Objective: This study aimed to explore the association between malnutrition and the level of blood pressure (BP) as well as elevated BP (EBP) in Han students aged 7 to 18 years in China. Methods: 170 037 subjects with normal nutritional status and malnutrition were enrolled in this study from 2014 Chinese National Surveys on Students' Constitution and Health with a multi-stage stratified cluster random sampling framework covering 31 provinces, autonomous regions and municipalities after the exclusion of 44 317 overweight and obese students. According to the standard of "Screening Standard for Malnutrition of School-age Children and Adolescents" (WS/T456-2014), the nutritional status of children were classified into two categories, normal nutritional status and malnutrition containing stunting, mild wasting and moderate severe wasting. The level of BP and prevalence of EBP were compared between students with normal nutritional status and malnutrition. The multivariate logistic regression model was used to analyze the association between malnutrition and EBP. Results: The levels of systolic BP (SBP) and diastolic BP (DBP) in Chinese Han students aged 7-18 years who were non-overweight and non-obesity status were (103.4±12.3) and (64.7±9.5) mmHg (1 mmHg=0.133 kPa), respectively. The prevalence of EBP, systolic EBP and diastolic EBP in Chinese Han malnourished students (N=21 012) were 3.1% (n=649), 1.5% (n=324) and 2.1% (n=445), respectively, which was significantly lower than those (N=148 320) with normal nutritional status (4.5% (n=6 707), 2.6% (n=3 872) and 2.7% (n=3 959)), and the corresponding differences were statistically significant (P<0.05). The OR (95%CI) between malnutrition and EBP was 0.68 (0.62-0.73), which were 0.65 (0.58-0.72) and 0.68 (0.60-0.77) for boys and girls. The OR (95%CI) between EBP and stunting as well as mild wasting and moderate severe wasting were 0.69 (0.62-0.77), 0.63 (0.55-0.72) and 0.79 (0.60-1.05), respectively. Conclusion The level of BP and prevalence of EBP in Chinese Han students with malnutrition were lower than those with normal nutritional status. The negative correlation existed between malnutrition and EBP in Chinese Han students aged 7 to 18 years.

Objective: To investigate the prevalence and related factors of dyslipidemia among children and adolescents aged 6-17 years in 7 provinces in China. Methods: Using the method of stratified cluster random sampling, 93 primary and secondary schools were selected from Guangdong, Hunan, Liaoning provinces, Shanghai, Chongqing, Tianjin municipalities and Ningxia Hui Autonomous Region in China, 2012. A total of 16 434 students aged 6-17 years old with completed physical and lipid profiles parameters were selected into this study from above 93 primary and secondary schools. Dyslipidemia was determined by the definition of Expert Advice on Prevention and Treatment of Dyslipidemia in Children and Adolescents in 2009. Logistic regression model was used to explore the factors related to dyslipidemia. Results: The prevalence of elevated total cholesterol, elevated triglyceride, elevated low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, and dyslipidemia was 5.4% (887 cases), 15.7% (2 578 cases), 3.0% (492 cases), 13.5% (2 221 cases) and 28.5% (4 679 cases) among children and adolescents aged 6-17 years, respectively. Sugary drinks intake ≥once per week (OR=1.14; 95%CI: 1.05-1.24), sedentary time >10 hours per day (OR=1.14, 95%CI: 1.01-1.28), overweight (OR=1.50, 95%CI: 1.33-1.70), and obesity (OR=2.62, 95%CI: 2.31-2.96) were significantly associated with the prevalence of dyslipidemia. Conclusion The prevalence of dyslipidemia was high among children and adolescents aged 6-17 in 7 provinces in China, 2012. Sugary drinks intake ≥once per week, sedentary time >10 hours per day, overweight and obesity might be the risk factors of dyslipidemia among children and adolescents.

To locate the nuclei in hematoxylin-eosin (HE) stained section images more simply, efficiently and accurately, a new method based on distance estimation is proposed in this paper, which shows a new mind on locating the nuclei from a clump image. Different from the mainstream methods, proposed method avoids the operations of searching the combined singles. It can directly locate the nuclei in a full image. Furthermore, when the distance estimation built on the matrix sequence of distance rough estimating (MSDRE) is combined with the fact that a center of a convex region must have the farthest distance to the boundary, it can fix the positions of nuclei quickly and precisely. In addition, a high accuracy and efficiency are achieved by this method in experiments, with the precision of 95.26% and efficiency of 1.54 second per thousand nuclei, which are better than the mainstream methods in recognizing nucleus clump samples. Proposed method increases the efficiency of nuclear location while maintaining the location's accuracy. This can be helpful for the automatic analysis system of HE images by improving the real-time performance and promoting the application of related researches.

Objective: To investigate consistency of whole-body muscle mass (WBMM) assessed using multi-frequency bioelectrical impedance analysis (MF-BIA) and dual energy X-ray Absorptiometry (DXA) measurement, and to delvelop the correction regression formulas for the method of MF-BIA. Methods: 1 488 participants who resided in Beijing longer than one year, under 22 to 55 years of age, with self-report BMI ≥24 kg/m² were voluntarily recruited based on convenience sampling in Beijing, from April 1^st 2014 to May 2^nd 2014. After excluded 171 participants who BMI ≤24 kg/m² or with organic diseases when physical examination, Finally 1 317 overweight/obese participants were enrolled into the current study. All the subjects received the measurement of WBMM using both MF-BIA and DXA methods. The paired-samples T test was used to compare the difference of measurement values between MF-BIA and DXA methods. We evaluated the agreement of WBMM measured by MF-BIA and DXA using the interclass correlation coefficients (ICC) and the Bland-Altman plots, and using linear regression method established correction regression formulas. Results: The differences of overweight male, obese male, overweight female, and obese female were (3.29 ± 1.94), (2.05 ± 2.65), (0.17 ± 1.85), and (-2.22 ± 2.89) kg between methods of MF-BIA and DXA, respectively; Except the overweight female, the others groups had the statistically significant difference (P<0.05). The ICC for overweight male, obese male, overweight female, and obese female were 0.958, 0.956, 0.911, and 0.851, respectively (P<0.001). Bland-Altman plots showed that the limit of agreement for four groups were -0.51-7.09, -3.14-7.24, -3.46-3.80, and -7.88-3.44 kg, respectively. Correction regression formulas: overweight male population: y_DXA=-0.648+ 0.952 x_MF-BIA; obese male population: y_DXA=-3.646 + 1.026x_MF-BIA; overweight female groups: y_DXA=-4.800 + 1.117 x_MF-BIA; obese female group: y_DXA=-9.884+ 1.287x_MF-BIA. Conclusion The correlation and agreement of WBMM measured by the methods of BIA and DXA were relative weak in Chinese excess weight male and obese female adults. Therefore, measuring WBMM by MF-BIA method in these adults should be corrected to reduce bias compared with the DXA method.

Objective: To investigate the associations between the appendicular skeletal muscle mass index and main anthropometric parameters, and to provide clues for preventing the reduction of skeletal muscle mass among overweight and obese adults in China. Methods: 1 488 volunteered participants who resided in Beijing longer than one year, between 22 and 55 years old, with self-report BMI ≥24 kg/m² were recruited from April to May 2014. 171 participants whose BMI ≤24 kg/m² or with organic diseases at the first physical examination were excluded, finally 1 317 overweight/obese participants (male and female were 507, and 810, respectively) were enrolled into the present study. After measuring the anthropometric parameters and body composition by the DXA, Pearson correlation analysis and multiple linear regression models were used to analyze the associations between the appendicular skeletal muscle mass index and main anthropometric parameters. Results: The average age of males and females was (35.6±8.4) and (38.2±9.4) years old, respectively. The females' mean levels of body fat percentage, BMI, waist circumference, hip circumference, and bone mineral density were (41.59±4.14)%, (29.00±3.75) kg/m², (92.56±9.00) cm, (101.74±6.75) cm, and (1.20±0.10) g/cm², respectively; and the males' mean levels were (34.22±4.61)%, (30.07±4.12) kg/m², (99.63±9.49) cm, (102.93±7.28) cm, and (1.28±0.11) g/cm², respectively. The mean level of appendicular skeletal muscle mass and skeletal muscle mass index in males were (26.98±3.88), and (8.96±1.02) kg, respectively, which were significantly higher than it in females ((18.57±2.61), and (7.26±0.83) kg, respectively) (P<0.001). For male, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat percentage and bone mineral density were 0.814, 0.601, 0.637, 0.558, and 0.434, respectively; for female, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat rate and bone mineral density were 0.761, 0.534, 0.585, 0.610, and 0.304, respectively. The correlations were statistically significant (P<0.001). Multiple linear regression analysis showed that the skeletal muscle mass index of male decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.13, 95%CI:-0.15--0.12) (P<0.05), while increased with the increase of BMI (β=0.31, 95%CI: 0.29-0.32) and bone mineral density (β=0.54, 95%CI: 0.10-1.01) (P<0.05). The skeletal muscle mass index of female decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.12, 95%CI:-0.14--0.12) (P<0.05), while increased with the increase of BMI (β=0.26, 95%CI: 0.25-0.28) and hip circumference (β=0.01, 95%CI: 0.00-0.02) (P<0.05). Conclusion The skeletal muscle mass index of male was higher than it of female. For male, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and bone mineral density. While for female, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and hip circumference.

Objective: To examine the association between polymorphism of rs10185316 in insulin-induced gene 2 (INSIG2) and blood pressure among children and adolescents. Methods: 9 junior middle schools in Dongcheng District of Beijing and 5 schools (3 primary junior middle schools, 2 primary schools) in Haidian District of Beijing were chosen in 2005 and 2007, respectively. According to the Chinese BMI percentile criteria for screening overweight and obesity in school children, we recruited 1 425 overweight or obese children and 605 normal weight children. A total of 2 018 students with complete data of blood pressure and genotype data were included in this study. According to the blood pressure criterion of children and adolescents, 702 participants were categorized into high blood pressure group and 1 316 into normal blood pressure group. Participants' information of gender, age, height, weight and blood pressure were collected by questionnaire and physical examination. Genomic DNA was extracted from peripheral blood sample for genotyping of INSIG2 rs10185316 polymorphism. Multiple linear regression was conducted to analyze the associations between rs10185316 polymorphism in INSIG2 and SBP, DBP, mean arterial pressure (MAP) and pulse pressure. Results: The age, BMI, SBP and DBP of the high blood pressure group were separately (14.3±1.4) years old, (27.3±4.2) kg/m², (130.5±10.9) and (76.7±13.3) mmHg (1 mmHg=0.133 kPa), all higher than that of the normal blood pressure group, which were (12.2±2.9) years old, (22.0±4.0) kg/m², (104.4±10.9) and(54.6±15.2) mmHg, respectively (all P values<0.001). After age, sex, district and BMI adjusted, compared with the participants carrying INSIG2 rs10185316 CC genotype, CG/GG genotype carriers had lower DBP (β(95%CI):-1.67(-2.84--0.50), P=0.005), higher PP(β(95%CI): 1.91(0.61-3.20), P=0.004), and lower MAP(β(95%CI):=-1.03(-2.01--0.05), P=0.039). Conclusion INSIG2 rs10185316 polymorphism was associated with DBP, PP and MAP among children and adolescents in an independent way from BMI.

Objective To explore the association between cesarean section and obesity in child and adolescent.Methods In this study,a total number of 42 758 primary and middle school students aged between 6 and 17 were selected,using the stratified cluster sampling method in 93 primary and middle schools in Hunan,Ningxia,Tianjin,Chongqing,Liaoning,Shanghai and Guangdong provinces and autonomous regions.Log-Binomial regression model was used to analyze the association between cesarean section and obesity in childhood or adolescent.Results Mean age of the subjects was (10.5±3.2) years.The overall rate of cesarean section among subjects attending primary or secondary schools was 42.3％,with 55.9％ in boys and,40.6％ in girls respectively and with difference statistically significant (P＜0.001).The rate on obesity among those that received cesarean section (17.6％) was significantly higher than those who experienced vaginal delivery (10.2％) (P＜0.001).Results from the log-binomial regression model showed that cesarean section significantly increased the risk of obesity in child and adolescent (OR=1.72,95％CI:1.63-1.82;P＜0.001).After adjusting for factors as sex,residential areas (urban or rural),feeding patterns,frequencies of milk-feeding,eating high-energy foods,eating fried foods and the levels of parental education,family income,parental obesity,physical activity levels,gestational age and birth weight etc.,the differences were still statistically significant (OR=1.48,95％ CI:1.39-1.57;P＜0.001).Conclusion The rate of cesarean section among pregnant women in China appeared high which may significantly increase the risk of obesity in child or adolescent.

OBJECTIVETo examine the contribution of insulin related indices on the association between body fat and blood pressure among overweight adults.

METHODSFrom April to May 2014, based on convenience sampling, we recruited overweight and obese volunteer participants aged 20-55 years living in Beijing at least 1 year through a strict examination by doctors in a physical examination center. In this study, we excluded the participants who reported suffering from any severe heart, lung, liver or kidney organic diseases, and abnormal development, disabilities, and secondary obesity caused by other disease. Also participants with use of antihypertensive drugs, hypoglycemic drugs and lipid lowering drugs were excluded for this study. A total of 1 221 participants were investigated in this study. With a simple self-designed questionnaire, the birthdates, sex, drug use, and disease history were examined. Participants' blood pressure (BP), percentage of body fat (PBF), glucose and fasting insulin level were measured. Mediation analysis was used to analyze the total effect of PBF on BP (c), the association between PBF and insulin related indices (a), and the mediation effect of serum fasting insulin level/HOMA-IR/HOMA-%S on relation between PBF and systolic/diastolic blood pressure (SBP/DBP).

RESULTSPBF was positively associated with SBP (c=0.25 ± 0.05 and 0.19 ± 0.03 for male and female, respectively, P<0.001). In males, PBF was positively associated with fasting insulin level and HOMA-IR (a=0.28 ± 0.05 and 0.24 ± 0.05, P<0.001), and negatively associated with HOMA-%S (a=-0.29 ± 0.05, P<0.001); in females, PBF was positively associated with fasting insulin level, HOMA-IR (a=0.21 ± 0.04 and 0.20 ± 0.04, P<0.001), and negatively associated with HOMA-%S (a=-0.13 ± 0.04, P<0.001). In further mediation analysis for female participants, fasting insulin level/HOMA-IR/HOMA-%S played mediation roles in the relation between PBF and SBP, with ratio of mediation of 13.78%,18.3%, and 5.98%. Fasting insulin level/HOMA-IR also mediated the relation between PBF and DBP, with mediation ratio of 11.98% and 14.13%.

CONCLUSIONIn overweight/obese female participants, insulin related indices mediated the relation between PBF and BP.

Adipose Tissue ; physiology ; Adult ; Beijing ; Blood Glucose ; analysis ; Blood Pressure ; Body Mass Index ; Female ; Humans ; Insulin ; physiology ; Insulin Resistance ; Male ; Middle Aged ; Obesity ; physiopathology ; Overweight ; physiopathology ; Risk Factors ; Young Adult

OBJECTIVETo explore the effect of weight-loss for overweight or obese population under the health management programs, and to provide evidence for the development of safe and effective weight-loss programs.

METHODS738 participants who resided in Beijing longer than one year, under 22 to 55 years of age, with BMI≥24 kg/m(2) and without organic diseases were voluntarily recruited, from September 1(st) to October 15(th) 2013. All the participants were randomly divided into general management group or under health management group, in which all the subjects received intervention measures for 6 months. Anthropometry and body composition were measured at baseline and 6 months for all the subjects. Weight-loss effect from the health management programs was evaluated through analyzing the changes on weight and body fat.

RESULTS618 participants completed the follow-up process, including 321 in the general management group and 297 in the health management group. 6 months after the intervention process, values of weight and body fat rate in the two groups appeared both significantly lower than that at the baseline levels. Difference before and after the intervention program was statistically significant (P<0.001). However, the differences of those with reduction value as 2.19 kg or 2.19% among health management group were higher than that in the general management group, which were 0.97 kg and 1.28% respectively, with difference statistically significant (P<0.001). The effective rate of 24.2% loss-weight and the 52.5% losing rate on body fat among the health management group were both higher than 11.8% and 34.3%, seen in the general management group, respectively, with difference statistically significant (P<0.001).

CONCLUSIONThe healthy management programs could effectively control the weight and body fate rate among the overweight or obese adults.

Adipose Tissue ; Adult ; Behavior Therapy ; Body Composition ; Body Mass Index ; China ; Exercise ; Feeding Behavior ; Female ; Humans ; Middle Aged ; Obesity ; prevention & control ; Overweight ; Risk Reduction Behavior ; Treatment Outcome ; Weight Loss ; physiology ; Weight Reduction Programs ; methods

OBJECTIVETo analyze the influence factors of body image dissatisfaction among children and adolescents with normal weight.

METHODSThe primary and middle school students who were selected from Changping district of Bejing city using the stratified cluster sampling method were measured body height, weight, and waist circumference. Body image cognitive attitude of students or their parents was surveyed using 'Ma figural shape'. The cognitive attitude of obesity risk factors was surveyed by self-designed questionnaires. The students with normal weight were selected according to 'reference norm for screening overweight and obesity in Chinese children and adolescents (WGOC) in 2005' and 'reference norm for screening underweight in Chinese children and adolescents aged 6-19 years'. The association between body image dissatisfaction and cognitive attitude of obesity risk factors was analyzed for each gender.

RESULTSThe study validly surveyed and measured 680 students, and there were 36.6% (249/680) students with overweight or obesity, 4.0% (27/680) students with underweight, and 59.4% (404/680) students with normal weight. Prevalence of body image satisfaction, expecting to be thinner, and to be fatter in students with normal weight was 32.7% (132/404), 35.1% (142/404), and 32.2% (130/404), respectively. The prevalence of expecting to be thinner in females and middle students was higher than that in males and primary students (46.4% (102/220) vs 21.8% (40/184)), (39.8% (88/221) vs 29.5% (54/183)), respectively; χ² values were 26.65 and 4.67 respectively (P < 0.05). The prevalence of expecting to be fatter in males was higher than that in females ((42.9% (79/184) vs 23.2% (51/220)) (χ² = 17.91, P < 0.001). The concordance ratio on body image cognitive attitude between students and their parent was 60.4% (244/404), and the consistency coefficient was 0.41 (P < 0.001). The factors including parents expecting their children to be thinner, the negative attitude on less drinking sugary beverages and having breakfast per day might increase the risks of children expecting to be thinner in males, the OR (95% CI) value were 5.20 (1.51-17.89), 3.43 (1.11-10.59), and 6.53(1.14-37.58), respectively. The parents expecting their children to be fatter might increase the risk of children expecting to be fatter in males, the OR (95% CI) value were 7.57 (3.47-16.52). The factors including parents expecting their children to be thinner, and the positive attitude on less eating high calorie snacks might increase the risk of children expecting to be thinner in females, the OR (95% CI) value were 65.74 (8.45-511.21) and 3.03 (1.01-9.09), respectively. The parents expecting their children to be thinner or fatter might increase the risk of children expecting to be fatter in females, the OR (95% CI) value were 17.38 (1.53-197.74) and 9.64 (3.98-23.35), respectively.

CONCLUSIONThe prevalence of body image dissatisfaction among students with normal weight was high, and the concordance ratio on body image cognitive attitude between themselves and their parents was low. Guiding students to have the correct cognitive attitude on less drinking sugary beverages, having breakfast per day, and less eating high calorie snacks may be conducive to prevent body image dissatisfaction.

Adolescent ; Asian Continental Ancestry Group ; Body Image ; Body Mass Index ; Body Weight ; Child ; Female ; Food Preferences ; Humans ; Male ; Obesity ; Overweight ; Personal Satisfaction ; Prevalence ; Risk Factors ; Students ; Surveys and Questionnaires ; Young Adult