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Purpose: Although fibroblast growth factor-23 (FGF23) is involved in the development of metabolic diseases, its association with metabolic-associated fatty liver disease (MAFLD) remains unknown. We explored the relationship between serum fibroblast growth factor-23 level, metabolic associated fatty liver disease, and liver fat content. Patients and Methods: Participants were enrolled from communities in Shanghai. Serum fibroblast growth factor-23 level was determined using two-side sandwich enzyme-linked immunosorbent assays. MAFLD was diagnosed using the international expert consensus (2020) criteria. Liver fat content was assessed using ultrasound. Results: We enrolled 1827 individuals aged 30– 80 years (mean age, 59.4± 7.3 years). MAFLD was diagnosed in 445/1393 (31.9%) non-diabetic participants and 245/434 (56.5%) diabetic participants. After adjusting for confounders, one standard deviation increase in serum FGF23 was associated with MAFLD in diabetic (odds ratio, 1.27; 95% confidence interval, 1.15– 1.49; P< 0.001) and non-diabetic (odds ratio, 1.28; 95% confidence interval, 1.07– 1.74; P=0.030) groups. In a fully adjusted linear regression model, serum FGF23 emerged as a positive determinant of liver fat content in both diabetic and non-diabetic groups (P=0.039; P=0.034). Conclusion: Participants with MAFLD had higher serum fibroblast growth factor-23 level than those without MAFLD, regardless of diabetes status. Serum fibroblast growth factor-23 was independently related to MAFLD and liver fat content. [ABSTRACT FROM AUTHOR]

aim of this study was to elucidate the association of NC with urine albumin-to-creatinine ratio (UACR) and MAU. Methods: A total of 1882 Shanghai community residents were enrolled (816 men and 1066 women), with age ranging from 40 to 80 years. Anthropometric parameters, including NC, and biochemical indices were measured. MAU was determined if 30 mg/g ≤ UACR < 300 mg/g. An elevated NC was defined as NC ≥ 38.5 cm for men and NC ≥ 34.5 cm for women. Results: Individuals with an elevated NC had significantly higher prevalence of MAU and UACR values than those with normal NC in both men and women (all P < 0.05). The logistic regression analysis showed that there were significant and positive associations between elevated NC and the increasing risk of MAU after adjusting for lipid profile and glycemic indices (P = 0.007 for men and P = 0.009 for women). After further adjusting for blood pressure, elevated NC caused an 69.3% additional risk of MAU in men (P = 0.037) and the positive correlation in women disappeared (P = 0.131). Conclusion: There was an independent and positive association between elevated NC and the risk of MAU in men in the Chinese community population. Chinese Clinical Trial Registry (Www.chictr.org.cn) Registration Number: ChiCTR1900024011. [ABSTRACT FROM AUTHOR]

Objective. Neck circumference (NC) is a simple anthropometric index for the assessment of upper body obesity. Thyroid hormones are closely related to obesity, body fat distribution indicators, and metabolic parameters. However, there are currently no reports on the association between NC and thyroid hormones in the Chinese population. This study aimed to explore the relationship between NC and thyroid hormones in men with normal thyroid function. Methods. A total of 737 euthyroid men from Shanghai communities were enrolled. Anthropometric parameters, including NC and waist circumference (WC), were measured. Serum thyroid hormones were measured by electrochemical luminescence immunoassay. Results. NC, WC, and body mass index (BMI) were significantly positively correlated with serum free triiodothyronine (FT3) (all P < 0.05). FT3 levels all presented significant upward trends with the increase in NC, WC, or BMI quartiles (all P for trend < 0.05), whereas there were no significant correlations between the three obesity indices and free thyroxine or thyroid-stimulating hormone (both P > 0.05). After adjustment for metabolic confounding factors such as age, blood pressure, blood glucose, lipid profiles, and CRP in multiple linear regression analysis, the correlation between FT3 and NC disappeared (standardized β = −0.015, P = 0.705), and FT3 remained significantly associated with WC (standardized β = 0.103, P = 0.012) and BMI (standardized β = 0.082, P = 0.047). Conclusions. In euthyroid men from Shanghai communities, there was no independent correlation between serum FT3 levels and NC. The trial was registered with ChiCTR1900024011. [ABSTRACT FROM AUTHOR]

Background. Accumulating evidence has shown that neck circumference (NC) is associated with obesity-related metabolic abnormalities. Nonalcoholic fatty liver disease (NAFLD) is regarded as a liver manifestation of metabolic syndrome. This study aimed to investigate the relationship between NC and liver fat content (LFC) and NAFLD. Methods. A total of 1698 subjects (577 men and 1121 women) from the Shanghai community were enrolled. All the subjects underwent NC measurement and biochemical measurements. LFC was calculated using the parameters from abdominal ultrasound images. Elevated NC was defined as NC ≥38.5 cm in men and NC ≥34.5 cm in women. Results. Subjects with NAFLD based on the LFC measurement had higher values of NC, liver enzyme profiles, homoeostasis model assessment-insulin resistance index, and LFC than those without NAFLD (all P < 0.05), irrespective of sex. NC showed an upward trend with the increase of LFC in both men and women (both P < 0.05). An elevated NC could identify 55.22% of men and 50.29% of women with NAFLD based on quantitative ultrasonography. The positive correlation between NC and LFC remained significant even after adjustment for central obesity (both P < 0.05). After adjusting for confounding factors, the risk of NAFLD in subjects with an elevated NC was 1.52-fold higher in men (P = 0.036) and 2.31-fold higher in women (P < 0.001). Conclusions. There was a significant and positive correlation between NC and LFC. The risk of NAFLD increased significantly in subjects with an elevated NC. [ABSTRACT FROM AUTHOR]

Purpose: Although overt thyroid dysfunction has been found to influence the level of glycated albumin (GA), the associations between thyroid hormones and GA in individuals with euthyroidism and subclinical hypothyroidism (SHypo) are still unknown. The present study aimed to investigate whether thyroid hormones were related to GA in euthyroid and SHypo individuals. Methods: We recruited 685 euthyroid and 103 SHypo subjects with normal weight from communities in Shanghai. Electrochemiluminescence immunoassay was used to detect the serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone. GA was detected by the enzymatic method. Glycated hemoglobin (HbA1c) was detected by high-performance liquid chromatography. Results: Among the 788 subjects (age range 31– 81 years old), 307 were men and 481 were women. In the Spearman correlation analysis and multiple stepwise regression analysis, FT3 was negatively correlated with both GA and GA/HbA1c in euthyroid subjects (all P < 0.05). The values of GA and GA/HbA1c were reduced by approximately 0.30 and 0.05, respectively, for each 0.50 pmol/L increment in FT3. In SHypo subjects, FT4 was negatively associated with both GA and GA/HbA1c (all P < 0.05). The values of GA and GA/HbA1c were reduced by approximately 0.23 and 0.03, respectively, for each 1.00 pmol/L increment in FT4. Conclusion: In euthyroid and SHypo subjects, more attention should be paid to the potential effects of individual differences in thyroid hormones on GA. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the trend and prevalence of prediabetes and diabetes among high-risk adults in Shanghai from 2002 to 2012. Methods: From 2002 to 2012, 10043 subjects with known risk factors for diabetes participated in the diabetes-screening project at the Shanghai Sixth People’s Hospital of Shanghai Jiao Tong University. All participants were asked to complete a nurse-administered standard questionnaire concerning age, sex, smoking status, and personal and family histories of diabetes, cardiovascular disease, stroke, hypertension and other diseases. The participants’ body mass index scores, blood pressures and blood glucose levels at 0, 30, 60, 120 and 180 min were measured in response to a 75 g oral glucose tolerance test. Results: The overall prevalence of diabetes increased from 27.93% to 34.78% between 2002 and 2012 in high-risk subjects. The study also showed that the prevalence increased much faster in male compared to female subjects. Specifically, an increased rate was seen in middle-aged men, with no change observed in middle-aged females over the eleven-year period. Conclusion: This study showed that sex, age, parental diabetic history, and being overweight were associated with an increased risk for diabetes in high-risk people. Therefore, as prediabetes and diabetes are highly prevalent in people with multiple diabetes risk factors in Shanghai, screening programs targeting these individuals may be beneficial. [ABSTRACT FROM AUTHOR]

To assess the role of body fat and serum C-reactive protein (CRP) level in the prediction of cardiovascular events among individuals from Shanghai communities. A total of 5502 individuals aged over 20 years from 1998 to 2001 in two communities of Shanghai were included. In this cohort 2790 individuals aged over 30 years underwent a five year follow-up. Logistic regression model was used to estimate the relationship between CRP level and the risk of metabolic syndrome (MS). Receiver operating characteristic curve was used to find out the best cut-point for body mass index (BMI) and waist circumference (W) to assess MS defined as Chinese Diabetes Society (2004) working definition. Our data showed: 1.Compared with those subjects in the lowest quartile, individuals in the highest quartile of CRP level (men 2.11 mg/L, women 2.22mg/L) had increased risk of MS(10 times in men, 8.5 times in women) at baseline. 2.The best cut-point for BMI in assessing MS was 25kg/m² in both men and women, and for W was 85cm in men and 80cm in women at baseline. 3.Compared with the subgroup of BMI<25 kg/m² with CRP<2 mg/L, the relative risk of cardiovascular events was as following: 1.98 in the subgroup of BMI≥25kg/m² with CRP<2mg/L,1.55 in the subgroup of BMI<25kg/m² with CRP≥2mg/L and 2.26 in the subgroup of BMI≥25kg/m² with CRP≥2mg/L. 4.Compared with the subgroup of W<85cm with CRP<2 mg/L in men and W<80cm with CRP<2 mg/L in women, the relative risk of cardiovascular events was as following: in men 1.83 in the subgroup of W≥85cm with CRP<2mg/L, 1.15 in the subgroup of W<85cm with CRP≥2mg/L and 2.34 in the subgroup of W≥85cm with CRP≥2mg/L; and in women 1.61 in the subgroup of W≥80cm with CRP<2mg/L, 1.25 in the subgroup of W<80cm with CRP≥2mg/L and 2.21 in the subgroup of W≥80cm with CRP≥2mg/L. In conclusion, 1.The risk of MS was dramatically increased in subjects with CRP level above 2mg/L. 2.To determine MS the optimal cut-point for BMI was 25kg/m² and for W was 85cm in men and 80cm in women. 3. In a five year follow-up study, the risk of cardiovascular events was significantly elevated not only in individuals with BMI over 25kg/m² but also in men with W over 85cm and in women with W over 80cm independent of CRP level. The risk of cardio vascular events was further increased in subjects with elevated CRP level combined with either higher BMI or W. [ABSTRACT FROM AUTHOR]

• Osteocalcin plays a protective role in insulin resistance and obesity. • Osteocalcin levels were independently and inversely correlated with prolonged QTc interval after adjusting for confounding factors among a community-based population. • VFA partially mediated the inverse correlation between osteocalcin levels and QTc interval. Osteocalcin, a bone-derived factor, could be a feasible marker for metabolic disorders and adverse cardiovascular outcomes. This study aimed to explore the correlation between serum osteocalcin levels and correct QT interval (QTc) interval prolongation, a risk factor of cardiac morbidity and mortality. We recruited 1210 subjects (age range: 26–80 years) in communities in Shanghai. Serum osteocalcin levels were determined using an electrochemiluminescence immunoassay. The QTc interval was measured using a 12-lead electrocardiogram and was calculated by the Bazett formula. A prolonged QTc interval was defined as QTc > 440 ms. Visceral fat area (VFA) was assessed by magnetic resonance imaging. A VFA of 80 cm2 was applied as a cut-off point for central obesity. Subjects with diabetes, overweight/obesity, or central obesity had significantly lower serum osteocalcin levels than those without (all P < 0.01). In subjects with a normal QTc interval, QTc interval lengthening accompanied decreasing osteocalcin levels (P for trend = 0.033), and the decline was more obvious in subjects with a prolonged QTc interval (P for trend = 0.022). Serum osteocalcin levels were correlated with the QTc interval (standardized β = –0.082, P = 0.005). Neither diabetes nor overweight/obesity was correlated with the QTc interval, whereas central obesity was positively correlated (P = 0.032). In addition, the correlation between osteocalcin levels and the QTc interval was attenuated when central obesity was included in the model simultaneously (standardized β = –0.075, P = 0.010). Mediation analysis revealed that VFA played a mediating role in the aforementioned correlation, and the estimated percentage of the total effect mediated by VFA was 20.9% (P = 0.007). VFA partially mediated the inverse correlation between the serum osteocalcin levels and QTc interval, suggesting that improving fat metabolism may be a mechanism by which osteocalcin protects against cardiovascular diseases. [ABSTRACT FROM AUTHOR]