OBJECTIVETo investigate foot biomechanics characteristic of patients with type 2 diabetes mellitus.

METHODSThis study was conducted among 303 patients with type 2 diabetes. The whole foot was divided into 10 regions, namely the first toe (T1); the second to fifth toes (T2-5); the first, second, third, fourth, and fifth metatarsals (M1, M2, M3, M4, and M5, respectively); midfoot (MF), and the heel medial (HM). Foot arch index, foot angle and maximum peak pressure (MPP) of the 10 regions were measured using a Footscan gait system.

RESULTSThe maximum peak pressure of 10 regions decreased in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the left foot, and in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the right foot. The MPP in M1 region was higher in the right than in the left foot (P<0.05). The MPP in M3, M4, M5, and MF was higher in the left than in the right foot (P<0.05). The percentage of high-risk foot (defined by a total plantar pressure ≥70 N/cm) was 34% on the left and 17.7% on the right. An increased BMI was associated with a significant increase in high-risk foot, but not for the right foot in underweight patients. Foot flat phase was extended and forefoot push-off phase shortened in stance phase in the patients. Compared with the right foot, the left foot showed a significantly increased foot arch index and increased low and high arch rates with a decreased normal arch rate. Total plantar pressure was higher in of the left high arch foot than in normal arch foot. The foot angle was significantly larger on the right than on the left. The bilateral total plantar pressures were significantly greater in male patients (P<0.05) and increased with age but were not associated with the duration of DM, foot angle, or glycosylated hemoglobin level.

CONCLUSIONDiabetic patients have obvious alterations in foot biomechanics with abnormalities of the plantar pressure, and the percentage of high-risk foot increases in overweight and obese patients, suggesting the need of body weight control in these patients when administering offloading treatment for prevention of diabetic foot ulcer.

Biomechanical Phenomena ; Diabetes Mellitus, Type 2 ; physiopathology ; Diabetic Foot ; prevention & control ; Female ; Foot ; physiopathology ; Gait ; Heel ; physiopathology ; Humans ; Male ; Obesity ; physiopathology ; Overweight ; physiopathology ; Pressure

In this study we performed Tissue Doppler Imaging (TDI), two-dimensional speckle tracking imaging (2D- STI) and three-dimensional speckle tracking imaging (3D-STI) on enrolled healthy, overweight and obese groups (34 subjects in each group), respectively, to analyze cardiac structure and its function. Compared with healthy group, global longitudinal strain (GLS), global circumferential strain (GCS), global area strain(GAS) and global radial strain (GRS) decreased progressively (P < 0.05). The ratio of early diastolic mitral inflow velocity to global early diastolic strain rate of left ventricle (E/e'sr) (r = 0.466, P < 0.001), GLS (r = 0.502, P < 0. 001), GCS (r = 0.426, P < 0.001), GAS (r = 0.535, P < 0.001) and GRS (r = -0.554, P < 0.001) were correlated with body mass index (BMI). E/e'sr (r = 0.37, P = 0.003), GLS (r = 0.455, P < 0.001), GCS (r = 0.282, P = 0.02), GAS (r = 0.412, P < 0.001) and GRS (r = -0.471, P < 0.001) were correlated with free fatty acid (FFA). Stepwise multiple linear regression revealed that BMI was independently correlated with E/e'sr, GLS, GCS, GAS and GRS. Waist to hip ratio (WHR) was independently correlated with GLS, GCS, GAS and GRS. FFA was independently correlated with E/e'sr (P < 0.05). The study showed that cardiac structure changed and impaired left ventricular global systolic and diastolic function in overweight and obes population. Moreover, BMI, WHR and FFA may be independent influence factors of cardiac function in overweight and obese population.
Body Mass Index ; Case-Control Studies ; Echocardiography, Three-Dimensional ; Heart ; physiopathology ; Heart Ventricles ; physiopathology ; Humans ; Linear Models ; Obesity ; physiopathology ; Overweight ; physiopathology ; Reproducibility of Results ; Ventricular Function, Left

OBJECTIVETo study the growth of macrosomic infants, the incidence of overweight and the factors related to overweight at 18 months old.

METHODSEighty-four macrosomic infants without underlying diseases were enrolled in this study. Their growth was followed up regularly. Factors related to overweight at 18 months old were investigated.

RESULTSTwenty infants (24%) showed as overweight at 18 months old. More male infants were overweight than female infants (30% vs 11%; P<0.05). The overweight infants at 18 months old had a higher proportion of overweight at 6 months (80% vs 22%; P<0.01) and at 12 months old (80% vs 13%; P<0.01) than non-overweight infants at 18 months. The spearman correlation analysis demonstrated that weight-for-length Z score at 18 months old was positively correlated with birth weight and weight gain between 0 to 6 months, 7 to 12 months and 13 to 18 months (P<0.05). The strongest correlation was observed between weight gain form 0 to 6 months and weight-for-length Z score at 18 months old (r=0.597, P<0.01).

CONCLUSIONSMore attention should be given to the aspect of rapid weight gain in the first 6 months of life in macrosomic infants, especially males, to prevent obesity in early childhood.

Child Development ; Female ; Fetal Macrosomia ; physiopathology ; Follow-Up Studies ; Growth ; Humans ; Infant ; Infant, Newborn ; Male ; Overweight

Leptin, an adipocyte-derived hormone, serves numerous physiological functions in the body, particularly during puberty and reproduction. The exact mechanism by which leptin activates the gonadotropin-releasing hormone (GnRH) neurons to trigger puberty and reproduction remains unclear. Given the widespread distribution of leptin receptors in the body, both central and peripheral mechanisms involving the hypothalamic-pituitary-gonadal axis have been hypothesized. Leptin is necessary for normal reproductive function, but when present in excess, it can have detrimental effects on the male reproductive system. Human and animal studies point to leptin as a link between infertility and obesity, a suggestion that is corroborated by findings of low sperm count, increased sperm abnormalities, oxidative stress, and increased leptin levels in obese men. In addition, daily leptin administration to normal-weight rats has been shown to result in similar abnormalities in sperm parameters. The major pathways causing these abnormalities remain unidentified; however, these adverse effects have been attributed to leptin-induced increased oxidative stress because they are prevented by concurrently administering melatonin. Studies on leptin and its impact on sperm function are highly relevant in understanding and managing male infertility, particularly in overweight and obese men.
Animals ; Humans ; Infertility, Male/physiopathology* ; Leptin/physiology* ; Male ; Obesity/complications* ; Overweight/complications* ; Reproduction/physiology*

OBJECTIVETo evaluate the current status of penis and testicular development in boys and the effects of overweight/obesity on their development in the Zhengzhou area of Henan Province.

METHODSHeight, weight, waist circumference, hip circumference, penis length and testicular volume were measured in 3 546 4 to 12-year-old boys. The penis length and testicular volume were compared between the overweight/obesity and normal weight groups.

RESULTSBefore 9 years of age, the testicular volume was progressively smaller, and after 9 years old, it gradually increased. By the age of 11, it increased rapidly. The penis length increased gradually between 4 and 11 years of age, and after the age of 11 it increased rapidly. Phimosis was found in 144 cases (4.01%) and cryptorchidism was found in 18 cases (0.51%). A total of 639 (18.02%) boys were overweight or obese among 3 546 boys. At the ages of 6 and 7 years, the testicular volume in the overweight/obesity group was greater than in the normal control group (P<0.05). The penis length in the overweight/obesity group was significantly shorter than in the normal control group (P<0.05) by the age of 11 years. The correlation analysis showed that the testicular volume at the ages of 4 and 5 years was positively correlated with height, weight, BMI, waist circumference and hip circumference in overweight/obese boys. The penis length at the ages of 7 and 8 years was negatively correlated with weight, waist circumference and hip circumference. By the age of 12 years, the penis length was positively correlated with the height.

CONCLUSIONSThe development of penis and testicles in boys in the Zhengzhou area is in line with the level of sex development of Chinese boys. Overweight/obesity adversely affects the development of penis and testicles.

Child ; Child, Preschool ; China ; Humans ; Male ; Obesity ; epidemiology ; physiopathology ; Overweight ; epidemiology ; physiopathology ; Penis ; growth & development ; Testis ; growth & development

OBJECTIVETo study the effects of overweight and obesity on physical function (including systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse, weight vital capacity index) in children and adolescents.

METHODSThe data of 2010 Chinese National Survey on Students Constitution and Health was analyzed. The samples of overweight and normal-weight group were randomly selected from the data by matching gender, urban or rural for getting the same number sample size as obese group (10 601 each group). The students aged 7 - 18 years were classified into 3 groups by BMI percentiles (P₅, P₁₅, P₂₅, P₅₀, P₇₅, P₈₅ and P₉₅), to analyze the change of physical function along with BMI percentile.

RESULTSCompared to the normal-weigh group, SBP of the obese boys of all age groups increased by 8.0 - 12.0 mm Hg, DBP increased by 4.7 - 5.9 mm Hg, while SBP of the obese girls increased by 7.5 - 11.6 mm Hg, DBP increased by 4.7 - 6.1 mm Hg, with statistical significance (P < 0.05). In 13 - 15-year group, pulse of obese boys was 0.8 times/min higher than that of normal-weight. In 16 - 18-year group, pulse of obese boys was 1.1 times/min higher than that of overweight or normal-weight, while pulse of obese girls were 1.5 and 1.7 times/min higher than that of overweight and normal-weight, respectively (P < 0.05). Pulses in boys aged 7 - 9 years when BMI were P₅, P₅₀, P(95) were 87.63, 87.00, 87.83 times/min, and pulses in boys aged 10 - 12 were 85.66, 85.30, 85.43 times/min, respectively. Pulses in boys aged 13 - 15 years when BMI were P₅, P₅₀, P₉₅ were 82.60, 81.39, 82.34 times/min, and pulses in boys aged 16 - 18 years were 80.15, 79.00, 79.98 times/min. In both boys and girls of all age groups, weight vital capacity index had the trend of obese < overweight < normal-weight (P < 0.05). Compared to the normal-weight group, weight vital capacity index of overweight boys decreased by 6.4 - 8.4 ml/kg, that of obese boys decreased by 11.9 - 14.8 ml/kg, while that of overweight girls decreased by 5.3 - 7.7 ml/kg, that of obese girls decreased 11.0 - 11.5 ml/kg.

CONCLUSIONCompared to the normal-weight, overweight and obese children and adolescents had elevated blood pressure, increased pulse, decreased weight vital capacity index.

Adolescent ; Child ; China ; epidemiology ; Ethnic Groups ; Female ; Humans ; Male ; Obesity ; epidemiology ; physiopathology ; Overweight ; epidemiology ; physiopathology ; Risk Factors ; Students

OBJECTIVETo examine the relationship between overweight or obesity and the risk of the various hypertension hemodynamic subtypes in Yi farmers and migrants.

METHODSA cross-sectional study of 2 358 Yi farmers and 1 392 Yi migrants was carried out in the Liangshan Yi autonomous prefecture, Sichuan, China in 2007.

RESULTSThe standardized prevalence of overweight in female Yi farmers (6.22%) was higher than in males (3.15%), whereas in Yi migrants 31.56% of males and 18.78% of females were overweight. The standardized prevalence of obesity was 0 and 0.61% in male and female Yi farmers, compared to 3.91% and 5.57% in male and female Yi migrants, respectively. For both genders the standardized prevalence of ISH, IDH, and SDH was higher in Yi migrants than Yi farmers. Overweight and obese Yi men and women had a higher risk for IDH and SDH (P<0.001) than non-overweight/obese individuals. However, an association of overweight or obesity with ISH was observed only in men.

CONCLUSIONYi migrants have substantially higher proportion of overweight and obese individuals, as well as individuals affected by ISH, IDH, and SDH, than do Yi farmers. Overweight and obesity are significant risk factors for the development of hypertension in Yi people.

Adolescent ; Adult ; Aged ; Body Mass Index ; China ; epidemiology ; Diastole ; Female ; Hemodynamics ; Humans ; Hypertension ; ethnology ; physiopathology ; Male ; Middle Aged ; Obesity ; ethnology ; physiopathology ; Overweight ; ethnology ; physiopathology ; Systole ; Young Adult

This study investigated the prevalence and risk factors of urinary incontinence (UI) among perimenopausal women in Wuhan. A cross-sectional survey was performed on 1067 women aged 40-65 years sampled in Wuhan urban area from April to October 2014. Information about demographic characteristics, menstruation, parity and UI symptoms was collected using a questionnaire. The data were evaluated by Chi-square test and multiple Logistic regression analysis. The prevalence rate of UI was 37.2%, with stress UI (32.2%) being more prevalent than urgency UI (21.6%) and mixed UI (16.6%). 31.2% women with UI stated that UI had negative impact on their life. Risk factors for UI included menstrual disorder, menopause, overweight, perineal laceration, atrophic vaginitis, constipation and pelvic organ prolapse. Appropriate investigation apropos the factors associated with UI should be performed to diminish its impact on women's life.
Adult ; Aged ; Atrophic Vaginitis ; epidemiology ; physiopathology ; Constipation ; epidemiology ; physiopathology ; Female ; Humans ; Lacerations ; epidemiology ; physiopathology ; Menstrual Cycle ; physiology ; Middle Aged ; Overweight ; epidemiology ; physiopathology ; Pelvic Organ Prolapse ; epidemiology ; physiopathology ; Perimenopause ; physiology ; Pregnancy ; Risk Factors ; Surveys and Questionnaires ; Urinary Incontinence ; epidemiology ; physiopathology

BACKGROUND: The Shanghai growth standards are higher than World Health Organization (WHO) growth standards, which may influence the feeding practices of the caregivers and increase the risk of overweight in these infants. This study aimed to compare the effects of different growth standards on childhood obesity in Shanghai metropolitan area. METHODS: This was a cluster-randomized controlled trial conducted in 2 downtown areas with 19 community health service centers in Shanghai from November 2013 to December 2015. Randomization was done at the level of the community. Infants (health newborns) were assessed and monitored by the Shanghai growth standards (S-group) and the 2006 WHO growth standards (W-group), respectively. Measurements were taken at 1.0, 2.0, 4.0, 6.0, 9.0 and 12.0 months of age during follow-up period. Based on the values of length and weight measurements, according to the group's growth standards, doctors provided the caregivers with corresponding clinical consultation. Changes in weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and weight-for length z-score (WLZ) between 2 groups were assessed using mixed regression models. Overweight was compared between 2 group at all follow-up measurements. RESULTS: A total of 6509 infants (52.1% were boys) were in the W-group, and 8510 infants (51.4% were boys) were in the S-group. The overweight ratios between two groups were distinct at 9 months of age (3.4% in W-group and 4.3% in S-group) and 12 months of age (2.2% in W-group and 3.8% in S-group), and the differences were statistically significant (P = 0.020 and P < 0.001, respectively). Compared to W-group, the increase in WAZ (coefficient = 0.04, P = 0.004) and WLZ (coefficient = 0.09, P < 0.001) were significantly greater, and the LAZ was lower (coefficient = -0.04, P = 0.047) in S-group (W-group values were used as reference in mixed regression models). CONCLUSION: Compared to the Shanghai growth standards, the adoption of WHO 2006 growth standards would reduce the risk of infant overweight in Shanghai metropolitan area up to 1 year of age. TRIAL REGISTRATION NUMBER ChiCTR1800015371, http://www.chictr.org.cn/ Chinese Clinical Trial Registry.
Body Height ; physiology ; Body Weight ; physiology ; China ; Feeding Behavior ; physiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Overweight ; physiopathology

OBJECTIVETo assess and compare the predictive effects of hypertension before puberty and during puberty on adult hypertension.

METHODSA total of 412 adults from the "Beijing children and adolescents blood pressure (BP) study" cohort were followed up in a clinical examination in 2005. Systolic and diastolic BP, height, and weight in childhood were measured at a baseline survey in 1987. The participants were divided into pre-puberty and puberty sub-cohorts according to their pubertal development stage at baseline. Information on adult BP, anthropometric indices and life style were collected through questionnaire and physical examination. BP changes and the predictive effect on adult hypertension were compared between the two sub-cohorts. Correlation of BP levels between 1987 and 2005 was examined through linear regression models.

RESULTSFrom childhood to adulthood, the regression coefficients of systolic BP were similar in the two sub-cohorts (both β=0.34, P<0.001), while the coefficient of diastolic BP was larger in the pubertal cohort (β=0.31, P<0.001) compared with the pre-pubertal cohort (β=0.12, P=0.017). Fifty percent of children with pubertal hypertension became hypertensive adults, while pre-pubertal hypertension resulted in 34.3%. After adjustment for sex, age, family history of hypertension, obesity in childhood, and adulthood, pubertal hypertension predicted a higher risk of adult hypertension than pre-pubertal hypertension, with odds ratios (95% confidence intervals) of 10.00 (3.03-33.07) and 2.71 (0.83-8.85), respectively.

CONCLUSIONOur results suggest that hypertension during puberty is likely to result in adult hypertension.

Adolescent ; Adult ; Age Factors ; Blood Pressure ; Body Mass Index ; Child ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Overweight ; epidemiology ; physiopathology ; Puberty ; physiology ; Risk Factors