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Abstract Introduction Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs. Methods Data from 31,781 participants in the China National Health Survey conducted from 2012 to 2017 were analyzed. Linear and non-linear relationships between RBIs and CRFs (hyperuricemia, diabetes, dyslipidemia) were assessed using restricted cubic splines. Propensity score weighting was used to balance confounders between RBI groups in the multivariable logistic regression models. Results Hemoglobin concentration, red blood cell count and hematocrit all showed a significant linear dose-response association with all CRFs (p values

Abstract Background Hand grip strength (HGS) is a powerful indicator of sarcopenia and other adverse health outcomes. Normative values for HGS for general Chinese people with a broad age spectrum are lacking. This study aims to establish normative values of HGS and explore the correlations between HGS and body composition among unselected people aged 8–80 in China. Methods From 2012 to 2017, 39 655 participants aged 8–80 years in the China National Health Survey were included. Absolute HGS was measured using a Jamar dynamometer. The relative HGS was normalized by body mass index. Body composition indexes included body mass index, body fat percentage, muscle mass, fat mass index (FMI) and muscle mass index (MMI). Sex‐specific smoothed centile tables for the P1, P5, P25, P50, P75, P95 and P99 centiles of HGS and body composition were generated using lambda‐mu‐sigma method. The correlations between muscle strength and body composition were estimated by partial Spearman correlation analysis. Results The median values (25th and 75th percentile) of HGS in boys and girls (8–19 years old) were 22 (14, 34) kg and 18 (12, 22) kg, respectively; in men and women aged 20–80 were 39 (33, 44) kg and 24 (20, 27) kg, respectively. Values of upper and lower HGS across ages had three periods: an increase to a peak in the 20 s in men (with the 5th and 95th values of 30 and 55 kg, respectively) and 30 s in women (with the 5th and 95th values of 18 and 34 kg, respectively), preservation through midlife (20s–40 s), and then a decline after their 50 s. The lowest HGS values in both sexes were in the 70‐ to 80‐year‐old group, with the 5th and 95th percentile values of 16 and 40 kg in men, and 10 and 25 kg in women. There were substantial sex differences in body composition in the life course (all P values

The normative values of vertical jump (VJ) and sit-and-reach (SR) for Chinese people are still unclear. We aimed to determine these values and their correlations with body composition using data from China National Health Survey which included 19,269 participants aged 8–80 years. Sex-specific smoothed centile tables were generated for the P1, P5, P25, P50, P75, P95, and P99 centiles of VJ and SR using lambda-mu-sigma method. The median (Interquartile range) values of VJ and SR in males and females were as follows: 20.3 (8.8) cm and 14.1 (5.5) cm for VJ, 1.8 (11.6) cm and 6.8 (10.4) cm for SR, respectively. In males, VJ values increased to a peak around the age of 18, with the 5th and 95th values being 17.7 cm and 41.3 cm, respectively. After reaching the peak, VJ values gradually declined with age. In females, VJ values remained relatively stable from childhood to early adulthood, and then declined after the age of 30. The peak values of SR were observed in early adulthood in both sexes, and remained stable in females but declined with age in males. VJ had a negative association with body composition, particularly in females. SR was found to have a negative association with fat mass indexes in males. However, correlations in females were only marginally statistically significant. The study provides age- and sex-specific percentile reference values for VJ and SR in Chinese people and can aid in the assessment of muscle fitness and facilitate early prediction of neuromuscular disorders.

Background: The relationship between muscle mass and fat mass might be an indicator to assess the cardiometabolic risk independently from overweight/obesity, but evidence from a representative general Chinese population is lacking. Objective: To understand the age- and sex-specific associations between muscle-to-fat ratio (MFR) and cardiometabolic risks in Chinese population. Methods: 31,178 (12,526 men and 18,652 women) subjects from the China National Health Survey were included. Muscle mass and fat mass were assessed by a bioelectrical impedance device. MFR was calculated as muscle mass divided by fat mass. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum lipids, fasting plasma glucose and serum uric acid were measured. General linear regressions, quantile regressions and restricted cubic-spline (RCS) regressions were applied to assess the effect of MFR on cardiometabolic profiles. Results: Per unit increase of MFR was associated with a 0.631 (0.759–0.502) mmHg SBP decrease in men, 2.648 (3.073–2.223) in women; 0.480 (0.568–0.392) mmHg DBP decrease in men, 2.049 (2.325–1.774) in women; a 0.054 (0.062–0.046) mmol/L total cholesterol decrease in men, 0.147 (0.172–0.122) in women; 0.084 (0.098–0.070) mmol/L triglycerides decrease in men, 0.225 (0.256–0.194) in women; a 0.045 (0.054–0.037) mmol/L low-density lipoprotein decrease in men, 0.183 (0.209–0.157) in women; a 2.870 (2.235–3.506) μmol/L serum uric acid decrease in men, 13.352 (14.967–11.737) in women; and a 0.027 (0.020–0.033) mmol/L high-density lipoprotein increase in men, 0.112 (0.098–0.126) mmol/L in women. The effect in overweight/obese people was much significant than in under/normal weight counterparts. The RCS curves revealed both linear and non-linear relationships between increased MFR and lower cardiometabolic risk. Conclusions: Muscle-to-fat ratio is independently associated with multiple cardiometabolic parameters among Chinese adults. Higher MFR is related with better cardiometabolic health, and the effect is much significant in overweight/obese people and women.

Reproductive factors have been demonstrated to be associated with hyperuricemia. Body composition is an essential determinant influencing serum uric acid (SUA), but it is largely unknown whether increased SUA was influenced by changed body composition during the menopausal transition. As a secondary analysis of China National Health Survey from 2012-to 2017, this study included 18,997 women aged 20 to 80. Menarche age and menopause information were collected by questionnaire interview. Body mass index (BMI), body fat percentage (BFP), fat mass index (FMI), and fat-free mass index (FFMI) were used as body composition indexes. Hyperuricemia was defined as SUA higher than 360μmol/L (approximately 6 mg/dl). Mediation analysis was performed to explore the direct and indirect effects of menopause on hyperuricemia. A 1:2 age-matched case-control data set (n=6202) was designed to control age-related confounders and was used in multivariable analyses. After adjustment of covariates, postmenopausal women had 14.08 (10.89-17.27) μmol/L higher SUA than their premenopausal counterparts. Overweight/obesity and higher levels of BFP, FMI, and FFMI were all found to be positively associated with hyperuricemia. The mediation analysis showed that the total effect of menopause on hyperuricemia was positive, but was substantially mediated by body composition indexes. Forty-five percent of the total effect can be attributed to the indirect effect mediated by BMI (OR for the natural indirect effect (NIE): 1.09, 95%CI: 1.04-1.13), and over 80% mediated by BFP (OR for NIE: 1.23, 95%CI: 1.16-1.29). However, FFMI did not present the mediated role in the association (OR for NIE: 0.99, 95%CI: 0.96-1.02). The findings revealed that body composition, especially the fat mass indexes, significantly mediated the association between menopause and hyperuricemia. The role of body composition as mediator constitutes clinical and public health significance that should be recognized and considered in healthcare for women experiencing their menopause transition.

Alcohol intake and excess adiposity are associated with serum uric acid (SUA), but their interaction effect on hyperuricemia (HUA) remains unclear. Using data from the China National Health Survey (CNHS) (2012–2017), we analyzed the additive interaction of beer, spirits intake, excess adiposity [measured by body mass index (BMI), body fat percentage (BFP), and visceral fat index (VFI)] with HUA among male participants aged 20–80 from mainland China. The relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (SI) were calculated to assess the interaction effect on the additive scale. Both RERI and AP larger than 0 and SI larger than 1 indicate a positive additive interaction. Among 12,592 male participants, the mean SUA level was 367.1 ± 85.5 μmol/L and 24.1% were HUA. Overweight/obese men who were presently drinking spirits had an odds ratio (OR) of 3.20 (95%CI: 2.71–3.79) than the never drink group, with RERI, AP, and SI of 0.45 (95%CI: 0.08–0.81), 0.14 (95%CI: 0.03–0.25), and 1.25 (95%CI: 1.02–1.54), respectively. However, although combined exposures on beer intake and excess adiposity had the highest OR compared with no beer intake and nonobese participants, there was no additive interaction, with RERI, AP, and SI in the overweight/obesity and the beer intake group of 0.58 (−0.41–1.57), 0.17 (−0.08–0.41), and 1.30 (0.85–1.97), respectively. Other excess adiposity indexes revealed similar estimates. Our findings suggested that the exposures of both excess adiposity and alcohol drink could result in an additive interaction effect on HUA: the combined risk of excess adiposity with spirits intake but not with beer was greater than the sum of the effects among Chinese male adults.

Adiposity and alcohol consumption are reported to be associated with a higher level of serum uric acid (SUA), but whether their effect differs on SUA percentile distribution is still unclear. In this study, we aimed to investigate how alcohol intake and body fat percentage (%BF) integrated with body mass index (BMI) influence the distribution of SUA in Chinese adults. Data from the China National Health Survey (CNHS) which included adults from 10 provinces of China were used (n = 31,746, aged 20–80 years, 40% male). %BF and BMI were integrated into eight expanded body composition groups to understand how excess body adiposity affects the distribution of SUA in the populational level. Self-report alcohol intake information was collected by face-to-face questionnaire interview. Quantile regression (QR) was used to analyze the data. We found that adiposity and alcohol consumption were associated with SUA, especially at the upper percentile in both sexes. In obese men, the QR coefficients at the 75th and 95th percentiles were 74.0 (63.1–84.9) and 80.9 (52.5–109.3) μmol/L, respectively. The highest quartile of %BF in men had a 92.6 (79.3–105.9) μmol/L higher SUA levels at its 95th percentile than the 5th quartile (p < 0.001). Compared with normal or underweight with the lowest %BF group (NWBF1), the obesity-highest %BF group (OBBF4) had the strongest positive effect on SUA, especially at the higher percentile of SUA. In BMI-defined normal or underweight participants, a higher quartile of %BF had greater effect size in all SUA percentiles. In men, current alcohol drinking had the strongest effect at the 95th percentile of SUA (QR coefficient: 31.8, with 95% CI: 22.6–41.0) comparing with 14.5, 95% CI of 8.4 to 20.6 in the 5th SUA percentile. High risk of alcohol consumption had a greater effect on SUA, especially in the higher SUA percentile. The observation of stronger association at the higher percentile of SUA suggests that decreasing body adiposity and alcohol intake at the populational level may shift the upper tails of the SUA distributions to lower values, thereby reducing the incidence of hyperuricemia.

Introduction: The prevalence of hyperuricemia is increasing world widely; the understanding of population attributable faction of modifiable risk factors is important for disease prevention. Given the sparse evidence on how modifiable risk factors influence hyperuricemia in mainland China, we aim to explore the effect of excess weight and alcohol consumption and the population attributable fractions of hyperuricemia based on a national survey in mainland China. Methods: Using data from China National Health Survey which included 31746 Han Chinese aged 20-80 from ten provinces, we estimated the prevalence and modifiable risk factors (overweight/obesity and alcohol consumption)of hyperuricemia. Hyperuricemia was defined as serum uric acid > 417 μmol/L in men and > 340 μmol/L in women. Restricted cubic spline models were used to demonstrate the linear and non-linear association between exposures and hyperuricemia. The adjusted population attributable risk (PAR) was calculated to understand the relative importance of each modifiable risk factor. Results: The prevalence of hyperuricemia was 25.1% in men and 15.9% in women. The population fraction of hyperuricemia cases that could be avoided by weight loss was 20.6% (19.2% to 22.0%) in men and 18.1% (17.1% to 19.0%) in women. The PAR of alcohol consumption was 12.8% (8.5% to 17.1%) in men. Participants from southwest China had the highest hyperuricemia prevalence (47.9% in men and 29.9% in women), but with lower PAR of modifiable risk factors, especially in men (16.7%). Subjects in North China had lower hyperuricemia prevalence but higher PAR of modifiable risk factors. 44.8% male hyperuricemia cases in Inner Mongolia (26.9% of hyperuricemia prevalence) and 37.7% cases in men from Heilongjiang (34.4% of hyperuricemia prevalence) were attributable to overweight/obesity and alcohol consumption. Conclusion: There are significant sex and geographic difference on population attributable risk of hyperuricemia due to modifiable risk factors. More tailored prevention strategies are needed to prevent hyperuricemia through weight loss and the reduction of alcohol consumption.

Objectives To estimate the prevalence, ethnic differences and associated risk factors of myopic maculopathy in Han and Uygur adults in Xinjiang, China.Design and setting A cross-sectional study with multistage, stratified cluster sampling method was conducted in Xinjiang, China.Participants A total of 4023 Han and Uygur participants aged 40 years and older were eligible for the study.Outcome measures The association between myopic maculopathy and its risk factors was screened using the generalised estimating equation (GEE) model. We also investigated whether ethnic differences exist between Han and Uygur populations affected by myopic maculopathy. Myopic maculopathy was defined in accordance with International Photographic Classification and Grading System for Myopic Maculopathy.Results A total of 3044 subjects (5946 eyes) were included in our study (1736 Han and 1308 Uygur individuals). The participants consisted of 1256 (41.3%) men and 1788 (58.7%) women. The average age was 52.2±9.4 years, and the mean spherical equivalent (SE) was −0.18±2.31 dioptre (D). Myopic maculopathy was detected in 198 eyes of 138 participants. The age-adjusted prevalence of myopic maculopathy reached 5.8% (95% CI 4.8 to 6.8). In the GEE model, myopic maculopathy was significantly associated with old age (per year; OR: 1.16; 95% CI 1.13 to 1.19; p

Objective. The effect of adiposity on hypertension among Uyghur Chinese is not clear. This study aimed to compare the effect of BMI and its optimal cut-off value in identifying hypertension in Uyghur and Han adults in China. Methods. By using a multistage stratified sampling method, 3072 Uyghur and 3195 Han adults underwent questionnaire interview, physical examination, and biochemical tests. Age- and sex-standardized prevalence of hypertension was calculated. Adjusted odds ratios for adiposity associated with hypertension were estimated. ROC analyses were used for assessing the ethnic and sex specific optimal BMI cut-off values in identifying hypertension. Results. Both in Uyghur and Han, increased BMI was consistent with the elevated systolic and diastolic blood pressure. Although more Uyghur were overweight/obese, their standardized prevalence of hypertension (17.87%) was lower than that of Han (20.28%). Han adults had 1.42 times odds than Uyghur of hypertension. The adjusted ORs of overweight and obesity were 2.67 and 6.04 in Uyghur and 2.74 and 7.58 in Han. In male, the optimal cut-off values of BMI identifying hypertension in Uyghur and Han were 24.6 kg/m2 and 24.9 kg/m2 , respectively, but the correspond values in Uyghur and Han females were 27.2 kg/m2 and 25.0 kg/m2. Conclusions. Adiposity had strong effect on hypertension, but this effect was less strong in Uyghur female than in Han female.

The normative values of vertical jump (VJ) and sit-and-reach (SR) for Chinese people are still unclear.We aimed to determine these values and their correlations with body composition using data from China National Health Survey which included 19,269 participants aged 8-80 years. Sex-specific smoothed centile tables were generated for the P1, P5, P25, P50, P75, P95, and P99 centiles of VJ and SR using lambdamu-sigma method. The median (Interquartile range) values of VJ and SR in males and females were as follows: 20.3 (8.8) cm and 14.1 (5.5) cm for VJ, 1.8 (11.6) cm and 6.8 (10.4) cm for SR, respectively. In males, VJ values increased to a peak around the age of 18, with the 5th and 95th values being 17.7 cm and 41.3 cm, respectively. After reaching the peak, VJ values gradually declined with age. In females, VJ values remained relatively stable from childhood to early adulthood, and then declined after the age of 30. The peak values of SR were observed in early adulthood in both sexes, and remained stable in females but declined with age in males. VJ had a negative association with body composition, particularly in females. SR was found to have a negative association with fat mass indexes in males. However, correlations in females were only marginally statistically significant. The study provides age- and sex-specific percentile reference values for VJ and SR in Chinese people and can aid in the assessment of muscle fitness and facilitate early prediction of neuromuscular disorders. [ABSTRACT FROM AUTHOR]