1.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.
2.The association between mid-upper arm circumference and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus
Qian LI ; Meng YE ; Fang SU ; Wen WANG ; Yanzhe WU ; Li WU ; Hong ZHU
China Modern Doctor 2025;63(22):16-20,25
Objective To explore the association between mid-upper arm circumference(MUAC)and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 402 middle-aged and elderly patients with T2DM admitted to Nanjing Drum Tower Hospital Group Suqian Hospital from March 2022 to October 2024 were selected.Among them,308 patients with simple diabetes mellitus were included in non-sarcopenia group,and 94 patients with combined sarcopenia were included in sarcopenia group.Multivariate Logistic regression analysis was used to determine the association between MU AC and sarcopenia in middle-aged and elderly patients with T2DM.The predictive ability of MUAC for sarcopenia in middle-aged and elderly patients with T2DM was evaluated by using the receiver operating characteristic curve.Results There were statistically significant differences in age,body mass index,MUAC,triglycerides,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,appendicular skeletal muscle mass,appendicular skeletal muscle mass index,grip strength and 6-meter walking speed between two groups of patients(P<0.05).The results of multivariate Logistic regression showed that a smaller MUAC and increased age were both risk factors for sarcopenia in middle-aged and elderly patients with T2DM(P<0.05).The optimal cutoff value of MUAC for diagnosing sarcopenia in middle-aged and elderly patients with T2DM:27.90cm for males and 26.95cm for females.Conclusion MUAC is associated with sarcopenia in middle-aged and elderly patients with T2DM and can be used for the early identification and diagnosis of middle-aged and elderly T2DM patients with sarcopenia.
3.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.
4.The correlation between phase angle and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus
Qian LI ; Hong ZHU ; Meng YE ; Yanzhe WU ; Li WU ; Weiwei MA
Journal of Capital Medical University 2025;46(2):340-347
Objective To explore the association between phase angle(PhA)and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM),and to evaluate its predictive value for the risk of sarcopenia in these patients.Methods We collected data from 356 middle-aged and elderly T2DM patients hospitalized in the Department of Endocrinology,Nanjing Drum Tower Hospital Group Suqian Hospital from March 2022 to June 2024,including 274 patients with diabetes only and 82 patients with T2DM combined with sarcopenia.A Logistic regression analysis was conducted to assess the relationship between phase angle and sarcopenia.The predictive value of PhA for sarcopenia in T2DM patients was analyzed using the receiver operating characteristic(ROC)curve,and the trend of PhA with the severity of sarcopenia in T2DM patients was tested by the Jonckheere-Terpstra method.Results Univariate analysis showed that the PhA value in the T2DM with sarcopenia group was significantly lower than that in the diabetes alone group,with a statistically significant difference(P<0.05).Additionally,height,body mass,body mass index(BMI),waist circumference,arm circumference,calf circumference,fasting insulin,postprandial 2 h insulin,fasting C-peptide,postprandial 2 h C-peptide,triglycerides,albumin,blood urea nitrogen,body composition indicators,6 m walking speed,muscle mass,and muscle strength-related indicators were significantly lower in the T2DM with sarcopenia group compared to the diabetes alone group.Age,duration of diabetes,glycated hemoglobin,25-hydroxyvitamin D[25-(OH)D]were significantly higher in the T2DM with sarcopenia group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis indicated that,after adjusting for other factors,PhA remained associated with sarcopenia in T2DM patients(P<0.05),with a decreased PhA increasing the risk of sarcopenia.ROC curve analysis showed that the area under the curve(AUC)for PhA predicting sarcopenia in T2DM patients was 0.769(95% CI:0.710-0.829),indicating the predictive efficacy of PhA.Trend analysis demonstrated a significant negative correlation between PhA and the severity of sarcopenia in T2DM patients(P<0.05).Conclusion The PhA is significantly associated with sarcopenia in patients with T2DM.It can serve as an early predictive and diagnostic tool for sarcopenia in individuals with T2DM.
5.Develop and assessment of a predictive model for the first-course efficacy of acute myeloid leukemia
Feng ZHU ; Yile ZHOU ; Yi ZHANG ; Liping MAO ; De ZHOU ; Liya MA ; Chunmei YANG ; Wenjuan YU ; Xingnong YE ; Juying WEI ; Haitao MENG ; Min YANG ; Wenyuan MAI ; Jiejing QIAN ; Yanling REN ; Yinjun LOU ; Jian HUANG ; Gaixiang XU ; Wanzhuo XIE ; Hongyan TONG ; Huafeng WANG ; Jie JIN
Chinese Journal of Hematology 2025;46(4):336-342
Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.
6.Emergency management of radial artery sheath dissection during extubation in a routine coronary angiography patient
Xueqing ZHU ; Yang GE ; Chaokai HE ; Ye ZHANG ; Meng LI ; Liting WANG ; Shaozhang TENG ; Ying XIA ; Hao QIAN
Chinese Journal of Nursing 2025;60(12):1508-1511
To summarize the nursing experience of a patient with coronary heart disease who was left in the radial artery during the removal of the radial artery sheath after coronary angiography via the radial artery pathway.Nursing points:to start the emergency transfer process,to shorten the treatment transfer time;to assist to locate the position of the sheath to provide a basis for the selection of surgical incision;to conduct dynamic assessment of hemostatic effect,prevention of radial artery occlusion;to closely monitor pain and signs to prevent vasovagal reflex;to implement the whole psychological intervention,and to reduce the psychological burden of patients and their families.The ruptured sheath tube was successfully removed by emergency surgery of vascular surgery.A total of 6 days after the operation,the patient was transferred to cardiac surgery for coronary artery bypass grafting,and was discharged 23 days later.After 3 months of follow-up,the blood supply of the limbs was good,and the incision healed well.
7.Research on the application of relaxation training combined with exercise intervention in colorectal cancer patients undergoing chemotherapy
Jingyan YUE ; Cheng HANG ; Wei LIU ; Lufen ZHANG ; Qian GENG ; Weifen MENG ; Shuqin ZHU
Chinese Journal of Nursing 2025;60(11):1288-1294
Objective Analysis of the effects of relaxation training combined with exercise intervention in patients with colorectal cancer undergoing chemotherapy,aiming to provide reference for clinical nursing practice.Methods Using a convenience sampling method,80 colorectal cancer patients undergoing chemotherapy in the oncology ward of a tertiary A hospital in Changzhou,Jiangsu Province from November 2022 to November 2023 were selected as study subjects.Patients were divided into an experimental group and a control group using a random number table method,with 40 patients in each group.The experimental group received relaxation training combined with exercise interventionin addition to routine care provided to the control group.The control group received routine care.Differences in 6-minute walking distance,anxiety,depression and quality of life scores before and after six chemotherapy cycles were compared between the 2 groups.Results Finally,70 patients completed the intervention,with 35 patients in each group.After the intervention,there were differences in 6-minute walking distance,anxiety scores,depression scores,and overall health status scores between the 2 groups were all statistically significant(P<0.001).Conclusion Relaxation training combined with exercise intervention can maintain exercise endurance in colorectal cancer patients undergoing chemotherapy and alleviate anxiety and depression to some extent,helping to improve patients' quality of life.
8.The association between mid-upper arm circumference and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus
Qian LI ; Meng YE ; Fang SU ; Wen WANG ; Yanzhe WU ; Li WU ; Hong ZHU
China Modern Doctor 2025;63(22):16-20,25
Objective To explore the association between mid-upper arm circumference(MUAC)and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 402 middle-aged and elderly patients with T2DM admitted to Nanjing Drum Tower Hospital Group Suqian Hospital from March 2022 to October 2024 were selected.Among them,308 patients with simple diabetes mellitus were included in non-sarcopenia group,and 94 patients with combined sarcopenia were included in sarcopenia group.Multivariate Logistic regression analysis was used to determine the association between MU AC and sarcopenia in middle-aged and elderly patients with T2DM.The predictive ability of MUAC for sarcopenia in middle-aged and elderly patients with T2DM was evaluated by using the receiver operating characteristic curve.Results There were statistically significant differences in age,body mass index,MUAC,triglycerides,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,appendicular skeletal muscle mass,appendicular skeletal muscle mass index,grip strength and 6-meter walking speed between two groups of patients(P<0.05).The results of multivariate Logistic regression showed that a smaller MUAC and increased age were both risk factors for sarcopenia in middle-aged and elderly patients with T2DM(P<0.05).The optimal cutoff value of MUAC for diagnosing sarcopenia in middle-aged and elderly patients with T2DM:27.90cm for males and 26.95cm for females.Conclusion MUAC is associated with sarcopenia in middle-aged and elderly patients with T2DM and can be used for the early identification and diagnosis of middle-aged and elderly T2DM patients with sarcopenia.
9.Emergency management of radial artery sheath dissection during extubation in a routine coronary angiography patient
Xueqing ZHU ; Yang GE ; Chaokai HE ; Ye ZHANG ; Meng LI ; Liting WANG ; Shaozhang TENG ; Ying XIA ; Hao QIAN
Chinese Journal of Nursing 2025;60(12):1508-1511
To summarize the nursing experience of a patient with coronary heart disease who was left in the radial artery during the removal of the radial artery sheath after coronary angiography via the radial artery pathway.Nursing points:to start the emergency transfer process,to shorten the treatment transfer time;to assist to locate the position of the sheath to provide a basis for the selection of surgical incision;to conduct dynamic assessment of hemostatic effect,prevention of radial artery occlusion;to closely monitor pain and signs to prevent vasovagal reflex;to implement the whole psychological intervention,and to reduce the psychological burden of patients and their families.The ruptured sheath tube was successfully removed by emergency surgery of vascular surgery.A total of 6 days after the operation,the patient was transferred to cardiac surgery for coronary artery bypass grafting,and was discharged 23 days later.After 3 months of follow-up,the blood supply of the limbs was good,and the incision healed well.
10.Research on the application of relaxation training combined with exercise intervention in colorectal cancer patients undergoing chemotherapy
Jingyan YUE ; Cheng HANG ; Wei LIU ; Lufen ZHANG ; Qian GENG ; Weifen MENG ; Shuqin ZHU
Chinese Journal of Nursing 2025;60(11):1288-1294
Objective Analysis of the effects of relaxation training combined with exercise intervention in patients with colorectal cancer undergoing chemotherapy,aiming to provide reference for clinical nursing practice.Methods Using a convenience sampling method,80 colorectal cancer patients undergoing chemotherapy in the oncology ward of a tertiary A hospital in Changzhou,Jiangsu Province from November 2022 to November 2023 were selected as study subjects.Patients were divided into an experimental group and a control group using a random number table method,with 40 patients in each group.The experimental group received relaxation training combined with exercise interventionin addition to routine care provided to the control group.The control group received routine care.Differences in 6-minute walking distance,anxiety,depression and quality of life scores before and after six chemotherapy cycles were compared between the 2 groups.Results Finally,70 patients completed the intervention,with 35 patients in each group.After the intervention,there were differences in 6-minute walking distance,anxiety scores,depression scores,and overall health status scores between the 2 groups were all statistically significant(P<0.001).Conclusion Relaxation training combined with exercise intervention can maintain exercise endurance in colorectal cancer patients undergoing chemotherapy and alleviate anxiety and depression to some extent,helping to improve patients' quality of life.

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