Z. C. Pang

A simple Chinese risk score for undiagnosed diabetes

Diabet. Med. 27, 274–281 (2010)

Risk factors associated with the dramatic increase in the prevalence of diabetes in the adult Chinese population in Qingdao, China

Objectiveu2003 To investigate the major risk factors and their association with the dramatic increase in the prevalence of diabetes from 2001–2002 to 2006 in Qingdao, China.

Increasing trend in the prevalence of Type 2 diabetes and pre‐diabetes in the Chinese rural and urban population in Qingdao, China

Aimsu2002 To determine the secular trend of prevalence of Type 2 diabetes and pre‐diabetes in a Chinese population from 2001 to 2006.

A large-scale diabetes prevention program in real-life settings in Qingdao of China (2006–2012)

AIMSnQingdao Diabetes Prevention Program aims to translate the trial experience to real-life settings with goals to: (1) raise the public awareness of diabetes and diabetes risk factors, and promote healthy diet and physical activity; (2) reduce the number of high-risk people developing diabetes through lifestyle counselling; (3) early diagnosis of diabetes; (4) evaluate the effectiveness, cost-effectiveness, feasibility, acceptability and sustainability of the programs.nnnPROGRAM DESIGNnThe projects first phase (2006-2009) was focused on health promotion targeting at the entire population of 1.94 million, and training of professionals; and the second phase (2009-2012) on lifestyle counselling targeting at individuals with a diabetes risk score of >or=14. The effectiveness of the intervention and the cost-effectiveness of the program between the intervention arm (n=8000) and the control arm (n=4000) who are randomly selected from the project targeting and not-targeting areas will be evaluated with the diabetes incidence as the primary outcome. Milestone achieved from 2006 to 2009: 3993 health professionals finished training courses; 724,130 educational booklets were distributed to families and 318,284 high-risk individuals recorded and 130,164 underwent at least one follow-up counselling session.

Diabetes self-risk assessment questionnaires coupled with a multimedia health promotion campaign are cheap and effective tools to increase public awareness of diabetes in a large Chinese population

Aimsu2002 To evaluate costs and effectiveness of implementing a diabetes self‐risk assessment (Diabetes Risk Score) questionnaire coupled with a multimedia health promotion campaign on changes in diabetes awareness in a large diabetes prevention programme.

Exposure to famine in early life and the risk of obesity in adulthood in Qingdao: Evidence from the 1959–1961 Chinese famine

BACKGROUND AND AIMSnWe aimed to evaluate the association between famine exposure during early life and obesity and obesitymax (obese at the highest weight) in adulthood.nnnMETHODS AND RESULTSnData were from two population-based cross-sectional surveys conducted in 2006 and 2009 in Qingdao, China. A total of 8185 subjects born between 1/1/1941 and 12/31/1971 were categorized into unexposed (born between 01/01/1962 and 12/31/1971), fetal/infant exposed (born between 01/01/1959 and 12/31/1961), childhood exposed (born between 01/01/1949 and 12/31/1958) and adolescence exposed (born between 01/01/1941 and 12/31/1948) according to their age when exposed to the Chinese famine from 1959 to 1961. Obesity was defined as BMI (body mass index) ≥28.0 and obesitymax was defined as BMImax (BMI at the highest weight) ≥28.0. We compared fetal/infant exposed, childhood exposed and adolescence exposed to the unexposed using logistic regression models to assess the effect of famine exposure on later obesity and obesitymax. Fetal/infant exposed (ORxa0=xa01.59, Pxa0<xa00.001), childhood exposed (ORxa0=xa01.42, Pxa0<xa00.01) and adolescence exposed (ORxa0=xa01.86, Pxa0<xa00.01) all had higher risks of obesity than the unexposed. Exposure groups were more likely to be obese at their highest weight than the unexposed, and ORs (95%CIs) for obesitymax in the fetal/infant exposed, childhood exposed and adolescence exposed were 1.49(1.20-1.86), 1.24(1.02-1.49) and 1.64 (1.40-1.93), respectively. Similar results were found in both men and women.nnnCONCLUSIONnExposure to famine in early life was associated with increased risks of obesity and obesitymax in adulthood. Preventing undernutrition in early life appears beneficial to reduce the prevalence of later obesity.

The association of gamma-glutamyltransferase and C-reactive protein with IFG/IGT in Chinese adults in Qingdao, China

BACKGROUNDnSerum gamma-glutamyltransferase (GGT) and C-reactive protein(CRP) have been previously shown to be associated with impaired fasting glucose/impaired glucose tolerance (IFG/IGT), but such an association has not been well verified, and is examined in a non-diabetic Chinese population.nnnMETHODSnA population-based cross-sectional study was conducted in 2006 in Qingdao, China. Data of 1143 men and 1689 women aged 35-74 years and free of diabetes at baseline were analyzed. Multivariable logistic regression analysis was performed to estimate the odds ratio (OR) and its 95% confidence interval (CI).nnnRESULTSnCompared with the lowest quartile, the ORs (95%CI) for IFG/IGT corresponding to the highest quartile were 0.89(0.61,1.28) in men and 0.87(0.64,1.18) in women for CRP and 2.12(1.40,3.38) and 1.87(1.32,2.62) for GGT, when the two were fitted simultaneously in a model adjusting for age, school years, alcohol-drinking, smoking, family history of diabetes, systolic blood pressure, waist circumference, triglycerides and high-density lipoprotein.nnnCONCLUSIONSnThe elevated GGT, but not CRP, was independently associated with the presence of the IFG/IGT in both genders in this Chinese population.

Evaluation of two screening methods for undiagnosed diabetes in China: An cost-effectiveness study

AIMSnTo evaluate the performance and cost-effectiveness of two screening methods to identify undiagnosed diabetes at primary care settings among a Chinese population.nnnMETHODSnTwo screening methods using a fasting capillary glucose (FCG) test or a Chinese diabetes risk score (DRS) at primary care settings followed by diagnostic tests were compared. The performance of FCG and DRS was evaluated by using receiver operating characteristic (ROC) curve analysis. The main economic outcome measures were the total cost of screening per 1000 persons, proportion of undiagnosed diabetes detected, and cost per undiagnosed diabetes identified from the societal perspective.nnnRESULTSnAmong all participants, 14.6% (1349/9232) had undiagnosed diabetes defined by fasting plasma glucose ≥ 7.0mmol/l and/or 2h plasma glucose ≥ 11.1mmol/l and/or hemoglobin A1c ≥ 6.5%. At the optimal cutoff point of 6.1mmol/l for FCG and 14 for DRS, the sensitivity was 65.1% and 65.8%, and specificity was 72.4% and 55.2%, respectively. The area under the ROC curve was 75.3% for FCG and 63.7% for DRS (P<0.001). Based on the input costs, the total cost of screening 1000 persons was ¥64,000 (

The impact of new screen-detected and previously known type 2 diabetes on health-related quality of life: a population-based study in Qingdao, China

9143) for FCG and ¥81,000 (

C-Reactive Protein and Gamma-Glutamyltransferase Concentrations in Relation to the Prevalence of Type 2 Diabetes Diagnosed by Glucose or HbA1c Criteria in Chinese Adults in Qingdao, China

11,571) for DRS. The average cost per case identified was ¥674 (