B rs10830963 and T2DM were detected. The AC and CC genotypes and the C allele of rs151290 in KCNQ1 may be risk factors for T2DM in Han Chinese in Henan province.

Association of the rs11196218 polymorphism in TCF7L2 with type 2 diabetes mellitus in Asian population

Objective To clarify the association of rs11196218 polymorphism in transcription factor 7-like 2 (TCF7L2) and type 2 diabetes mellitus (T2DM) in Asian population by a case–control study and meta-analysis. Methods In the case–control study, 1842 patients with T2DM and 7777 normal glucose-tolerant controls in the Henan province of China were genotyped for rs11196218 in TCF7L2 by PCR–ligase detection reaction. We used allele, co-dominant, dominant and recessive models to evaluate the risk association and performed a meta-analysis of the results of different genetic models in previous studies and the current study. Results The AG genotype of rs11196218 was associated with risk of T2DM in the Henan population (odds ratio 1.37, 95% confidence interval 1.06–1.78), and dominant model showed marginal significant association (1.28, 0.99–1.67). Meta-analysis of 10 studies revealed the dominant model associated with T2DM in the overall population (1.20, 1.05–1.36). When stratified by region (southern and northern China and Japan), both the AG genotype and the dominant model were associated with risk of T2DM in southern Chinese (1.31, 1.03–1.66; 1.27, 1.01–1.60, respectively). Conclusion The rs11196218 polymorphism in TCF7L2 is associated with risk of T2DM in Asian population.

Effect of dynamic change in body mass index on the risk of hypertension: Results from the Rural Chinese Cohort Study

OBJECTIVES To examine the effect of change in body mass index (BMI) on incident hypertension by gender and age groups. METHODS A total of 10,145 non-hypertensive participants 18-75years old from rural areas in the middle of China were selected for this cohort study. Questionnaire interview and anthropometric and laboratory measurements were performed at baseline (during July to August 2007 and July to August 2008) and follow-up (during July to August 2013 and July to October 2014). Multiple logistic regression analysis was used to examine the relationship between change in BMI and incident hypertension. RESULTS During a mean follow-up of 6.03±0.69years, hypertension developed in 794 of 3986 men and 1184 of 6159 women. Both genders who were obese (BMI ≥28kg/m2 for Chinese people) at follow-up, regardless of their obesity status at baseline, showed greater risk of hypertension than those who were non-obese (BMI <28kg/m2) at both baseline and follow-up. We found a dose-response relationship between change in BMI and incident hypertension. Risk of hypertension was markedly greater with a BMI gain of the highest quartile or more as compared with a BMI reduction of the lowest quartile or more, except for women 60-75years old. CONCLUSIONS Risk of hypertension was high for non-hypertensive people in rural China with stable obesity. BMI dynamic gain may be related to incident hypertension for men of all ages and young and middle-aged women.

High pulse pressure is related to risk of type 2 diabetes mellitus in Chinese middle-aged females

BACKGROUND To examine the association of risk of incident type 2 diabetes mellitus (T2DM) with high pulse pressure (PP) by sex. METHODS We performed a prospective cohort study of 12,272 eligible participants (4664 males and 7608 females) without diabetes at baseline. Participants were classified as having normal PP (20-60mmHg) and high PP (>60mmHg) at baseline. The analysis was further stratified by sex, quartiles of age and high PP categories. RESULTS During 6years of follow-up, T2DM developed in 775 participants and the incidence was 10.57/1000person-years. With PP 70 to 76mmHg, the multivariable adjusted hazard ratio (HR) (95% confidence interval) for incident T2DM in females was 1.722 (1.093-2.714) after adjustment for baseline age, smoking, alcohol intake, physical activity level and family history of T2DM, and 1.634 (1.037-2.575) after adjustment for the above factors and body mass index, waist circumference, blood lipid levels and fasting plasma glucose (FPG) category. After stratification by quartiles of age, for females aged 52 to 59, the multivariable adjusted HRs (95% CI) for high PP as compared to normal PP were 2.263 (1.517-3.377) and 2.140 (1.426-3.210) in different models. During follow-up, levels of FPG, fasting plasma insulin and homeostatic model assessment of insulin resistance index (HOMA-IR) were higher in females with higher than normal PP group, but β-cell function was impaired in the high PP group (P<0.05). CONCLUSION High PP may be related to incident T2DM among female in China, especially women 52 to 59years old.