1.Non-alcoholic fatty liver disease related health outcomes and influencing factors among community inhabitants
Yunlong KAN ; Yongmei LI ; Minhua TANG ; Yangbo GENG ; Genming ZHAO ; Yonggen JIANG
Shanghai Journal of Preventive Medicine 2024;36(6):596-601
ObjectiveTo describe different non-alcoholic fatty liver disease (NAFLD) outcomes among community inhabitants, and further to explore the correlation between bio-indicator level variance and the outcomes. MethodsPhysical indicators (height, weight, waist circumstances, hip circumstances, blood pressure, etc), biochemical indicators [fasting plasma glucose, HbA1c, serum triglycerides(TG), serum total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), liver related transaminase, etc] and clinical imaging (B-scan ultrasonography) were collected during the follow-up from the Songjiang Natural Population Sub-cohort. The identification of NAFLD was supported by the definition criteria from Guidelines for the diagnosis and treatment of non⁃alcoholic fatty liver disease. Paired t-test and multifactorial logistic regression model were used to compare the difference between the indicator level of the subjects from different outcome subgroups and to further analyze the correlation between these indicator variance and different NAFLD outcomes. ResultsDuring a median follow-up time of 2.94 years, 12 076 subjects were involved. The cumulative NAFLD incidence and remission rate were 21.57% and 31.15%, respectively. The proportion of subjects who still had NAFLD was 27.96%. Among subjects with newly-developed NAFLD, indicators including blood pressure, BMI, fasting plasma glucose, and plasma lipid level increased, while in the remission subgroup, blood pressure, BMI(WHR), waist-hip ratio(WHR), and TG level were significantly decreased. Increased level of systolic pressure, WHR, BMI, HbA1c, and LDL-C might be the risk factors to the occurrence of NAFLD. While decreased level of WHR, BMI, TC and LDL-C level and elevated HDL-C level were likely to be the influencing factors of NAFLD remission process. ConclusionThe NAFLD morbidity in the community inhabitants is relatively high. BMI, WHR, fasting plasma sugar and plama lipid level variance may act as the influencing factors towards different NAFLD outcomes.
2.A cohort study of lipid levels and recurrence risk of ischemic stroke in a community-based natural population in Songjiang District, Shanghai
Yangbo GENG ; Huayuan FEI ; Yunlong KAN ; Minhua TANG ; Yunhui WANG ; Jianguo YU ; Jiedong XU ; Yiling WU ; Genming ZHAO ; Yonggen JIANG ; Yan JIN
Shanghai Journal of Preventive Medicine 2025;37(7):562-568
ObjectiveTo investigate the recurrence of ischemic stroke (IS) and to analyze the association between four indices of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) and the risk of IS recurrence by analyzing the follow-up data related to IS in the community-based natural population of Songjiang District, Shanghai, so as to provide a scientific basis for improving the prognosis of stroke patients in the community and controlling IS recurrence. MethodsA prospective follow-up study was conducted among the IS patients in the community-based cohort population, collecting data about patient’s age, gender, disease history, biochemical indicators, and etc. Cox regression model and restricted cubic spline model were used to analyze the relationship between different levels of plasma lipids and the recurrence of IS in these patients. ResultsA total of 1 368 patients with IS were included. The total follow-up duration was 7 171.46 person-years, with a median follow-up time of 6.24 years. There were 420 cases of IS recurrence, resulting in a cumulative recurrence rate of 30.70%. The results of multivariate Cox regression analysis showed that the recurrence risk of IS was reduced when the baseline TC and LDL-C levels of IS patients were in the ranges of 4.65‒5.67 mmol·L-1 and 2.52‒3.46 mmol·L-1, respectively. The results of restricted cubic spline analysis showed a U-shaped relationship between baseline TC and LDL-C levels and the recurrence risk in IS patients. ConclusionThe cumulative recurrence rate of patients with IS in the community of Songjiang District in Shanghai is high, and the levels of TC and LDL-C at baseline survey are correlated with the recurrence of IS in these patients. It is suggested to pay more attention to the levels of LDL-C and TC in patients with IS, so as to improve the prognosis.