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*
;
Adult
;
COVID-19/transmission*
;
COVID-19 Nucleic Acid Testing
;
COVID-19 Serological Testing
;
Cohort Studies
;
Disease Transmission, Infectious/statistics & numerical data*
;
Female
;
Fetal Blood/immunology*
;
Humans
;
Infectious Disease Transmission, Vertical/statistics & numerical data*
;
Live Birth/epidemiology*
;
Maternal Age
;
Milk, Human/virology*
;
Obesity, Maternal/epidemiology*
;
Placenta/pathology*
;
Pregnancy
;
Pregnancy Complications, Infectious/physiopathology*
;
Pregnancy Outcome/epidemiology*
;
Pregnancy Trimester, First
;
Pregnancy Trimester, Second
;
Prospective Studies
;
RNA, Viral/analysis*
;
Risk Factors
;
SARS-CoV-2
;
Severity of Illness Index
;
Singapore/epidemiology*
;
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
;
Chronic Disease
;
prevention & control
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Humans
;
Pediatric Obesity
;
epidemiology
;
physiopathology
3.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
4.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
;
Aged
;
Demography
;
Diabetes Mellitus, Type 2/complications
;
Female
;
Glomerular Filtration Rate
;
Humans
;
Hypertension/complications
;
Male
;
Middle Aged
;
Nutrition Surveys
;
Obesity/complications
;
Prevalence
;
Renal Insufficiency, Chronic/complications/epidemiology/*physiopathology
;
Republic of Korea/epidemiology
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Risk Factors
;
Socioeconomic Factors
5.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
;
Aged
;
Asian Continental Ancestry Group
;
Chi-Square Distribution
;
Disorders of Excessive Somnolence/diagnosis/*epidemiology/physiopathology
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Female
;
Humans
;
Intra-Abdominal Fat/*physiopathology
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Logistic Models
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Male
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Middle Aged
;
Multivariate Analysis
;
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
;
Risk Factors
;
*Sleep
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Sleep Apnea, Obstructive/diagnosis/*epidemiology/physiopathology
6.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
7.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
;
Age Factors
;
Aged
;
Alcohol Drinking
;
Arthritis/physiopathology
;
Body Mass Index
;
Depression/physiopathology
;
Diabetes Mellitus/physiopathology
;
Female
;
*Health Surveys
;
Humans
;
Hypertension/physiopathology
;
Male
;
Middle Aged
;
Obesity/physiopathology
;
Odds Ratio
;
Questionnaires
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Republic of Korea
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Risk Factors
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Sex Factors
;
*Sleep
;
Smoking
;
Wounds and Injuries/*epidemiology
;
Young Adult
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
;
Alcohol Drinking
;
Body Mass Index
;
Comorbidity
;
Databases, Factual
;
Dementia/complications
;
Demography
;
Female
;
*Health Behavior
;
Heart Diseases/complications
;
Humans
;
Hypertension/complications
;
Male
;
Middle Aged
;
Mild Cognitive Impairment/complications/*physiopathology
;
Obesity/epidemiology
;
Sex Factors
;
Smoking
;
Stroke/complications
9.Relationship Between Body Mass Index and Early Menarche of Adolescent Girls in Seoul.
Chang Mo OH ; In Hwan OH ; Kyung Sik CHOI ; Bong Keun CHOE ; Tai Young YOON ; Joong Myung CHOI
Journal of Preventive Medicine and Public Health 2012;45(4):227-234
OBJECTIVES: The object of this study was to determine the relationship between body mass index (BMI) and early menarche in adolescent girls in Seoul. METHODS: A retrospective study was conducted with 144 middle school students in Seoul who provided informed consent. We measured their body composition, and used the questionnaire survey method for data collection from November to December 2008. Past elemental body composition data were collected from elementary school health records of first year of middle school. RESULTS: The early menarcheal group was taller and heavier than the late menarcheal group (p<0.05 from 8-12 years old). The body fat percentage (%), BMI were higher in the early menarcheal girls than the late-menarcheal girls (p<0.05, age at 13). In the result of multiple logistic regression, the BMI at the age of 8 and 9 was associated with early menarche after adjusting for birth weight, breast feeding and age at menarche of the mother (BMI at the age of 8: p for trend=0.01, BMI at the age of 9: p for trend=0.04). An increase in BMI from 7 to 8 year was associated with early menarche after adjusting for birth weight, breast feeding, age at menarche of the mother (p for trend=0.048). CONCLUSIONS: The BMI at the age of 8 and 9 was associated with the early menarche of girls and increase in BMI from 7 to 8 year was associated with the early menarche of girls. These results suggest that BMI and increase in BMI before menarche cause early menarche. Although this study does not represent all Korean adolescent girls, it is one of the few studies that have investigated the temporal relationship between BMI and early menarche.
Adipose Tissue/*physiology
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Adolescent
;
Age of Onset
;
Body Composition/physiology
;
*Body Mass Index
;
Child
;
Female
;
Humans
;
Menarche/*physiology
;
Obesity/physiopathology
;
Overweight/*physiopathology
;
Republic of Korea/epidemiology
;
Retrospective Studies
10.Body mass index and hypertension hemodynamic subtypes in Yi farmers and migrants.
Guang Liang SHAN ; Da Ying WEI ; Chun Xiu WANG ; Jian Hua ZHANG ; Bin WANG ; Ming Ju MA ; Li PAN ; Tao YU ; Fang XUE ; Ping WANG ; Zheng Lai WU
Biomedical and Environmental Sciences 2012;25(1):53-60
OBJECTIVETo examine the relationship between overweight or obesity and the risk of the various hypertension hemodynamic subtypes in Yi farmers and migrants.
METHODSA cross-sectional study of 2 358 Yi farmers and 1 392 Yi migrants was carried out in the Liangshan Yi autonomous prefecture, Sichuan, China in 2007.
RESULTSThe standardized prevalence of overweight in female Yi farmers (6.22%) was higher than in males (3.15%), whereas in Yi migrants 31.56% of males and 18.78% of females were overweight. The standardized prevalence of obesity was 0 and 0.61% in male and female Yi farmers, compared to 3.91% and 5.57% in male and female Yi migrants, respectively. For both genders the standardized prevalence of ISH, IDH, and SDH was higher in Yi migrants than Yi farmers. Overweight and obese Yi men and women had a higher risk for IDH and SDH (P<0.001) than non-overweight/obese individuals. However, an association of overweight or obesity with ISH was observed only in men.
CONCLUSIONYi migrants have substantially higher proportion of overweight and obese individuals, as well as individuals affected by ISH, IDH, and SDH, than do Yi farmers. Overweight and obesity are significant risk factors for the development of hypertension in Yi people.
Adolescent ; Adult ; Aged ; Body Mass Index ; China ; epidemiology ; Diastole ; Female ; Hemodynamics ; Humans ; Hypertension ; ethnology ; physiopathology ; Male ; Middle Aged ; Obesity ; ethnology ; physiopathology ; Overweight ; ethnology ; physiopathology ; Systole ; Young Adult

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