Yu-Qin Liu

Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of northeast china: the CHPSNE study

BackgroundObesity increases the risk of many diseases. However, there has been little literature about the epidemiology of obesity classified by body mass index (BMI) or waist (abdominal obesity) among urban Chinese adults. This study is to fill the gap by assessing the prevalence of obesity and associated risk factors among urban Chinese adults.MethodsA representative sample of 25,196 urban adults aged 18 to 74 years in Northeast China was selected and measurements of height, weight and waist circumference (WC) were taken from 2009–2010. Definitions of overweight and obesity by the World Health Organization (WHO) were used.ResultsThe overall prevalence rates of general obesity and overweight classified by BMI were 15.0% (15.7% for men and 14.3% for women, p<0.01) and 19.2% (20.8% for men and 17.7% for women, p<0.01), respectively, and the overall prevalence rate of abdominal obesity was 37.6% (31.1% for men and women 43.9% for women, p<0.01). Multivariable logistic regression showed that the elderly and those who had a history of parental obesity, alcohol drinking, or former cigarette smoking were at high risk of obesity classified by BMI or WC, whereas those with a higher level of education, higher family income, or a healthy and balanced diet were at low risk of obesity. Analysis stratified by gender showed that men with a higher level education level, a white-collar job, a cadre job, or higher family income were the high risk group, and women with a higher level of education or higher family income were the low risk group.ConclusionsObesity and overweight have become epidemic in urban populations in China; associations of risk factors with obesity differ between men and women.

Body mass index compared with abdominal obesity indicators in relation to prehypertension and hypertension in adults: the CHPSNE study.

BACKGROUND Debate ensues regarding the stronger indicator of obesity, body mass index (BMI), or waist circumference (WC), in association with hypertension. Furthermore, little research has been done to compare BMI and WC in their associations with prehypertension. METHODS A cross-sectional survey was undertaken in 33 communities randomly selected from 3 cities in Northeastern China during 2009-2010, using a total of 25,196 adults aged 18-74 years with an overall response rate of 87.4%. Diagnoses of prehypertension and hypertension were based on the criteria set by the Seventh Report of the Joint National Committee. Generalized overweight and obesity were defined as BMI 25-29.9 and ≥30 kg/m(2), respectively. Abdominal overweight and obesity were defined as WC 94-102 and >102 cm in men and WC 80-88 and >88 cm in women, respectively. RESULTS Both BMI and WC were positively related to the prevalence rate of elevated blood pressure. Among younger individuals, aged 18-44 years, WC seemed to be associated with a higher odds ratio (OR) than BMI for hypertension (e.g., for men, 17.18 (BMI) vs. 23.28 (WC) for obesity), in contrast, BMI seemed to be associated with a higher OR than WC for prehypertension (e.g., for men, 5.99 (BMI) vs. 1.51 (WC) for obesity). Among older individuals, aged ≥45 years, the adjusted OR for hypertension was modestly higher for WC than for BMI in men. In women, the adjusted OR was modestly higher for BMI than for WC. CONCLUSIONS In this Chinese population, the association of body fat and abdominal fat with hypertension and prehypertension depends on age and sex.

Sex difference in the prevalence of metabolic syndrome and cardiovascular-related risk factors in urban adults from 33 communities of China: The CHPSNE study:

Little is known about the epidemiology of metabolic syndrome in urban areas of China. To estimate the prevalence of MetS and identify its cardiovascular-related factors in men and women, a representative sample of 15,477 urban adults aged 18–74 years in Northeast China was selected from 2009 to 2010. The diagnosis of metabolic syndrome was based on criteria set by the National Cholesterol Education Program/Adult Treatment Panel. The overall prevalence of metabolic syndrome was 27.4% (men 27.9% and women 26.8%). Multivariable logistic regression analysis revealed that a higher education level and a higher family income were associated with a higher prevalence of metabolic syndrome in men, but associated with lower prevalence of metabolic syndrome among women. Higher physical activity was associated with a decreased prevalence of metabolic syndrome in men (adjusted odds ratios (aORs) = 0.88, 95% confidence interval (CI): 0.79–0.99), but associated with an increased prevalence of metabolic syndrome in women (aOR = 1.14, 95% CI: 1.00–1.29). Compared with rice as the major staple food, cooked wheaten foods were associated with lower adjusted odds for metabolic syndrome both in men (aOR = 0.72, 95% CI: 0.58–0.90) and in women (aOR = 0.72, 95% CI: 0.56–0.92). In conclusion, metabolic syndrome is highly prevalent in urban areas of China, and there is heterogeneity by sex in the relationships between risk factors and metabolic syndrome prevalence.

Asthma and asthma related symptoms in 23,326 Chinese children in relation to indoor and outdoor environmental factors: the Seven Northeastern Cities (SNEC) Study.

BACKGROUND Both the levels and patterns of outdoor and indoor air pollutants have changed dramatically during the last decade in China. However, few studies have evaluated the effects of the present air pollution on the health of Chinese children. This study examines the association between outdoor and indoor air pollution and respiratory diseases among children living in Liaoning, a heavy industrial province of China. METHODS A cross-sectional study of 23,326 Chinese children aged 6 to 13 years was conducted in 25 districts of 7 cities in Northeast China during 2009. Three-year (2006-2008) average concentrations of particles with an aerodynamic diameter of ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), and ozone (O3) were calculated from monitoring stations in each of the 25 districts. We used two-level logistic regression models to examine the effects of yearly variations in exposure to each pollutant, controlling for important covariates. RESULTS The prevalence of respiratory symptoms was higher for those dwelling close to a busy road, those living near smokestacks or factories, those living with smokers, those living in one-story houses typically with small yards, and those with home renovation, bedroom carpet or pets. Ventilation device use was associated with decreased odds of asthma in children. The adjusted odds ratio for diagnosed-asthma was 1.34 (95% confidence interval [CI], 1.24-1.45) per 31 μg/m(3) increase in PM10, 1.23 (95%CI, 1.14-1.32) per 21 μg/m(3) increase in SO2, 1.25 (95%CI, 1.16-1.36) per 10 μg/m(3) increase in NO2, and 1.31 (95%CI, 1.21-1.41) per 23 μg/m(3) increase in O3, respectively. CONCLUSION Outdoor and indoor air pollution was associated with an increased likelihood of respiratory morbidity among Chinese children.

Air pollution associated hypertension and increased blood pressure may be reduced by breastfeeding in Chinese children: The Seven Northeastern Cities Chinese Children's Study

BACKGROUND Little is known about the association between air pollution and hypertension among children, and no studies report whether breastfeeding modifies this association in children. METHODS Nine thousand three hundred fifty-four Chinese children, ages 5-17 years old, from 24 elementary schools and 24 middle schools in the Seven Northeastern Cities during 2012-2013 were evaluated. The weight, height, and BP were measured. Four-year average concentrations of particles with an aerodynamic diameter of ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), ozone (O3), and carbon monoxide (CO) were calculated from monitoring stations. Two-level regression analysis was used to examine the effects, controlling for covariates. RESULTS The results showed that associations existed between hypertension and pollutants. The odds ratios for hypertension ranged from 1.12 per 46.3 μg/m3 increase for O3 (95% confidence interval [CI], 1.10-1.13) to 1.68 per 30.6 μg/m3 increase for PM10 (95% CI, 1.53-1.86). The increases in mean diastolic BP ranged from 0.58 mm Hg per 46.3 μg/m3 increase for O3 (95% CI, 0.52-0.63 mm Hg) to 2.89 mm Hg per 563.4 μg/m3 increase for CO (95% CI: 2.53-3.24 mm Hg). The increase in systolic BP ranged from 0.50 mm Hg per 46.3 μg/m3 increase for O3 (95% CI: 0.43-0.57 mm Hg) to 2.10 mm Hg per 30.6 μg/m3 increase for PM10 (95% CI, 1.73-2.47 mm Hg). Compared with children who had been breastfed, non-breastfed children exhibited consistently stronger effects. CONCLUSION Study findings indicate that high levels of PM10, SO2, NO2, O3, and CO are associated with increased arterial BP and hypertension among the children. Breastfeeding may reduce the risk.

Predictive equations using regression analysis of pulmonary function for healthy children in Northeast China.

Background There have been few published studies on spirometric reference values for healthy children in China. We hypothesize that there would have been changes in lung function that would not have been precisely predicted by the existing spirometric reference equations. The objective of the study was to develop more accurate predictive equations for spirometric reference values for children aged 9 to 15 years in Northeast China. Methodology/Principal Findings Spirometric measurements were obtained from 3,922 children, including 1,974 boys and 1,948 girls, who were randomly selected from five cities of Liaoning province, Northeast China, using the ATS (American Thoracic Society) and ERS (European Respiratory Society) standards. The data was then randomly split into a training subset containing 2078 cases and a validation subset containing 1844 cases. Predictive equations used multiple linear regression techniques with three predictor variables: height, age and weight. Model goodness of fit was examined using the coefficient of determination or the R2 and adjusted R2. The predicted values were compared with those obtained from the existing spirometric reference equations. The results showed the prediction equations using linear regression analysis performed well for most spirometric parameters. Paired t-tests were used to compare the predicted values obtained from the developed and existing spirometric reference equations based on the validation subset. The t-test for males was not statistically significant (p>0.01). The predictive accuracy of the developed equations was higher than the existing equations and the predictive ability of the model was also validated. Conclusion/Significance We developed prediction equations using linear regression analysis of spirometric parameters for children aged 9–15 years in Northeast China. These equations represent the first attempt at predicting lung function for Chinese children following the ATS/ERS Task Force 2005 guidelines on spirometry standardization.

Sex difference of the prevalence and risk factors associated with prehypertension among urban Chinese adults from 33 communities of China: the Chpsne study

Background: As a new category of blood pressure (BP) classification according to the Seventh Report of The Joint National Committee, prehypertension has aroused peoples great concern in recent years due to its associations with increased incidence of cardiovascular disease. However, there is little information about the epidemiology of prehypertension in urban China. The aim of this study is to estimate the prevalence of prehypertension and to identify its risk factors among urban Chinese men and women. Methods: A cross-sectional survey in a representative sample of 25 196 Chinese adults aged 18–74 years was conducted in three cities of northeast of China during 2009 and 2010. Body weight, height, waist circumference, and BP were measured by trained observers. Results: Overall, the prevalence of prehypertension was 56.9%, men 71.1% and women 44.6%, respectively. Multivariate analysis revealed that higher education or a higher family income were risk factors of prehypertension among men, but shown as protective factors among women. Among men, high odds ratios (ORs) of prehypertension were found in overweight [OR 2.31; 95% confidence interval (CI) 2.02–2.71] and obese (OR 7.92, 95% CI 4.36–14.42) adults (defined as body mass index), whereas abdominal obesity (OR 2.94, 95% CI 2.48–3.57) (defined as waist circumference) was the main determinant for prehypertension status in women. Conclusion: Our results indicate that hypertension is highly prevalent in urban China and there is a sex difference in the relationships between risk factors and prehypertension.

Gender-specific differences in associations of overweight and obesity with asthma and asthma-related symptoms in 30 056 children: result from 25 districts of Northeastern China

Abstract Objective: The relationship between obesity and allergic respiratory diseases in childhood is still controversial. Furthermore, significant debate on the issue of whether or not gender modifies this association also exists due to inconsistent findings. The objective of this study is to evaluate the association between obesity and respiratory health in children, and to investigate the modifications of gender on this association. Methods: 30 056 children (aged 2–14 years) were randomly selected from 25 districts within 7 cities in Northeastern China in 2009. A standard questionnaire from the American Thoracic Society was used to characterize the childrens’ histories of respiratory symptoms and illnesses. Child weight and height were measured, and obesity was calculated with an age and sex-specific body mass index. Results: The overall prevalence rates of obesity and overweightness were 14.08% and 12.32%, respectively. Compared to the children with normal body weights, asthma and asthma-related symptoms were more prevalent in overweight and obese children. Analysis stratified by gender showed that obesity was associated with more respiratory symptoms and diseases in females than in males. A significant association between obesity and diagnosed asthma [adjusted odds ratio (aOR) = 1.28; 95% confidence interval (CI): 1.02–1.60], as well as current wheezing (aOR = 1.46; 95%CI: 1.20–1.79) was found in females but not in males. Conclusions: There is an association between asthma symptoms and obesity in these Chinese children, and obesity had a significantly larger effect on females than males.

Environmental tobacco smoke exposure, urine CC-16 levels, and asthma outcomes among Chinese children

Previous studies have shown the relationship between club cell secretory protein (Clara) (CC‐16) and respiratory diseases. However, few studies have explored the associations between urine CC‐16 levels and environmental tobacco smoke (ETS) exposure in children. The objective of this study was to evaluate whether ETS exposure is associated with CC‐16 when stratified by asthma status.