Objective: This study was aimed at examining the trends and correlates of physical activity (PA) and sedentary behaviors among Chinese children. Methods: A total of 4,341 subjects (6,936 observations) aged 6-17 years who participated in the China Health and Nutrition Survey (2004-2015) were included. Of the subjects, 41% participated in the survey twice or more. Random-effects ordinal regression models and repeated-measures mixed-effects models were used to examine the PA trends. Quantile regression models were applied to examine the factors influencing PA and sedentary behaviors. Results: From 2004 to 2015, the prevalence of physical inactivity among Chinese children aged 6-17 years increased by 5.5% [odds ratio ( Conclusions A declining PA trend among Chinese children aged 6-17 years was observed from 2004 to 2015, and certain subgroups and geographical areas are at higher risk of physical inactivity.
Adolescent ; Asian Continental Ancestry Group/statistics & numerical data* ; Child ; Child Behavior/ethnology* ; China/epidemiology* ; Exercise ; Female ; Humans ; Male ; Nutrition Surveys ; Regression Analysis ; Sedentary Behavior/ethnology*

INTRODUCTIONWe studied the effects of ethnicity on early infant growth patterns in exclusively breast-fed (EBF) infants from a Singaporean multiethnic population. This was a prospective cohort study conducted in National University Hospital, Singapore.

MATERIALS AND METHODSHealthy, EBF infants born at-term completing 37 weeks and above, and whose birthweight was appropriate for gestational age (>10 centile, <90 centile) were recruited. Infants were required to be EBF at least until the minimum age of weaning. All infants who were preterm and premature, formula-fed, required Intensive/High Dependency care, or born with major congenital anomalies were excluded. A multivariable linear regression analysis was conducted at 5 predetermined time-points (birth; 4-8 weeks; 3-4, 5-8, 12 months) to study the effects of antenatal/parental factors on infant growth.

RESULTSA total of 213 infants were recruited. Maternal age, height and body mass index positively influenced birthweights while maternal hypertension and paternal smoking negatively influenced birthweights. Mean duration of breastfeeding was 8.9 months. Chinese ethnicity did not influence birth anthropometry, but was the single consistent factor that significantly increased weight and length Z-scores from 4-8 weeks until 8 months of life. Chinese ethnicity did not influence head growth throughout the first year of life.

CONCLUSIONEBF Chinese infants have increased weights and lengths compared to non-Chinese infants until 8 months' age, despite similar birth anthropometry. This period of discrepant growth coincides with the average duration of breastfeeding. We hypothesise that ethnic variations in breast milk macronutrient composition influence early somatic growth in infants.

Anthropometry ; methods ; Asian Continental Ancestry Group ; statistics & numerical data ; Birth Weight ; Body Mass Index ; Breast Feeding ; ethnology ; Child Development ; physiology ; Ethnic Groups ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Singapore ; epidemiology

INTRODUCTIONThe objectives of this current study were to: 1) examine the prevalence and correlates of diabetes mellitus (DM) among older adults (aged 60 years and above) in a multi-ethnic population; 2) examine the prevalence and correlates of comorbid DM and depression among them; and 3) assess the effect of comorbid depression on disability, cognition and healthcare utilisation.

MATERIALS AND METHODSData for the current study came from the Well-being of the Singapore Elderly (WiSE) study; a single phase, cross-sectional survey conducted among Singapore residents aged 60 years and above. A total of 2565 respondents completed the survey; depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) while a diagnosis of DM was considered if respondents stated that a doctor had diagnosed them with DM.

RESULTSDM was reported by 25.5% of the population. The prevalence of depression was significantly higher in those diagnosed with DM than those without DM (6% vs 3%). After adjusting for sociodemographic correlates, smoking and other chronic conditions, DM remained significantly associated with depression and subsyndromal depression. However, after including measures of functioning and cognitive impairment as covariates, DM was not significantly related to depression and subsyndromal depression. Those with comorbid DM and depression were more likely to be of Indian and Malay ethnicity, aged 75 to 84 years (versus 60 to 74 years) and widowed.

CONCLUSIONGiven the significant association of certain sociodemographic groups with comorbid depression among those with DM, targeted interventions for prevention and early diagnosis in these groups should be considered.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; statistics & numerical data ; Comorbidity ; Cross-Sectional Studies ; Depression ; epidemiology ; Depressive Disorder ; epidemiology ; Diabetes Mellitus ; epidemiology ; Ethnic Groups ; statistics & numerical data ; Female ; Health Services ; utilization ; Humans ; India ; ethnology ; Malaysia ; ethnology ; Male ; Middle Aged ; Prevalence ; Severity of Illness Index ; Singapore ; epidemiology ; Surveys and Questionnaires

PURPOSE: The aim of the present study was to develop an osteoporosis risk-assessment model to identify high-risk individuals among Korean men. MATERIALS AND METHODS: The study used data from 1340 and 1110 men > or =50 years who participated in the 2009 and 2010 Korean National Health and Nutrition Examination Survey, respectively, for development and validation of an osteoporosis risk-assessment model. Osteoporosis was defined as T score < or =-2.5 at either the femoral neck or lumbar spine. Performance of the candidate models and the Osteoporosis Self-assessment Tool for Asian (OSTA) was compared with sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). A net reclassification improvement was further calculated to compare the developed Korean Osteoporosis Risk-Assessment Model for Men (KORAM-M) with OSTA. RESULTS: In the development dataset, the prevalence of osteoporosis was 8.1%. KORAM-M, consisting of age and body weight, had a sensitivity of 90.8%, a specificity of 42.4%, and an AUC of 0.666 with a cut-off score of -9. In the validation dataset, similar results were shown: sensitivity 87.9%, specificity 39.7%, and AUC 0.638. Additionally, risk categorization with KORAM-M showed improved reclassification over that of OSTA up to 22.8%. CONCLUSION: KORAM-M can be simply used as a pre-screening tool to identify candidates for dual energy X-ray absorptiometry tests.
Aged ; Asian Continental Ancestry Group/*statistics & numerical data ; Bone Density ; Female ; Humans ; Male ; Middle Aged ; *Models, Biological ; Nutrition Surveys ; Osteoporosis/*diagnosis/ethnology ; Predictive Value of Tests ; Prevalence ; ROC Curve ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment/*methods ; Sensitivity and Specificity ; Surveys and Questionnaires/*standards

PURPOSE: This study determined which obesity measurement correlates the best with diabetes and prediabetes. MATERIALS AND METHODS: This cross-sectional study enrolled 1603 subjects (611 men, 992 women; age 30-64 years) at the Cardiovascular and Metabolic Diseases Etiology Research Center. Body mass index, waist circumference, waist-height ratio, waist-hip ratio, waist-thigh ratio, and visceral fat were used as measures of obesity. Visceral fat was acquired using dual-energy X-ray absorptiometry (DXA). The prevalences of diabetes and prediabetes were defined using the criteria in the American Diabetes Association 2015 guidelines. RESULTS: After adjusting for age and other potential confounding factors, participants with a visceral fat mass in the upper 10th percentile had a higher odds ratio (OR) for diabetes and prediabetes than the upper 10th percentile of other adiposity indices [men, OR=15.9, 95% confidence interval (CI)=6.4-39.2; women, OR=6.9, 95% CI=3.5-13.7]. Visceral fat mass also had the highest area under the curve with diabetes and prediabetes in both men (0.69, 95% CI=0.64-0.73) and women (0.70, 95% CI=0.67-0.74) compared to other anthropometric measurements of obesity. CONCLUSION: Visceral fat mass measured using DXA is an indicator of diabetes or prediabetes, due to its ability to differentiate between abdominal visceral and subcutaneous fat.
Absorptiometry, Photon ; *Adiposity ; Adult ; Anthropometry ; Asian Continental Ancestry Group/*statistics & numerical data ; Biomarkers/blood ; Body Mass Index ; Cross-Sectional Studies ; Diabetes Mellitus/*ethnology ; Female ; Humans ; *Intra-Abdominal Fat ; Male ; Middle Aged ; Obesity/complications/*ethnology ; Odds Ratio ; Prediabetic State/*ethnology ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Waist Circumference

OBJECTIVETo investigate the knowledge and willingness of breast cancers patients from Shanghai for genetic counseling and gene testing.

METHODSA total of 428 patients filled out the questionnaire and the data was statistically analyzed.

RESULTSMost of the patients were unaware of genetic counseling and gene testing. But after a brief introduction, a majority of them were willing to accept genetic counseling and recommend their family members to participate. The willingness was education- and age-related. When told that gene testing may benefit themselves, 92.1% of the patients were willing to be tested. However, when told that gene testing may only benefit their family, only 33.9% of the patients were willing to join the testing. The acceptance was also age-, education- and family income-related. The difference was statistically significant. Moreover, the willingness ratio to participate the gene testing was lower than expected. Overall, 74.1% of the patients were willing to accept cheaper preliminary gene screening, whilst only 19.2% were willing to accept genetic testing of higher price. Despite of being told that testing results will be maintained as confidential, still 43.2% worried about adverse effects. Such patients tended to younger, from low-income families, with a family history of associated cancers, or personal history of other cancers. The difference was statistically significant.

CONCLUSIONThe majorities of patients do not know but are willing to accept genetic counseling and gene testing and recommend their family to participate. Lack of genetic knowledge, cost for the testing and concerns about discrimination are the obstacles for patients to participate in genetic counseling and gene testing. To spread the knowledge about breast cancer and establish a follow-up screening system for high-risk population may improve the tertiary prevention for breast cancer.

Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; statistics & numerical data ; BRCA1 Protein ; genetics ; BRCA2 Protein ; genetics ; Breast Neoplasms ; diagnosis ; ethnology ; genetics ; Chi-Square Distribution ; China ; Educational Status ; Female ; Genetic Counseling ; Genetic Predisposition to Disease ; genetics ; Genetic Testing ; Health Knowledge, Attitudes, Practice ; Humans ; Middle Aged ; Social Class

OBJECTIVETo describe the status of prevalence, awareness, treatment, and control of hypertension among half a million adults in 10 regions under the China Kadoorie Biobank (CKB) cohort.

METHODSThe baseline survey of CKB was performed in 10 areas across China during 2004-2008, included 512 891 adults aged from 30 to 79 years. Regional differences of prevalence, awareness, treatment and control of hypertension were compared after adjustment for age and/or sex.

RESULTSThe overall prevalence of hypertension from the CKB was 35.2% (180 612/512 891), with the highest as 44.4% in Zhejiang and the lowest as 22.0% in Haikou. Prevalence in the rural areas (35.1%) was higher than that in the urban areas (32.1%), with statistical significance (P<0.001). Among all the participants with hypertension, 59 703 (33.1%) were aware of hypertension, 65 172 (36.1%) were receiving anti-hypertension treatment and 22 329 (12.4%) were under controll. However, only a small part of those receiving treatment were under controll (30.5%, 19 884/65 172) in this study. The control of hypertension and of those receiving treatment were higher in Suzhou for males (17.4%, 39.1%), while were higher in Liuzhou for females (23.5%, 42.6%) than those in other regions.

CONCLUSIONSParticipants under the CKB presented relatively high prevalence of hypertension, but lower rates on awareness, treatment and control of hypertension. Distribution of awareness, treatment, and control of hypertension varied greatly among the ten areas, under the CKB.

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Asian Continental Ancestry Group ; Biological Specimen Banks ; Blood Pressure ; China ; epidemiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Health Knowledge, Attitudes, Practice ; ethnology ; Humans ; Hypertension ; drug therapy ; epidemiology ; Male ; Middle Aged ; Prevalence ; Rural Population ; statistics & numerical data ; Surveys and Questionnaires ; Treatment Outcome ; Urban Population ; statistics & numerical data

INTRODUCTIONClinical practice guidelines recommend different blood pressure (BP) goals for chronic kidney disease (CKD) patients. Usage of antihypertensive medication and attainment of BP targets in Asian CKD patients remain unclear. This study describes the profile of antihypertensive agents used and BP components in a multiethnic Asian population with stable CKD.

METHODSStable CKD outpatients with variability of serum creatinine levels < 20%, taken > 3 months apart, were recruited. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using automated manometers, according to practice guidelines. Serum creatinine was assayed and the estimated glomerular filtration rate (GFR) calculated using the CKD Epidemiology Collaboration equation. BP and antihypertensive medication profile was examined using univariate analyses.

RESULTS613 patients (55.1% male; 74.7% Chinese, 6.4% Indian, 11.4% Malay; 35.7% diabetes mellitus) with a mean age of 57.8 ± 14.5 years were recruited. Mean SBP was 139 ± 20 mmHg, DBP was 74 ± 11 mmHg, serum creatinine was 166 ± 115 µmol/L and GFR was 53 ± 32 mL/min/1.73 m(2). At a lower GFR, SBP increased (p < 0.001), whereas DBP decreased (p = 0.0052). Mean SBP increased in tandem with the number of antihypertensive agents used (p < 0.001), while mean DBP decreased when ≥ 3 antihypertensive agents were used (p = 0.0020).

CONCLUSIONDifferent targets are recommended for each BP component in CKD patients. A majority of patients cannot attain SBP targets and/or exceed DBP targets. Research into monitoring and treatment methods is required to better define BP targets in CKD patients.

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Asian Continental Ancestry Group ; Blood Pressure ; Blood Pressure Determination ; Creatinine ; blood ; Diastole ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; drug therapy ; ethnology ; Male ; Middle Aged ; Outpatients ; Practice Guidelines as Topic ; Renal Insufficiency, Chronic ; drug therapy ; ethnology ; Singapore ; Statistics as Topic ; Systole

PURPOSE: In this study, we aimed to evaluate whether nonalcoholic fatty liver disease (NAFLD) was associated with the presence and morphology of coronary atherosclerotic plaques shown by multidetector computed tomography (MDCT) in asymptomatic subjects without a history of cardiovascular disease. MATERIALS AND METHODS: We retrospectively enrolled 772 consecutive South Korean individuals who had undergone both dualsource 64-slice MDCT coronary angiography and hepatic ultrasonography during general routine health evaluations. The MDCT studies were assessed for the presence, morphology (calcified, mixed, and non-calcified), and severity of coronary plaques. RESULTS: Coronary atherosclerotic plaques were detected in 316 subjects (40.9%) by MDCT, and NAFLD was found in 346 subjects (44.8%) by hepatic ultrasonography. Subjects with NAFLD had higher prevalences of all types of atherosclerotic plaque and non-calcified, mixed, and calcified plaques than the subjects without NAFLD. However, the prevalence of significant stenosis did not differ between groups. After adjusting for age, smoking status, diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome, NAFLD remained a significant predictor for all types of coronary atherosclerotic plaque [odds ratio (OR): 1.48; 95% confidence interval (CI): 1.05-2.08; p=0.025] in binary logistic analysis, as well as for calcified plaques (OR: 1.70; 95% CI: 1.07-2.70; p=0.025) in multinomial regression analysis. CONCLUSION: Our study demonstrated that NAFLD was significantly associated with the presence and the calcified morphology of coronary atherosclerotic plaques detected by MDCT. Further prospective clinical studies are needed to clarify the exact physiopathologic role of NAFLD in coronary atherosclerosis.
Adult ; Aged ; Asian Continental Ancestry Group/statistics & numerical data ; Calcinosis/ethnology/*radiography ; Case-Control Studies ; Coronary Angiography/*methods ; Coronary Artery Disease/ethnology/pathology/*radiography ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/*methods ; Non-alcoholic Fatty Liver Disease/epidemiology/*ultrasonography ; Odds Ratio ; Plaque, Atherosclerotic/*diagnosis/epidemiology ; Prevalence ; Regression Analysis ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Ultrasonography

PURPOSE: The association of interleukin-10 (IL-10) polymorphisms (-1082G/A, -819C/T, -592A/C) and interleukin-6 (IL-6) poly-morphisms (-174G/C) with tuberculosis (TB) risk has been widely reported. However, the results are controversial. To clarify the role of these polymorphisms in TB, we performed a meta-analysis of all available and relevant published studies. MATERIALS AND METHODS: Based on comprehensive searches of the PubMed, Medline, Embase, Web of Science, Elsevier Science Direct and Cochrane Library database, we identified outcome data from all articles estimating the association between IL-10 and IL-6 polymorphisms and TB risk. RESULTS: The results indicated significant association of the allele model, heterozygous model and dominant model of IL-6 -174G/C polymorphism with decreased risk of TB. In the stratified analysis by ethnicity, significantly increased risk was observed for IL-10 -1082G/A polymorphism in Europeans under recessive model, for IL-10 -819C/T polymorphism in Asians under heterozygous model and dominant model and IL-10 -592A/C polymorphism in Asians under Allele model, homozygous model and recessive model. Moreover, significantly decreased risk of TB was associated with Asians for IL-6 -174C/G polymorphism in allele model, heterozygous model and dominant model. We also performed the analyses by sample types in IL-10 -1082G/A polymorphism, and observed significantly increased TB risk in mixed group under homozygous model. CONCLUSION: The results suggested that the IL-10 -1082G/A polymorphism is associated with increased TB risk in Europeans, while IL-10 -819C/T and IL-10 -592A/C polymorphisms in Asians. However, IL-6 -174G/C polymorphism might be a genetic risk factor that decreases TB susceptibility in Asians.
Alleles ; Asian Continental Ancestry Group/genetics/statistics & numerical data ; Case-Control Studies ; European Continental Ancestry Group/genetics/statistics & numerical data ; *Genetic Predisposition to Disease ; Humans ; Interleukin-10/*genetics ; Interleukin-6/*genetics ; Polymorphism, Genetic ; *Polymorphism, Single Nucleotide ; Risk Factors ; Tuberculosis/*ethnology/*genetics