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Abstract: The purpose of this study was to assess the prevalence of metabolic syndrome (MetS) and its components among middle-aged and elderly adults in Jiangsu province, China. Moreover, factors associated with MetS were also assessed. A population-based cross-sectional survey was conducted with 4 randomly selected areas including both urban and rural areas from Jiangsu province, China. After the procedure, 3914 adults aged 35 to 74 years were included in the study. Metabolic syndrome was defined by the modified National Cholesterol Education Program Adult Treatment Panel III report. Data were collected by interviewer-administered questionnaire, biophysical assessment, and biochemical examination. Crude and age-standardized prevalence of MetS was 31.5% and 30.5%, respectively. Prevalence rate increased significantly with age in female but not in male subjects, whereas this was true for both sexes with increased body mass index. High blood pressure was the most prevalent component of MetS (45.2%), followed by elevated triglycerides (40.1%) and low high-density lipoprotein cholesterol (40.1%). Multivariate ordinal regression analysis revealed that women had significantly higher risk of MetS than men (odds ratio = 1.72, P < .001). Older age, living in urban area, income, family history of diabetes, and family history of hypertension were positively associated with MetS risk. However, higher education and tea drinking everyday were found to be negatively associated with MetS (P < .05). Moreover, substantial agreement (κ = 0.79) was found between the International Diabetes Federation and modified Adult Treatment Panel III criteria among 3 comparisons of MetS definitions. Metabolic syndrome was highly prevalent in middle-aged and elderly Chinese population in Jiangsu province. Community-based strategies for diet and lifestyle modifications are strongly suggested, especially in women and the elderly. [Copyright &y& Elsevier]

Abstract: Objective: Inflammation and iron deficiency are two important causes of anemia. Magnesium intake is inversely associated with inflammation. However, little is known as to whether magnesium intake is related to anemia. We assessed the joint association of magnesium and iron intake with anemia among Chinese adults. Methods: A cross-sectional household survey of 2849 men and women 20 y of age or older was conducted in 2002. Nutrient intakes were assessed by 3-d weighed food records. Serum ferritin and hemoglobin concentrations were measured. Results: The prevalence of anemia was 18.3% in men and 31.5% in women. Magnesium and iron intakes were positively associated with hemoglobin levels and inversely related to the prevalence of anemia. The risks of anemia were reduced by 26% (P for trend = 0.03) and 52% (P < 0.01), respectively, for iron and magnesium intake comparing the fourth quartile with the first with adjustment for potential confounders. The lowest risk of anemia was observed among participants with the highest intakes of magnesium and iron (odds ratio 0.46, 95% confidence interval 0.31–0.68). The inverse association of iron intake and anemia but not the association of magnesium intake and anemia was modified by serum ferritin levels. The observed relations were not appreciably modified by gender. Conclusion: This study suggests that magnesium is a potent predictor of anemia in Chinese adults. [Copyright &y& Elsevier]

Abstract: Background: Anemia is prevalent in China. Tofu made from soybean is a popular food. Soybean is shown to have an affect on iron status. No study has examined the relation between tofu and iron status. Objective: To investigate the association between tofu intake and anemia among Chinese adults. Design: A cross-sectional household survey of 2,849 men and women aged 20 years and older (mean age 47.0±14.5 years), from a nationally representative random sample in Jiangsu province undertaken in 2002 (response rate 89%). Tofu intake was assessed by food frequency questionnaire. Nutrient intake was measured by 3-day weighed food records. Serum ferritin and hemoglobin were measured. Results: The prevalence of anemia was 18.3% in men and 31.5% in women. Mean hemoglobin values increased by quartiles of tofu intake (men: 14.1, 14.0, 14.5, and 14.8 mg/dL [141, 140, 145, and 148 g/L]; women: 12.4, 12.5, 12.6 and 13.3 g/dL [124, 125,126, and 133 g/L]), and the prevalence of anemia decreased concomitantly. Comparing first and fourth quartiles of tofu intake, the prevalence of anemia was 23.9% vs 10.7% in men, and 38.1% vs 16.8% in women. Tofu intake was inversely associated with serum ferritin levels in women. In multivariate analyses, the odds ratio of anemia for men in fourth compared to first quartile of tofu intake was 0.30 (95% confidence interval 0.17 to 0.50), and the corresponding odds ratio for women was 0.31 (95% confidence interval 0.20 to 0.47). The association between tofu intake and anemia was independent of iron intake. Conclusions: Tofu intake was associated with lower risk of anemia among Chinese adults in both sexes. [Copyright &y& Elsevier]

Summary: Objective: Compare the association between 2 years change of waist circumference (WC) or body mass index (BMI) and incident type 2 diabetes mellitus (T2DM) in cohort populations. Methods: Prospective cohort study, based on a baseline investigation from 1999, we conducted the first follow-up for subjects whose follow time met 2 years, and the second follow-up for subjects whose follow time met 5 years. Two years change of WC or BMI was measured by the D-value between baseline and the first follow up values. The association between 2 years change of WC or BMI and incident T2DM were analyzed by using Poisson regression model. Results: Among 3461 participants without T2DM at baseline, 160 subjects developed T2DM during follow up period. Across quartiles of WC D-value, hazards ratio (HR) of incident T2DM increased, but there was no significant dose response relationship was found between BMI D-value and incident T2DM. Compared with subjects whose both WC and BMI were modified, there was no significant increase for T2DM risk in subjects whose WC was modified but BMI was not modified [HR(95%CI)=1.66(0.70–3.97)], but the T2DM risk was significantly higher in subjects whose WC was not modified but BMI was modified [HR(95%CI)=1.73(1.17–2.54)]. Conclusions: WC change was a better predictor for incident T2DM than BMI change. Intervention programs designed to reduce WC through lifestyle modification, including physical activity and diet, may have significant public health significance in preventing incident T2DM. [Copyright &y& Elsevier]

Abstract: Background: Few prospective studies on association between waist circumference and hypertension have taken account of the dynamic change of WC, which caused by lifestyle modification. Methods: After a baseline investigation, we conducted the first and the second follow-up assessments for subjects after 2 and 5years, respectively. The difference value (D-value, the value at the first follow-up minus the value at baseline) in WC was calculated to evaluate 2years change of WC. The association between 2years change of WC and incident hypertension was analyzed by using Cox proportional hazards regression model. Results: Among 2778 participants free of hypertension at baseline and the first follow-up, 660 (23.8%) subjects developed hypertension over a period of 5years (between the first and the second follow-up assessments). In both genders, the incidence density and HRs of hypertension were all increased with WC D-value regardless of their abdominal obesity status at baseline. Compared with participants who were non-abdominal obese both at baseline and first follow up, hypertension risk was higher in subjects who were abdominal obese both at baseline and the first follow-up, and in subjects who were non-abdominal obese at baseline but with abdominal obesity at the first follow up. Conclusions: WC dynamic change was associated with incident hypertension, and more WC reduction was associated with more hypertension risk decrease. [Copyright &y& Elsevier]

Abstract: Background: The high prevalence of smoking and metabolic syndrome (MS) and increased incidence of cardiovascular disease (CVD) in China indicates that there may be an interaction between smoking and MS on cardiovascular risk. Therefore, we aimed to examine the independent and combined effects of smoking and MS on risk of CVD in a Chinese cohort. Methods: We analyzed data from a population-based prospective cohort of 3598 participants aged 35–74years from Jiangsu China who were free of diabetes and CVD at enrollment and were followed for cardiovascular events (including myocardial infarction, ischemic stroke, hemorrhagic stroke, and cardiovascular mortality) until 31 August 2008. Results: During 8years (median 6.3years) of follow-up, 82 participants developed CVD. After adjusting for age, sex, body mass index, alcohol consumption, family history of cardiovascular disease and MS, smoking significantly increased cardiovascular risk in a dose–response manner. After further adjustment for smoking status, the hazard ratio of CVD for participants with MS was 2.49 (95% confidence interval 1.59–3.90) compared with those without the syndrome. There was a statistically significant additive interaction between current smoking and MS on cardiovascular risk. The risk of CVD for current smokers with MS was 1.81 times as high as the sum of risks in participants with a single condition alone. Conclusions: Both cigarette smoking and MS are strong risk factors of CVD in the Chinese population. Moreover, this study further demonstrates an additive interaction of current smoking and MS on cardiovascular risk. [Copyright &y& Elsevier]

Abstract: Purpose: To compare the influence of two different upper limb positions on contrast agent effects in chest CT enhancement. Materials and methods: In 142 patients undergoing contrast-enhanced CT chest scanning, an indwelling venous catheter was placed in the right hand and iodinated contrast agent was injected through a high-pressure single syringe pump. The patients were divided into three age groups (<40 years; 40–60 years; and >60 years) and randomly assigned to one of two upper limb position groups: (1) supine position, both upper limbs extended and raised above head in the same horizontal plane as the body; and (2) supine position, both upper limbs raised and crossed on the forehead, with the right arm on top. Differences in mean CT values on the two sides of the thoracic inlet along the right subclavian vein were used to evaluate the effects of the contrast agent. Results: Although contrast agent effects were not significantly different among the three age groups with either limb position, there was a significant difference between patients adopting the second limb positions (Chi-square value was 5.936, P <0.05). An excellent or good contrast agent effect was observed in 63.08% of patients assuming the first limb position, as compared with 81.69% assuming the second position. Conclusion: For contrast-enhanced CT chest scans, use of the second limb position can reduce retention of the contrast agent in the right axillary vein and the right subclavian vein outside the thorax, increase contrast agent utilization, and decrease artifacts caused by high-density, local retention of the contrast agent. [Copyright &y& Elsevier]