1.Characteristics of obesity and its related disorders in China.
Wei-Ping JIA ; Chen WANG ; Shan JIANG ; Jie-Min PAN
Biomedical and Environmental Sciences 2010;23(1):4-11
Obesity is a medical condition with excess body fat accumulation to the extent which leads to serious health consequences. Abdominal obesity, also known as central obesity, refers to the presence of excess fat in the abdominal area. Obesity, especially abdominal obesity, contributes to many metabolic disorders including metabolic syndrome (MetS), type 2 diabetes (T2DM) and cardiovascular diseases (CVD). The incidence of obesity has increased dramatically in recent years worldwide. In China, more than one-third of adults are overweight or obese and 10%-20% of all adults are affected by MetS. The pathogenesis underlying the abdominal obesity remains unclear. The ultimate health outcome of obesity and its related metabolic disorders haveprompted physicians to take aggressive treatments (lifestyle changes, pharmacological interventions and surgical therapies) before a serious consequence becomes clinically apparent. In this review, we discuss the prevalence, pathogenesis and clinic features of obesity in China.
Age Distribution
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China
;
epidemiology
;
Diabetes Mellitus, Type 2
;
complications
;
epidemiology
;
Humans
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Metabolic Syndrome
;
complications
;
epidemiology
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Obesity
;
complications
;
epidemiology
2.Association between metabolically healthy obesity and incident risk of stroke in adult aged over 40 from rural Henan province.
Hong Chao LIAN ; Xiao Kang XIE ; Ruo Xi ZHOU ; Rui LIN ; Shang Xin SHI ; Xue Ru FU ; Dong Sheng HU ; Yang ZHAO
Chinese Journal of Preventive Medicine 2022;56(3):295-301
Objective: To investigate the association between metabolically healthy obesity and the incident risk of stroke in people aged ≥40 years from rural areas of Henan Province. Methods: During 2007 to 2008, 20 194 residents aged ≥18 years were selected for baseline examination by random cluster sampling and 17 265 participants were followed up during 2013 to 2014. According to the aim of current study, a total of 11 864 eligible subjects were included in this post-hoc analysis. Depending on body mass index and metabolic status, subjects were divided into four groups: metabolically healthy normal weight, metabolically healthy obesity, metabolically abnormal normal weight and metabolically abnormal obesity. Multivariate logistic regression model was used to analyze the relationship between metabolically healthy obesity and the risk of stroke. Results: The median (Q1, Q3) age of study participants was 54(46, 61) years, and 4 526 participants were men. During the mean follow-up of 6 years, the cumulative incidence of stroke was 7.16%. The incidence of stroke in metabolically healthy normal weight, metabolically healthy obesity, metabolically abnormal normal weight, and metabolically abnormal obesity were 3.73%, 4.61%, 8.99% and 9.38%, respectively (χ²=117.458, P<0.001). After adjusting possible confounding factors, compared with metabolically healthy normal weight, the risk of stroke was significantly increased in the metabolically healthy obesity group, metabolically abnormal normal weight group and metabolically abnormal obesity group with the odds ratio (OR) and 95% confidence interval (CI) of 1.52(1.10-2.12), 2.11(1.61-2.77) and 2.78(2.18-3.55), respectively. Stratified analysis showed that the risk of stroke was significantly higher in metabolically healthy obesity people aged 40-59 years compared with metabolically healthy normal weight group (OR=2.12, 95%CI: 1.36-3.30). Conclusion: Metabolically healthy obesity, metabolically abnormal normal weight and metabolically abnormal obesity are positively associated with the risk of stroke.
Adolescent
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Adult
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Body Mass Index
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Humans
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Male
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Middle Aged
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Obesity/complications*
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Obesity, Metabolically Benign/epidemiology*
;
Risk Factors
;
Stroke/epidemiology*
3.Obesity is positively Associated with Depression in Older Adults: Role of Systemic Inflammation.
Ye Xin GUO ; An Qi WANG ; Xin GAO ; Jun NA ; Wei ZHE ; Yi ZENG ; Jing Rui ZHANG ; Yuan Jing JIANG ; Fei YAN ; Mukaram YUNUS ; Hui WANG ; Zhao Xue YIN
Biomedical and Environmental Sciences 2023;36(6):481-489
OBJECTIVE:
We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.
METHODS:
Adults ≥ 65 years old ( n = 1,973) were interviewed at baseline in 2018 and 1,459 were followed up in 2021. General and abdominal obesity were assessed, and serum C-reactive protein (CRP) levels were measured at baseline. Depression status was assessed at baseline and at follow-up. Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms, as well as the relationship between obesity and CRP levels. The associations of CRP levels with the geriatric depression scale, as well as with its three dimensions, were investigated using multiple linear regressions.
RESULTS:
General obesity was associated with worsening depression symptoms and incident depression, with an odds ratio ( OR) [95% confidence interval ( CI)] of 1.53 (1.13-2.12) and 1.80 (1.23-2.63), especially among old male subjects, with OR (95% CI) of 2.12 (1.25-3.58) and 2.24 (1.22-4.11), respectively; however, no significant relationship was observed between abdominal obesity and depression. In addition, general obesity was associated with high levels of CRP, with OR (95% CI) of 2.58 (1.75-3.81), especially in subjects free of depression at baseline, with OR (95% CI) of 3.15 (1.97-5.04), and CRP levels were positively correlated with a score of specific dimension (life satisfaction) of depression, P < 0.05.
CONCLUSION
General obesity, rather than abdominal obesity, was associated with worsening depressive symptoms and incident depression, which can be partly explained by the systemic inflammatory response, and the impact of obesity on depression should be taken more seriously in the older male population.
Humans
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Male
;
Aged
;
Depression/etiology*
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C-Reactive Protein/metabolism*
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Obesity, Abdominal/epidemiology*
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Longitudinal Studies
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Inflammation/epidemiology*
;
Obesity/complications*
4.Analysis of dangerous factors for alcoholic liver disease.
Xiao-Lan LU ; Jin-Yan LUO ; Ming TAO ; Ping ZHAO ; Hong-Li ZHAO ; Xiao-Dong ZHANG ; Yan GENG
Chinese Journal of Hepatology 2004;12(7):442-443
China
;
epidemiology
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Female
;
Humans
;
Liver Diseases, Alcoholic
;
epidemiology
;
etiology
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Male
;
Obesity
;
complications
;
Risk Factors
;
Sex Factors
5.Blood pressure, hypertension and other cardiovascular risk factor in six communities in Papua New Guinea, 1985-1986
H. King ; V. Collins ; L. F. King ; C. Finch ; M. P. Alpers
Papua New Guinea medical journal 1994;37(2):100-109
Surveys of noncommunicable diseases were performed in six communities in Papua New Guinea during 1985-1986. Results are reported here with respect to blood pressure and associated factors in adults. Mean systolic and diastolic blood pressures were lowest, and hypertension was rarest (less than 2%), in three rural/semirural villages on Karkar Island, Madang Province. Intermediate values for blood pressure and moderate prevalence of hypertension (3-6%) were observed in rural and urban Tolai communities in East New Britain Province. A periurban village in the Eastern Highlands Province displayed the highest mean blood pressures and prevalence of hypertension (12% in men and 5% in women). There was a modest rise in mean systolic blood pressure with age in most groups, but the age-related rise in diastolic pressure was much less pronounced. Other cardiovascular risk factors--body mass index (BMI), and plasma cholesterol, glucose and insulin concentrations--were lowest in the least developed rural villages on Karkar Island and highest in the urban Tolai and periurban highland communities. Both systolic and diastolic blood pressures were significantly (and positively) related to age, male sex, BMI and speaking a non-Austronesian language. It is concluded that there is now a considerable variation in the prevalence of hypertension, and the levels of blood pressure and other cardiovascular risk factors, in different communities in Papua New Guinea.
Adult
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Blood Pressure
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Cardiovascular Diseases - etiology
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Diabetes Mellitus - epidemiology
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Hypertension - complications
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Obesity - epidemiology
;
Papua New Guinea
6.Correlation analysis between body mass index and clinical characteristics of rheumatoid arthritis.
Jing Feng ZHANG ; Yin Ji JIN ; Hui WEI ; Zhong Qiang YAO ; Jin Xia ZHAO
Journal of Peking University(Health Sciences) 2023;55(6):993-999
OBJECTIVE:
To analyze the clinical features of overweight and obese rheumatoid arthritis (RA)patients, and the relationship between body mass index (BMI) and disease characteristics.
METHODS:
The demographic data, extra-articular manifestations, comorbidities, and disease activity of RA patients admitted to the Rheumatology and Immunology Department of Peking University Third Hospital from January 2015 to December 2020 were collected, and the above characteristics of overweight and obese RA patients were retrospectively analyzed. According to the WHO, BMI≥30 kg/m2 referred to obese individuals, 25≤BMI < 30 kg/m2 referred to overweight individuals, 18.5≤BMI < 25 kg/m2 referred to normal individuals, BMI < 18.5 kg/m2 referred to reduced body mass individuals. t test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non-normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, Chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1. Analyzing whether overweight or obesity was associated with comorbidities using Logistic regression adjusted confounding factors.
RESULTS:
A total of 481 RA patients were included in this study, with an average BMI value of (23.28±3.75) kg/m2.Of the patients, 31 cases (6.5%) were with BMI < 18.5 kg/m2, 309 cases (64.2%) with 18.5≤ BMI < 25 kg/m2, amounting to 340 cases (70.7%). There were 119 overweight individuals (25≤ BMI < 30 kg/m2, 24.7%) and 22 obese individuals (BMI≥30 kg/m2, 4.6%), totaling 141 (29.3%).The proportion of the overweight and obese RA patients suffering from hypertension (57.4% vs. 39.1%, P < 0.001), diabetes (25.5% vs. 15.0%, P=0.006), hyperlipidemia (22.7% vs. 10.9%, P=0.001), fatty liver (28.4% vs. 7.4%, P < 0.001), osteoarthritis (39.0% vs. 29.4%, P=0.040) was significantly higher, and the proportion of the patients with osteoporosis(59.6% vs. 70.9%, P=0.016) and anemia (36.2% vs. 55.6%, P < 0.001) was significantly lower. However, there was no difference between the two groups in coronary heart disease (5.7% vs. 7.6%, P=0.442), cerebrovascular disease (6.4% vs. 8.8%, P=0.372) and peripheral atherosclerosis (9.2% vs. 7.6%, P=0.565).The median C-reactive protein (CRP, 1.52 mg/dL vs. 2.35 mg/dL, P=0.008), median erythrocyte sedimentation rate (ESR, 34.0 mm/h vs. 50.0 mm/h, P=0.003), pain visual simulation score (VAS) (3.66±3.08 vs. 4.40±2.85, P=0.011), and 28 joint disease activity scores (DAS-28, 5.05±1.60 vs. 5.45±1.52, P=0.010) in the overweight and obese RA group were all lower than those in the normal and reduced weight groups. Multivariate regression analysis showed that overweight and obesity was an independent risk factor for hypertension, diabetes, hyperlipidemia and fatty liver, and had protective effects on osteoporosis and anemia.
CONCLUSION
In RA patients, RA disease activity is lower in overweight and obesity patients. Overweight and obesity is associated with hypertension, diabetes and hyperlipidemia, but not with cardiovascular and cerebrovascular diseases.
Humans
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Body Mass Index
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Overweight/epidemiology*
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Retrospective Studies
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Arthritis, Rheumatoid/epidemiology*
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Obesity/epidemiology*
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Diabetes Mellitus
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Hypertension/complications*
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Fatty Liver/complications*
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Hyperlipidemias/complications*
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Osteoporosis/complications*
;
Anemia
7.A pre-conception cohort study of fertility and its related factors among couples with the intention of conception.
He Qing SONG ; Feng Yun YANG ; Yong Mei WU ; Shou Le WU ; Jiang Man LE ; Hai Qi WANG ; Li Feng ZHANG ; Dong Xiao YIN ; Hong JIANG
Chinese Journal of Preventive Medicine 2023;57(2):179-186
Objective: To describe fertility and explore factors associated with it among pre-conception couples of childbearing age. Methods: Based on the pre-conceptional offspring trajectory study of the School of Public Health of Fudan University, couples of childbearing age who participated in the pre-conception physical examination in Shanghai Jiading District from 2016 to 2021 were recruited and followed up. Couples' time to pregnancy (TTP) was analyzed and Cox proportional hazards regression model was used to explore the factors associated with TTP. Kaplan-Meier was used to calculate each menstrual cycle's cumulative pregnancy rate. Results: A total of 1 095 preconception couples were included in the analysis, the M(Q1,Q3)of TTP was 4.33 (2.41, 9.78) menstrual cycles. Age of women (FR=0.90, 95%CI: 0.85-0.95, P<0.001), women who were overweight or obese before pregnancy (FR=0.36, 95%CI: 0.24-0.55, P<0.001), women who were exposed to second-hand smoking (FR=0.63, 95%CI: 0.44-0.92, P=0.016), women whose home or office had been renovated in the past 2 years and had a particular smell (FR=0.46, 95%CI: 0.26-0.81, P=0.008) were risk factors for impaired fertility. Regular menstrual cycles (FR=1.64, 95%CI: 1.16-2.31, P=0.005), females who often drank tea/coffee (FR=1.55, 95%CI: 1.11-2.17, P=0.011) and males who took folic acid before conception (FR=2.35, 95%CI: 1.38-4.23, P=0.002) were associated with better fertility. The cumulative pregnancy rate of 3, 6, and 12 menstrual cycles was 37.6%, 64.4%, and 78.4%, respectively. Conclusion: Older couples, overweight or obesity before pregnancy, irregular menstruation, exposure to secondhand smoke and decoration pollutants in females are associated with impaired fertility. Frequent tea/coffee drinking before pregnancy in females and taking folic acid before pregnancy in males are associated with shortened conception time.
Pregnancy
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Male
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Humans
;
Female
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Cohort Studies
;
Overweight/complications*
;
Coffee
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Intention
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China/epidemiology*
;
Fertility
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Obesity/complications*
;
Tea
8.Advances in the epidemiological study of fatty liver.
Hua-jie ZHANG ; Hui ZHUANG ; Xue-en LIU
Chinese Journal of Epidemiology 2004;25(7):630-632
Alcohol Drinking
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China
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epidemiology
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Exercise
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Fatty Liver
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epidemiology
;
etiology
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prevention & control
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Humans
;
Hyperlipidemias
;
complications
;
Obesity
;
complications
;
Prevalence
9.Prevalence of nonalcoholic fatty liver disease and metabolic syndrome in obese children.
Hong-bo SHI ; Jun-fen FU ; Li LIANG ; Chun-lin WANG ; Jian-fang ZHU ; Fang ZHOU ; Zheng-yan ZHAO
Chinese Journal of Pediatrics 2009;47(2):114-118
OBJECTIVEThe incidences of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) are very high in obese children, and insulin resistance may be the key point linking them together. Debates still remain as to whether NAFLD could be a component of MS. Some researchers reported that NAFLD was a composition of MS, while the others stated that NAFLD was an independent predicting factor of MS. Here we analyzed the prevalence of NAFLD and MS in 308 obese children who came to our endocrinology department from June 2003 to September 2006, and we also evaluated the relationship between NAFLD and MS in this group of obese children.
METHODTotally 308 obese children aged from 9 to 14 years with mean age of (10.7 +/- 2.6) years were enrolled. Two hundred and thirty one were males, and 77 were females. Body mass index (BMI), waist circumference (WC), biochemical indicators, liver B-mode ultrasound examination, oral glucose tolerance test (OGTT) and insulin releasing test were performed for all of the cases. The incidences of NAFLD including simple nonalcoholic fatty liver (SNAFL) and nonalcoholic steatohepatitis (NASH) as well as MS were calculated. Three subgroups were selected according to the diagnostic criteria: Group 1: OCWLD (obese children without liver disorder), Group 2: SNAFL and Group 3: NASH. The prevalence of MS, components of MS, free insulin, whole body insulin sensitivity index (WBISI), homeostasis model of insulin resistance (HOMA(IR)) were compared among these three subgroups.
RESULT(1) Among all the obese children, the prevalence of NAFLD, SNAFL, NASH and MS was 65.9% (203), 45.5% (140), 20.5% (63) and 24.7% (76) respectively. Among all the MS children, the prevalence of NAFLD was 84.2% (64/76). The prevalence of MS was 29.3% (41/140) in SNAFL group and 36.5% (23/63) in NASH group, which was significantly higher than that of OCWLD group 11.4% (12/105) (P < 0.05), but no significant difference was found between SNAFL group and NASH group (P > 0.05). Moreover, there were significantly higher incidences in NASH group concerning every component of MS (hypertension, hyperlipidemia, hyperglycemia) compared with that of OCWLD group. The incidence of hypertension in SNAFL was significantly higher than that of OCWLD group. And the incidence of hyperlipidemia was markedly increased in NASH group compared with SNAFL group. NAFLD group had higher free insulin and more severe IR compared with that of OCWLD group. When OCWLD developed to SNAFL and NASH, free insulin and IR deteriorated calculated by HOMA-IR and WBISI. However there was no significant difference between NAFLD and MS children concerning free insulin and IR.
CONCLUSIONThe prevalence of NAFLD and MS hits high in obese children. The prevalence of NAFLD was very high among children with MS and NAFLD and MS shared the common mechanism of IR. The higher prevalence of MS and higher frequencies of MS components were tightly associated with the development of NAFLD and severity of IR.
Adolescent ; Child ; Fatty Liver ; diagnosis ; epidemiology ; etiology ; metabolism ; Female ; Humans ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; Obesity ; complications ; epidemiology ; Prevalence