1.Pregnancy Outcomes in COVID-19: A Prospective Cohort Study in Singapore.
Citra Nz MATTAR ; Shirin KALIMUDDIN ; Sapna P SADARANGANI ; Shephali TAGORE ; Serene THAIN ; Koh Cheng THOON ; Eliane Y HONG ; Abhiram KANNEGANTI ; Chee Wai KU ; Grace Mf CHAN ; Kelvin Zx LEE ; Jeannie Jy YAP ; Shaun S TAN ; Benedict YAN ; Barnaby E YOUNG ; David C LYE ; Danielle E ANDERSON ; Liying YANG ; Lin Lin SU ; Jyoti SOMANI ; Lay Kok TAN ; Mahesh A CHOOLANI ; Jerry Ky CHAN
Annals of the Academy of Medicine, Singapore 2020;49(11):857-869
INTRODUCTION:
Pregnant women are reported to be at increased risk of severe coronavirus disease 2019 (COVID-19) due to underlying immunosuppression during pregnancy. However, the clinical course of COVID-19 in pregnancy and risk of vertical and horizontal transmission remain relatively unknown. We aim to describe and evaluate outcomes in pregnant women with COVID-19 in Singapore.
METHODS:
Prospective observational study of 16 pregnant patients admitted for COVID-19 to 4 tertiary hospitals in Singapore. Outcomes included severe disease, pregnancy loss, and vertical and horizontal transmission.
RESULTS:
Of the 16 patients, 37.5%, 43.8% and 18.7% were infected in the first, second and third trimesters, respectively. Two gravidas aged ≥35 years (12.5%) developed severe pneumonia; one patient (body mass index 32.9kg/m2) required transfer to intensive care. The median duration of acute infection was 19 days; one patient remained reverse transcription polymerase chain reaction (RT-PCR) positive >11 weeks from diagnosis. There were no maternal mortalities. Five pregnancies produced term live-births while 2 spontaneous miscarriages occurred at 11 and 23 weeks. RT-PCR of breast milk and maternal and neonatal samples taken at birth were negative; placenta and cord histology showed non-specific inflammation; and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific immunoglobulins were elevated in paired maternal and umbilical cord blood (n=5).
CONCLUSION
The majority of COVID-19 infected pregnant women had mild disease and only 2 women with risk factors (obesity, older age) had severe infection; this represents a slightly higher incidence than observed in age-matched non-pregnant women. Among the women who delivered, there was no definitive evidence of mother-to-child transmission via breast milk or placenta.
Abortion, Spontaneous/epidemiology*
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Adult
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COVID-19/transmission*
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COVID-19 Nucleic Acid Testing
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COVID-19 Serological Testing
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Cohort Studies
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Disease Transmission, Infectious/statistics & numerical data*
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Female
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Fetal Blood/immunology*
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Humans
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Infectious Disease Transmission, Vertical/statistics & numerical data*
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Live Birth/epidemiology*
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Maternal Age
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Milk, Human/virology*
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Obesity, Maternal/epidemiology*
;
Placenta/pathology*
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Pregnancy
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Pregnancy Complications, Infectious/physiopathology*
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Pregnancy Outcome/epidemiology*
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Pregnancy Trimester, First
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Pregnancy Trimester, Second
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Prospective Studies
;
RNA, Viral/analysis*
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Risk Factors
;
SARS-CoV-2
;
Severity of Illness Index
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Singapore/epidemiology*
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Umbilical Cord/pathology*
;
Young Adult
2.Health hazards in childhood obesity: Evidence based on Chinese population.
Peiyu YE ; Fangfang CHEN ; Jie MI
Chinese Journal of Preventive Medicine 2016;50(1):97-100
Childhood obesity has become a critical issue in public health area. We searched Wanfang Data and PubMed databases for published studies on health hazards of childhood obesity in China during 2000-2015. From the evidence of the Chinese population studies, we know childhood obesity brings not only cardiovascular, endocrine and respiratory system health hazards, but also other health hazards to liver, moving skeleton, psychological behavior and cognition intelligence, et al. Only to understand the health hazards of childhood obesity, and put the key preventable period of chronic diseases forward to childhood, can pandemic of chronic diseases be controlled from the sources.
China
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Chronic Disease
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prevention & control
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Humans
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Pediatric Obesity
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epidemiology
;
physiopathology
3.Association of Demographic and Socioeconomic Factors With Risk Factors for Chronic Kidney Disease.
Tae Hyun KIM ; Min Jee LEE ; Ki Bong YOO ; Euna HAN ; Jae Woo CHOI
Journal of Preventive Medicine and Public Health 2015;48(3):170-177
OBJECTIVES: The goal of this study was to examine the association of various demographic and socioeconomic factors with risk factors for chronic kidney disease (CKD). METHODS: We used nationally representative pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2007-2013. We estimated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease equation. We defined CKD as a GFR <60 mL/min/1.73 m2, and 1304 of the 45 208 individuals included in the KNHANES were found to have CKD by this definition. The outcome variable was whether individual subjects adhered to the CKD prevention and management guidelines recommended by the Korea Centers for Disease Control and Prevention. The guidelines suggest that individuals maintain a normal weight, abstain from alcohol consumption and smoking, manage diabetes and hypertension, and engage in regular exercise in order to prevent and manage CKD. RESULTS: This study found that individuals with CKD were more likely to be obese and have hypertension or diabetes than individuals without CKD. In particular, male and less-educated CKD patients were less likely to adhere to the guidelines. CONCLUSIONS: Although the prevalence of CKD, as indicated by the KNHANES data, decreased from 2007 to 2013, the prevalence of most risk factors associated with CKD fluctuated over the same time period. Since a variety of demographic and socioeconomic factors are related to the successful implementation of guidelines for preventing and managing CKD, individually tailored prevention activities should be developed.
Adult
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Aged
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Demography
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Diabetes Mellitus, Type 2/complications
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Female
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Glomerular Filtration Rate
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Humans
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Hypertension/complications
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Male
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Middle Aged
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Nutrition Surveys
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Obesity/complications
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Prevalence
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Renal Insufficiency, Chronic/complications/epidemiology/*physiopathology
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Republic of Korea/epidemiology
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Risk Factors
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Socioeconomic Factors
4.Obstructive sleep apnea with excessive daytime sleepiness is associated with non-alcoholic fatty liver disease regardless of visceral fat.
Ji Hee YU ; Jae Hee AHN ; Hye Jin YOO ; Ji A SEO ; Sin Gon KIM ; Kyung Mook CHOI ; Sei Hyun BAIK ; Dong Seop CHOI ; Chol SHIN ; Nan Hee KIM
The Korean Journal of Internal Medicine 2015;30(6):846-855
BACKGROUND/AIMS: Obstructive sleep apnea (OSA) is associated with an increased risk of obesity and non-alcoholic fatty liver disease (NAFLD), but it remains unclear whether the risk of NAFLD is independently related to OSA regardless of visceral obesity. Thus, the aim of the present study was to examine whether OSA alone or in combination with excessive daytime sleepiness (EDS) or short sleep duration was associated with NAFLD independent of visceral fat in Korean adults. METHODS: A total of 621 participants were selected from the Korean Genome and Epidemiology Study (KoGES). The abdominal visceral fat area (VFA) and hepatic fat components of the participants were assessed using computed tomography scans and they were then categorized into four groups depending on the presence of OSA and EDS. RESULTS: The proportions of NAFLD were 21.1%, 18.5%, 32.4%, and 46.7% in participants without OSA/EDS, with only EDS, with only OSA, and with both OSA and EDS, respectively. A combination of OSA and EDS increased the odds ratio (OR) for developing NAFLD (OR, 2.75; 95% confidence interval [CI], 1.21 to 6.28) compared to those without OSA/EDS, and this association remained significant (OR, 2.38; 95% CI, 1.01 to 5.59) even after adjusting for VFA. In short sleepers (< 5 hours) with OSA, the adjusted OR for NAFLD was 2.50 (95% CI, 1.08 to 5.75) compared to those sleeping longer than 5 hours without OSA. CONCLUSIONS: In the present study, OSA was closely associated with NAFLD in Korean adults. This association was particularly strong in those with EDS or short sleep duration regardless of VFA.
*Adiposity
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Aged
;
Asian Continental Ancestry Group
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Chi-Square Distribution
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Disorders of Excessive Somnolence/diagnosis/*epidemiology/physiopathology
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Female
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Humans
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Intra-Abdominal Fat/*physiopathology
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Logistic Models
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Male
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Middle Aged
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Multivariate Analysis
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Non-alcoholic Fatty Liver Disease/diagnosis/*epidemiology/physiopathology
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Obesity, Abdominal/diagnosis/*epidemiology/physiopathology
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Odds Ratio
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Republic of Korea/epidemiology
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Risk Factors
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*Sleep
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Sleep Apnea, Obstructive/diagnosis/*epidemiology/physiopathology
5.Status of penis and testicular development and effects of overweight/obesity on them in boys in the Zhengzhou area.
Yao-Dong ZHANG ; Li-Na TAN ; Shu-Ying LUO ; Yong-Xing CHEN ; Hai-Yan WEI
Chinese Journal of Contemporary Pediatrics 2015;17(1):72-76
OBJECTIVETo evaluate the current status of penis and testicular development in boys and the effects of overweight/obesity on their development in the Zhengzhou area of Henan Province.
METHODSHeight, weight, waist circumference, hip circumference, penis length and testicular volume were measured in 3 546 4 to 12-year-old boys. The penis length and testicular volume were compared between the overweight/obesity and normal weight groups.
RESULTSBefore 9 years of age, the testicular volume was progressively smaller, and after 9 years old, it gradually increased. By the age of 11, it increased rapidly. The penis length increased gradually between 4 and 11 years of age, and after the age of 11 it increased rapidly. Phimosis was found in 144 cases (4.01%) and cryptorchidism was found in 18 cases (0.51%). A total of 639 (18.02%) boys were overweight or obese among 3 546 boys. At the ages of 6 and 7 years, the testicular volume in the overweight/obesity group was greater than in the normal control group (P<0.05). The penis length in the overweight/obesity group was significantly shorter than in the normal control group (P<0.05) by the age of 11 years. The correlation analysis showed that the testicular volume at the ages of 4 and 5 years was positively correlated with height, weight, BMI, waist circumference and hip circumference in overweight/obese boys. The penis length at the ages of 7 and 8 years was negatively correlated with weight, waist circumference and hip circumference. By the age of 12 years, the penis length was positively correlated with the height.
CONCLUSIONSThe development of penis and testicles in boys in the Zhengzhou area is in line with the level of sex development of Chinese boys. Overweight/obesity adversely affects the development of penis and testicles.
Child ; Child, Preschool ; China ; Humans ; Male ; Obesity ; epidemiology ; physiopathology ; Overweight ; epidemiology ; physiopathology ; Penis ; growth & development ; Testis ; growth & development
6.The Effect of Sleep Duration on the Risk of Unintentional Injury in Korean Adults.
Yeon Yong KIM ; Un Na KIM ; Jin Seok LEE ; Jong Heon PARK
Journal of Preventive Medicine and Public Health 2014;47(3):150-157
OBJECTIVES: The decrease or increase in sleep duration has recently been recognized as a risk factor for several diseases, including hypertension and obesity. Many studies have explored the relationship of decreased sleep durations and injuries, but few have examined the relationship between increased sleep duration and injury. The objective of this research is to identify the risk for injury associated with both decreased and increased sleep durations. METHODS: Data from the 2010 Community Health Survey were used in this study. We conducted logistic regression with average sleep duration as the independent variable, injury as a dependent variable, and controlling for age, sex, occupation, education, region (cities and provinces), smoking, alcohol use, body mass index, hypertension, diabetes, arthritis, and depression. Seven categories of sleep duration were established: < or =4, 5, 6, 7, 8, 9, and > or =10 hours. RESULTS: Using 7 hours of sleep as the reference, the adjusted injury risk (odds ratio) for those sleeping a total of < or =4 h/d was 1.53; 1.28 for 5 hours, for 1.11 for 6 hours, 0.98 for 8 hours, 1.12 for 9 hours, and 1.48 for > or =10 hours. The difference in risk was statistically significant for each category except for the 8 and 9 hours. In this study, risk increased as the sleep duration decreased or increased, except for the 8 and 9 hours. CONCLUSIONS: This research found that either a decrease or increase in sleep duration was associated with an increased risk for injury. The concept of proper sleep duration can be evaluated by its associated injury risk.
Adult
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Age Factors
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Aged
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Alcohol Drinking
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Arthritis/physiopathology
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Body Mass Index
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Depression/physiopathology
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Diabetes Mellitus/physiopathology
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Female
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*Health Surveys
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Humans
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Hypertension/physiopathology
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Male
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Middle Aged
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Obesity/physiopathology
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Odds Ratio
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Questionnaires
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Republic of Korea
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Risk Factors
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Sex Factors
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*Sleep
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Smoking
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Wounds and Injuries/*epidemiology
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Young Adult
7.Central obesity and metabolic risk factors in middle-aged Chinese.
Xue Yao YIN ; Fen Ping ZHENG ; Jia Qiang ZHOU ; Ying DU ; Qian Qian PAN ; Sai Fei ZHANG ; Dan YU ; Hong LI
Biomedical and Environmental Sciences 2014;27(5):343-352
OBJECTIVECentral obesity is considered to be a central component of metabolic syndrome. Waist circumference (WC) has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese.
METHODSThe study involved 923 subjects aged 40-65 years. The metabolic risk factors were defined according to the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and ⋝90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and ⋝85 cm were used as cut-off values of central pre-obesity and central obesity in females.
RESULTSFirst, WC values corresponding to body mass index (BMI) 24 kg/m2 and visceral fat area (VFA) 80 cm2 were 88.55 cm and 88.51 cm in males, and 81.46 cm and 82.51 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females (81.75 cm). Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels.
CONCLUSIONWC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.
Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Intra-Abdominal Fat ; physiopathology ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; physiopathology ; Middle Aged ; Obesity ; diagnosis ; ROC Curve ; Waist Circumference
8.Comparison of Demographic Characteristics, Comorbidity, and Health Habits of Older Adults with Mild Cognitive Impairment and Older Adults with Normal Cognitive Function.
Myonghwa PARK ; Mi Ra SUNG ; Sun Kyung KIM ; Dong Young LEE
Journal of Korean Academy of Nursing 2014;44(4):351-360
PURPOSE: This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF). METHODS: Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above. RESULTS: The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption. CONCLUSION: Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.
Aged
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Aged, 80 and over
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Alcohol Drinking
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Body Mass Index
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Comorbidity
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Databases, Factual
;
Dementia/complications
;
Demography
;
Female
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*Health Behavior
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Heart Diseases/complications
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Humans
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Hypertension/complications
;
Male
;
Middle Aged
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Mild Cognitive Impairment/complications/*physiopathology
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Obesity/epidemiology
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Sex Factors
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Smoking
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Stroke/complications
9.Relationship between obesity, overweight and physical function in students of Han nationality aged 7 - 18 years in 2010.
Hai-jun WANG ; Lian-guo FU ; Jun MA ; Yi SONG ; Pei-jin HU ; Bing ZHANG
Chinese Journal of Preventive Medicine 2012;46(9):796-801
OBJECTIVETo study the effects of overweight and obesity on physical function (including systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse, weight vital capacity index) in children and adolescents.
METHODSThe data of 2010 Chinese National Survey on Students Constitution and Health was analyzed. The samples of overweight and normal-weight group were randomly selected from the data by matching gender, urban or rural for getting the same number sample size as obese group (10 601 each group). The students aged 7 - 18 years were classified into 3 groups by BMI percentiles (P₅, P₁₅, P₂₅, P₅₀, P₇₅, P₈₅ and P₉₅), to analyze the change of physical function along with BMI percentile.
RESULTSCompared to the normal-weigh group, SBP of the obese boys of all age groups increased by 8.0 - 12.0 mm Hg, DBP increased by 4.7 - 5.9 mm Hg, while SBP of the obese girls increased by 7.5 - 11.6 mm Hg, DBP increased by 4.7 - 6.1 mm Hg, with statistical significance (P < 0.05). In 13 - 15-year group, pulse of obese boys was 0.8 times/min higher than that of normal-weight. In 16 - 18-year group, pulse of obese boys was 1.1 times/min higher than that of overweight or normal-weight, while pulse of obese girls were 1.5 and 1.7 times/min higher than that of overweight and normal-weight, respectively (P < 0.05). Pulses in boys aged 7 - 9 years when BMI were P₅, P₅₀, P(95) were 87.63, 87.00, 87.83 times/min, and pulses in boys aged 10 - 12 were 85.66, 85.30, 85.43 times/min, respectively. Pulses in boys aged 13 - 15 years when BMI were P₅, P₅₀, P₉₅ were 82.60, 81.39, 82.34 times/min, and pulses in boys aged 16 - 18 years were 80.15, 79.00, 79.98 times/min. In both boys and girls of all age groups, weight vital capacity index had the trend of obese < overweight < normal-weight (P < 0.05). Compared to the normal-weight group, weight vital capacity index of overweight boys decreased by 6.4 - 8.4 ml/kg, that of obese boys decreased by 11.9 - 14.8 ml/kg, while that of overweight girls decreased by 5.3 - 7.7 ml/kg, that of obese girls decreased 11.0 - 11.5 ml/kg.
CONCLUSIONCompared to the normal-weight, overweight and obese children and adolescents had elevated blood pressure, increased pulse, decreased weight vital capacity index.
Adolescent ; Child ; China ; epidemiology ; Ethnic Groups ; Female ; Humans ; Male ; Obesity ; epidemiology ; physiopathology ; Overweight ; epidemiology ; physiopathology ; Risk Factors ; Students
10.Blood pressure levels of 2438 Hasakh children in the Yili region of Xinjiang Province.
Ying-Sheng ZHENG ; Min LI ; Pei-Ru XU ; Lei ZHANG ; Yong-Jie XU ; Yu LIU ; Ming-Gang YE ; Zhi-Qiang WANG
Chinese Journal of Contemporary Pediatrics 2012;14(5):362-365
OBJECTIVETo study blood pressure levels, the prevalence of hypertension and factors associated with the development of hypertension in Hasakh children in the Yili region of Xinjiang Province.
METHODSA total of 2438 Hasakh school children from the Yili region of Xinjiang Province were sampled by stratified random cluster sampling method between May and June 2009. Height, weight, waist circumference, hip circumference, skinfold thickness and blood pressure were measured. Body mass index (BMI) was calculated.
RESULTSMean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 94±13 mm Hg and 60±9 mm Hg respectively in the 2438 children, and both averages were lower than in the Han children. Hypertension was noted in 138 children (5.66%). The prevalence of hypertension in girls (6.97%, 84/1206) was higher than in boys (4.38%, 54/1232) (P<0.05). The prevalence of hypertension and blood pressone were positively correlated with BMI, waist circumference, hip circumference, skinfold thickness circumference, gender and age.
CONCLUSIONSAverage blood pressure levels in Hasakh children in the Yili region of Xinjiang Province are lower than in domestic age-matched Han children. The prevalence of hypertension in girls is higher than in boys. Obesity is highly correlated with the development of hypertension.
Adolescent ; Blood Pressure ; Body Mass Index ; Child ; China ; epidemiology ; ethnology ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; Male ; Obesity ; physiopathology ; Prevalence ; Risk Factors ; Skinfold Thickness ; Waist Circumference

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