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Importance Childhood and adolescence are critical periods for lifelong bone mineral accrual, but few studies have determined the impact of childhood adiposity on adult bone density. Objective To determine the long‐term impact of childhood adiposity on adult areal bone mineral density (aBMD) and the effect of adult adiposity on this relationship. Methods We conducted a longitudinal study of 1156 adults (56.3% men), for whom skinfold thickness (SFT) had been measured during childhood (6–18 years) and fat mass percentage (FMP) and aBMD were measured during adulthood (29–43 years). Adult aBMD in the lumbar spine (LS), femoral neck (FN), arms, and legs was measured using dual‐energy X‐ray absorptiometry. The direct effect of childhood SFT and its indirect effect through adult FMP on adult aBMD were estimated using general linear regression and a causal steps approach. Results Significant positive associations between childhood SFT and adult aBMD were found in the LS in men (β = 0.089, P = 0.044) and in all the skeletal sites in women. With respect to the adult fat–bone relationship, high adult FMP was associated with low aBMD in most of the sites in men, but with high FN aBMD in women (β = 0.144, P = 0.002). Moreover, suppressive effects of adult FMP on the associations between childhood SFT and adult aBMD in the LS (−34.8%) and legs (−67.1%) of men, and a positive effect on the FN aBMD in women (17.0%) were identified. Interpretation Childhood adiposity appears to have a positive long‐term effect on adult aBMD, which may be reduced by adiposity in adult men but reinforced by adiposity in adult women., This longitudinal study presented sexual discrepancies in fat‐bone relationship from a life course perspective. Childhood adiposity appears to have a positive long‐term effect on adult aBMD, which may be reduced by adiposity in adult men but reinforced by adiposity in adult women.

Summary Background & Aims The rise in the prevalence of childhood obesity has increased the demand for accurately evaluating body fatness in pediatric population. The aim of this study was to provide a series of sex- and age-specific body fat reference centiles for evaluating total body fat development and fat distribution in Chinese children and adolescents using dual-energy x-ray absorptiometry (DXA). Methods A nationwide sample of Chinese children and adolescents aged 3-18 years (n=12,790) was drawn from a cross-sectional survey of the China Child and Adolescent Cardiovascular Health study (2013-2019). Fat measurements, including total fat mass index (FMI), total body fat percentage (BF%), regional FMI, trunk to leg (T/L) fat ratio and android to gynoid (A/G) fat ratio, were derived from whole body DXA scans. Sex- and age-specific centiles were estimated using the lambda-mu-sigma method and then compared with values derived from the US National Health and Nutrition Examination Survey (1999-2004) and Korean National Health and Nutrition Examination Survey (2008-2011). Results During early childhood, almost all body fat parameters decreased with age, except an increase in A/G ratio. After 7 years onward, drastic upward trends of total FMI and BF% were exhibited in boys till 10 years, followed by opposite downward trends during 11-14 years; while sustained increase of FMI was shown in girls across ages accompanied by relatively constant BF% levels. Meanwhile, steady increases were noticed for A/G ratio and T/L ratio, which were more pronounced in boys. In addition, the proposed body fat references were much lower than the US but similar to Koreans despite of subtle differences. Conclusions This is the first study to present a set of DXA-based body fat reference for Chinese children and adolescents aged 3-18 years. The new reference provides clinicians and researchers a useful tool for assessing body fat development and distribution patterns across the periods from early childhood to adolescence.

Importance Several methods have been established in recent decades that allow use of spot urine to estimate dietary sodium intake. However, their accuracies have been controversial in children. Objective To validate the performance of three commonly used methods—the Kawasaki, Tanaka, and International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) methods. Additionally, this study explored the accuracies of the Tanaka and INTERSALT methods by using spot urine samples taken at four separate times. Method Forty‐one adolescents aged 14 to 16 years completed two non‐consecutive 24‐hour urine collections and their mean values were used as reference data. The second‐morning urine was used for assessment with the Kawasaki method; a casual spot urine and spot urine samples taken at four separate times (morning, afternoon, evening, and overnight) were used for assessment with the Tanaka and INTERSALT methods. Results The mean differences were 1801 mg, 542 mg, 47 mg, and −31 mg for the Kawasaki, Tanaka, INTERSALT1 (with potassium), and INTERSALT2 (without potassium) methods with their required spot urine, respectively. The proportions of relative difference levels within ± 10% were 4.9% for the Kawasaki method, 19.5% for the Tanaka method, 36.6% for the INTERSALT1 method, and 36.6% for the INTERSALT2 method. Interpretation The INTERSALT method seemed to provide minimally biased estimations of mean population sodium intake with casual spot urine. However, there is a need to be cautious regarding inconsistencies in estimation among different levels of sodium intake. The methods assessed in this study were unable to accurately estimate sodium intake at the individual level., The INTERSALT provided unbiased estimations of mean population sodium intake in adolescents aged 14 to 16 years.

In this paper, a broadband double-ridge horn antenna (DRHA) covering 5G millimeter-wave (mm-wave) band is proposed, which maintains stable radiation pattern and gain in the entire band. By redesigning the transition between coaxial and waveguide, there is no splitting or deterioration in the axis pattern throughout the entire 18–54 GHz frequency band, and the VSWRs are all below 2. Meanwhile, by replacing the H-Side wall of the antenna with metal grid, the variation on 3 dB beamwidth of the radiation pattern also become more stable against frequencies. In order to fabricate the prototype successfully, the method of block processing and assembly is adopted, which can ensure high precision machining and make the assembly simple and easy to operate. Prototype measurement results show that the VSWR of the antenna is in well agreement with the simulation ones, while the gain is stable as well as no pattern splitting in the entire frequency band can be observed. It will find potential applications in 5G mm-wave frequency band, especially in the field of antenna measurement system as a standard calibration antenna or a probe antenna.

Introduction Gaucher disease (GD) is caused by a deficiency of β-glucosidase (GCase), leading to accumulation of glucosylceramide (GlcC) and glucosylsphingosine (Lyso-Gb1). Lyso-Gb1 is a reliable biomarker for GD. Objectives This study aims to develop a simple, effective and accurate method for the screening and diagnosis of GD using dried blood spot (DBS) samples. Methods Lyso-Gb1 in DBS was extracted by 50% acetonitrile aqueous solution containing isotope-labeled internal standard and analyzed using liquid chromatography tandem mass spectrometry (LC-MS/MS). A reference interval was established by analyzing samples from 277 healthy controls. Lyso-Gb1 was detected in the residual DBS samples from 142 high-risk patients with splenomegaly and/or thrombocytopenia. Based on GCase activity in DBS, samples were classified into four groups: confirmed GD patients (n = 52), GD carriers (n = 5), false positive (n = 36) and negative (n = 49). Results The optimized Lyso-Gb1 assay showed intra- and inter-assay variations ranged between 2.0%–8.2% and 3.8%–10.2%, respectively. Accuracies ranged from 93.5% to 112.6%. The lowest limit of quantification was 1 ng/mL. The normal reference interval of Lyso-Gb1 in DBS ranged from 2.1 to 9.9 ng/mL. Among the 142 subjects, except for one GD patient (Lyso-Gb1 > 2500 ng/mL), the Lyso-Gb1 concentrations in 51 GD patients ranged from 190.5 to 2380.6 ng/mL (the median 614.8 ng/mL). Also, one negative patient was found to have an elevated Lyso-Gb1 level (684.5 ng/mL), while the other patients were normal. The negative case was then confirmed to be an atypical GD patient with a c.1091A > G (p.Y364C) homozygous variant in PSAP gene by next generation sequencing. Conclusions The optimized method to determine Lyso-Gb1 in DBS was demonstrated as a useful tool for the screening and diagnosis of GD.

Objective This study aims to evaluate the prevalence of hypertension and hypertension subtypes among Chinese children aged 6--17 years in a multicenter school-based sample by three separate screenings. Methods Students from six major cities in China (Changchun, Beijing, Jinan, Shanghai, Chongqing, and Chengdu) were recruited in this cross-sectional survey during 2012 and 2015. Each participant was seated and had three consecutive blood pressure measurements on the right arm in the morning by an automated oscillometric device and the hypertensive ones were followed to the next visit. Hypertension was diagnosed by BP references for Chinese children and adolescents in 2010. Results Data from 44 396 children aged 6--17 years were included in analysis, 50.9% of whom were boys. The prevalence of confirmed hypertension after three separate screenings was 4% in the total population, 5% in boys, and 3% in girls, respectively. The prevalence of confirmed isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic and diastolic hypertension (SDH) in the total population was 2.7, 0.3 and 1%, respectively. Conclusion Around 4% urban Chinese children and adolescents aged 6-17 years were hypertensive after three separate BP screenings in 2012-2015. ISH was the most frequent form of hypertension in children.

Objective To investigate the associations of fat mass in specific regions with cardiometabolic risk factors in Chinese children and adolescents. Patients and Methods This cross-sectional study consisted of 8460 children and adolescents aged 6 to 18 years from Chinese urban areas who underwent dual-energy x-ray absorptiometry for regional fat masses and had cardiometabolic risk factors measured between January 1, 2013, and December 31, 2015. Results In the multivariate model containing arm fat mass, leg fat mass, and trunk fat mass, after adjustment for region, family income, age, puberty development, physical activity, and smoking, higher trunk fat mass was independently associated with greater odds of clustered cardiometabolic risk (odds ratio [OR], 2.21; 95% CI, 1.80-2.72), higher leg fat mass was associated with lower odds of clustered risk (OR, 0.72; 95% CI, 0.59-0.87), and arm fat mass was not significantly associated with clustered risk (OR, 1.22; 95% CI, 0.97-1.55). In the multivariate model including android fat mass, gynoid fat mass, and other covariates, higher android fat mass was positively associated with clustered risk (OR, 2.23; 95% CI, 1.88-2.64), but gynoid fat mass was not associated with clustered risk (OR, 0.86; 95% CI, 0.72-1.03). Analyses for individual risk factors demonstrated similar results. Conclusion Fat stored in different regions has differential influences on cardiometabolic risk in youth. Prospective studies are warranted to evaluate the long-term impacts of regional fat masses in childhood on cardiovascular risk in adulthood.

Background. Genome-wide association studies have found an obesity-related single-nucleotide polymorphism rs10938397 near the glucosamine-6-phosphate deaminase 2 gene (GNPDA2) encoding, an enzyme that catalyzes the deamination of the glucosamine-6-phosphate involved in the hexosamine signaling pathway, but the molecular mechanisms underlying the missing link between GNPDA2 and obesity remain elusive. Methods. As obesity is accompanied by an increase in the size and the number of adipocytes, the present study investigates the possible mechanism of the GNPDA2 in adipogenesis using GeneChip® Human Transcriptome Array 2.0 in human adipose-derived mesenchymal stem cells. Results. We found that overexpression of GNPDA2 enhanced accumulation of lipid droplets, and knocking down the gene decreased accumulation of lipid droplets. GO term enrichment analysis indicated that most differentially expressed genes (DEGs) affected by deficiency of GNPDA2 have functions to lipid and glucose metabolism. Further KEGG enrichment analysis showed that the greatest proportion of DEGs are involved in thermogenesis, peroxisome proliferator-activated receptor (PPAR) signaling pathway, carbon metabolism, and fatty acid metabolism including fatty acid degradation, elongation, and biosynthesis. Conclusion. These findings suggest that GNPDA2 may be a critical gene for lipid and glucose metabolism, and the expression level of GNPDA2 alters the transcriptome profile of human adipose-derived mesenchymal stem cells.

Sitosterolemia is a rare autosomal recessive disease characterized by a significant increase in blood plant sterol levels. Clinical manifestations usually include xanthomas, hypercholesterolemia,premature atherosclerosis and hematological abnormalities. We report here a sitosterolemia patient who presented with multiple xanthomas and profound hypercholesterolemia since 3 years old. The girl was mistreated as familial hypercholesterolemia for 6 years until correct diagnosis was made by detecting serum plant cholesterol levels. Sequence analysis revealed compound heterozygous mutations in ABCG5 gene, including the previously reported mutation c.904+1G＞A and a novel missense mutation c.1528C＞A. Although cholestyramine therapy reduced cholesterol level in association with marked regress of the xanthomas, serum plant sterol levels still remain high. Our study suggests that patients develop severe hypercholesterolemia and xanthomas at early age should be suspected of sitosterolemia. In addition, we also describe a novel missense mutation in exon 11 of the ABCG5 gene, which enriches the genetic mutation spectrum of sitosterolemia.

Background and aims Considerable attention is given nowadays to the presence of cardiovascular diseases risk factors in children. The current blood lipid classification system for Chinese children was based on the United States National Cholesterol Education Program (NCEP) cutpoints, which did not take the age, gender and race differences into consideration. This study aimed to develop gender- and age-specific lipid cutpoints for dyslipidemia screening in Chinese children and compare the ability of new cutpoints and NCEP pediatric cutpoints to predict obesity and unfavorable blood pressure (BP) levels. Methods Data were obtained from a nationwide multicenter cross-sectional study: The China Child and Adolescent Cardiovascular Health Study, comprising 12,875 Chinese children aged 6–18 years. We calculated cutpoints for abnormal levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) that were linked to Chinese adult abnormal lipid thresholds using the General Additive Model for Location Scale and Shape method. Results Borderline-high and high cutpoints (TC, LDL-C and TG) as well as low cutpoints (HDL-C) were developed to classify the abnormal blood lipid levels in Chinese children. Better performance for prediction of obesity, elevated BP, and hypertension were found with the proposed cutpoints in comparison with the NCEP pediatric cutpoints (AUC for obesity: 0.612 vs. 0.597, p = 0.017; AUC for elevated BP: 0.529 vs. 0.521, p = 0.017; AUC for hypertension: 0.536 vs. 0.527, p = 0.016). Conclusions The gender- and age-specific cutpoints should improve the accuracy of dyslipidemia screening in China and be more reasonable in practice.

BACKGROUND Several formulas using spot urine have been developed to estimate 24-hour sodium excretion, but none of them have been validated in pediatrics. We aimed to evaluate the performance of 8 formulas—Kawasaki; Tanaka; International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT1); INTERSALT without potassium (INTERSALT2); Mage; Whitton; Uechi simple-mean; and Uechi regression—in estimating 24-hour sodium excretion at both population and individual levels in Chinese young adolescents. METHODS This cross-sectional study consisted of 284 students aged 10–15 years from Hunan, China. Two spot urine and 24-hour urine samples were collected from each participant. RESULTS The median 24-hour urinary sodium excretion was 2,742 mg. The mean differences (95% confidence intervals) of 24-hour sodium excretion by the 8 equations were 1,613 (1,491 to 1,735) mg for Kawasaki, −12 (−97 to 73) mg for Tanaka, −214 (−319 to −110) mg for INTERSALT1, −289 (−394 to −185) mg for INTERSALT2, −615 (−730 to −500) mg for Mage, 1,082 (967 to 1,198) mg for Whitton, −479 (−610 to −348) mg for Uechi simple-mean, and −620 (−716 to −525) mg for Uechi regression. The Tanaka formula performed best in relative and absolute difference distributions, with 35.2% participants having relative differences within 10%, and 45.8% participants having absolute differences within 393 mg. The misclassification rates were all >50% except for the Tanaka formula (43.7%). CONCLUSIONS In our study, Tanaka could offer a plausible alternative of mean populational 24-hour sodium estimation for young adolescents. However, the results did not support the use of these equations in pediatrics at individual levels.

We presented a quad-ridge horn antenna (QRHA) used as a probe in near-field measurement system application. The antenna was designed with proper shape and size, and has a smaller phase difference distribution over a wide frequency range, so it can obtain good radiation pattern performance. The antenna was dual polarized and matched over more than a 6:1 impedance bandwidth. The design process of simulation model and prototype was given in this paper. The experimental results have shown that measured were in good agreement with simulated. Finally, the antenna was used as the probe of the near field measurement system and verified by testing the linearly polarized antenna.

Background Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS). It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events. Methods Consecutive first-ever stroke patients (n = 546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition (National Institutes of Health Stroke Scale Score ≤ 3) and exclusion criteria. MRI scans were performed within 7 days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS), SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0–1) and poor outcome (mRS 2–6). Secondary outcomes were stroke progression and stroke recurrence. Results Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P P = 0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence. Conclusion WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.

BACKGROUND Despite an increasing number of studies investigating the links between increased BMI and a better prognosis of cardiovascular disease, which has been termed the "obesity paradox," few of them take the lean mass into consideration. OBJECTIVES This study aimed to explore the associations of body composition compartments, especially the lean mass, with cardiometabolic abnormalities in children and adolescents. METHODS In a nationwide cross-sectional study of 6- to 18-y-old children (n = 8967, 50.1% boys), we measured body composition using DXA scan, and calculated BMI, fat mass index (FMI), and lean mass index (LMI). The exploratory outcomes were cardiometabolic abnormalities, including hypertension, dyslipidemia, hyperglycemia, and insulin resistance. Adjusted linear regression coefficients and ORs were calculated to assess the associations between body composition indicators and cardiometabolic abnormalities. RESULTS Unlike BMI and FMI, LMI was inversely associated with homeostasis model assessment of insulin resistance (β: -0.06; 95% CI: -0.09, -0.03; P

In this paper a broadband dual-polarization probe has been designed and simulated which can be used for 5G millimeter-wave frequency band (below 50GHz) measuring. The probe not only has a wide impedance matching bandwidth, but also has no deterioration of the pattern of the interested frequency band. At the same time, the structure is simple and occupy small volume. The simulation results show that the impedance bandwidth of the probe proposed to this paper is 6-50GHz, and the isolation between the ports is more than 30dB in the whole frequency band, and it has good radiation performance and cross-polarization level. Therefore, this probe can find a scene in 5G millimeter wave frequency band measurement application, especially in multi-probe spherical near-field measurement system.

ObjectiveVitamin D deficiency has recently evolved as a major public health issue worldwide. But the relationship between vitamin D and cardiovascular health in children remains unclear. Accordingly, we aimed to examine the associations between 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors, and to assess the possible effect modification of obesity on the associations in a Chinese pediatric population.Research design and methodsA cross-sectional sample of 6091 children aged 6–18 years was obtained using a cluster sampling method. The 25(OH)D concentrations, and metabolic risk factors, including waist to height ratio, blood pressure, blood lipids, fasting blood glucose (FBG), and insulin were measured. Adjusted ORs and multiplicative or additive interaction were calculated to assess the associations and effect modification, respectively.ResultsTriglycerides, FBG, insulin, and homeostasis model assessment of insulin resistance were inversely associated with 25(OH)D concentrations (pConclusionsVitamin D insufficiency is associated with increased odds of various cardiometabolic risk factors in Chinese children and has a synergistic effect on hyperglycemia with obesity.

Western firms are recognizing that digitization is transforming the way business is conducted in China, the world’s largest online market, just as much if not more than in their home markets. However, the importance of what we call the “Relational Digital Ecosystem” – a fundamental determinant of online competition in China – remains overlooked by many Western firms. By applying the concept of the Relational Digital Ecosystem to understand the workings of the “wanghong” economy in China – a sweeping recent digital phenomenon still largely unheard of in the West – we illustrate how digital competition is different in China than in the West. We then discuss how Western firms can respond to this ecosystem by more strategically engaging Chinese consumers in five ways.

OBJECTIVE We aimed to investigate associations of childhood pulse pressure (PP) and change in PP status with adult subclinical vascular damage. METHODS Data were obtained from a population-based cohort of children aged 6-18 years started in 1987. The study constituted 1254 participants who were followed up in 2010-2011 (aged 28-42 years). Carotid arteriosclerosis and aortic stiffness were assessed by carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (PWV), respectively. RESULTS Both childhood PP and mean arterial pressure (MAP) were independently associated with adult carotid IMT and PWV adjusted for sex, childhood age, follow-up duration, and other traditional cardiovascular risk factors. After further adjustment for adult values of PP and MAP, childhood PP was still associated with adult carotid IMT but not with PWV, whereas childhood MAP was associated with adult PWV but not with carotid IMT. In addition, compared with participants who had normal PP in both childhood and adulthood, participants who had high PP in adulthood, irrespective of their childhood PP status, had higher levels of carotid IMT and PWV (all P

Objective To report the 4-year experience of early prenatal diagnosis of lysosomal storage disorders (LSDs) at a center in mainland China. Method Forty-seven pregnancies affected with LSDs were assed using enzymes and/or molecular studies. Prenatal studies were performed on 43 uncultured chorionic villi (CV) samples, two amniotic fluid samples, and two umbilical cord blood samples. Results Of the 47 fetuses, 23 (48.9%) were determined to normal, 13 (27.7%) to be carriers, and 11 (23.4%) diagnosed as affected. In this cohort, mucopolysaccharidoses (MPS) type II was the most common LSD, followed by Pompe disease and then metachromatic leucodystrophy. In the 17 MPS II cases, the four affected fetuses showed MPS II enzyme activity expression levels of 1.4% to 6.7%, while the enzyme activity levels of the 13 normal fetuses ranged from 72% to 240.4%. In the seven Pompe cases, three fetuses were normal with Pompe enzyme activity expression levels of 20%, 38.8%, and 77.3%, while four carrier pregnancies showed enzyme activity levels of 17.5%, 17.5%, 33.4%, and 13.8%, respectively. Conclusion Based on different enzyme properties in uncultured CV, different prenatal diagnostic strategies should be adopted for MPS II and Pompe disease. Combining enzyme assay and molecular studies in uncultured CV improves the reliability of prenatal diagnosis of LSDs.

Biotinidase (BTD) deficiency is a rare autosomal recessive metabolic disease, which develops neurological and cutaneous symptoms because of the impaired biotin recycling. Pathogenic mutations on BTD gene cause BTD deficiency. Clinical features and mutation analysis of Chinese children with BTD deficiency were rarely described. Herein, for the first time, we reported the clinical features, BTD gene mutations and their functional studies of eight symptomatic children with BTD deficiency from southern China. Fatigue, hypotonia, proximal muscular weakness, hearing deficits, rash and respiratory problems are common clinical phenotype of our patients. Seizures are observed only in patients with profound BTD deficiency. Five novel mutations were detected, among which c.637delC (H213TfsTer51) was found in 50% of our patients and might be considered as a common mutation. In vitro studies confirmed three mild mutations c.1368AC (Q456H), c.1613GA (R538H), and c.644TA (L215H) which retained 10-30% of wild type enzyme activity, and six severe mutations c.235CT (R79C), c.1271GC (C424S), c.1412GA (C471Y), c.637delC (H213TfsTer51), c.395TG (M132W), c.464TC (L155P), and c.1493dupT (L498FfsTer13) which retained10% of wild type enzyme activity. c.1330GC (D444H) decreased the protein expression but not activity of BTD enzyme, and H213TfsTer51 was structurally damaging while L498FfsTer13 was functionally damaging. These results will be helpful in establishing the definitive diagnosis of BTD deficiency at the gene level, offering appropriate genetic counseling, and providing clues to structure/function relationships of the enzyme.

Background The genome-wide association study has founded hypertension-related single nucleotide polymorphism (SNP) rs11191548 near CYP17A1 encoding a key enzyme involved in steroid metabolism, but the molecular mechanisms are not understood and the associations of the SNP with hypertension-related traits are not fully described, especially in children. The aim of the present study is to investigate the associations between the SNP and two hypertension-related traits, lipids and leptin. Methods We genotyped the SNP in Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study. A total of 3503 children participated in the study. Results The SNP rs11191548 was significantly associated with high-density lipoprotein cholesterol (HDL) (P = 0.014 and 0.028, respectively) and leptin (P = 0.011 and 0.026, respectively) under an additive model after adjustment for age, gender, and systolic blood pressure (SBP) or diastolic blood pressure (DBP). There was a statistically significant association of rs11191548 with high leptin after adjustment for age, gender, and SBP or DBP. The P-values remain significant after correction for multiple testing. Conclusions We demonstrate for the first time that the SNP rs11191548 near CYP17A1 is associated with HDL and leptin in Chinese children. These novel findings provide important evidence that HDL and leptin maybe possibly mediate the process of CYP17A1 involved in hypertension. Electronic supplementary material The online version of this article (10.1186/s12881-018-0523-y) contains supplementary material, which is available to authorized users.

The prototypes of autonomous vessels are expected to come into service within the coming years, but safety concerns remain due to complex traffic and natural conditions (e.g., Yangtze River). However, the response of autonomous vessels to potential accidents is still uncertain. The accident prevention for autonomous vessels is unconvincing due to the lack of objective studies on the causation analysis for maritime accidents. This paper constitutes an attempt to cover the aforementioned gap by studying the potential causations for maritime accidents in the Yangtze River by using a Bayesian-based network training approach. More than two hundred accidents reported between 2013 and 2019 in the Yangtze River are collected. As a result, a Bayesian network (BN) is successfully established to describe the causations among different risk influencing factors. By analysing the BN, this study reveals that the occurrence of maritime accidents (e.g., collision, grounding) can be expected to reduce with the development of autonomous vessels as the crews are removed. However, the extent of the consequences from some accidents (e.g., fire, critical weathers) could be more serious than conventional ones. Therefore, more attention and thoughts are needed to ensure the safe navigation of autonomous vessels in the Yangtze River.

Background: Previous longitudinal studies have shown inconsistent results regarding the influence of adipokines on changes in weight and body fat. We aimed to determine the predictive value of serum leptin, adiponectin, and their ratio on subsequent changes in obesity measures in children. Methods: Two hundred forty-six obese and 532 nonobese children aged 6–11 years were remeasured for BMI and waist circumference after 6.4 ± 0.2 years. Z-score of BMI was used to standardize for age and sex. Obesity was defined using the international BMI cutoffs. Waist-to-height ratio (WHtR) was calculated to define central obesity using a boundary value of 0.5. Fasting serum leptin and adiponectin levels were measured at baseline. Results: Newly identified obese children had significantly higher levels of leptin and leptin-to-adiponectin ratio than nonobese children. There were lower adiponectin levels in boys with persistent obesity versus those with transient obesity. After adjusting for age, Tanner stage, and corresponding adiposity measures at baseline, leptin levels and leptin-to-adiponectin ratio were positively associated with BMI Z-score gain in girls and WHtR gain in boys. An inverse association between leptin and BMI Z-score gain was detected in boys. Stratified analyses revealed significant associations only in the nonobese and prepubertal group. There were no significant associations between adiponectin and changes in obesity measures. Conclusions: High leptin levels and leptin-to-adiponectin ratio are sex-specific predictors of obesity measures gain in nonobese and prepubertal children. Body composition measurement is necessary to assess fat mass growth and distribution during childhood and adolescence.

Background The American Heart Association's 2020 Strategic Goals have defined a new concept of cardiovascular health for adults and children, emphasizing the importance of primordial prevention of cardiovascular diseases. However, detailed data on the trends of ideal cardiovascular health in Chinese children and adolescents are sparse. Methods A total of 5596 children and adolescents (aged 6–18years) were selected from two cross-sectional surveys conducted in 2004 and 2014, respectively. Cardiovascular health behaviors (smoking, body mass index, physical activity, and diet) and factors (total cholesterol, blood pressure, and glucose) were evaluated, and only participants with information on all 7 metrics ( n =4309) were included for the cardiovascular score analysis. Results During 2004–2014, ideal levels of almost all the seven metrics decreased, except for a marked increase in physical activity (boys: 23.0% vs 52.8%; girls: 16.2% vs 41.0%). Overall, only 19.5% of boys and 22.0% of girls had ideal cardiovascular health (score≥6) in 2004, which worsened in 2014 (boys: 9.8%; girls: 16.0%). The prevalence of ideal cardiovascular health factors also declined, but the prevalence of ideal cardiovascular health behaviors increased. Being a girl and having a younger age (aged 6–11years) were associated with higher prevalence of ideal cardiovascular health. Higher family income and parental education were associated with a higher prevalence of ideal cardiovascular health behaviors. Conclusion Adverse trends in ideal cardiovascular health were observed among Chinese children and adolescents during 2004–2014. Effective intervention programs, in particular targeting children and adolescents, need to be developed to promote cardiovascular health in China.

OBJECTIVE Atherosclerosis and arterial stiffness predict cardiovascular morbidity and mortality. We aimed to investigate the influence of BMI and blood pressure (BP) in childhood, and change in BMI and BP, on the development of subclinical atherosclerosis and arterial stiffness in adulthood. METHODS The study consisted of 1252 individuals aged 27-42 years who had 2-10 measurements of BMI and BP from childhood. In the final survey (2010-2011), subclinical markers of vascular damage, including carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), and brachial-ankle pulse wave velocity (baPWV), were measured. RESULTS Pearson correlation analyses showed that BMI and BP in childhood and adulthood, and also cumulative and incremental values from childhood to adulthood, were all significantly associated with adult cIMT, cfPWV, and baPWV in males and in females (all P

Purpose. Genome-wide association studies have found two obesity-related single-nucleotide polymorphisms (SNPs), rs17782313 near the melanocortin-4 receptor (MC4R) gene and rs6265 near the brain-derived neurotrophic factor (BDNF) gene, but the associations of both SNPs with other obesity-related traits are not fully described, especially in children. The aim of the present study is to investigate the associations between the SNPs and adiponectin that has a regulatory role in glucose and lipid metabolism. Methods. We examined the associations of the SNPs with adiponectin in Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study. A total of 3503 children participated in the study. Results. The SNP rs6265 was significantly associated with adiponectin under an additive model (P=0.02 and 0.024, resp.) after adjustment for age, gender, and BMI or obesity statuses. The SNP rs17782313 was significantly associated with low adiponectin under a recessive model. No statistical significance was found between the two SNPs and low adiponectin after correction for multiple testing. Conclusion. We demonstrate for the first time that the SNP rs17782313 near MC4R and the SNP rs6265 near BDNF are associated with adiponectin in Chinese children. These novel findings provide important evidence that adiponectin possibly mediates MC4R and BDNF involved in obesity.

Gaucher disease (GD) is a common lysosomal storage disorder caused by deficiency of glucocerebrosidase (GCase) due to the pathogenic variants in the GBA gene. The aim of this study was to evaluate the performance of high risk screening program for GD by measuring the enzyme activities of GCase and chitotriosidease in dried blood spots of patients with splenomegaly and/or thrombocytopenia. A total of 787 subjects (364 females and 423 males) with unexplained splenomegaly and/or thrombocytopenia were enrolled in this study from May 2016 to Aug 2019. The cutoff value of GCase activity was set as less than 3.0 pmol/punch/h for screening positive. The diagnosis of GD was confirmed by Sanger sequencing of the GBA gene. Among 131 screening positive cases, 49 patients were confirmed GD. The positive predictive value was 37.4%.Three patients with boundary values (GCase 3–4 pmol/punch/h) and other three splenectomic patients with normal GCase activity were confirmed GD by GBA genetic analysis because of increased chitotriosidase or Gaucher cells in bone marrow. A total of 55 GD cases were identified. The sensitivity and specificity of the high risk screening were 98.2% and 89.5%, respectively. These 55 GD patients presented splenomegaly (100%), hepatomegaly (70.9%), thrombocytopenia (83.6%). The level of GCase in GD patients was (1.7 ± 1.6) pmol/punch/h. The increased chitotriosidase (383.8 ± 130.2 pmol/punch/h) was found in 42 (76.4%) patients with GD. Molecular genetic analysis identified 44 variants in the GBA gene, including 11 novel variants. The results showed the high risk screening for GD is accurate, rapid and cost-effective.

Pompe disease is an autosomal recessive disorder caused by deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA). Early and precise diagnosis can be highly important for the treatment, genetic counselling and prenatal diagnosis of this disease in potential candidates. Considering that Pompe disease studies have not been frequently conduced in China, to better understand the clinical course and molecular defects among this group, our study examined 21 Chinese patients with classic infantile Pompe disease. The median age of symptom onset in the patients was 2.5 months (0-7 months), and the median age of confirmed diagnosis was 5.6 months (2-12 months). GAA gene mutation analysis revealed 17 different mutations, two of which were novel (c.538C>A and c.2096T>C). The most frequent mutation in these patients was c.1935C>A, accounting for 40.5% (17/42 alleles) of the mutations. These results confirm the high prevalence of the c.1935C>A mutation in Chinese patients with classic infantile Pompe disease. Furthermore, identification of the novel alterations in the GAA gene will help to broaden the spectrum of the GAA mutations causing Pompe disease and to better understand the potential pathogenic role of each change.

In this paper, a decoupling design of an eight by eight MIMO antenna array with four choke grooves structure is proposed. By properly choosing the position of the feeding and shorting pin on two symmetrically placed radiator can get a relatively low isolation, adding four choke grooves on the ground can further reduce the isolation between eight feed ports. All of eight antennas work at 3.5 GHz band, and the measured results prove the proposed antenna has excellent performance. This special design will make it more compatible for a phone with metal frame using in 5G wireless environment.

Introduction: Cardiovascular diseases remain the leading cause of death and disease burden in China and worldwide. We aimed to evaluate the status of cardiovascular health among urban Chinese children and adolescents. Methods: We conducted a cross-sectional study comprising 12,618 children and adolescents aged 6–18 years, who were recruited from Chinese urban areas during 2013–2015. The poor, intermediate, and ideal levels of 7 cardiovascular health metrics, including smoking, body mass index, dietary intake, physical activity, blood pressure, blood glucose, and total cholesterol were defined according to revised American Heart Association criteria. Results: Ideal smoking status was the most prevalent health component (overall, 90.7%; males, 86.3% and females, 95.4%), whereas ideal health diet score (overall, 8.7%; males, 9.1% and females, 8.3%) was the least prevalent among urban Chinese children and adolescents. The majority (overall, 84.9%; males, 82.6% and females, 87.4%) of participants had 3–5 ideal metrics. The overall prevalence of ideal cardiovascular health (i.e. meeting all 7 ideal components) was extremely low (overall, 0.5%; males, 0.5% and females, 0.4%). Conclusions: The prevalence of ideal cardiovascular health in urban Chinese children and adolescents is extremely low, particularly for physical activity and healthy dietary intake. Effective public health interventions are required to improve cardiovascular health in children and adolescents to reduce future cardiovascular risk.Key messagesIdeal health diet score was the least prevalent health component among urban Chinese children and adolescentsThe prevalence of ideal cardiovascular health in urban Chinese children and adolescents was extremely lowEffective public health interventions are required to improve cardiovascular health in children and adolescents to reduce future cardiovascular risk Ideal health diet score was the least prevalent health component among urban Chinese children and adolescents The prevalence of ideal cardiovascular health in urban Chinese children and adolescents was extremely low Effective public health interventions are required to improve cardiovascular health in children and adolescents to reduce future cardiovascular risk

Background: Serum lipid trends in children and adolescents are predictors of the future prevalence of cardiovascular disease in adults. Methods: Data were obtained from cross-sectional studies conducted in 2004 and 2014. A total of 3249 children aged 6–18 years were included in the present study; serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were measured. Results: Overall, upward trends in mean TC, non-HDL-C, and LDL-C levels, and in geometric mean TG levels, were observed (all P < 0.001). Mean HDL-C levels significantly decreased between 2004 and 2014 (from 1.54 mmol/L to 1.47 mmol/L; P < 0.001). The prevalence of abnormal levels of serum lipids, with the exception of the prevalence of low HDL-C (P = 0.503), significantly increased over the study period (all P < 0.05). The prevalence of hyperlipidemia (from 13.3%; 95% confidence interval [CI], 11.6%–15.0% to 24.5%; 95% CI, 22.4%–26.6%; P < 0.001) and dyslipidemia (from 18.8%; 95% CI, 16.9%–20.7% to 28.9%; 95% CI, 26.7%–31.3%; P < 0.001) also increased from 2004 to 2014. The prevalence of abnormal serum lipids increased, and mean serum lipid levels, with the exception of TC levels, worsened in subjects with obesity compared with non-overweight subjects, as well as in subjects with mixed obesity compared with non-obese subjects (P < 0.05 for all). Conclusions: Adverse trends in serum lipid concentrations over the past 10 years were observed among children aged 6–9 years, with the exception of specific lipids, and among adolescents aged 10–18 years, from several schools in Beijing, China.

ObjectivesTo demonstrate the accuracy and flexibility of using waist-to-height ratio (WHtR) as a screening tool for identifying children and adolescents with cardiometabolic risk (CMR) across a wide range of prevalence levels among general paediatric populations.DesignA nationwide population-based cross-sectional study with all data collected at school settings in six cities of China.ParticipantsA total of 8130 children and adolescents aged 7–18 years with complete anthropometric and CMR measurements based on blood tests were recruited.Outcome measuresElevated blood pressure, dyslipidaemia, elevated fasting blood glucose and central obesity were measured. The primary outcome, CMRs, was defined as meeting three or more of the above risk factors. The accuracy of WHtR for identifying CMRs was evaluated using areas under the curves (AUCs) with 95% CI of the receiver operating characteristic curve. The predictability of WHtR at given CMRs prevalence levels was estimated by positive predictive value (PPV) and negative predictive value.ResultsOverall, 6.1% of study participants were presented with CMRs. WHtR had high AUCs ranging from 0.84 (95% CI 0.81 to 0.88) to 0.88 (95% CI 0.86 to 0.90) in the total population and age-subgroup and gender-subgroup. The overall optimal WHtR cut-off value was 0.467, with boys having a higher cut-off than girls (0.481 vs 0.456). WHtR achieved an overall sensitivity of 0.89 and PPV of 18.8% at a specificity of 0.75. The screening performance of WHtR remained satisfactory across a wide range of given CMRs prevalence levels (5%, 10% and 20%).ConclusionWHtR as a screening tool could accurately and flexibly identify children affected with the clusters of three or more of CMR factors from the general paediatric population with various CMR prevalence levels. Our findings provide support for policy-making on early CMR identification and management in the high-risk group of children.

Objectives: Vitamin D is involved in various physiologic and pathologic processes in the human body. The aim of this study was to determine the prevalence of vitamin D deficiency and the association of adiposity indicators with 25-hydroxyvitamin D (25[OH]D) in Chinese children and adolescents. Methods: This was a population-based, nationwide, multicenter cross-sectional study involving 10 696 participants(51.2% boys) 6 to 18 y of age. Total body fat mass was assessed by dual-energy x-ray absorptiometry,and measures of body mass index (BMI), fat mass index (FMI), fat mass percentage (FMP), and plasma 25(OH)D concentrations were obtained.Results: The adjusted mean of 25(OH)D was 39.3 nmol/L for all participants, 40.7 nmol/L for boys, and37.9 nmol/L for girls. Of the children, 30% had vitamin D deficiency (25[OH]D

Body mass plays a crucial role in the bone growth and development, but few studies have examined the association of long-term cumulative impact and trajectory patterns of childhood body mass index (BMI) with adult bone mass, and the mediation effect of adult BMI and body composition on these associations. A total of 397 Chinese adults (54.4%) who had been examined for BMI 4–8 times during childhood (6–19 years) and bone mass in adulthood (29–37 years), were included for analysis. Adult bone mineral content (BMC), areal bone mineral density (aBMD) and body composition were assessed via dual-energy x-ray absorptiometry. Childhood BMI growth curves were constructed using a random-effects mixed model. The area under the curve (AUC) was calculated to represent the long-term impact of childhood BMI. At baseline, 24.4%, 66.2%, 7.6% and 1.8% of the participants were underweight, normal weight, overweight and obese, respectively. Quadratic curve parameters of childhood BMI differed significantly between groups of adult whole body (WB) BMC, lumbar spine (LS) aBMD and femoral neck (FN) aBMD, with low BMC/aBMD groups having lower childhood BMI than the normal groups. AUC of childhood BMI was significantly and positively related to adult WB BMC and aBMD at each site, irrespective of sex. Significant mediation effects of adult BMI were shown on the association of childhood BMI AUC with adult WB BMC in males (52.0%) and FN aBMD in both sexes (males: 65.4%; females: 64.3%). Additionally, mediation effect of fat mass index was only noted on the association of childhood BMI AUC with adult WB BMC (41.3%), with a positive total indirect effect estimated at 0.118. The adult lean mass index, by contrast, mediated the childhood BMI-adult BMC/aBMD association positively at all sites in males (71.5%~89.2%) and at WB BMC in females (45.0%). These findings suggest that the impact of body weight on adult bones originates from childhood, which is mediated by concurrent BMI and body composition.

BMI as a body weight indicator, may inadequately represent the biological effect of body fat on lipid profiles. This study aims to assess whether body fat indicators were superior to BMI for recognizing children with dyslipidemia. A nationwide cross-sectional study involving 8944 pediatric participants aged 6–18 years. Measures of fat mass index (FMI), fat mass percentage (FMP), BMI, and four lipid profiles were obtained. Among boys, the standard multi-linear regression coefficients of FMI for TC, LDL-C, and TG were higher than those of BMI (P

ObjectiveTo investigate the association of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) with cardiometabolic risk factors in children and adolescents.Research design and methodsThis cross-sectional study consisted of 8460 children and adolescents aged 6–18 years from Chinese urban areas who underwent dual-energy X-ray absorptiometry scan and had metabolic risk factors measured.ResultsIn multivariate analysis adjusted for region, family income, age, puberty development, physical activity, and smoking, VAT and SAT were significantly associated with all metabolic risk factors for both sexes (all pConclusionsBoth abdominal VAT and SAT have adverse impacts on most of the cardiometabolic risk factors in youth. However, their relative contributions differ between sexes.

Background Observational studies have reported inconsistent results on the association between circulating fatty acids and obesity. Objective The objective of this study was to investigate the relationship between erythrocyte phospholipid fatty acid composition and obesity in children and adolescents. Methods We conducted a case-control study including 1442 obese and 1442 normal-weight children and adolescents. Circulating fatty acid composition between cases and controls were compared both in the present study and literature-based meta-analysis. Individual fatty acids contributing most to discriminating cases and controls were identified by orthogonal partial least squares–discriminant analysis and their associations with obesity were explored by a conditional logistic regression model. Results Five saturated fatty acids (14:0, 16:0, 17:0, 18:0, 20:0) were higher, 9 polyunsaturated fatty acids (18:3n-3, 20:3n-3, 20:5n-3, 22:5n-3, 22:6n-3, 18:2n-6, 20:2n-6, 20:3n-6, 20:4n-6) were lower in cases than in controls, while pooled results from the comparative meta-analysis were only consistent in 22:5n-3, 22:6n-3 and 18:2n-6. The orthogonal partial least squares–discriminant analysis model indicated that 16:0, 18:0, 20:4n-6, and 22:6n-3 were the fatty acids contributing most to discriminating cases and controls. In the conditional logistic regression model, significant positive associations were found for 16:0 (per 1 SD OR = 1.43, 95% CI, 1.35–1.52) and 18:0 (per 1 SD OR = 1.12, 95% CI, 1.09–1.16), while significant inverse associations were found for 20:4n-6 (per 1 SD OR = 0.63, 95% CI, 0.58–0.69) and 22:6n-3 (per 1 SD OR = 0.56, 95% CI, 0.52–0.61). Conclusions Erythrocyte phospholipid 16:0 and 18:0 were positively and 20:4n-6 and 22:6n-3 were inversely associated with obesity in children and adolescents.

The aim of this study was to assess sustained hypertension in children and its impact on cardiovascular target organ damage (TOD). Blood pressure (BP) was measured in children in Beijing in 2009. Primary hypertension was diagnosed based on three separate visits. Hypertensive children and normotensive children were followed up in 2011. According to these evaluations, three groups were defi ned: sustained hypertension, non-sustained hypertension and normotensive. Cardiovascular TOD and metabolic disorders were evaluated using pulse-wave velocity (PWV), carotid intima ‐ media thickness (cIMT), and assessments of left ventricular structure and kidney function. A total of 3032 children aged 9 ‐ 15 years participated in this survey, of whom 128 were diagnosed with hypertension after three separate BP measurements. Eighty out of 128 (62.5%) hypertensive and 158 normotensive children were available for follow-up in 2011. Forty-eight children were defi ned as having sustained hypertension, 38 as non-sustained hypertension and 152 as normotensive. Mean levels of brachial ‐ ankle PWV (baPWV), left ventricular mass, left ventricular mass index (LVMI) and cIMT were signifi cantly different between the three groups ( p 0.01). Compared to normotensives, the odds ratios and 95% confi dence intervals for elevated LVM and cIMT were 5.27 (1.57 ‐ 17.66) and 2.88 (1.03 ‐ 8.09) in the non-sustained hypertensive group, and 3.28 (1.00 ‐ 10.74) and 7.25 (2.69 ‐ 19.58) in the sustained hypertensive group. The children with sustained hypertension have the highest risk of developing arterial stiffness, left ventricular hypertrophy and early blood vessel endothelium damage. The indices of cIMT, LVMI and PWV were useful to identify children at high risk of cardiovascular TOD.

We seek to observe the association between childhood obesity by different measures and adult obesity, metabolic syndrome (MetS), and diabetes. Thousand two hundred and nine subjects from "Beijing Blood Pressure Cohort Study" were followed 22.9 ± 0.5 years in average from childhood to adulthood. We defined childhood obesity using body mass index (BMI) or left subscapular skinfold (LSSF), and adult obesity as BMI ≥ 28 kg/m(2). MetS was defined according to the joint statement of International Diabetes Federation and American Heart Association with modified waist circumference (≥ 90/85 cm for men/women). Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/L or blood glucose 2 h after oral glucose tolerance test ≥ 11.1 mmol/L or currently using blood glucose-lowering agents. Multiple linear and logistic regression models were used to assess the association. The incidence of adult obesity was 13.4, 60.0, 48.3, and 65.1 % for children without obesity, having obesity by BMI only, by LSSF only, and by both, respectively. Compared to children without obesity, children obese by LSSF only or by both had higher risk of diabetes. After controlling for adult obesity, childhood obesity predicted independently long-term risks of diabetes (odds ratio 2.8, 95 % confidence interval 1.2-6.3) or abdominal obesity (2.7, 1.6-4.7) other than MetS as a whole (1.2, 0.6-2.4). Childhood obesity predicts long-term risk of adult diabetes, and the effect is independent of adult obesity. LSSF is better than BMI in predicting adult diabetes.

Background/objectives There are few studies investigating the long-term association between childhood blood pressure (BP) and adult cardiovascular remodeling. We seek to examine the effect of elevated childhood BP on cardiovascular remodeling in early or middle adulthood. Methods We used the "Beijing BP Cohort Study", where 1259 subjects aged 6–18years old were followed over 24years from childhood (1987) to early or middle adulthood (2011). Anthropometric measures and BP were obtained at baseline and follow-up examinations. Carotid–femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), and left ventricular mass index (LVMI) were measured to assess cardiovascular remodeling in early or middle adulthood. Multiple logistic regression models were used to assess the odds ratio (OR) and 95% confidence interval (CI) for cardiovascular remodeling. Results 82 out of 384 children with elevated BP (21.4%) had adult hypertension. Compared to those with normal BP, children with elevated BP were at 2.1 times (95% CI: 1.4–3.1) likely to develop hypertension in early or middle adulthood. Compared to those with normal BP, children with elevated BP were at higher OR of developing high cfPWV (OR=1.8, 95% CI=1.3–2.4), high cIMT (1.4, 1.0–1.9), or high LVMI (1.4, 1.0–1.9) in early or middle adulthood. The ORs for remodeling (for any measures) were 1.4 (0.9–2.0) in early adulthood for children age 6–11years, and 1.6 (1.1–2.4) in middle adulthood for those aged 12–18years. Conclusions Children with elevated BP from 6years old have accelerated remodeling on both cardiac and arterial system in early or middle adulthood.

Background: The potential mechanism underlying the relationship between the risk of cardiovascular diseases and metabolically healthy obese (MHO) individuals remains unclear. The aim of the study was to prospectively investigate the potential role of the adipokines in the association between the MHO phenotype and hypertension in children and adolescents. Methods: A total of 1184 participants at baseline were recruited from a cohort of the Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study. The participants were classified according to their body mass index (BMI) and metabolic syndrome (MS) components. The levels of the adipokines, including leptin, adiponectin, and resistin, were measured. Results: MHO individuals had higher leptin levels (11.58 ug/L vs 1.20 ug/L), leptin/adiponectin ratio (1.18 vs 0.07), and lower adiponectin (11.65 ug/L vs 15.64 ug/L) levels compared to metabolically healthy normal-weight individuals (all P < 0.05). Compared to metabolically healthy normal-weight individuals, the prevalence of high leptin levels (26.5% vs 0.4%), low adiponectin levels (17.9% vs 6.3%) and a high leptin/adiponectin ratio (26.0% vs 2.1%) was higher in MHO individuals (all P < 0.01). The MHO individuals with abnormal adipokines were significantly more likely to developing hypertension (high leptin, relative risk 11.04; 95% confidence interval, 1.18–103.35; and high leptin/adiponectin ratio, relative risk 9.88; 95% confidence interval, 1.11–87.97) compared to metabolically healthy normal-weight individuals with normal adipokine levels. Conclusions: The abnormal adipokine levels contribute to the increased hypertension risk in MHO children and adolescents. The non-traditional risk factors should be highlighted in MHO children and adolescents in clinical practice and research.

OBJECTIVE: To investigate the association of childhood adiposity and change in adiposity status from childhood to adulthood with nonalcoholic fatty liver disease (NAFLD) and abnormal liver enzyme levels in adulthood. METHODS: Data were obtained from a population-based cohort of children aged 6 to 18 years started in 1987. From 2010 to 2014, 1350 subjects (aged 28–45 years) from the original cohort were followed. Childhood overweight and obesity were defined using BMI and subscapular skinfold thickness, respectively. In adulthood, ultrasound-based NAFLD, abnormal liver enzymes, and related risk factors were assessed. Results Overweight or obese children were more likely to have adult NAFLD (males: odds ratio [OR] = 2.49 for BMI and 2.78 for subscapular skinfold thickness; females: OR = 3.34 and 3.61; all Ps < .001) and alanine aminotransferase (ALT) elevation (males: OR = 1.64 and 1.66; females: OR = 2.12 and 3.01; all Ps < .05) than children with normal weight for both sexes. Compared with subjects who had normal weight in childhood and were nonobese in adulthood, subjects who were obese in adulthood, irrespective of their childhood adiposity status, were more likely to have NAFLD and ALT elevation in adulthood for both sexes. However, subjects who were overweight or obese in childhood but became nonobese in adulthood had similar likelihood of having NAFLD and ALT elevation in adulthood for both sexes. CONCLUSIONS: Overweight or obese children are more likely to have NAFLD and ALT elevation in adulthood. However, the risk associated with increased weight during childhood can be mitigated by becoming nonobese in adulthood.

Background Obesity and hypertension are two risk factors of left ventricular hypertrophy (LVH) in adults. We aimed to examine the impacts of body weight and blood pressure (BP) from childhood on adult LV geometric remodeling. Methods The study cohort consisted of 1256 adults aged 27–42years who had 2–10 measurements of body mass index (BMI) and BP from childhood in 1987 to adulthood in 2010. We calculated the cumulative and incremental values of BMI and BP from childhood to adulthood. In adulthood, four LV geometric patterns were defined based on the values of left ventricular mass index (g/m 2.7 ) and relative wall thickness: normal geometry, concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH). Results The prevalence of abnormal LV geometric patterns in adults was 26.4% for CR, 2.0% for EH and 2.5% for CH. For childhood values, systolic BP (Odds Ratio [OR]=1.26, 95% confidence interval [CI]=1.08–1.47) but not BMI (OR=1.06, 95%CI=0.93-1.18) was associated with adult CR, whereas BMI (OR=3.53, 95%CI=2.09–5.98) but not systolic BP (OR=1.04, 95%CI=0.65–1.66) was associated with adult EH. Both childhood BMI (OR=2.69, 95%CI=1.77–4.09) and systolic BP (OR=1.64, 95%CI=1.07–2.51) were independently associated with adult CH. For adulthood, cumulative and incremental values, BMI and systolic BP were independently associated with adult CR, EH and CH. Conclusion Excessive body weight and elevated BP from childhood have independent influences on the development of adult LV geometric remodeling.

OBJECTIVE Recent genome-wide association studies have identified a few single nucleotide polymorphisms (SNPs), which are associated with body mass index (BMI)/obesity. This study aimed to examine the identified associations among a population of Chinese children. RESEARCH DESIGN AND METHODS Five SNPs (SEC16B rs10913469, SH2B1 rs4788102, PCSK1rs6235, KCTD15 rs29941, BAT2 rs2844479) were genotyped for a group of Chinese children (N = 2849, age range 6-18 years). A total of 1230 obese cases and 1619 controls with normal weight were identified based on the Chinese age- and sex-specific BMI references. RESULTS Of five studied variants, only two (SEC16B rs10913469, SH2B1 rs4788102) were nominally associated with indices of adiposity and obesity risk in girls and only SEC16B rs10913469 in children at puberty (p

With the rapid development of the economy, China is facing pressures caused by traditional energy deficiency and environmental pollution in recent years, which has forced the Chinese government to start to pay attention to the development and utilization of renewable energy (RE). This article, based on data and statistics available up to 2008, studies features of China's RE technology innovation and problems thereof. It finds that national science and technology programs are the main aspect of China's RE technology innovation, and most of R&D funds for the RE technology come from China's three main national programs. Besides, the overall expenditures on RE technology innovation constitute only a small proportion of China's total domestic R&D funding and seem not enough. This paper also finds that, compared with research and development stages of RE technology, the demonstration and diffusion of RE technology in China are given less attention and thus are relatively less sufficient. Furthermore, influenced by China's traditional scientific research system, there appears lack of sufficient incentives and opportunities for private sectors to fully participate in RE technology innovation because most national programs are undertaken by universities or research institutes.

Fucosidosis is a rare lysosomal storage disease caused by α-fucosidase deficiency, which leads to progressive neurological deterioration and death. Hematopoietic stem cell transplantation is the best curative therapy if performed during the early stages of disease. We report two fucosidosis patients with brain abnormalities and the challenge faced in their management. The first patient received supportive therapy and the second one firstly underwent unrelated donor umbilical cord blood transplantation. After a period of follow-up, we found neurological symptoms were worsening day by day on patient1. By contrast, patient2 who received cord blood transplantation acquired clinical neurologic improvement in response to normalization of deficient enzymatic activity. This report indicates that hematopoietic transplant could reduce the severity and retard the progression of clinical neurological deterioration. Umbilical cord blood transplantation is a novel approach for treating fucosidosis patients who lack suitable bone morrow donors.