Objective To understand the pattern of and influencing factors on leisure time physical exercises among adults in Zhejiang. Method Totally 17 437 residents aged 18 years and over selected by stratified cluster random sampling in Zhejiang in 2010 were investigated. Result Overall 21.82%(95%CI:17.12%-27.38%) of adults took part in leisure time physical exercises in 2010. The proportion was higher in urban (29.04%,95%CI:23.46%-35.33%) than in rural (18.81%,95%CI:12.89%-26.61%) (χ2=222.06, P<0.05) areas, and also higher in females (22.91%,95%CI:17.66%-29.15%) than in males (20.56%,95%CI:16.39%-25.48%) (χ2=13.94, P<0.05). Adults aged 18-24 and 55-74 years were more likely to take apart in physical exercises (χ2=266.73, P<0.05), and the lowest proportion was found among farmers (5.33%,95%CI:3.99%-7.11%) (χ2=2 078.40, P<0.05). These proportions both increased along with education level and family income increase (χ2=444.87, P<0.05;χ2=332.20, P<0.05). Overall 83.04%and 90.08%of physical exercisers took part in exercises at least 3 times per week and 30 minutes per time, only 30.67% of those reached moderate or vigorous intensity, and overall 5.38% (95%CI: 3.85%-7.48%) of adults took part in regular leisure time physical exercises in 2010. Multiple logistic regression showed that age, education level, occupation and chronic disease history have influence on regular physical exercises. Conclusion The leisure time physical exercises level was generally low among adults in Zhejiang. Young and middle-aged adults with less education and low income especially farmers should be put on emphasis.

Objective : To explore the association of dietary niacin intake and metabolic syndrome ( MS ) and its components among adults in Zhejiang Province, so as to provide the reference for dietary intervention of MS. Methods: Using the multi-stage cluster random sampling method, the permanent residents aged 18 years and above were selected and investigated by a questionnaire developed by China Center for Disease Control and Prevention. Their waist circumference, blood pressure, glucose and lipid were measured. The daily dietary niacin intake of each person were calculated by "24-hour dietary review for 3 consecutive days", and divided into Q1, Q2, Q3 and Q4 groups according to quartiles. The multivariate logistic regression model was used to analyze the association of niacin intake with the risks of MS and its components. Results: Among 2 438 participants, 871 cases with MS were detected, with a detection rate of 35.73%. The multivariate logistic regression analysis showed that compared with niacin intake Q1 group, Q2 ( OR=0.741, 95%CI: 0.561-0.978 ) and Q4 group ( OR=0.679, 95%CI: 0.487-0.947 ) had a lower risk of MS, Q2 ( OR=0.688, 95%CI: 0.516-0.919 ) and Q4 group ( OR=0.678, 95%CI: 0.479-0.960 ) had a lower risk of abdominal obesity, Q4 group ( OR=0.721, 95%CI: 0.536-0.969 ) had a lower risk of hyperglycemia. Further stratificating by gender, compared with niacin intake Q1 group, Q2 ( OR=0.664, 95%CI: 0.453-0.972 ) and Q3 group ( OR=0.646, 95%CI: 0.432-0.965 ) in women had a lower risk of MS, Q2 (OR=0.667, 95%CI: 0.460-0.967) and Q3 group ( OR=0.607, 95%CI: 0.408-0.902 ) had a lower risk of abdominal obesity; Q2 group ( OR=1.836, 95%CI: 1.202-2.805 ) in men had a higher risk of low high-density lipoprotein cholesterol. Conclusion Niacin intake is associated with an increased risk of MS, abdominal obesity and hyperglycemia.

Objective To evaluate the utility of waist-to-height ratio ( WHtR ) in predicting metabolic syndrome ( MS) among non-overweight Chinese adults, and to investigate the difference by age and sex. Methods Based on a population-based cross-sectional survey on MS in Zhejiang province in 2010, data of 10 792 non-overweight (body mass index<24. 0 kg/m2 ) adults aged 18 years and older were analyzed by using the receiver operating characteristic(ROC)curve analysis and multiple logistic regression. Results The area under ROC curve (AUC) values of WHtR in MS prediction were 0. 765(95%CI 0. 740-0. 789) and 0. 786(95%CI 0. 765-0. 807), and odds ratios(OR) of WHtR for MS were 1. 23(95%CI 1. 20-1. 27) and 1. 22(95%CI 1. 20-1. 26) in non-overweight men and women, respectively. These two values were with significant difference among non-overweight adults with different agedandsexes(P<0.01). No-overweightmenhadsmallerAUCandORamong18-34agegroupwhilelargerAUCand OR among 35-49, 50-64, and 65-plus age groups than women. The AUC and OR showed slight difference among age groups in non-overweight men, while these two values decreased with age in non-overweight women. The optimal cutoff value was higher in non-overweight women (0. 509 vs 0. 498) than that in men. Non-overweight men aged 50-64 years old had higher cutoff value than those aged 18-34, 35-49, and 65-plus years, while among non-overweight women the cutoff values increased with age. Conclusion WHtR had preferable discriminatory power and association with MS among non-overweight Chinese adults. Further studies should be conducted to explore the difference by age and sex.

Objective To discuss the values of three screening methods for the detection of early breast cancer,and to analyze the features of the screening cancer.Methods The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years.The three screening methods included physical examination with ultrasound and mammography,physical examination with mammography and mammography only.The rate of recall,biopsy,cancer detection of three methods were analyzed and the mammographic findings were reviewed Chi-square test or Fisher's exact test were used for the statistics.Results The recall rates were 4.90% (49/1001),6.90%(166/2407)and 4.48% (85/1899) in three methods respectively,the biopsy rates were 1.60% (16/1001),1.04% (25/2407) and 0.63%(12/1899),the cancer detection rates were 0.50% (5/1001),0.17% (4/2407) and 0 (0/1899).There were statistical differences among the three groups (X2=12.99,6.264,8.764,P < 0.05).Physical examination with ultrasound and mammnography had the highest cancer detection rate,ten breast cancers were detected and 8 were early stage breast cancer.Of seven cancers detected by mammography,only two were found by ultrasound.A cluster of calcifications were found in 2 cases,linear calcifications in 2 cases.One case presented as a asymmetric density,one as a asymmetric density with calcifications,one as multiple nodules with a duster of calcifications.Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review.Conclusion Physical examination with ultrasound and mammography is the best method for breast cancer screening.The breast cancer can be detected by mammography earlier than other methods.

ObjectiveTo study the epidemiological characteristics of diabetes mellitus and awareness rate in Zhejiang adults.MethodA total of 17 437 adults from 15 counties were randomly selected with stratified multi-stage cluster sampling method from July to November,2010.Each participant was required to complete a set of standardized questionnaire,physical examination,and blood specimen collection.ResultsThe overall standardized rate of diabetes mellitus was 5.94％ ( crude prevalence 8.80％ ).It was increased by 96.67％ during past 8 years,as compared with the prevalence 3.02％ in 2002.The standardized rate of diabetes mellitus of the urban and rural area were 7.52％ and 5.19％ ( crude prevalence 11.33％ and 7.09％ ),respectively.The standardized rate of diabetes mellitus in the urban was higher than rural ( u =6.58,P＜0.05 ).The standardized rate of diabetes mellitus of the male and the female were 5.74％ and 6.15％ ( crude prevalence 8.36％ and 9.13％ ),respectively,without significant difference ( u =1.39,P＞0.05 ).The awareness rate of diabetes mellitus was 59.19％ ( 56.66％ in male and 61.23 ％ in female,x2 =3.26,P＞0.05 ).The awareness rate of the urban was higher than the rural (63.47％ vs 54.69％,x2=12.20,P＜0.01 ).ConclusionThe prevalence of diabetes mellitus showed a rapidly rising trend in Zhejiang province.The effective intervention should be taken at its early stage.

Objective To access the prevalence of type 2 diabetes mellitus ( T2DM) and its associated risk factors among adults with obesity in Zhejiang province. Methods The enrolled subjects were selected among local residents aged≥18 years with body mass index≥28 kg/m2 from 15 counties by multi stage stratified cluster random sampling from July to November, 2010. Each participant was required to attend complete questionnaire, physical examination, and testing overnight fasting blood specimen. Results A total of 1 351 residents were enrolled, including 613 males and 738 females. The prevalence of T2DM in adult population with obesity was 15. 03%, being 14. 03% in male, and 15. 85% in female;and that in urban area was 16. 64%, and in rural area was 13. 93%. Data from multivariable logistic regression showed that factors such as ageing (OR=1. 473, 95% CI 1. 243-1. 747), a family history of T2DM(OR=8. 945, 95% CI 5. 481-14. 598), staple food intake (OR=1. 185, 95% CI 1. 017-1. 380), triglyceride(≥1. 7 mmol/L, OR=1. 542, 95%CI 1. 066-2. 232) were risk factors of T2DM;while annual income(OR=0. 695, 95%CI 0. 544-0. 888), and milk intake(OR=0. 750, 95%CI 0. 567-0. 993) were shown as protective factors. Conclusion The prevalence of T2DM in adults with obesity was raised, ageing, a family history of T2DM, staple food intake, and dyslipidemia appeared to be major risk factors for T2DM.

Objective To study the influence of diet and behavior related factors on the peripheral blood triglyceride levels in adults,through a cross-sectional survey.Methods The current study included 13 434 subjects without histories of major chronic diseases from a population-based cross-sectional survey:the 2010 Metabolic Syndrome Survey in Zhejiang Province.A generalized linear model was used to investigate the influence of diet/behavior-related factors on the peripheral blood triglyceride levels.Results Mean TG of the sample population appeared as (1.36± 1.18) mmol/L.The proportions of elevated TG and marginally elevated TG were 10.3％ and 11.0％ respectively,with statistically significant difference seen between males and females (x2=44.135,P＜0.001).In this sampled population,the daily intake of cooking oil was exceeding the recommendation levels by over 50％ while the intake of fruit,milk,nuts and physical exercise were much below the recommendation.There were statistically significant differences between smoking,alcohol-intake,meat,fruit and water intake in male population from this study.However,in females,the intake of aquatic product and physical exercise showed statistically significant differences.After controlling for other variables,factors as age,drinking,staple food and aquatic products showed positive influence on TG,while milk presented negative influence on TG.Through interaction analysis,fruit and meat intake in males and staple food in females showed positive influence on TG,when compared to the reference group.Conclusion Hyperglyceridemia appeared as one of the major metabolic abnormities in Zhejiang province.Programs on monitoring the alcohol,staple food and meat intake should be priority on intervention,in the communities.

OBJECTIVETo explore the association between socioeconomic status (SES) and blood pressure control in diagnosed hypertension patients.

METHODSThe database of Zhejiang provincial survey on metabolic syndrome which implemented in 2010 in which prior hypoertensive patients were brought into this sutdy. Descriptive statistics were applied to test the distributive differences of relevant factors (age, sex, marital status, hypertension duration, BMI, education level, per capita household yearly income, smoking, alcohol drinking, fruit and vegetable intake) between patients with optimally-controlled blood pressure and those without. The SES of diagnosed hypertension patients was measured separately by two common indicators: education level and the per capita household yearly income. Univariate and multivariate logistic regression models were used to differentiate the association between those two SES indicators and blood pressure control, and the trend of the association was also tested.

RESULTSTotally, 2 394 hypertension patients were diagnosed and identified. Of the patients analysed, the overall mean was (61.53 ± 10.64) years, and 55.7% (1 334 cases) had ≤ 5 years' disease duration. 1 090 achieved optimal blood pressure control, which accounted for a proportion of 45.5%. 1 676 had elementary school education and below, accounting for 70.1%. The patients with per capita household yearly income of < 5 000 Yuan and 5 000-14 999 Yuan groups were 401 (29.4%) and 690 (50.5%) respectively. 416 (17.4%) were smokers and 541 (22.6%) were alcohol drinkers. Based on the statistical tests, we found that the distributions of age, marital status, hypertension duration, body mass index, smoking and alcohol drinking were different between two groups (t or χ² values were 4.57, 5.44, 6.40, 6.21, 5.99, 3.98, respectively, all P values were < 0.05). Optical blood pressure control in higer education level group was significantly better than that of in lower education level (χ² = 12.65, P < 0.001), and there was no statistical significance association between per capita household yearly income and optimal blood pressure control (χ² = 2.78, P = 0.249). Multivariate logistic regression models revealed that, of those two SES indicators, a positive association was shown between education level and optimal blood pressure control: compared with patients in the category of 'elementary school and below, those of 'junior high school and above observed an OR of 1.40 (95% CI: 1.09-1.81). And in further trend χ² test, we identified a trend of such association (χ² trend = 12.74, P = 0.002). However, no significant association has been recognized between per capita household yearly income and optimal blood pressure control: compared with patients in the category of < 5 000 Yuan group, those of 5 000-14 999 Yuan and ≥ 15 000 Yuan groups had OR of 0.93 (95% CI: 0.72-1.20) and 1.04 (95% CI: 0.83-1.31) respectively.

CONCLUSIONAmong all diagnosed hypertension patients, those with lower education level have poorer blood pressure control and should be labelled as the key population for intense health education and standardized management to improve their blood pressure control status.

Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Demography ; Education ; Feeding Behavior ; Fruit ; Humans ; Hypertension ; Income ; Logistic Models ; Metabolic Syndrome ; Smoking ; Social Class ; Treatment Outcome ; Vegetables

OBJECTIVETo understand the prevalence of dyslipidemia among non-overweight adults and related factors in Zhejiang province.

METHODSA total of 10 868 non-overweight adults (aged ≥18 years and BMI<24.0 kg/m²) included in a population-based cross-sectional survey on metabolic syndrome in Zhejiang province in 2010 were selected to conduct questionnaire survey, health examination and blood fat detection.

RESULTSThe overall prevalence of dyslipidemia in this population was 41.38%. The prevalence was significantly higher in males (43.19%) than in females (39.84%) (χ² = 12.53, P < 0.001). The prevalence of dyslipidemia significantly decreased in males (trend χ² = 47.61, P < 0.001) but increased in females (trend χ² = 3.88, P < 0.05) with age. There was no significant difference in the prevalence between urban area (41.21%) and rural area (41.49%) (χ² = 0.08, P = 0.774). Multiple logistic regression analysis showed that sex, family history of chronic diseases, smoking, alcohol use, high meat and egg diet, cooking with animal oil, physical activity, central obesity and BMI were factors related to prevalence of dyslipidemia.

CONCLUSIONThe prevalence of dyslipidemia was high among the non-overweight adults in Zhejiang, and family history, smoking, high-fat diet, physical inactivity, central obesity seemed to be the major risk factors.

Adult ; Alcohol Drinking ; China ; epidemiology ; Chronic Disease ; Cross-Sectional Studies ; Diet ; Dyslipidemias ; epidemiology ; Female ; Humans ; Lipids ; Male ; Metabolic Syndrome ; Obesity, Abdominal ; Prevalence ; Risk Factors ; Smoking ; Surveys and Questionnaires

OBJECTIVETo investigate the joint association of adiposity, physical activity, sedentary leisure time and job intensity on diabetes and impaired glycoregulation.

METHODSData was from the 2010 Zhejiang survey and 17 437 adults ( ≥18 years) were examined. Logistic regression was used in this cross-sectional study.

RESULTSUnder the same level of sedentary leisure time, adiposity anticipants showed an OR of 2.52-2.75 times for people with diabetes than those with normal or underweight BMI, and anticipants with highest WC having an OR of 2.09-3.71 times than those with the lowest WC. With the same level of physical activity, those adiposity anticipants had an OR of 2.19-5.98 times for diabetes than those with normal or underweight BMI, and anticipants with the highest WC had an OR of 3.10-6.25 times than those with the lowest WC. Anticipants who had no physical activity but with adiposity. BMI had an OR of 3.21 times than those with normal or underweight BMI, but there was no significant difference between diabetes and BMI in those that practising physical activities. Within the 3 levels of physical activity, participants that practising no physical activity, had an OR of 1.68-4.23 times for diabetes than those who were physically active when WC was used as a measure for adiposity.

CONCLUSIONControlling weight and waist seemed more important than improving physical activity or reducing sedentary leisure time in the prevention program on diabetes. WC was better measure on the risks for adiposity-related diabetes than BMI, especially when physical activity was under consideration.