OBJECTIVETo examine the prevalence and characteristics of aortic arch calcification (AAC) in residents aged 50 or over in Guangzhou, China.

METHODSFace-to-face interview, physical examination and laboratory tests were conducted on 10 413 Chinese adults aged 50 or over. Posterior-anterior plain chest X-ray radiographs were obtained from 10 305 subjects using a Toshiba KSO-15R machine. The radiographs were reviewed together by two radiologists while 300 radiographs were independently gone through by two radiologists to assess the agreement with Kappa coefficient method.

RESULTSThe rate of agreement on Diagnosis for the two radiologists was 85.0% and Kappa coefficient was 0.68, with P < 0.001 which showed a moderate agreement between the two radiologists. Among the 10 305 subjects, there were 3064 men and 7349 women, with their mean age (+/- standard deviation) as 64.0 +/- 6.0 and 66.2 +/- 5.8, respectively. Most of them had educational level of middle school or below, and most of their occupations were factory or agricultural workers. The prevalence of AAC was 40.6%. Women showed significantly higher prevalence rate than men (41.4% versus 38.6%, P < 0.001) and the prevalence of AAC increased significantly with age. Subjects with primary educational level or below had the highest prevalence of AAC. There was no significant association found between occupation and AAC prevalence. 98.7% of the subjects with AAC occurred in aortic arch. Most AAC had a length of 10 mm or longer and a width from 1-4 mm, which indicated the severity of AAC among the subjects.

CONCLUSIONThe prevalence of AAC among Guangzhou Biobank Cohort was about 40.6%, higher than those reported in foreign studies, while most of the lesions were quite serious.

Aged ; Aorta, Thoracic ; pathology ; Calcinosis ; epidemiology ; Cardiomyopathies ; epidemiology ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence

OBJECTIVETo investigate the relative effects of degree and distribution of body fat with several cardiovascular disease (CVD) risk factors in elderly Chinese subjects.

METHODSOne hundred and thirty-five elderly Chinese individuals (age range, 60-65 y) without any history of significant renal, hepatic or cardiac disease were recruited. Seated blood pressure, anthropometric and fasting plasma biochemical parameters were measured. Student's t-test was used to compare the differences in biochemical and anthropometric markers between cohorts.

RESULTSMales were heavier (64.6 +/- 8.6, 57.2 +/- 8.2kg, P < 0.001), taller (1.65 +/- 0.06, 1.51 +/- 0.05 m, P < 0.001) and their greater body fat was predominantly deposited centrally (Waist-to- hip ratio, 0.91 +/- 0.06, 0.88 +/- 0.07, P < 0.05). Females were more generally obese with increased body mass index (BMI, 23.8 +/- 4.6, 25.0 +/- 3.5 kg/m2, P < 0.05) and percentage body fat [26.3% (24.5%-28.1%) vs 37.2% (36.0%-38.9%), P < 0.001] than the males. However, despite an 11% higher proportion of body fat in females, no significant differences were identified in blood pressure, lipid profile, indices of insulin resistance or albumin-to-creatinine ratios.

CONCLUSIONIt is likely that central adiposity contributes disproportionately to these metabolic disorders in males even though they are much leaner than elderly Chinese females.

Adult ; Aged ; Body Mass Index ; Cardiovascular Diseases ; etiology ; Female ; Humans ; Male ; Middle Aged ; Obesity ; complications ; Risk Factors

PURPOSETo review evidence-based management of nephropathy in patients with type 2 diabetes.

DATA SOURCESA literature search (MEDLINE 1966 to 2000) was performed using the key word "diabetic nephropathy". Relevant book chapters were also reviewed.

STUDY SELECTIONWell-controlled, prospective landmark studies and expert review articles on diabetic nephropathy were selected.

DATA EXTRACTIONData and conclusions from the selected articles that provide solid evidence to the optimal management of diabetic nephropathy were extracted and interpreted in light of our clinical research experience with many thousands of Hong Kong Chinese patients.

RESULTSHypertension, long diabetes duration, poor glycaemic control and central obesity are the most important risk factors. Microalbuminuria is a practical marker to predict overt nephropathy in type 2 diabetic patients. Risk factor modification, renal function monitoring and combined therapies are the current integrated approaches to manage patients with diabetic kidney disease. Optimal glycaemic control is the mainstay of treatment but effective antihypertensive therapy is also key to delaying the progression of diabetic nephropathy. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists have important renoprotective actions independent of their blood pressure lowering actions.

CONCLUSIONSDiabetic nephropathy is the leading cause of end-stage renal disease worldwide. Monitoring renal function and screening for microalbuminuria will allow the identification of patients with nephropathy at a very early stage for intervention. Tight glycaemic control and aggressive antihypertensive treatment as well as the use of renin-angiotensin system inhibitors should substantially delay the progression of nephropathy.

Albuminuria ; diagnosis ; therapy ; Blood Glucose ; analysis ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Nephropathies ; epidemiology ; therapy ; Dietary Proteins ; administration & dosage ; Humans ; Hyperlipidemias ; therapy ; Hypertension ; therapy

Objective To examine the impact of International Physical Activity Questionnaire (IPAQ) physical activity intensity on to the prevalence of diabetes mellitus among Chinese elderly. Methods A total number of 1996 residents aged 50 or above living in Guangzhou city were recruited from the phase 3 of the Guangzhou Biobank Cohort Study. Information on physical activity and fasting plasma glucose status was derived from standardized interviews and laboratory assays. Results Among the participants who were classified as physically active (60.0%), moderate active (29.8%) and inactive (10.2%), the prevalence rates of type 2 diabetes mellitus were 9.1%, 12.0%and 14.2%,respectively. After adjustment on age, sex, obesity and other potential confounding factors, data from logistic regression model showed that the odds ratios (95% confidence interval) for diabetes on subjects in physically moderate active and active group were 0.75 (0.46-1.26)and 0.60 (0.38-0.97) respectively with P for trend as 0.03, when comparing to those physically inactive ones. Conclusion Promotion of physical activity might have had some effects in reducing the risk of diabetes mellitus among the older adults.

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.