1.Association between dietary behavior and type 2 diabetes in the older adults aged 65 years and over in 18 longevity areas of China
Xuehua HU ; Yue CHEN ; Zenghang ZHANG ; Chen CHEN ; Yingli QU ; Xi MENG ; Jun WANG ; Zinan XU ; Zheng LI ; Sixin LIU ; Wenhui SHI ; Zhanhong XUE ; Fanye LONG ; Xiaoming SHI ; Yuebin LYU
Chinese Journal of Preventive Medicine 2025;59(5):588-596
Objective:To explore the impact of plant and animal dietary behaviors on type 2 diabetes mellitus (T2DM) in older adults aged ≥65 in 18 longevity areas of China.Methods:The subjects were 5 223 older adults over 65 years old from the Healthy Ageing and Biomarkers Cohort Study (HABCS) in 18 longevity areas in China. Through a questionnaire survey and physical examination, information about their demographic characteristics, lifestyles, daily activities, self-health status, current diseases, and fasting venous blood were collected. Food Frequency and Questionnaire (FFQ) was used to collect data on food intake frequency. Based on the prior method, the plant-based diet index (PDI) and animal-based diet index (ADI) of 5 223 older adults were calculated. Subjects were divided into three groups (low-level group: PDI<39 or ADI<31, middle-level group: 39≤PDI≤42 or 31≤ADI≤34, high-level group: PDI>42 or ADI>34) by tertiles of PDI and ADI. Multivariate logistic regression was used to analyze the association between PDI and ADI and the risk of T2DM.Results:The average age of 5 223 subjects was (84.8±11.5) years, with the median ( Q1, Q3) of PDI about 41(38, 43) and the median ( Q1, Q3) of ADI about 33 (30, 35). The prevalence rate of T2DM was 16.41% (857/5 223). After adjusting for covariates, multivariate logistic regression showed that PDI was negatively associated with T2DM. Compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 0.83 (0.69-0.99). ADI was positively associated with T2DM, and compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 1.28 (1.06-1.55). For every one-point increase in PDI and ADI, the risk of T2DM decreased by 2% and increased by 3%, respectively, with the OR (95% CI) of 0.98 (0.96-1.00) and 1.03 (1.01-1.06), respectively. Conclusion:In Chinese older adults ≥65 years in 18 longevity areas, higher adherence to the plant-based behavior may be negatively associated with the risk of T2DM, while higher adherence to the animal-based behavior may be positively associated with the risk of T2DM.
2.Distribution characteristics and long-term change trend of body mass index in Chinese older adults aged 65 years and above
Li QI ; Chen CHEN ; Sirui CHEN ; Zhipei LI ; Sixin LIU ; Jinhui ZHOU ; Jiahao CHEN ; Hao QIAN ; Chun TAN ; Xianglong DAI ; Ziyue ZHU ; Jun WANG ; Xi MENG ; Wenhui SHI ; Yuebin LYU ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2025;59(6):908-915
Objective:To describe the body mass index (BMI) level and long-term trends of Chinese older adults aged 65 and above.Methods:Older adults aged 65 and above from six waves (2002-2018) of the China Longitudinal Healthy Longevity Survey were selected as the study population. Multiple cross-sectional design with six survey waves conducted in 2002, 2005, 2008, 2011, 2014, and 2018 was adopted, enrolling 15 647, 15 358, 15 622, 9 166, 6 302, and 12 417 participants, respectively. Additionally, a total of 13, 755 participants were included in the cohort study design. Relevant information was collected through questionnaires and physical examinations. The χ2 trend test was used to compare the changes in the rates of underweight and overweight/obesity over the years, and the linear mixed-e?ects model (LMM) was used to fit trajectory curves of BMI changes with advancing age in older adults. Results:The baseline ages of the participants included in 2002, 2005, 2008, 2011, 2014, and 2018 were (85.16±11.26), (84.23±11.83), (84.99±12.16), (81.10±11.86), (78.89±11.30), and (83.08±12.42) years, respectively, with a relatively high proportion of females and rural residents. In the cohort study, the 13 755 participants had a median ( Q1, Q3) follow-up time of 6.5 (5.2, 10.0) years, with a cumulative follow-up duration of 109 041 person-years. In each wave, males had higher BMI than females, urban residents had higher BMI than rural residents, and BMI gradually decreased with increasing age (all P<0.001). The mean BMI of older adults in China increased from (19.37±3.80) kg/m2 in 2002 to (22.04±4.01) kg/m2 in 2018 ( P<0.001). Across all survey years, the prevalence of underweight was consistently higher in women than in men and in rural areas than in urban areas, with an upward trend as age increased (all P<0.001). In 2018, the underweight rates in the 65-79, 80-89, 90-99, and ≥100-year-old age groups were 8.0%, 16.7%, 26.2%, and 35.5%, respectively. Meanwhile, the prevalence of overweight/obesity was higher in men than in women and in urban areas than in rural areas, showing a declining trend with advancing age (all P<0.001). The prevalence of underweight among the older adults decreased significantly from 45.2% in 2002 to 18.9% in 2018 ( P<0.001), while the prevalence of overweight/obesity increased from 11.0% in 1998 to 29.6% in 2018 ( P<0.001). The trajectory curves fitted by the LMM model showed that individuals born in later decades had higher BMI levels at the same age compared to earlier cohorts. Conclusion:From 2002 to 2018, the BMI level among Chinese older adults showed an increasing trend. The prevalence of underweight showed a declining trend, while the rates of obesity and overweight increased. However, the underweight rate remained notably high among the oldest old.
3.Association between dietary behavior and type 2 diabetes in the older adults aged 65 years and over in 18 longevity areas of China
Xuehua HU ; Yue CHEN ; Zenghang ZHANG ; Chen CHEN ; Yingli QU ; Xi MENG ; Jun WANG ; Zinan XU ; Zheng LI ; Sixin LIU ; Wenhui SHI ; Zhanhong XUE ; Fanye LONG ; Xiaoming SHI ; Yuebin LYU
Chinese Journal of Preventive Medicine 2025;59(5):588-596
Objective:To explore the impact of plant and animal dietary behaviors on type 2 diabetes mellitus (T2DM) in older adults aged ≥65 in 18 longevity areas of China.Methods:The subjects were 5 223 older adults over 65 years old from the Healthy Ageing and Biomarkers Cohort Study (HABCS) in 18 longevity areas in China. Through a questionnaire survey and physical examination, information about their demographic characteristics, lifestyles, daily activities, self-health status, current diseases, and fasting venous blood were collected. Food Frequency and Questionnaire (FFQ) was used to collect data on food intake frequency. Based on the prior method, the plant-based diet index (PDI) and animal-based diet index (ADI) of 5 223 older adults were calculated. Subjects were divided into three groups (low-level group: PDI<39 or ADI<31, middle-level group: 39≤PDI≤42 or 31≤ADI≤34, high-level group: PDI>42 or ADI>34) by tertiles of PDI and ADI. Multivariate logistic regression was used to analyze the association between PDI and ADI and the risk of T2DM.Results:The average age of 5 223 subjects was (84.8±11.5) years, with the median ( Q1, Q3) of PDI about 41(38, 43) and the median ( Q1, Q3) of ADI about 33 (30, 35). The prevalence rate of T2DM was 16.41% (857/5 223). After adjusting for covariates, multivariate logistic regression showed that PDI was negatively associated with T2DM. Compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 0.83 (0.69-0.99). ADI was positively associated with T2DM, and compared with the low-level group, the OR (95% CI) for T2DM in the high-level group was 1.28 (1.06-1.55). For every one-point increase in PDI and ADI, the risk of T2DM decreased by 2% and increased by 3%, respectively, with the OR (95% CI) of 0.98 (0.96-1.00) and 1.03 (1.01-1.06), respectively. Conclusion:In Chinese older adults ≥65 years in 18 longevity areas, higher adherence to the plant-based behavior may be negatively associated with the risk of T2DM, while higher adherence to the animal-based behavior may be positively associated with the risk of T2DM.
4.Distribution characteristics and long-term change trend of body mass index in Chinese older adults aged 65 years and above
Li QI ; Chen CHEN ; Sirui CHEN ; Zhipei LI ; Sixin LIU ; Jinhui ZHOU ; Jiahao CHEN ; Hao QIAN ; Chun TAN ; Xianglong DAI ; Ziyue ZHU ; Jun WANG ; Xi MENG ; Wenhui SHI ; Yuebin LYU ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2025;59(6):908-915
Objective:To describe the body mass index (BMI) level and long-term trends of Chinese older adults aged 65 and above.Methods:Older adults aged 65 and above from six waves (2002-2018) of the China Longitudinal Healthy Longevity Survey were selected as the study population. Multiple cross-sectional design with six survey waves conducted in 2002, 2005, 2008, 2011, 2014, and 2018 was adopted, enrolling 15 647, 15 358, 15 622, 9 166, 6 302, and 12 417 participants, respectively. Additionally, a total of 13, 755 participants were included in the cohort study design. Relevant information was collected through questionnaires and physical examinations. The χ2 trend test was used to compare the changes in the rates of underweight and overweight/obesity over the years, and the linear mixed-e?ects model (LMM) was used to fit trajectory curves of BMI changes with advancing age in older adults. Results:The baseline ages of the participants included in 2002, 2005, 2008, 2011, 2014, and 2018 were (85.16±11.26), (84.23±11.83), (84.99±12.16), (81.10±11.86), (78.89±11.30), and (83.08±12.42) years, respectively, with a relatively high proportion of females and rural residents. In the cohort study, the 13 755 participants had a median ( Q1, Q3) follow-up time of 6.5 (5.2, 10.0) years, with a cumulative follow-up duration of 109 041 person-years. In each wave, males had higher BMI than females, urban residents had higher BMI than rural residents, and BMI gradually decreased with increasing age (all P<0.001). The mean BMI of older adults in China increased from (19.37±3.80) kg/m2 in 2002 to (22.04±4.01) kg/m2 in 2018 ( P<0.001). Across all survey years, the prevalence of underweight was consistently higher in women than in men and in rural areas than in urban areas, with an upward trend as age increased (all P<0.001). In 2018, the underweight rates in the 65-79, 80-89, 90-99, and ≥100-year-old age groups were 8.0%, 16.7%, 26.2%, and 35.5%, respectively. Meanwhile, the prevalence of overweight/obesity was higher in men than in women and in urban areas than in rural areas, showing a declining trend with advancing age (all P<0.001). The prevalence of underweight among the older adults decreased significantly from 45.2% in 2002 to 18.9% in 2018 ( P<0.001), while the prevalence of overweight/obesity increased from 11.0% in 1998 to 29.6% in 2018 ( P<0.001). The trajectory curves fitted by the LMM model showed that individuals born in later decades had higher BMI levels at the same age compared to earlier cohorts. Conclusion:From 2002 to 2018, the BMI level among Chinese older adults showed an increasing trend. The prevalence of underweight showed a declining trend, while the rates of obesity and overweight increased. However, the underweight rate remained notably high among the oldest old.
5.Prediction model related to 6-year risk of frailty in older adults aged 65 years or above in China
Jinhui ZHOU ; Li QI ; Jun WANG ; Sixin LIU ; Wenhui SHI ; Lihong YE ; Zhenwei ZHANG ; Zenghang ZHANG ; Xi MENG ; Jia CUI ; Chen CHEN ; Yuebin LYU ; Xiaoming SHI
Chinese Journal of Epidemiology 2024;45(6):809-816
Objective:To develop a prediction tool for 6-year incident risk of frailty among Chinese older adults aged 65 years or above.Methods:Data from the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2018 was used, including 13 676 older adults aged 65 years or above who were free of frailty at baseline. Key predictors of frailty were identified via the least absolute shrinkage and selection operator (LASSO) method, and were thereafter used to predict the incident frailty based on the Cox proportional hazards regression model. The model was internally validated by 2 000 Bootstrap resamples and evaluated for the performance of discrimination and calibration using the area under the receiver operating characteristic curve (AUC) and calibration curve, respectively. The net benefit of the developed prediction tool was evaluated by decision-curve analysis.Results:The M( Q1, Q3) age and follow-up time of the participants were 81.0 (71.0, 90.0) years and 6.0 (4.1, 9.2) years, respectively. A total of 4 126 older persons (30.2%) were recorded with frailty incidents during the follow-up, with the corresponding incidence density of 41.8/1 000 person-years. A total of 15 key predictors of frailty were selected by LASSO, namely, age, sex, race, education years, meat consumption, tea drinking, performing housework, raising domestic animals, playing cards or mahjong, and baseline status of visual function, activities of the daily living score, instrumental activities of the daily living score, hypertension, heart disease, and self-rated health. The prediction model was internally validated with an AUC of 0.802, with the max Youden's index of 0.467 at a risk threshold of 19.0%. The calibration curve showed high consistency between predicted probabilities and observed proportions of frailty events. The decision curve indicated that higher net benefits could be obtained via the prediction model than did strategies based on intervention in all or none participants for any risk threshold less than 59%, and the model-based net benefit was estimated to be 0.10 at a risk threshold of 19.0%. Conclusions:The herein developed 6-year incident risk prediction model of frailty, based on easily accessible questionnaires and physical examination variables, has good predictive performance. It has application potential in identifying populations at high risk of incident frailty.
6.Effects of Repetitive Transcranial Magnetic Stimulation Combined with Biofeedback Non Motor Symptoms on Serum Levels of IL-6, CRP and TNF-α in Patients with Parkinson's Disease
Chanjuan CHEN ; Xiaojun YU ; Dan HE ; Sixin LIU ; Jie WU
Progress in Modern Biomedicine 2017;17(22):4314-4317
Objective:To investigate the Repetitive transcranial magnetic stimulation combined with biofeedback non motor symptoms on clinical effects and serum levels of IL-6,CRP and TNF-α of Parkinson's disease.Methods:84 cases of Parkinson's disease in our hospital were randomly divided into experimental group and control group,with 42 cases in each group.The control group were treated with EMG and EEG biofeedback,while the experimental group were treated with repetitive transcranial magnetic stimulation on the basis of the control group.Then the serum levels of C reactive protein (CRP) and interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α),the non motor symptoms questionnaire (NMSQuest),Parkinson's disease Sleep Scale (PDSS) and Hamilton Depression Scale (HAMD) score in the two groups were observed and compared before and after the treatment.Results:Compared with before treatment,the serum levels of CRP,IL-6 and TNF-α,the NMSQuest and HAMD in the two groups decreased after the treatment,while the PDSS score increased,and the differences were statistically significant (P<0.05);Compared with the control group,the serum levels of CRP,IL-6 and TNF-α,NMSQuest and HAMD in the experimental group were lower,while the PDSS score was higher,and the differences were statistically significant (P<0.05).Conclusion:Repetitive transcranial magnetic stimulation combined with biofeedback can reduce the serum levels of IL-6,CRP and TNF-α in patients with Parkinson's disease,which has better clinical effect on the non motor symptoms.
7.Total hip arthroplasty with onlay bone graft for treatment of severe adult hip dysplasia
Hongming LIU ; Jigui ZHU ; Zheng YE ; Jian ZHU ; Zhijun ZHU ; Sixin SUN
Chinese Journal of Tissue Engineering Research 2014;(26):4120-4124
BACKGROUND:Joint replacement surgery becomes difficult because of the abnormal changes in hip joint, especial y on the acetabular side. Therefore, the treatment on acetabulum is very important during total hip arthroplasty in patients with hip dysplasia. OBJECTIVE:To investigate the clinical therapeutic effects of total hip arthroplasty with onlay bone graft for treatment of CroweIII and IV adult hip dysplasia. METHODS:A total of in 14 patients with adult hip dysplasia were retrospectively analyzed. According to Crowe method, there were 11 cases of type III and 3 cases of type IV. Al patients underwent total hip arthroplasty. Autologous femur neck was used to make an onlay bone graft around the acetabulum during replacement. Radiographs were analyzed after replacement and during fol ow-up. Clinical efficacy was assessed using Harris standard. RESULTS AND CONCLUSION:Al patients were fol owed up for 1-9 years, averagely 4.5 years. Bone graft was partial y absorbed within 1 year after replacement in 4 patients, and began to grow 2 years later. Radiographs showed that al bone graft was fused to host bone. The average coverage rate of bone grafts on acetabulum was 36%. None hip was needed to be rebuilt up to now. Harris score of hip joint function increased from 35 points (26-52 points) before surgery to 91 points during final fol ow-up. Total hip arthroplasty with onlay bone graft is an effective method in treatment of CroweIII and IV adult hip dysplasia.
8.Clinical effect of endovascular stent placement on intracranial internal carotid artery dissection therapy
Sixin WANG ; Wu ZHOU ; Xiongjun HE ; Kaifeng LI ; Yajie LIU
Clinical Medicine of China 2013;29(z1):104-107
Objective To evaluate the clinical effect of endovascular stent placement to the treatment of intracranial internal carotid artery dissection.Methods Two patients with intracranial internal carotid artery dissection received the treatment of stent placement,and 1 patient with a dissection of the supra clinoid internal carotid artery received conventional anticoagulation treatment.Results Two patients with intracranial internal carotid artery dissection were given treatment of Apollo stent placement,of which 1 patient had improvement of left limb paresis,the score of NIHSS from 3 before operation to 2 after operation; the other one with episodic left limb weakness was not seen any attack after stent placement.Another one patient without stent placement receiving conventional anticoagulation treatment had some improvement of right limb paralysis.Conclusion The treatment of endovascular stent placement to the intracranial internal carotid artery dissection has better clinical efficacy and especially used for those patients with no effect to the conventional anticoagulation treatment.
9.Impact of enteral nutrition or parenteral nutrition in post-operative colorectal cancer patients on viscera organ functions and "passing wind" time
Huizhi YU ; Xiang LONG ; Chongmei LIU ; Yanli CAO ; Sixin LI ; Xiaoqiu WU
Chinese Journal of Clinical Nutrition 2009;17(5):268-270
Objective To study the impact of enteral nutrition (EN) or parenteral nutrition (PN) in postoperative colorectal cancer patients on viscera organ function and "passing wind" time.Methods Totally 30 patients with colorectal cancer joined this study with informed consent.Patients were randomly divided into EN group and PN group.Both two groups were given nutritional support from the first post-operative day to the 7th post-operative day.The pre-operative and post-operative viscera organ functions and the recovery time of gastrointestinal functions are observed.Results Total bilirubin was significantly lower in EN group than in PN group (P < 0.05).The length of post-operative hospital stay was significantly shorter in EN group than in PN group (P <0.01).The post-operative complications were not significantly different between two groups (P > 0.05).Conclusion Postoperative EN support is beneficial for colorectal cancer patient in terms of lower bilirubin levels,shorter post-operative hospital stay,and lower cost.
10.Changes of plasma homocysteine levels after stent implantation for intracranial and extracranial vascular stenosis
Minghui FANG ; Sixin WANG ; Lihong ZHOU ; Liang ZHAO ; Dazheng LIN ; Yanjun GAO ; Yanjuan MI ; Zhihua LIU ; Qidong CHEN
Chinese Journal of Tissue Engineering Research 2008;12(4):787-790
BACKGROUND: Ultra-high molecular weight polyethylene (UHMWPE) is widely used as acetabulum. The hip joint will produce lots of grind particles and lead to loosening of artificial joint because of alternating load and bad lubricate condition.OBJECTIVE: To learn about the lubricate mechanism of joint, introduce the present situation on artificial hip joint of UHMWPE including wear behavior and wear resistance properties, and grope for scientific evaluate method of tribological properties in artificial joints.RETRIEVAL STRATEGY: The articles published between January 2000 and October 2007 were searched by using computer with the key terms "hip joint, ultra-high molecular weight polyethylene, tribology" in CNKI, Weipu Science and Technology Database, Wanfang Database, and its language was limited to Chinese. Meanwhile, the English articles were searched in IEEE/IEE Electronic Library and Elsevier Electronic Journal Database with the key terms "hip simulators, ultra-high molecular weight polyethylene, tribology ". Those referring to the friction and wear property of the joints were included, whereas repeated researches were deleted.LITERATURE EVALUATION: Totally 729 articles were received. After the primary screening of the titles and abstracts, 601 repeated or similar researches were excluded, and other 128 articles were adopted for further analysis, finally 22 articles in accordance with the inclusion criteria were included as references.DATA SYNTHESIS: The study about UHMWPE focused two points, one is surface modification, the other is wear and friction mechanism.①The study indicates that wear properties of UHMWPE can be improved by surface modification, such as ion implantation and nanometer padding have a remarkable elevating ability of the wear and mechanical properties.②At recent years, scholars do many basal experiences about the tribology of hip joints, and have approved that wear rate of friction pairs would reduce under biological lubricate condition using artificial joint simulators or traditional tester in various conditions.CONCLUSION: The study about hip joint in China drops behind the developed counties, this traditional method can not really reflect wear and friction properties in vivo. Therefore, the following research should include making clear the relationships of load, environmental condition and wear of artificial joint in vivo, as well as groping for a scientific evaluate method of tribological properties in hip joints.

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