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Effects of health management on high-risk diabetic populations

Huiguang TIAN ; Ruolan DOU ; Chunmin HAO ; Jian WEI ; Jie WU ; Hongmin GAO ; Yu BAI

Chinese Journal of Health Management.2013;7(5):300-303. doi:10.3760/cma.j.issn.1674-0815.2013.05.004

Objective To assess the effects of health management on high-risk diabetic populations.Methods A total of 307 diabetic high-risk adults from 6 communities of Tianjin were recruited by using diabetes risk screening technology.Three-month intensive health management and nine-month follow-up were conducted in this participants.Paired t test for continuous variables and paired contingency table x2 test were used for data analysis.Results Energy intake (1989.8 vs.1766.4 kcal,t =6.84,P ＜0.05),effective exercises (120.4 vs.157.5 kcal,t =-5.00,P ＜ 0.05),body weight (73.0 vs.71.5 kg,t =6.92,P ＜0.05),systolic blood pressure (130.4 vs.124.6 mm Hg (1 mm Hg =0.133 kPa),t =8.36,P ＜0.05),diastolic blood pressure (81.8 vs.78.4 mm Hg,t =7.40,P ＜ 0.05),serum total cholesterol (5.21 vs.5.08 mmol/L,t =2.73,P ＜ 0.05),fasting plasma glucose (6.4 vs.5.8 mmol/L,t =16.37,P ＜ 0.05)and 2 h postprandial blood glucose (7.7 vs.6.9 mmol/L,t =9.67,P ＜ 0.05) were significantly improved after the intervention.Conclusions Community-based health management may provide an effective way to prevent and control the risk factors of diabetes.

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Relationship between dietary patterns and non alcoholic fatty liver disease among Karamay adults

Li LI ; Liqing GONG ; Yonghong ZHANG ; Yan JIANG ; Yajing GU ; Jing ZHOU

Chinese Journal of Health Management.2013;7(5):312-316. doi:10.3760/cma.j.issn.1674-0815.2013.05.007

Objective To explore the relationship between dietary patterns and non alcoholic fatty liver disease (NAFLD) in Karamay adults.Methods A total of 2377 subjects aged 20-75 years old who took health check-up during April and June 2011 were included in this investigation.Body mass index (BMI),waist to hip ratio (WHR),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),total cholesterol (TC),aspartate aminotransferase (AST) and serum uric acid (SUA)were measured.Food intake patterns and life style of the participants were accessed by using food frequency questionnaire (FFQ).Main component analysis and multivariate logistic regression model were used to explore the association of dietary patterns with NAFLD.Results Five dietary patterns were identified,including condiment dietary pattern, western dietary pattern, conventional healthy dietary pattern,snacks and bean pattern,and high protein dietary pattern.Subjects of condiment dietary pattern,western dietary pattern or conventional healthy dietary pattern showed significantly different prevalence of NAFLD (x2 values were 149.873,8.247 and 18.766,respectively; all P ＜ 0.05).In condiment dietary pattern,age,BMI,WHR,SUA and TG were significantly different in Q4 group (F values were 8.42,5.64,12.78,10.72 and 9.63,respectively; all P ＜0.05).For those with western dietary pattern,age,WHR,SBP,SUA,TC and TG showed significant different trend (F values were 9.84,6.87,6.11,10.61,6.87 and 8.13,respectively; all P ＜ 0.05).However,subjects with conventional healthy dietary pattern showed a significant different trend of age,BMI,WHR,SBP,SUA and AST (F values were 19.13,11.09,13.89,6.11,15.12,6.19,respectively ; all P ＜ 0.05).After age,BMI,WHR,SBP,SUA,AST,TC and TG were adjusted,the risk of NAFLD of those with condiment pattern or western pattern were significantly increased (odds ratio (OR) were 1.33 (95％ confidence interval (CI) 0.95-1.87) and 1.36 (95％ CI 0.979-1.902),respectively).Conclusion Dietary pattern may be associated with NAFLD.People need to learn healthy dietary habit to prevent NAFLD.

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Effectiveness of household-based health management on community patients with gestational diabetes

Huawei WEI

Chinese Journal of Health Management.2013;7(5):317-320. doi:10.3760/cma.j.issn.1674-0815.2013.05.008

Objective To evaluate the effect of household-based health management model on community patients with gestational diabetes.Methods Eighty-four singleton pregnant women with diabetes who visited New City Community Healthcare Center of Zaozhuang Municipal Hospital from January 2009 to December 2012 were randomly assigned to the management group (n =42) and the control group (n =42).The pregnant women in the management group accepted household-based health management,and the pregnant women in the control group accepted conventional health education,intervention,and followup.Blood glucose,lipid profiles,blood pressure,body mass index (BMI) and pregnancy outcomes were compared between the two groups.Results There were no significant different of clinical characteristics between the two groups at baseline.Right before delivery,fasting plasma glucose,2 h postprandial blood glucose,blood pressure,childbirth BMI,pregnancy weight gain,total cholesterol,triglyceride and low-density lipoprotein cholesterol of the management group were significantly lower than those of the control group (t values were 5.81,2.28,3.14,2.41,5.17,4.97,7.81,2.39 and 3.39,respectively; all P ＜0.05),however high-density lipoprotein cholesterol was relatively higher (t =2.02,P ＜ 0.05).Polyhydramnios,premature rupture of membranes,hypertensive disorders in pregnancy,natural labour,cesarean section,fetal macrosomia and neonatal hypoglycemia were found significantly different between the two groups (x2 values were 4.61,4.48,4.48,4.94,4.27,4.48 and 4.76,respectively; all P ＜ 0.05).Health behavior of the management group was significantly improved following the intervention (for balanced diet,regular exercise,proper medication,standardized monitoring,timely referral,high and low blood sugar treatment and emotional management,x2 values were 5.61,4.76,5.27,5.73,4.48,5.19 and 4.20,respectively; all P ＜ 0.05).Conclusion Household-based health management could improve health behavior,metabolic status and maternal or neonatal outcomes of community patients with gestational diabetes.

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Serum cystatin C level and its risk factors in Chinese healthy adults: a population based cross-section study

Jing LI ; Li JIAO

Chinese Journal of Health Management.2013;7(5):321-324. doi:10.3760/cma.j.issn.1674-0815.2013.05.009

Objective To investigate the average serum level and risk factors of serum cystatin C in Chinese healthy adults.Methods A total of 15 918 healthy adults who received health assessments in Peking Union Medical College Hospital during January 2012 and March 2013 were enrolled in this crosssection study.Serum cystatin C was measured.Estimated glomerular filtration rate was calculated by creatinine (eGFRcr).Multivariable linear regression analysis was used to assess factors that contribute to cystatin C variability.Results The mean serum cystatin C level was (0.79 ±0.14) mg/L (95％ reference interval (RI) was 0.56-1.08 mg/L).Male showed significantly higher cystatin C level than female (mean (0.84 ±0.13) vs (0.73 ±0.13) mg/L; RI 0.64-1.11 mg/L and 0.54-1.03 mg/L,respectively; P=0.000).Differences between genders are still significant after subgrouped by age.In the young-age group (age≤44 years old),the mean serum cystatin C level was (0.81 ±0.11)mg/L in male and (0.68 ±0.09)mg/L in female,P =0.000.In the middle-age group (45-59 years old),the mean cystatin C level was (0.85 ±0.12) mg/L in male and (0.75 ±0.12) mg/L in female,P =0.000.In the elderly group (≥60 yrs),the mean serum cystatin C level was (0.97 ±0.18) mg/L in male and (0.89 ±0.19) mg/L in female,P =0.000.Serum cystain C was increased with ages (in male:r =0.274,P =0.000 ; in femal,r =0.470,P =0.000).Differences between each two age groups are all significant for both gender,P =0.000.Cystatin C level in male is respectively (0.81 ±0.ll)mg/L,(0.85 ±0.12) mg/L and (0.97 ± 0.18) mg/L in the young-age,middle-age and elderly group.Cystatin C level in female is respectively (0.68 ±0.09) mg/L,(0.75 ±0.12) mg/L and (0.89 ±0.19) mg/L in the young-age,middle-age and elderly group.Male gender,older age,lower body weight,lower eGFRcr,lower high-density lipoprotein cholesterol,lower fasting blood glucose,increased mean blood pressure,higher body mass index and triglyceride were significantly associated with increased serum cystatin C level.Body weight,total cholesterol and low-density lipoprotein cholesterol were not risk factors of cystatin C.Conclusion Serum cystatin C level may be influenced by gender,age and other factors in Chinese healthy adults.

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Health status and needs for health promotion of a company staff

Jianwei REN ; Jianshi HUANG ; Zhenglai WU ; Weiwei CHEN

Chinese Journal of Health Management.2013;7(5):329-332. doi:10.3760/cma.j.issn.1674-0815.2013.05.011

Objective To understand the affecting factors of health and health promotion needs of one company staff so as to provide evidence for effective health intervention.Methods A convenience sampling method was used to enroll subjects in this cross-sectional study.All the participants were required to fill in a questionnaire to learn their demographics,health related factors and health promotion needs in the 2 work days of June 2012 had been studied.Chi-square test and unconditional logistic regression were used for data analysis.Results More males showed higher risk of disease than females (x2 =5.394,P ＜ 0.05).In conditional logistic regression,age was the main factor affecting health (odds ratio (OR) =3.127,95％ (confidence interval) CI 1.020-9.591,P ＜ 0.05) when gender,marital status,educational level and occupation were adjusted.Dietary nutritional knowledge (69.6％) and physical check-up (64.6％) were urgent needs among those surveyed.Conclusion Staff with varied demographic characteristics have different health related factors and physical check-up may provide a tool to meet their urgent needs of health promotion.

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Effects of metaformin on body weight management and blood glucose control in over-weight patients with newly diagnosed type 2 diabetes

Hui LI ; Mingxiao SUN ; Lei JIANG ; Yao WANG

Chinese Journal of Health Management.2013;7(5):292-295. doi:10.3760/cma.j.issn.1674-0815.2013.05.002

Objective To investigate the effects of metformin on blood glucose control and body weight management in over-weight patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods A retrospective study was performed in T2DM patients who were treated with metaformin (male 38,female 23,mean age (50.8 ± 7.9) years old).Based on body mass index (BMI),all the participants were assigned to obese,over-weight and normal weight group.Analysis of variance and multivariate analysis were used to confirm the effects of metformin on blood glucose and body weight.Results Fasting blood glucose (FBG),HbA1 c and BMI were significantly reduced over 2 years.In comparison with baseline,BMI of the obesity and overweight group was significantly decreased during follow up (P ＜ 0.05),while BMI of the normal weight group increased by 0.7 kg/m2.At baseline,FBS and HbAlc of the obese group were lower than those of the normal weight group (FBS (7.3 ± 0.8) vs.(11.8 ± 4.8) mmol/L,P ＜ 0.05 ; HbA1 c (6.8 ± 1.2) ％ vs.(8.5 ±3.1)％,P ＜0.05),whereas insulin level was higher than that of the normal weight group ((2.20 ± 0.36) vs.(1.87 ± 0.29) U,P ＜ 0.05).At 2 years,HbA1 c was reduced on average by 2.5％,1.4％ and 1.9％ in the obesity,over-weight and normal weight group,respectively.Conclusions The present study demonstrates the beneficial effect of metformin on newly diagnosed diabetics,especially obese patients.

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Impact of self-management of hypertension on self efficacy among community residents

Jin XIE ; Zhong DONG

Chinese Journal of Health Management.2013;7(5):304-307. doi:10.3760/cma.j.issn.1674-0815.2013.05.005

Objective To evaluate the impact of hypertension self-management on self efficacy of community residents.Methods November 2011 to February 2012,twenty-eight medium-sized and better adherence to community was selected from fourteen districts and counties in Beijing.In this community-based randomized controlled trial,323 hypertensive patients were randomly assigned to the treatment group (n =159,receiving hypertension self-management) and the control group (n=164,receiving standard hypertension management).A questionary survey was completed at baseline and 6 weeks.Rank sum test or Chi-square test was used for data analysis.Results The average age of the treatment group or the control group was (61.9 ±9.1) vs (61.8 ±9.0) years old,respectively.No significant difference in mean age,gender and education level was found between the two groups (F =0.164,x2 values were 0.782 and 2.093,respectively ; all P ＞ 0.05).In the treatment group,the scores of fatigue,headache and shortness of breath were declined (when compared with the controlled females,Z =-5.198,-3.873,-2.781 ; P ＜ 0.05).Self-efficacy score of the treatment group was increased after the intervention.Women's symptom management self-efficacy and common disease management self-efficacy were significantly higher (Z=-2.958,-2.582; P ＜ 0.05).In comparison with the control group,before and after self-management,the added scores of communication ability with doctors were increased.But the difference was not statistically significant (P ＞ 0.05).Conclusion Six-week self-management program may improve self efficacy among hypertensive patients.

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Chest computer tomography and serum tumor markers for lung cancer screening

Yuan HE ; Weimin WANG ; Dan FENG ; Qiang ZENG

Chinese Journal of Health Management.2013;7(5):325-328. doi:10.3760/cma.j.issn.1674-0815.2013.05.010

Objective To assess the value of chest computer tomography (CT) and serum tumor marker in lung cancer screening among health check-up populations.Methods A total of 88 596 adults who had a medical check-up (including chest CT,chest DR,and tumor biomarkers test) in our center were enrolled in this investigation.Clinical diagnosis of lung cancer was confirmed by three professional doctors.Receiver operating characteristic (ROC) curve was used to assess the relationship between serum level of tumor biomarkers and lung cancer.Results The average detection rate of lung cancer was 59.8/100 000 in our center during 2007 and 2011 (men 42.9/100 000,women 92.2/100 000).Rate of positive results of chest CT was 94.3％,which was approximately 2 times of chest DR.Moreover,carcinoembryonic antigen (CEA) testing was effective in early diagnosis of lung cancer with higher sensitivity (73.6％) and specificity (57.1％).Conclusion This study suggests that health checkup centers should pay more attention to lung cancer screening in high risk populations,and new technologies might be used to facilitate the early diagnosis of lung cancer.

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Current status and influencing factors of oral health behavior among the elderly living in Gongshu District of Hangzhou City

Chenxi ZHU ; Xiamin QIU ; Fuming HE ; Xinchi ZHOU ; Hongyi NIU ; Yingzhou LI

Chinese Journal of Health Management.2014;8(1):10-13. doi:10.3760/cma.j.issn.1674-0815.2014.01.005

Objective To explore the current status and influencing factors of oral health knowledge and behavior among the elderly living in Gongshu District of Hangzhou City.Methods A total of 600 elderly individuals were selected by multi-stage stratified cluster random sampling and interviewed with a self-designed questionnaire which included demographic characteristics and oral health knowledge and behavior.The status and influencing factors of oral health behavior were analyzed by single and multiplefactor analysis methods.Results A questionnaire survey was conducted among 600 elderly residents,with a response rate of 99.3％ (596/600) and an effective response rate of 94.1％ (561/600).The rate of good oral hygiene was 50.4％.Those elderly with different age,education level,medical insurance and oral hygiene showed significant difference in qualified rate of oral health behavior (x2 values were 10.79,21.32,5.72 and 16.33,respectively; all P＜0.05).In Logistic regression model,education level was positively correlated with oral health behavior among the elderly,and the qualified rate of oral health behavior of the elderly with education level of junior school or above was 2.69 times higher than that of illiterate elderly (x2=10.53,P=0.001).Conclusion The awareness rate of oral health knowledge among the elderly living in Gongshu District of Hangzhou City is at a relatively higher level,though oral health behavior is moderate.Age,education level,medical insurance and oral hygiene could be impacting factors of oral health behavior.

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Abnormal birth weight and its risk factors of 5055 newborn babies in Changzhi of Shanxi Province

Baoling HOU ; Wenjie LIN ; Li LIU ; Jun MA

Chinese Journal of Health Management.2014;8(1):22-25. doi:10.3760/cma.j.issn.1674-0815.2014.01.008

Objective To learn birth weight of newborn babies and its influencing factors to provide evidence for maternal healthcare.Methods A retrospective analysis was conducted among 5 055 newborn babies from January 2007 to December 2007 to learn their birth weight,gender,pregnant week,maternal age,parity and living areas.Univariate and multivariate Logistic regression analysis were used to explore factors that influenced birth weight.Results For those 5 055 infants,the average birth weight was (3128±675) g,and the incidence of low birth weight or fetal macrosomia was 14.6％ and 8.2％,respectively.In single factor Chi-square test,living area,pregnant week and maternal age were factors that influenced low birth weight and fetal macrosomia (x2 values were 223.807 and 34.120; 2 211.570 and 68.941; 92.199 and 18.745,respectively).Moreover,parity was related with the occurrence of low birth weight (x2=54.822),and gender was found to affect fetal macrosomia (x2=34.503,both P＜0.05).In Logistic regression analysis,preterm birth (odds ratio (OR)=37.140,95％ confidence interval (CI):30.094-45.853),rural residents (OR=0.390,95％ CI:0.310-0.492) and maternal age (OR=0.864,95％ CI:0.779-0.959) were risk factors of low birth weight,and baby boy (OR=0.524,95％ CI:0.423-0.650),urban residents (OR=0.616,95％ CI:0.501-0.758),postterm delivery (OR=4.175,95％ CI:2.918-5.974) and advanced maternal age (OR=1.229,95％ CI:1.104-1.368) were risk factors of fetal macrosomia.Conclusion This investigation suggests a relatively lower average birth weight and higher incidence of fetal macrosomia and low birth weight infant in Changzhi of Shanxi Province.Health interventions,maternal healthcare service programme and pre-and post-natal health education should be carried out to achieve normal birth weight.

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