Search

Evidence of the relationship between fecal short-chain fatty acids (SCFA) levels, dietary quality and type 2 diabetes mellitus (T2DM) in rural populations is limited. Here, we aimed to investigate the association between fecal SCFA levels and T2DM and the combined effects of dietar quality on T2DM in rural China. In total, 100 adults were included in the case–control study. Dietary quality was assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), and SCFA levels were analysed using the GC-MS system. Generalised linear regression was conducted to calculate the OR and 95 % CI to evaluate the effect of SCFA level and dietary quality on the risk of T2DM. Finally, an interaction was used to study the combined effect of SCFA levels and AHEI-2010 scores on T2DM. T2DM participants had lower levels of acetic and butyric acid. Generalised linear regression analysis revealed that the OR (95 % CI) of the highest acetic and butyric acid levels were 0·099 (0·022, 0·441) and 0·210 (0·057, 0·774), respectively, compared with the subjects with the lowest tertile of level. We also observed a significantly lower risk of T2DM with acetic acid levels > 1330·106 μg/g or butyric acid levels > 585·031 μg/g. Moreover, the risks of higher acetic and butyric acid levels of T2DM were 0·007 (95 % CI: 0·001, 0·148), 0·005 (95 % CI: 0·001, 0·120) compared with participants with lower AHEI-2010 scores (all P < 0·05). Acetate and butyrate levels may be important modifiable beneficial factors affecting T2DM in rural China. Improving dietary quality for body metabolism balance should be encouraged to promote good health. [ABSTRACT FROM AUTHOR]

Globalization has been the catalyst of world economic development in the past decades. However, the phenomenon has recently been severely challenged by a wave of deglobalization. Within this new trend, the conflict between the United States (US) and China has attracted the attention of scholars from various fields because of the two countries' significance in the world economy. In this study, we focus on the higher education sector, which is highly relevant to globalization, and explore the factors that may affect Chinese college students' attitudes towards US universities, including country image, cultural openness, consumer animosity and perceived quality. In particular, we distinguish between cognitive and affective animosity and test their different impacts on students' attitudes. The results show that students' perception of the US's image positively influences attitudes towards the country's universities thanks to the mediation of perceived quality. Moreover, cultural openness and cognitive animosity are positively related to attitudes, whereas affective animosity exerts a negative impact on attitudes. The implications and limitations of this study are also discussed. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Does a homozygous nonsense mutation in ACR lead to total fertilization failure (TFF) resulting in male infertility in humans? SUMMARY ANSWER A novel homozygous nonsense mutation of ACR (c.167G>A, p.Trp56X) was identified in two infertile brothers and shown to cause human TFF. WHAT IS KNOWN ALREADY ACROSIN, encoded by ACR , is a major acrosomal enzyme expressed only in the acrosome of the sperm head. Inhibition of acrosin prevents sperm penetration of the zona pellucida (ZP) in several species, including humans. Acr -knockout in hamsters causes male infertility with completely blocked fertilization. Of note, there are no reports of ACR mutations associated with TFF in humans. STUDY DESIGN, SIZE, DURATION Whole-exome sequencing (WES) was used for the identification of pathogenic genes for male factor TFF in eight involved couples. PARTICIPANTS/MATERIALS, SETTING, METHODS Data from eight infertile couples who had experienced TFF during their IVF or ICSI attempts were collected. Functional assays were used to verify the pathogenicity of the potential genetic factors identified by WES. Subzonal insemination (SUZI) and IVF assays were performed to determine the exact pathogenesis of TFF caused by deficiencies in ACROSIN. MAIN RESULTS AND THE ROLE OF CHANCE A novel homozygous nonsense mutation in ACR , c.167G>A, p.Trp56X, was identified in two additional primary infertile brothers whose parents were first cousins. This rare mutation caused ACROSIN deficiency and acrosomal ultrastructural defects in the affected sperm. Spermatozoa lacking ACROSIN were unable to penetrate the ZP, rather than hampering sperm binding, disrupting gamete fusion, or preventing oocyte activation. These findings were supported by the fertilization success of SUZI and ICSI attempts, as well as the normal expression of ACTL7A and PLCζ in the mutant sperm, suggesting that ICSI without remedial assisted oocyte activation is an optimal treatment for ARCOSIN-deficient TFF. LIMITATIONS, REASONS FOR CAUTION The absence of another independent pedigree to support our argument is a limitation of this study. WIDER IMPLICATIONS OF THE FINDINGS The findings expand our understanding of the genes involved in human TFF, providing information for appropriate genetic counseling and fertility guidance for these patients. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the National Natural Science Foundation of China (grant no. 82201803, 81901541, 82271639, and 32000584), University Synergy Innovation Program of Anhui Province (GXXT-2019-044), and the Nonprofit Central Research Institute Fund of the Chinese Academy of Medical Sciences (grant no. 2019PT310002). The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Large-scale farming of Undaria pinnatifida is conducted in northern China. Conspicuous natural populations of this alga are distributed on rocky shores in this region. However, the genetic relationship between U. pinnatifida from China and native populations in other countries remains largely uncertain. We obtained sequences for the mitochondrial cox3 and tatC–tLeu regions and the internal transcribed spacer one of nuclear ribosomal DNA from representative natural and farmed populations of U. pinnatifida in China. We analyzed genetic diversity, and evaluated the genetic relationship between Chinese populations and Japanese and Korean populations. The mitochondrial and nuclear DNA sequences revealed high genetic diversity in most Chinese populations. Unique mitochondrial haplotypes were detected in the Gouqi Island population consistent with historical records of a native population on the island. Phylogenetic analyses derived from the mitochondrial DNA sequences revealed that the Chinese samples were classifiable as the Continental and Northern Japan types. All natural populations from rocky reefs in northern China were grouped with the Continental type and all farmed populations with the Northern Japan type. Mitochondrial and nuclear DNA sequences revealed significant genetic differentiation between the farmed populations and adjacent natural populations from rocky reefs, in agreement with previous results obtained using microsatellites. [ABSTRACT FROM AUTHOR]

With rapid economic growth and institutional reform, the pursuit of money and material possessions has become the most prevalent value in contemporary China. This study focuses on the cultural root of money attitudes among the young adults. Specifically, 332 Chinese university students participated in a survey to report on their need for power, need for achievement, belief in guanxi , and love of money. Confirmatory factor analysis and regression analysis were applied to test the proposed hypotheses. The results show positive influences of need for power and need for achievement on individuals' love of money. Moreover, belief in guanxi mediates the relationship between need for power and love of money. The application of indigenous cultural concepts in analyzing social behavior in Eastern cultures is emphasized. Limitations and directions for future research are also discussed. [ABSTRACT FROM AUTHOR]

Objective: The International Parkinson and Movement Disorder Society (MDS) has published research criteria for prodromal Parkinson's disease (pPD), which includes cognitive impairment as a prodromal marker. However, the clinical features of mild cognitive impairment (MCI) in pPD remain unknown. Our study aimed to evaluate the frequency and clinical features of mild cognitive impairment of pPD in the elderly in China. Methods: The cross‐sectional community‐based study recruited 2688 participants aged ≥50 years. Subjects were diagnosed with pPD according to the MDS criteria. Overall, 39 pPD and 22 healthy controls underwent comprehensive clinical and neuropsychological assessment. MCI was also diagnosed by the MDS criteria. Next, we investigated the relationship between clinical factors and cognition. Results: Among the 2,663 dementia‐free and Parkinson disease (PD)‐free participants, 55 met the criteria for pPD (2.1%) and 23 pPD met the criteria for MCI. Memory, attention/working memory, and executive function were the most frequent impaired domains, and amnestic MCI multidomain phenotype was the most frequent MCI subtype (69.57%) in pPD. Additionally, correlation analysis revealed that the global cognitive performance was negatively related to UPDRS‐III score (r = −0.456, p = 0.004). Conclusion: MCI, specifically impairment in memory, attention/working memory, and executive domain, is present at the prodromal stage of PD. In addition, cognitive performance is correlated with motor symptoms in pPD. Our results reflect that cognitive profile, combined with motor symptoms, can help clinicians to identify individuals with pPD early, as those would be the optimal candidates for neuroprotective therapy. [ABSTRACT FROM AUTHOR]

Over the past few decades, more studies have suggested that the age at menarche (AAM) has continued to decline. However, the AAM for women in resource-constrained areas is not clear. Moreover, the association between the Chinese famine and AAM is still unclear in rural regions. The study aimed to investigate the secular trends of AAM for women born between 1935 and 2000 and to further explore the effect of famine on AAM in rural China. The study included 23,444 women participants from the baseline study of the Henan Rural Cohort study. Changing AAM over time was analysed using linear regressions. Multinomial logistic regression was conducted to analyse the association between famine exposure and AAM subgroups. The age-standardised mean AAM was 14.74 years. The average AAM declined from 16.98 years for those born in 1935 to 13.87 years for those born in 2000, a decline of 0.077 years per 1 year and 0.729 years per decade. Compared to the reference group, women exposed to famine during foetal, early childhood, middle childhood, and late childhood were 1.376 (95% CI = 1.071–1.769), 1.848 (95% CI = 1.512–2.259), 2.084 (95% CI = 1.725–2.518), and 2.146 (95% CI = 1.788–2.576) times more likely to be ≥18 years AAM than women unexposed to famine, respectively. AAM showed a decreasing trend in rural China. Furthermore, both foetal and childhood famine exposure, especially in late childhood, were positively associated with increased AAM compared to unexposed famine. [ABSTRACT FROM AUTHOR]

Purpose: A significant shift in meal pattern with frequent eating out was closely associated with multiple chronic outcomes, but with limited evidence on hyperuricemia. We aimed to explore the associations between eating out and serum uric acid (SUA) as well as hyperuricemia. Methods: A total of 29,597 participants were recruited from the Henan Rural Cohort Study. A validated food frequency questionnaire (FFQ) was used to collect dietary data, including the frequency of eating out. Linear regression models were used to examine the association of eating-out frequency with SUA and BMI. Logistic regression and restricted cubic spline were performed to assess the association and dose–response relationship between eating-out frequency and hyperuricemia. The mediation effect of BMI between eating out and the risk of hyperuricemia was evaluated. Results: Eating out was significantly associated with higher SUA levels in the total population and males (P < 0.001). Multivariate-adjusted odds ratios (ORs) with 95% confidence interval (CIs) of hyperuricemia were 1.26 (1.09, 1.46) for the total population and 1.18 (1.00, 1.40) for males (≥ 7 times/week vs 0 time/week). A non-linear positive dose–response relationship between eating-out frequency and hyperuricemia was observed. Furthermore, BMI played a partial mediating role in the relationship between eating out frequency and hyperuricemia, which explained 30.7% in the total population and 44.8% in males. Conclusion: Our findings indicated that eating out was associated with increased SUA levels and elevated hyperuricemia risk in rural China, especially in males. Moreover, the relationship was partly mediated by BMI. Clinical trials: ChiCTR-OOC-15006699 (2015-07-06). [ABSTRACT FROM AUTHOR]

Objective: The purpose of the current study was to investigate associations between spicy food intake and serum lipids levels in Chinese rural population. Design: Information on spicy food flavour and intake frequency was obtained using a two-item questionnaire survey. Dietary data were collected using a validated thirteen-item FFQ. Fasting blood samples were collected and measured for total cholesterol (TC), TAG, HDL-cholesterol and LDL-cholesterol. Multivariate linear and logistic regression models were employed to examine the relationship between spicy food and serum lipids levels according to the spicy food flavour and intake frequency, respectively. Setting: A cross-sectional study in Henan Province. Participants: 38 238 participants aged 18–79 years old. Results: Spicy flavour and intake frequency were consistently associated with decreased TC and non-HDL-cholesterol levels but mildly associated with elevated TAG levels. Each level increment in spicy flavour was inversely associated with high TC (OR: 0·91; 95 % CI 0·88, 0·93) and high non-HDL-cholesterol (OR: 0·88; 95 % CI 0·85, 0·91) but positively associated with high TAG (OR: 1·04; 95 % CI 1·01, 1·07). Similarly, 1-d increment in spicy food intake frequency was also inversely associated with high TC (OR: 0·92; 95 % CI 0·91, 0·94) and high non-HDL-cholesterol (OR: 0·91; 95 % CI 0·89, 0·93) but positively associated with high TAG (OR: 1·04; 95 % CI 1·02, 1·06). Conclusions: Spicy food intake was mildly associated with increased risk of abnormal TAG level, significantly associated with decreased risk of abnormal TC and non-HDL levels. Spicy food intake may be contribute to the management of lipid levels. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Studies have found that a plant‐based diet was associated with a lower risk of type 2 diabetes, but evidence is scarce on such associations in China. The aim of this study was to investigate whether a plant‐based diet is related to a lower risk of type 2 diabetes among Chinese adults. Materials and Methods: A total of 37,985 participants were enrolled from the Henan Rural Cohort Study. An overall plant‐based diet index (PDI) was created by assigning positive and reverse scores to 12 commonly consumed food groups. Multivariate logistic regression models and restricted cubic spline analysis were performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI). Results: After multivariable adjustment, the risk of type 2 diabetes was inversely associated with the PDI (extreme‐quartile OR = 0.88, 95% CI: 0.79–0.98; P = 0.027), the risk associated with a 1 standard deviation (SD) increase in PDI was 4% lower (95% CI, 0.93–1.00; P trend = 0.043) for type 2 diabetes. Moreover, the odds of type 2 diabetes was decreased with an increment of PDI after fitting restricted cubic splines (Ptrend < 0.01). Conclusions: Among Chinese populations, diets higher in plant foods and lower in animal foods were associated with a reduced risk of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background Previous reports about health-related quality of life (HRQoL) of type 2 diabetes mellitus (T2DM) concentrated on general patients rather than patients in rural areas with poor infrastructure and limited resources. Thus, the aims of this study were to evaluate the HRQoL of diabetics in the countryside and explore its influencing factors. Methods A total of 23 053 participants aged from 18 to 79 years were drawn from the Henan Rural Cohort Study for this cross-sectional study. The HRQoL of participants were assessed by utility index and VAS-score of European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) instrument. Binary logistic regression, generalized linear and tobit regression models were used to estimate the potential influencing factors on HRQoL. Results This study (23 053 participants) included 2231 T2DM patients with a crude prevalence of 9.68%. The utility index and VAS-score in health group were 0.96 ± 0.10 and 78.85 ± 14.53, while in T2DM group were 0.93 ± 0.15 and 74.09 ± 16.09, respectively. In total, most diabetics reported problem about pain/discomfort dimension. Being old, poverty, low physical activity, and with comorbidities was negatively related to HRQoL of diabetics, while high educational level was positively related to HRQoL. Conclusion HRQoL of rural T2DM patients depended on several sociodemographic factors. More attention should be paid to diabetics with poor socioeconomic status in rural areas. Clinical trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375. [ABSTRACT FROM AUTHOR]

Although microbial community and function patterns have been extensively studied, little is known about whether the patterns are consistent in different ecosystems and how they are influenced by seasonality or other environmental factors. To test the driving factors of microbial communities and potential functions, we collected soil samples from five forests (mixed broadleaved-Korean pine forest, mixed pine and oak forest, deciduous broadleaved mixed forest, subtropical evergreen broad-leaved forest and tropical rainforest) and three grassland ecosystems (meadow steppe, semi-arid grassland and arid grassland) across China in three seasons (spring, summer and autumn). Microbial diversity based on the sequencing of 16S rRNA gene for bacteria and internal transcribed spacer (ITS) genes for fungi were measured, and potential functions represented by soil extracellular enzyme activities (EEAs) were analyzed. The results found that soil EEAs were significantly higher in summer than in spring and autumn, and both bacterial and fungal richness indices showed greater seasonal fluctuations than the diversity. Fungal richness indices were highest in summer in both forest and grassland ecosystems, while the lowest were observed in spring for forest and in autumn for grassland, respectively. In addition, fungal communities were closely related to ecosystem types, while bacterial communities were not significantly different across ecosystems and exhibited a broader habitat niche breadth, but the relative abundance of dominant bacterial phyla showed stronger correlations with environmental variables (including climate, soil properties and nutrients) in grassland than in forest ecosystems. The decoupling of microbial community and EEAs was observed in both forest and grassland ecosystems, indicating the function redundancy of soil microorganisms. The present study provided crucial information about the effects of ecosystem types, seasonality and edaphic factors on soil microbial communities and EEAs, and could advance the understanding of soil potential function responses to environmental changes. [Display omitted] • Microbial richness indices exhibited greater seasonal fluctuations than diversity. • Fungal communities were closely related to ecosystem types. • Bacteria phyla were strongly correlated with environmental variables in grasslands. • Soil enzyme activities were higher in summer than spring and autumn. • Microbial communities and enzyme activities decoupled in forests and grasslands. [ABSTRACT FROM AUTHOR]

Purpose: Type 2 diabetes is a complex disease determined by variable genes and environmental factors. The study was designed to investigate the effect of interactions of four polymorphisms of suppressor of cytokine signaling 3 (SOCS3) with fruit and vegetable (F&V) intake on type 2 diabetes in a rural population of China. Methods: A total of 4411 participants from the rural areas of Henan, China were included in the study. Multivariate logistic regression and restricted cubic splines were used to estimate the associations between polymorphisms and risk allele score of SOCS3 and type 2 diabetes in different groups. Haplotype analysis was conducted to examine the effects of linkage inheritance at these four loci on type 2 diabetes. Results: Three of the four polymorphisms showed significant associations with type 2 diabetes in the less F&V intake group after adjusting the covariates, the odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were 1.24 (1.08–1.41) for rs4969168, 1.16 (1.02–1.32) for rs9892622, and 1.21 (1.06–1.39) for rs9914220. No significant association was detected in the more F&V intake group. The obvious dose–response relationship between the risk allele score and type 2 diabetes was also noted only in the less F&V intake group. Conclusions: Variants of SOCS3 gene were associated with type 2 diabetes and the associations could be modified by the F&V intake. [ABSTRACT FROM AUTHOR]

Objective: To assess the independent and combined effects of night sleep duration and sleep quality on depressive symptoms.Methods: A total of 28,202 participants (11,236 males and 16,966 females) aged 18-79 years from the Henan Rural Cohort were included in this study. Night sleep duration and sleep quality were defined by the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and restricted cubic splines were applied to evaluate the association of night sleep duration and sleep quality with depressive symptoms.Results: A U-shaped dose-response relationship between night sleep duration and depressive symptoms along with a J-shaped relationship between sleep quality and depressive symptoms were observed. Compared with reference group (7-<8 h), shorter sleep duration (<6 h) and longer sleep duration (≥10 h) were associated with increased risk of depressive symptoms in males (short sleep: Odds Ratio (OR) = 1.84, 95% confidence interval (CI), 1.34-2.52; long sleep: OR = 1.56, 95% CI, 1.01-2.42) and females (short sleep: OR = 2.19, 95% CI, 1.77-2.70; long sleep: OR = 1.51, 95% CI, 1.10-2.10). Compared with good sleepers, poor sleepers had 4.23-fold (95% CI:3.54-5.06) and 3.87-fold (95% CI: 3.41-4.40) increased odds of depressive symptoms in males and females. Furthermore, participants with longer night sleep duration (≥10 h) and poorer sleep quality had the strongest effect on depressive symptoms (males: OR = 6.64, 95% CI, 3.21-13.74; females: OR = 7.76, 95% CI, 5.00-12.02).Conclusions: Extreme night sleep duration and poor sleep quality were independently and combinedly related to elevated depressive symptoms, suggesting that keeping optimal night sleep duration and good sleep quality maybe benefit for maintaining mental health.Trial Registration: Chinese Clinical Trial Register. Registration number: ChiCTR-OOC-15006699. [ABSTRACT FROM AUTHOR]

This paper studied the relationship between personality traits and mental health conditions of medical personnel to provide a basis and reference for the implementation of targeted education on mental health. A self-report inventory, the Symptom Checklist-90 (SCL-90), was used to investigate the mental health status of 548 medical personnel dealing with the new coronavirus pneumonia in eight provinces and cities of China. The overall mean SCL-90 score and mean values of factors (somatization, obsessive-compulsive, anxiety, phobic anxiety, and psychoticism) of the medical personnel were significantly higher than in the norm group (p < 0.05), while their average interpersonal sensitivity score was significantly lower (p < 0.01). In addition, personal factors affecting the mental health status of medical personnel were identified (all p < 0.05). The overall mental health status of medical personnel responding to new coronavirus pneumonia is generally higher than that of the norm group in China. The results of this study should contribute to measures to alleviate the psychological pressures on medical personnel dealing with the new coronavirus epidemic in China. [ABSTRACT FROM AUTHOR]

Purpose: Soil nutrients, elemental stoichiometry, and their associated environmental control play important roles in nutrient cycling. The objectives of this study were (1) to investigate soil nutrients and elemental stoichiometry, especially potassium and its associative elemental stoichiometry with other nutrients under different land uses in terrestrial ecosystems; (2) to discuss the impacts of climate factors, soil texture, and soil physicochemical properties; and (3) to identify the key factors on soil nutrient levels and elemental stoichiometry. Materials and methods: Soil data, including pH, bulk density (BD), cation exchange capacity (CEC), volumetric water content (VMC), clay, silt and sand contents, total carbon (TC), nitrogen (TN), phosphorous (TP) and potassium (TK), available nitrogen (AN), phosphorus (AP), potassium (AK), and soil organic matter (SOM) under different land-use types, were collected, and their elemental stoichiometry ratios were calculated. Climate data including temperature, precipitation, relative humidity, wind speed, and evapotranspiration were collected. The least significant difference test and one-way analysis of variance were applied to investigate the variability of soil nutrients and elemental stoichiometry among land-use types; the ordinary least squares method and the general linear model were used to illustrate the correlations between soil nutrients, elemental stoichiometry, and soil properties or climate factors and to identify the key influencing factors. Results and discussion: Woodlands had the highest SOM, TN, AN, and AK contents, followed by grasslands, croplands, and shrublands, while the TP and TK contents only varied slightly among land-use types. SOM, TN, AN, N/P, and N/K were strongly negatively correlated to soil pH (p < 0.05) and were strongly positively correlated to soil CEC (p < 0.05). For soil texture, only C/N was moderately negatively correlated to silt content but moderately positively correlated to sand content (p < 0.05). For climate factors, SOM, TN, AN, N/P, and N/K were significantly negatively correlated to evapotranspiration and temperature (p < 0.05), and the correlations were usually moderate. Soil pH explained most of the total variation in soil nutrients, and climate factors explained 5.64–28.16% of soil nutrients and elemental stoichiometry (except for AP (0.0%) and TK (68.35%)). Conclusions: The results suggest that climate factors and soil properties both affect soil nutrients and elemental stoichiometry, and soil properties generally contribute more than climate factors to soil nutrient levels. The findings will help to improve our knowledge of nutrient flux responses to climate change while also assisting in developing management measures related to soil nutrients under conditions of climate change. [ABSTRACT FROM AUTHOR]

Purpose: Without precaution to deal with gas emissions and leachate generation, dumpsites have become a severe environmental problem in many developing countries. The objectives of this study were to investigate the pollution status of polycyclic aromatic hydrocarbons (PAHs) in dumpsite soil in rural areas of China and to verify phytoremediation effectiveness with Sedum alfredii Hance and alfalfa (Medicago sativa L.) under complex pollution conditions in PAH-contaminated soil. Materials and methods: In this study, we collected soil cores from four dumpsites in rural areas of North China (Hebei Province) for analysis, and correspondingly conducted an in situ phytoremediation experiment using Sedum alfredii Hance and alfalfa (Medicago sativa L.) at one of these sites, monitoring the total PAH concentration in soil. Results and discussion: Results showed generally moderate pollution by PAHs in soil samples from dumpsites with pockets of heavy pollution. PAH concentrations in dumpsite soil ranged from 827 to 1101 ng/g (dry weight). High-molecular-weight PAHs were present in higher proportions at oldest dumpsite in operation. Certain molecular ratios of PAHs can be used to diagnose the source of PAHs in soil, and it indicated that the main sources were combustion of domestic coal and biomass, as well as the automobile exhaust and kitchen exhaust. A 17-month in situ phytoremediation experiment resulted in the effective removal of PAHs in the Sedum alfredii and alfalfa plots, with total PAH concentrations decreasing by 82.4% and 81.3%, respectively. Furthermore, PAH concentrations in plants correlated to plant growth conditions. Conclusions: This study indicated that the soils of the dumpsites were generally moderately polluted by PAHs, and some parts of the area were heavily polluted. Both Sedum alfredii and alfalfa absorbed PAHs from soil, and PAH concentrations in these two plants correlated to the growth conditions of the plants. Phytoremediation can effectively be used for PAH removal in open dumpsites. [ABSTRACT FROM AUTHOR]

The two-item generalized anxiety disorder scale (GAD-2) has been investigated in different populations, but with limited evaluation in the Chinese population. This study aimed to validate the diagnostic accuracy of GAD-2 for identifying GAD through a validation study along with an updated meta-analysis. We recruited 694 adults in 2015 from "the Henan Rural Cohort study" where the GAD-7 questionnaire was adopted as the gold standard diagnosis. Receiver operating characteristics (ROC) curve and Cronbach's α were determined. Furthermore, a meta-analysis was conducted to evaluate the effectiveness of the GAD-2. In this study, 37 patients [5.33%; 95% confidence interval (CI): 3.78–7.27%] met the criteria for current GAD. The GAD-2 showed a Cronbach's alpha of 0.806 and an area under the ROC curve (AUC) of 0.954 (95% CI: 0.936–0.968). At a cutoff of 3, GAD-2 had highest Youden's index of 0.845, with a sensitivity of 0.865 and a specificity of 0.980. A total of 13 studies were included in the meta-analysis. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were 0.80, 0.82 and 17.81, respectively, at the optimal cutoff of 3. GAD-2 has acceptable properties for identifying GAD at a cutoff of 3 in the Chinese rural population. • The study aimed to determine the psychometric properties of the GAD-2 questionnaire among a Chinese rural population. • The Chinese version of GAD-2 questionnaire performed very well to screen for GAD with an optimal cutoff of 3. • An additional meta-analysis also validated the diagnostic accuracy of GAD-2 questionnaire for GAD. • Further multi-site studies were encouraged to maximize sample size and promote the generalizability of results. [ABSTRACT FROM AUTHOR]

Background We explored the association between serum uric acid (SUA) and metabolic syndrome (MetS) in Chinese rural adults. Methods A total of 16,577 subjects (6354 men and 10,223 women) were from the RuralDiab study. SUA concentration was measured by the enzymatic colorimetric method. A meta-analysis including 12 eligible studies focused on SUA and MetS was preformed to confirm the findings of the cross-sectional study. Results After adjustment for age, educational level, and other covariates, the odds ratio (ORs) for MetS increased smoothly with the increasing SUA concentration in both sexes ( P for no-linear trend > 0.05). The adjusted ORs of MetS comparing the fourth and firstly quartiles were 3.11 [95% CI: 2.58–3.74] in men and 3.64 [95% CI: 3.22–4.11] in women ( P trend  < 0.001). In continuous analysis, each 1 mg/dl increment in SUA concentration was significantly associated with a 41% increased risk of MetS in men and 62% in women. The meta-analysis validated the positive association between SUA and MetS (pooled OR: Men, 1.80 [95% CI: 1.57–2.07]; Women, 2.46 [95% CI: 1.95–3.12]). Conclusion SUA concentration was positively with the prevalence of MetS in Chinese rural population, and more studies are needed to explore the mechanisms of the relationship. What is already known on this topic? Previous studies have explored the association between serum uric acid and metabolic syndrome, but evidence on the strength and consistency of the association remains uncertain and limited, especially in rural population. In addition, the epidemiological research and meta-analysis on the association have not been reported. What does this study add? The results of this study showed that serum uric acid was significantly associated with metabolic syndrome and its components in Chinese rural population. Furthermore, the findings demonstrated that the significant associations varied across sex. In addition, the results of epidemiological research were similar with the meta-analysis, which demonstrates the credible of the results of the epidemiology research. [ABSTRACT FROM AUTHOR]

Background: The consistency and strength of the relationship between napping duration and type 2 diabetes mellitus (T2DM) remained uncertain, especially in the rural population. The purpose of this study was to explore the relationship between napping duration and T2DM in a Chinese rural population.Methods: A total of 12663 participants (4365 males and 8298 females) were derived from the RuralDiab study in China. Napping duration was obtained through a standardized questionnaire, and was divided into five categories: no napping (reference), 1∼, 31∼, 61∼, and ≥91 min. Fasting blood glucose was measured. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A meta-analysis including seven studies was conducted to validate the result of the RuralDiab study.Results: The crude and age-standardized prevalence of T2DM were 10.31% and 8.14%, respectively. Compared with no napping, the adjusted OR (95%CI) for napping duration ≥91 min was 1.23 (1.05-1.45). A similar relationship was found only in females aged 45-54 years, but not in males and other age group females. In addition, napping duration was associated with T2DM in a positive dose-dependent manner among females aged 45-54 years (P for trend <0.05). The meta-analysis demonstrated this association, and the pooled OR (95%CI) for the longest napping duration compared with no napping was 1.28 (1.22-1.35).Conclusion: Longer napping duration is associated with higher risk of T2DM in the Chinese rural population, and this association varies across gender and age. Further multi-center prospective researches are needed to confirm the relationship and reveal underlying mechanisms. [ABSTRACT FROM AUTHOR]

Calcium leaching is a critical factor in the clogging of leachate collection systems (LCS), a phenomenon that affects landfill stability and operation. The bottom ash (BA) of municipal solid waste (MSW) incineration plants contains large quantities of calcium-based compounds. Landfilling is the main disposal method for BA in China that intensifies the consequences of LCS clogging. The factors influencing BA calcium leaching were investigated using simulated leachate. The results showed that fine BA particles, low pH values, high temperature, and ratios of leachate to BA solids were conducive to calcium leaching. Calcium leaching was found to be higher in actual leachate than in simulated leachate. At pH = 5, the cumulative calcium dissolution ratios (CDRs) were 83.36% and 31.49% after 20 days of leaching in the actual and simulated leachate, respectively; at pH = 6, the values were 50.67% and 12.06%, respectively. The introduction of landfill gas could decrease the calcium dissolution and leaching rates. When the ratio of leachate to BA solid was 20:1 mL/g, the accumulative CDR values were 45.98% (pH = 6) and 5.80% (pH = 8) without landfill gases, and 4.59% (pH = 6) and 0.48% (pH = 8) with landfill gases. These results provide the scientific basis for clogging risk prediction with respect to calcium leaching in the LCS of landfills. BA landfilling in old landfill areas with relatively high leachate pH and low chemical oxygen demand, as well as when leachate mixed with an appropriate amount of landfill gases, could be feasible measures to reduce calcium leaching and further prevent clogging in LCS. • The study investigated impacting factors of Ca leaching from bottom ash in leachate. • Fine particle, low pH, high temperature and L/S ratio were conducive to Ca leaching. • Ca leaching was higher in actual leachate than in acid simulated leachate. • Landfill gas decreased Ca leaching rates from bottom ash in leachate. [ABSTRACT FROM AUTHOR]

Oral ingestion is the main exposure pathway through which humans ingest trace metals in the soil, particularly for children. Metals in different soil particle size fractions may vary in terms of concentration and properties. Urban school/kindergarten soil samples were collected from three cities: Lanzhou in northwest China, Wuhan in central China, and Shenzhen in southeast China. Soil samples were classified according to particle size (<63 μm, 63–150 μm, 150–250 μm, and 250–2000 μm) to estimate the effects of soil particle size on the total content and bioaccessibility of metals (Cd, Cr, Cu, Ni, Pb, and Zn). Based on the results, we assessed whether the standard size <150 μm (containing < 63 μm and 63–150 μm), recommended by the Technical Review Workgroup (TRW) of the Environmental Protection Agency (EPA), and <250 μm (containing < 63 μm, 63–150 μm, and 150–250) recommended by the Bioaccessibility Research Group of Europe (BARGE), are suitable where the largest proportion adhering to hands is the finest soil (<63 μm). The results showed that different metals exhibited different relationships between soil particle size and content and between soil particle size and bioaccessibility. Pb and Zn generally exhibited the greatest bioaccessibility in the coarsest particle sizes (250–2000 μm); whereas the highest Ni bioaccessibility occurred in the finest sizes (<63 μm); the bioaccessibility of other metals did not exhibit any obvious relationships with particle size. When assessing health risks using bioaccessible metal content in the recommended soil particle size ranges (<150 μm and <250 μm) and in finer particles (<63 μm), the results for noncarcinogenic risks to children exhibited no obvious difference, while the actual carcinogenic risks may be underestimated with the use of soil particle size ranges < 150 μm and <250 μm. Therefore, when choosing an optimal particle size fraction to evaluate the health risk of oral soil ingestion, we recommend the use of the bioaccessible metal content in <63 μm soil fraction. • Metal bioaccessibility exhibited different patterns with soil particle size. • Pb and Zn had highest bioaccessibility in the coarsest sizes. • Carcinogenic risk was underestimated when calculated by < 250 or <150 μm soil sizes. • Soil particles <63 μm was recommended to assess health risk by metals. [ABSTRACT FROM AUTHOR]

Objective: The purposes of the present study were to explore independent and interactive associations between night sleep duration, night sleep quality and coronary heart disease (CHD) based on a rural population in China.Methods: A total of 27,935 participants (11,177 men and 16,758 women) were investigated from the Henan Rural Cohort. Information about sleep was assessed by using the Pittsburgh Sleep Quality Index (PSQI). Restricted cubic splines and logistic regression were used to estimate the relationship between night sleep duration and quality with CHD.Result: Among the 27,935 participants, 1506 participants with CHD were identified. Compared with participants with scores lower than 3, the odds ratios (ORs) and 95% confidence intervals (95% CIs) of participants with score of 3-5, 6-8, ≥9 were respectively 1.42 (1.24-1.63), 1.99 (1.70-2.33), and 2.56 (2.13-3.08) with full adjustment of covariates. Compared with night sleep duration of 7 h, men and women who slept less than 5 h were 1.55 (1.11-2.17), 1.12 (0.59-2.12) and 1.80 (1.20-2.68), after being adjusted ORs (95% CIs) of the total. Moreover, the ORs and 95% CIs of CHD increased with the shortening of sleep duration at PSQI score above the highlighted levels.Conclusion: Poor sleep quality and short night sleep duration were all associated with CHD in Chinese rural areas. Moreover, the association was more obvious in women. In addition, the strongest prevalence of CHD was found in short sleepers with poor sleep quality. [ABSTRACT FROM AUTHOR]

Aims: This cross-sectional study aimed to investigate triglyceride level among Chinese elderly population with different diabetic progressions and related factors of triglyceride.Methods: Study participants (≥65years) were recruited from a nationwide cross-sectional surveillance and were divided into four subgroups according to diabetic progression. Their information was obtained via questionnaire and physical examination. Their lipids in fasting serum samples were analyzed.Results: The serum triglyceride levels (mmol/L, mean±SD) were 1.3±0.8 (subgroup of no prediabetes and no DM), 1.5±1.0 (subgroup of prediabetes), 1.6±1.1 (subgroup of newly diagnosed DM) and 1.7±1.1 (subgroup of previously diagnosed DM), respectively. Only one female participant had a higher triglyceride than upper limit for prevention of acute pancreatitis (11.0mmol/L). However, 23.1% of participants and 34.8% of DM participants had higher triglyceride than upper limit for prevention of cardiovascular diseases (1.7mmol/L). Triglyceride level was positively correlated with diabetic progression (rs=0.17, p<0.01). Age, gender, waist-to-height ratio (rather than BMI), systolic pressure, serum total cholesterol and HDL-C levels were statistically correlated with triglyceride level for total participants (R2=0.39, p<0.01).Conclusions: Aggravation of serum triglyceride level was related to diabetic progression in Chinese elderly population. Triglyceride control was unsatisfactory in Chinese elderly population, especially in elderly population with DM. [ABSTRACT FROM AUTHOR]

Previous studies exploring the relationship between dietary potassium and magnesium intake and the risk of type 2 diabetes mellitus (T2DM) have yielded inconsistent results and the lack evidence from rural China. Therefore, we aimed to investigate the association between dietary potassium and magnesium intake and the risk of T2DM in rural China. Data was collected from the Henan Rural Cohort Study in 2017. A validated semi-quantitative food frequency questionnaire assessed dietary potassium and magnesium intake. Logistic regression models were used to calculate odds ratio (ORs) and 95% confidence intervals (CIs) to evaluate the effect of dietary potassium, magnesium and the potassium-magnesium ratio on the risk of T2DM. A total of 38384 individuals were included in the study, and 3616 participants developed T2DM. Logistic regression analysis revealed that the OR (95% CI) of the highest versus dietary potassium and magnesium and potassium-magnesium ratio intakes were 0.67 (0.59, 0.75), 0.76 (0.67, 0.88), and 0.57 (0.50, 0.66), respectively, compared to the subjects with the lowest quartile of intakes. In addition, gender partially influences the relationship between dietary magnesium and T2DM prevalence (P- interaction = 0.042). The group with the highest dietary potassium and dietary magnesium intake had the lowest risk of T2DM, with an OR (95% CI) of 0.63 (0.51-0.77). Dietary potassium and magnesium intake are important modifiable risk factors for T2DM in rural China. Dietary potassium intake > 1.8g/day, dietary magnesium intake > 358.6mg/day and < 414.7mg/day and potassium-magnesium ratio >5.1 should be encouraged to prevent better and manage T2DM., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Aims: Human studies about short-chain fatty acids (SCFAs), the gut microbiome, and Type 2 diabetes (T2DM) are limited. Here we explored the association between SCFAs and T2DM and the effects of gut microbial diversity on glucose status in rural populations., Methods and Results: We performed a cross-sectional study from the Henan Rural Cohort and collected stool samples. Gut microbiota composition and faecal SCFA concentrations were measured by 16S rRNA and GC-MS. The population was divided based on the tertiles of SCFAs, and logistic regression models assessed the relationship between SCFAs and T2DM. Generalized linear models tested the interactions between SCFAs and gut microbial diversity on glucose indicators (glucose, HbAlc and insulin). Compared to the lowest tertile of total SCFA, acetate and butyrate, the highest tertile exhibited lower T2DM prevalence, with ORs and 95% CIs of 0.291 (0.085-0.991), 0.160 (0.044-0.574) and 0.171 (0.047-0.620), respectively. Restricted cubic spline demonstrated an approximately inverse S-shaped association. We also noted interactions of the ACE index with the highest tertile of valerate on glucose levels (P-interaction = 0.022) and the Shannon index with the middle tertile of butyrate on insulin levels (P-interaction = 0.034). Genus Prevotella&#95;9 and Odoribacter were inversely correlated with T2DM, and the genus Blautia was positively associated with T2DM. These bacteria are common SCFA-producing members., Conclusions: Inverse S-shaped associations between SCFAs (total SCFA, acetate, and butyrate) and T2DM were observed. Valerate and butyrate modify glucose status with increasing gut microbial diversity., Competing Interests: Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Purpose: To investigate the association between low-carbohydrate diet scores (LCDs) and the risk of type 2 diabetes in rural China., Methods: A total of 38,100 adults were included in the Henan Rural Cohort Study. Macronutrient intake was assessed via a validated food-frequency questionnaire to create low-carbohydrate diet (LCD) scores. Multivariate logistic regression models and subgroup analysis were performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI)., Results: After multivariable adjustment, participants with a high total low-carbohydrate diet score have a high risk of T2D (extreme-quartile OR = 1.23, 95% CI: 1.04-1.41; P = 0.007), whereas plant-based LCD score is not related to T2D risk. Among individuals with a BMI < 24 (extreme-quartile OR = 1.22, 95% CI: 1.01-1.47; P < 0.001) or high levels of physical activity (extreme-quartile OR = 1.42, 95% CI: 1.17-1.72; P < 0.001), the animal-based LCD score is positively correlated with the risk of T2D., Conclusion: Among Chinese rural populations, high-fat-low carbohydrate diet is associated with an increased risk of type 2 diabetes. High intake of animal protein and fat also increases T2D risk in those who are overweight or have high physical activity., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: High-sodium intake is one of the most important risk factors for hypertension and cardiovascular disease, yet reliable national estimates of sodium intake in Chinese adults have not been reported., Objectives: We estimated 24-h urinary sodium and potassium excretion and population daily sodium and potassium intake of Chinese adults for the first time at a national level., Methods: A nationally representative cross-sectional survey was conducted to collect 24-h urine specimens from Chinese adults aged ≥18 y as part of the China National Nutrition Survey 2015. Finally, 10,114 participants (4932 males and 5182 females) with complete 24-h urine specimens were included in the analysis. Estimates of mean urinary electrolyte excretion and demographic, socioeconomic, and health characteristics were used with weighted coefficients that accounted for sample selection probabilities, poststratification weighting, and nonresponse rates., Results: The estimation of overall weighted mean 24-h urinary sodium excretion was 4121 mg (95% confidence interval [CI]: 3993, 4250), 4155 mg (95% CI: 3993, 4317) in males and 4081 mg (95% CI: 3953, 4209) in females (P for sex difference = 0.36). Overall mean 24-h urinary potassium excretion was 1534 mg (95% CI: 1492, 1577), 1468 mg (95% CI: 1424, 1513) in males and 1614 mg (95% CI: 1569-1660) in females (P for sex difference <0.001). Mean 24-h urinary sodium excretion was significantly higher in rural adults (4350 mg; 95% CI: 4217, 4483) than in urban residents (3909 mg; 95% CI: 3739, 4080; P < 0.001), and in northern residents (4388 mg; 95% CI: 4237, 4539) than in southern residents (3998 mg; 95% CI: 3832, 4163; P = 0.002)., Conclusions: The first nationwide survey with 24-h urine collection confirmed that mean sodium intake in Chinese adults was more than twice the upper limit, whereas mean potassium intake was <60% of the lower limit, recommended by the World Health Organization. Urgent measures should be taken to reduce sodium intake and increase potassium intake in China., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: This study aimed to investigate the geographical distribution of dietary patterns and their association with T2DM among Chinese adults aged 45 years and above., Methods: Data was from the China Adults Chronic Diseases and Nutrition Surveillance (2015). Dietary intake for each participant was determined through a combination of 3-day 24-h dietary recall interviews and food frequency questionnaires. Principal component analysis was used to extract dietary patterns and spatial analysis was employed to investigate the geographic distribution of them. T2DM was diagnosed using criteria of ADA 2018, and binary logistic regression was employed to examine the relationship between dietary patterns and T2DM., Results: A total of 36,648 participants were included in the study; 10.9% of them were diagnosed as T2DM. Three dietary patterns were identified with the name of plant-based pattern, animal-based pattern, and oriental traditional pattern, which were represented located in northern, northwest, and southern regions, respectively. After adjusting for potential confounders, participants in the highest quartile of the plant-based pattern were associated with lower T2DM odds (OR = 0.82, 95% CI: 0.74, 0.90) when comparing with the lowest quartile. However, participants inclined to higher quartiles of animal-based pattern had a higher risk of T2DM (OR = 1.15, 95% CI: 1.04, 1.27) compared with those in the lower quartiles. No significant association was found between the oriental traditional pattern and T2DM (OR = 1.03, 95% CI: 0.93, 1.14)., Conclusion: Dietary patterns of Chinese population revealed geographical disparities, with plant-based dietary pattern showing protective effects and animal-based pattern carrying high risks for T2DM. Regional dietary variations and food environment are paramount in T2DM prevention and management.

Soil quality is essential for maintaining the sustainability of agroecosystems, especially under intensified agricultural activities and rapid land use change. The sampling and analysis of soil properties to assess the status of agricultural land is widely practiced at the field scale; however, the spatiotemporal variations in soil quality and its influencing factors at a large scale remain unclear. Here, we quantified spatiotemporal variations in the soil quality of agricultural land in China during 1980-2018 by using the soil quality index (SQI) area approach, and explored the drivers with a geographical detector method. The results showed that the distribution of the SQI in the two periods had a similar spatial trend, except for that in the southwest (SWC), and the SQI decreased from north to south regardless of land use type. The soil quality of woodland was comparatively good with mean SQI values of 1.55 and 1.53 in 1980 and 2018, respectively, followed by that in grassland and cropland. Soil organic carbon, total nitrogen and cation exchange capacity were the dominant soil indicators explaining the spatial heterogeneity of the SQI in all land uses; moreover, climatic factors (i.e., temperature and precipitation) showed a stronger effect on woodland. From 1980 to 2018, the SQI of grassland decreased deeply, especially in the SWC, which showed a severe decline of 12.5 %. The changes in precipitation and temperature were identified as the largest drivers of SQI temporal changes in woodland and grassland, respectively, and their interaction achieved the highest impact across all land uses. In addition, the bidirectional conversion between cropland and grassland in recent decades has aggravated the deterioration of soil quality. Therefore, quantifying spatiotemporal changes in the SQI and elucidating the role of factors influencing soil quality in agroecosystems can provide a guide for designing sustainable agriculture policies and improving environmental quality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: To investigate the dietary consumption of branched-chain amino acids(BCAAs)intake status of middle-aged and elderly people 50 years and older in China, and to analyze the distribution differences between different ages, genders and regions., Methods: The research sample was derived from the 2015 Chinese adult chronic disease and nutrition monitoring data. The survey adopts the stratified multi-stage cluster random sampling method, and selects 298 monitoring points from 31 provinces(autonomous regions and municipalities), a total of 44 218 people aged 50 years and over were sampled. Condiment weighing method, 24-hour dietary review method, and weighing method were used to obtain individual dietary data, and the dietary BCAAs intake of middle-aged and elderly people was calculated based on the Chinese Food Composition Table., Results: In 2015, the dietary BCAAs of middle-aged and elderly people in China accounted for 45.1% of leucine, 29.8% of valine and 25.1% of isoleucine. The top six dietary sources were cereals, red meat, vegetables, fish and seafood, beans and eggs. There were differences in the intake of three branched-chain amino acids(F=1926.67, P&lt;0.01), the intake of leucine was greater than that of valine, and the intake of valine was greater than isoleucine. There were statistically significant differences in dietary BCAAs intake between different age groups, genders, urban and rural areas and regions(P&lt;0.01), among which men were greater than women(t=12.89, P&lt;0.01), and the south was greater than the north(t=-6.36, P&lt;0.01), the eastern part was larger than the central part, and the central part was larger than the western part(F=82.42, P&lt;0.01). The intake of BCAAs decreased with the increase of age groups(F=22.69, P&lt;0.01), and there was no significant difference in age groups over 70 years old. The dietary intake of BCAAs was higher in the eastern coastal areas and Inner Mongolia, Xinjiang and Tibet., Conclusion: There were gender, age and geographical differences in dietary BCAAs intake among middle-aged and elderly people in China, and the contribution of various foods to dietary BCAAs was also different.

Objective: To investigate the dietary fiber intake status and analyze the relationship between dietary fiber and glucose metabolic disorder of the elderly in China., Methods: Data were collected from the participants of Chinese adult chronic diseases and nutrition surveillance in 2015. General information were collected by standardized questionnaires, anthropometric index and blood pressure of respondents were measured according to standard method. Food intake was collected by three consecutive day 24 h dietary recalls, dietary fiber was calculated through China food composition. Fasting venous blood were collected to measure glucose, HbA1C, and other related biochemical index. Subjects were divided into three groups: normal glucose(NG, normal glucose), pre-diabetes(Pre-DM, pre-diabetes mellitus) and diabetes(T2DM, type 2 diabetes mellitus). Multiple logistic regression model was used to analyze the relationship between dietary fiber intake and Pre-DM as well as T2DM., Results: A total of 20 996 elderly people aged 60 years and above were included. There 10 773 cases were males(51.3%) and 10 223 cases were females(48.7%), the age of both gender were(68.21±6.26) years and(67.67±6.26) years. A total of 6526 cases of pre-diabetes were detected in 20 996 elderly participants with detection rate of 31.1%. There 3274 cases were male and 3252 cases were female, the detection rates of both genders were 30.4% and 31.8%, respectively. While 1572 participants were detected as T2DM(784 of males and 788 of females), the detection rate of T2DM was 7.5%, 7.3% for males and 7.7% for females. There were significant differences in mean age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, TC, TG, HDL-C, LDL-C, HbA1c level among different dietary intake groups(P&lt;0.005). With the increase of dietary fiber intake, the proportion of overweight and obesity, central obesity and dyslipidemia showed an increasing trend(P&lt;0.05), and the proportion of hypertension showed a decreasing trend(P&lt;0.000 1). After adjusting for potential confounding factors, compared to participants with lowest fiber intake, participants in subgroups of lower, minor lower, and higher fiber intake were associated with decreased risk of pre-diabetes, the OR and 95%CI were(OR=0.911, 95%CI 0.835-0.993), (OR= 0.861, 95%CI 0.790-0.938) and(OR= 0.913, 95%CI 0.838-0.994), respectively. However, there was only a statistically significant negative association between the higher intake of dietary fiber and T2DM(OR = 0.848, 95%CI 0.726-0.991)., Conclusion: Dietary fiber intake was negatively related with diabetes and pre-diabetes mellitus. The risk of glucose metabolic disorder was decreased with the increase of dietary fiber intake.

The present study was conducted to investigate the nutrition status of dietary patterns and the association between dietary patterns and the risk of poor glycemic control in Chinese diabetics. The relevant data was collected from the China Nutrition and Health Surveillance 2015-2017 survey, which is a national cross-sectional surveillance program. A total of 2031 participants were included in the present statistical analysis. Food consumption was assessed through a validated and standard food frequency questionnaire. Dietary patterns were derived with reduced rank regression using hemoglobin A1c. Diabetes was diagnosed by medical institutions, glycemic control was defined as hemoglobin A1c less than 7%, poor glycemic control was defined as hemoglobin A1c greater than 7%. A multiple-variable-adjusted logistic regression, including age, living area, income level, educational attainment, body mass index, occupational physical activity, energy intake, current smoking status, current drinking status, diabetic medication use, insulin use, following diabetic diets, increased exercise, and glucose monitoring, was adjusted to explore the association between dietary patterns and the risk of poor glycemic control in diabetes. Two gender-specific dietary patterns have an increased risk of poor glycemic control and are characterized by a low intake of freshwater fish, poultry, and fruits. For male participants, the dietary pattern was characterized by a high intake of wheat and its products, a low intake of vegetables, corn and its products, shrimp and crab, and beans (Q4 vs. Q1, OR = 2.69, 95% CI : 1.76 to 4.10). For female participants, the dietary pattern was characterized by a low intake of snacks and nuts, and algae and mushroom (Q4 vs. Q1, OR = 2.18, 95% CI : 1.48 to 3.20).

The prevalence of metabolic syndrome (MetS) increased dramatically over the past years among adults in a separate province in China; little is known about newly diagnosed MetS in middle-aged and above residents nationwide. We investigated the prevalence of MetS and its components, the dietary patterns, and their relationship among the middle-aged and above population of China by using data from a national cross-sectional survey. General information involving lifestyles and health stations was collected, and dietary intake using a 3-day 24 h dietary recall and weighing method for edible oil and condiments was conducted. Height, weight, waist circumference, and blood pressure were measured, and fasting serum lipids and glucose were tested by trained clinical staff. Dietary patterns were derived from 23 food categories by using cluster analysis, and a multivariate logistic regression model was used to evaluate the odd ratio of MetS and its component across obtained dietary patterns. The estimated prevalence of MetS was 37.1% among 40,909 middle-aged and older participants in the study. Participants were classified into diversity pattern, northern pattern, and southern pattern that, respectively, accounted for 9.8%, 47.2%, and 43.0% of the total. Compared with those inclined to the northern pattern, participants prone to the southern pattern decreased the risk of MetS (OR = 0.81, 95%CI: 0.75- 0.87; p < 0.001), central obesity (OR = 0.70, 95%CI: 0.65−0.76; p < 0.001), and HDL-C (OR = 0.82, 95%CI: 0.76−0.89; p < 0.001), and elevated BP (OR = 0.86, 95%CI: 0.79−0.93; p < 0.001) respectively. However, participants of the southern pattern tended to have a higher risk of elevated glucose; the OR (95%CI) was 1.13 (1.05, 1.22; p = 0.002) after adjusting for potential confounding factors. Greater adherence to diverse dietary patterns was negatively related to the risk of central obesity and elevated blood pressure with an OR (95%CI) of 0.82 (0.71, 0.94; p = 0.005) and 0.77 (0.67, 0.88; p < 0.001), respectively. We concluded that dietary improvement and health promotion for MetS should be based on the district-specific nutritional status of the Chinese middle-aged and elderly population.

Purpose: To investigate the association of sleep duration with type 2 diabetes mellitus (T2DM) in a rural Chinese population., Methods: A 1:1 matched nested case-control study was performed based on a cohort that had been established in rural communities in Henan Province, China. T2DM patients and healthy controls (550 pairs) were included in this study., Results: Abnormal sleep duration significantly increased the risk of T2DM with an approximate U-shaped association (sleep duration ≤ 6 h, OR = 1.742, 95% CI = 1.007-3.011, P = 0.047; sleep duration 8-9 h, OR = 1.462, 95% CI = 1.038-2.060, P = 0.030) compared with participants with a night sleep duration of 7-8 h, after adjusting for multiple confounders. When stratified by gender, only women were sensitive to shorter sleep duration (OR = 2.483, 95% CI = 1.149-5.366, P = 0.021). Abnormal sleep duration (too short or too long) had adverse effects on homeostasis model assessment (HOMA) and blood metabolites, and the effect was more noticeable in people with longer sleep durations., Conclusion: In a rural Chinese population, both too short and too long sleep duration increased the risk of T2DM. Especially women with less sleep duration have a higher risk of T2DM. Abnormal sleep also affects the HOMA index and metabolites; the relationship between HOMA-IR, total cholesterol, and LDL-Cholesterol with sleep duration was U-shaped, while fasting plasma glucose, body mass index, waist circumference, and triglyceride levels increased significantly only with longer sleep duration., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objective: It is not clear whether ideal cardiovascular health (ICH) metrics have an impact on the association between age at menarche and type 2 diabetes (T2DM) in rural postmenopausal Chinese women. Methods: In all, 15,450 postmenopausal women were enrolled from the Henan Rural Cohort study. Logistic regression models and interaction plots were used to analyze associations between age at menarche, ICH metrics and T2DM and interactive effects. Results: Age at menarche was inversely associated with risk of T2DM, with adjusted OR of 1.224, 1.116, 1.00 and 0.971, 0.850 for those with age at menarche ≤13, 14, 15-16 (reference), 17, and ≥18 years, respectively, and each year of delay in menarche age correlated with a 5.1% lower risk of T2DM. Negative interaction effects of age at menarche and number of ICH metrics on the risk of T2DM was observed. Conclusion: Meeting more ICH metrics might attenuate the association between early menstrual age and increased risk of T2DM, implying that meeting a higher number of ICH metrics may be an effective way to prevent T2DM for women of early menarche age., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wu, Bao, Liu, Liao, Kang, Sang, Abdulai, Zhai, Wang and Li.)

Background: The reliability and validity of recalled body shape were unknown in China. This study was conducted to examine the reliability and validity of recalled body shape as well as the responsiveness of obesity classification by recalled body shape among the Chinese rural population., Methods: A total of 166 people from the Henan rural cohort were enrolled. The Spearman's correlation coefficient (SCC), intraclass correlation coefficient (ICC), and Cronbach's α were calculated to assess the reliability and validity of recalled body shape. Additionally, the receiver operator characteristic curve (ROC) was performed to assess the responsiveness., Results: The SCC between the twice recalled body shape ranged from 0.383 to 0.578, and the ICC ranged from 0.357 to 0.615. Besides, the Cronbach's α of the recalled body shape questionnaire was 0.845. At the age of 20-70, the SCC between recalled body shape and actual body mass index (BMI) and waist circumference (WC) ranged from 0.563 to 0.699 and 0.409 to 0.661, respectively. Furthermore, above the age of 20, the area under the curve (AUC) of classifying general obesity and abdominal obesity by recalled body shape ranged from 0.833 to 0.960 and 0.686 to 0.870, respectively., Conclusion: The results indicated that recalled body shape had moderate reliability, validity, and discriminative degree for earlier obesity among the Chinese rural population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Liao, Liu, Kang, Niu, Song, Wang, Wei, Liu, Sun, Mao, Hou, Wang and Li.)

Background: Stroke is the leading cause of death in China, and its burdens are rapidly increasing. The prevalence and control of stroke risk factors among stroke patients in China are unknown., Objective: We investigated the stroke risk factors of stroke patients in China., Design: We examined stroke risk factors in 6580 stroke patients aged 18 years or older in the China National Chronic Diseases and Nutrition Surveillance of Adults (2015-2017). With regard to the basic characteristics of the study participants, categorical variables were described as frequency (percent). The chi-square test was used to analyze the difference between men and women. The multivariate logistic regression model was used in the multivariate analysis., Results: Among the 6580 stroke patients, hypertension was the most common stroke risk factor identified in most cases (78.51%), followed by overweight or obesity (61.58%), dyslipidemia (54.38%), smoking (24.04%), diabetes (21.75%), family history of stroke (17.43%), lack of exercise (16.35%), and atrial fibrillation (4.47%). Drinking stroke patients had a lower rate of hypertension, diabetes, and dyslipidemia. Patients with hyperuricemia had a higher rate of hypertension and dyslipidemia than no-hyperuricemia patients. The hypertension awareness, treatment, and control rates among hypertension stroke patients were 73.62%, 70.19%, and 17.79%, respectively. The diabetes awareness, treatment, and control rates among diabetes patients were 69.74%, 65.83%, and 34.59%, respectively. The dyslipidemia awareness, treatment, and control rates among dyslipidemia patients were 42.37%, 29.4%, and 20.07%, respectively. Among treated hypertension patients, the rates of taking medicine as medically advised, controlled diet, increased exercise, and blood pressure monitoring were 91.31%, 58.88%, 45.78%, and 73.99%, respectively. Among treated diabetes patients, the rates of oral antidiabetic medications, insulin injection, diet control, and blood glucose monitoring were 78.24%, 34.71%, 85.77%, and 78.24%, respectively. Among treated dyslipidemic patients, the rate of taking medicine as medical advice, controlled diet, increased exercise, and regular blood lipid monitoring was 80.61%, 77.57%, 56.46%, and 40.3%, respectively., Conclusions: The most common risk factors for community stroke patients in China are hypertension, dyslipidemia, and overweight or obesity. The stroke community patients' suboptimal awareness and treatment of hypertension, and suboptimal awareness, treatment, and control of diabetes, and dyslipidemia are significant problems in China.

This study aimed to assess the association of dietary fiber intake with serum uric acid (SUA) levels and risk of hyperuricemia (HUA) among Chinese adults using the latest nationally representative data. A total of 66,427 Chinese adults aged 18 years and over from the China Adult Chronic Disease and Nutrition Surveillance in 2015 were included in this study. Dietary intakes were measured with a 3-day 24 h dietary recall and the household condiment weighing method. Mixed-effect linear and logistic regression models were used to evaluate the associations of dietary fiber intake with SUA levels and risk of HUA, respectively. Compared to the lowest intake group, the coefficient and 95% confidence in the highest intake group of total fiber were −0.06 (−0.08, −0.04) (p-trend < 0.001), −0.18 (−0.2, −0.16) (p-trend < 0.001) for cereal fiber, 0.03 (0.01, 0.04) (p-trend = 0.051) for legume fiber, 0 (−0.01, 0.02) (p-trend = 0.869) for vegetable fiber and 0.01 (−0.001, 0.04) (p-trend = 0.296) for fruit fiber. The odds ratio (OR) and 95% confidence interval (CI) of HUA for the highest vs. lowest intake group of total fiber were 0.88 (0.84, 0.91) (p-trend = 0.001), 0.67 (0.63, 0.71) (p-trend < 0.001) for cereal fiber, 1.05 (1, 1.09) (p-trend = 0.248) for legume fiber, 1.01 (0.97, 1.05) (p-trend = 0.982) for vegetable fiber and 1.06 (1, 1.12) (p-trend = 0.264) for fruit fiber. Our findings suggest that consumption of total fiber and cereal fiber were significantly inversely associated with SUA levels and HUA risk among the Chinese adult population. Developing and implementing effective public education programs are urgently needed to increase the intake of dietary fiber, especially cereal fiber among Chinese adults.

Background: The objectives of the present study were to explore the epidemiological characteristics of hypertension among rural older adults in resource-limited regions, and then evaluate the loss of health-adjusted life expectancy due to hypertension., Methods: Participants aged between 60 and 79 years were enrolled from Henan rural cohort study. The prevalence, awareness, treatment, and control of hypertension were detailed across subgroups. Variances within subgroups were identified via Student's t tests or one-way ANOVA for continuous variables and chi-squared tests for categorical ones, and logistic regression model was employed to detect the potential influencing factors. The health-adjusted life expectancy was calculated by the Sullivan method with EuroqOL-5D data., Results: Among 16,785 participants, 7,472 (44.52%) were attacked by hypertension, 4,858 (65.02%) had been already aware of their condition, 4,009 (53.65%) were taking antihypertensive medication for treatment, while only 1,478 (19.78%) had their hypertension controlled. The prevalence of hypertension was significantly higher among women than men and it increased with age for both genders. For the older ones aged 60 years, the life expectancy was 22.0872 years and the health-adjusted life expectancy was 15.5578 and 15.9418 for those with or without hypertension, respectively. Namely, in this particular age group, subjects without hypertension could gain 0.3840 years of health-adjusted life expectancy., Conclusion: The prevalence of hypertension was relatively high while the awareness, treatment, and control were fairly low. The health-adjusted life expectancy of older adults in resource-limited areas could increase from the reduction of hypertension. There is an urgent need for strategies pertaining to the prevention and treatment of hypertension., Clinical Trial Registration: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hu, Liu, Liao, Kang, Ma, Mao, Hou, Huo, Li and Wang.)

Background: The combined effect of sleep quality and night sleep duration on health-related quality of life (HRQoL) remains unclear, especially in resource-limited countries and areas. This study aimed to explore the independent and combined effects of sleep quality and night sleep duration on HRQoL., Methods: A total of 21,926 eligible participants from the Henan rural cohort study were selected. The Pittsburgh Sleep Quality Index was utilized to evaluate sleep quality and night sleep duration. The Tobit regression model, generalized linear model (GLM), and logistic regression model were performed to assess the associations of sleep quality and night sleep duration with HRQoL. The restricted cubic spline was applied to identify the dose-response relationships of sleep quality and night sleep duration with HRQoL., Results: After multivariable adjustment, the Tobit regression and GLM indicated that the regression coefficients [95% confidence interval (CI)] for poor sleep quality were - 0.124 (- 0.133, - 0.114) and - 6.25 (- 6.71, - 5.78) on utility index and VAS score, respectively. Compared with the reference group (7 h-), participants with short sleep duration (< 6 h) or long sleep duration (≥10 h) reported a lower HRQoL. A U-shape relationship between night sleep duration and HRQoL was observed, along with a J-shape relationship between sleep quality and HRQoL (P for non-linear < 0.001). Furthermore, individuals with longer night sleep duration (≥10 h) and poorer sleep quality were strongly associated with lower HRQoL (utility index [odds ratio (OR) (95% CI)]: 6.626 (3.548, 8.920), VAS score [OR (95% CI)]: 2.962 (1.916, 4.578))., Conclusion: Poor sleep quality and extreme night sleep duration were independently and combinedly associated with low HRQoL, suggesting that maintaining good sleep quality and appropriate night sleep duration was important., Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375 ., (© 2022. The Author(s).)

Magnesium is an essential element and participates in many metabolic pathways. Inadequate magnesium levels may lead to various health problems such as type 2 diabetes (T2DM), hypertension, and cancer. But the role of Mg in childbearing women of China is still a relatively narrow researched field. We aimed to assess the Mg nutritional status, explore the risk factors of Mg deficiency, and the associations between Mg and glucose parameters among childbearing women in a nationally representative sample. A total of 1895 18-44 years childbearing women were recruited from the China Adult Chronic Disease and Nutrition Surveillance (2015). Multivariate logistic regression was used to explore the risk factors for Mg deficiency and estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the risk of hyperglycemia. The mean value of Mg was 0.87 mmol/L and the prevalence of deficiency was 4.69%. The risk factors of Mg deficiency (Mg < 0.75 mmol/L) was city-type of rural ( p = 0.045), while calcium ( p = 0.001), LDL-C ( p = 0.024), age group of 26-35 years ( p = 0.016), 36-44 years ( p = 0.006), and CNNM2 rs3740393 genotypes of GC ( p = 0.027) were protective factors. It was also found that magnesium deficiency induces an increase in plasma glucose ( p = 0.001). Compared with the reference range, Mg < 0.75 mmol/L would have a 6.53 fold risk for T2DM, a 5.31 fold risk for glucose-hyperglycemia, and a 9.60 fold risk for HbA1c-hyperglycemia. Consistently, there was a negative association between plasma Mg and blood glucose parameters in the dose-response study. More attention should be paid to the nutritional status of magnesium and the impact of magnesium deficiency on human health.

The purpose of this study was to examine the association between dietary protein intake and the risk of type 2 diabetes mellitus (T2DM) among a Chinese rural elderly population. We used the demographic and dietary information of adults over age 65 in the Henan Rural Cohort Study to identify and pair 950 T2DM patients with healthy controls in a 1 : 1 matched case-control study. Dietary data was collected through a Food Frequency Questionnaire. A multivariate logistic regression model was applied to calculate the odds ratio (OR) and 95% confidence interval (CI) of T2DM risk according to protein intake. After adjustment for confounding factors, higher intake of total protein was negatively associated with T2DM risk in the total population (extreme-tertile OR=0.75, 95% CI: 0.58-0.93) and women (extreme-tertile OR=0.84, 95% CI: 0.47-0.93). Multivariate-adjusted ORs for the risk of T2DM in the highest compared with lowest tertile of plant protein intake in the total population and in women were 0.86 (95% CI: 0.60-0.84) and 0.58 (95% CI: 0.36-0.95), respectively. Our results suggest that the protein intake, especially plant protein, has a significant association with the risk of T2DM in rural elderly populations, and the sources of protein may be also important in future guidelines.

We aimed to investigate the association between dietary patterns and low HDL-C among the elderly population living in North China. The data were from a national cross-sectional survey conducted in 2015. General information in terms of living habits, health status, and food intake using 24 h dietary recall for three consecutive days was procured, and the weight of edible oil and condiments recorded. Anthropometric index, blood pressure, and fasting serum lipids were measured using standard methods. Dietary patterns were derived from food categories by exploratory factor analysis, and multivariate logistic regression was used to estimate the odds ratios of low HDL-C across quartiles of dietary patterns. Among 3387 elderly participants, 21.9% had low HDL-C levels. After adjusting for potential confounding factors, participants with highest score versus lowest score in the balanced dietary pattern had a decreased risk of low HDL-C (OR = 0.38, 95% CI: 0.16-0.88, p for trend = 0.013) in the group with a BMI of 27.1 kg/m 2 and above. Compared to the lowest quartile, there was a statistically significant negative association between the highest scores of the Western dietary pattern and low HDL-C (OR = 0.37, 95% CI: 0.17-0.82, p for trend = 0.018) in the group with a BMI of 21.6-24.8 kg/m 2 . However, greater adherence to a thrifty dietary pattern (highest quartiles vs. lowest quartiles) was associated with increased risk of low HDL-C (OR = 3.31, 95% CI: 1.05-10.40, p for trend = 0.044), especially in the subgroup with a BMI of 21.6 kg/m 2 and below. The study revealed that it is urgent to develop district-specific dietary improvement plans for dyslipidemia based on the nutritional status of the elderly population in North China.

Background: The study aimed to characterize the prevalence of alcohol consumption and further investigate the relationship between alcohol consumption and type 2 diabetes mellitus (T2DM)., Methods: We studied 39,259 participants aged 18 to 79 years of the Henan Rural Cohort study. The associations between alcohol consumption and T2DM were examined using the logistic regression models and restricted cubic spline., Results: For men, alcohol abstinence was associated with an increased risk of T2DM (1.491(1.265, 1.758)), whereas current drinkers were not associated with T2DM (1.03(0.91, 1.15)). Further analysis of alcohol drinkers revealed that only high-risk drinkers of WHO drinking risk levels increased the risk of T2DM (1.289(1.061,1.566)) compared to never drinkers. The risk of T2DM increased as the age of starting to consume alcohol decreased and as the number of years of consuming alcohol and the alcohol intake increased only in men. We further found that the risk of T2DM decreased as the number of years of abstinence increases and no association between alcohol abstinence and T2DM was found after more than 10 years of abstinence among men., Conclusions: Our results suggested that reducing the amount of alcohol consumed and adhering to abstinence from alcohol consumption are beneficial in reducing the risk of T2DM., Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375., (© 2021. The Author(s).)

Background: The study aimed to investigate the independent and combined effects of midpoint of sleep and night sleep duration on type 2 diabetes mellitus (T2DM) in areas with limited resources., Methods: A total of 37,276 participants (14,456 men and 22,820 women) were derived from the Henan Rural Cohort Study. Sleep information was assessed based on the Pittsburgh Sleep Quality Index. Logistic regression models and restricted cubic splines were used to estimate the relationship of the midpoint of sleep and night sleep duration with T2DM., Results: Of the 37,276 included participants, 3580 subjects suffered from T2DM. The mean midpoint of sleep among the Early, Intermediate and Late groups were 1:05 AM ±23 min, 1:56 AM ±14 min, and 2:57 AM ±34 min, respectively. Compared to the Intermediate group, adjusted odds ratios (ORs) and 95% confidence interval (CI) of T2DM were 1.13 (1.04-1.22) and 1.14 (1.03-1.26) in the Early group and the Late group. Adjusted OR (95% CI) for T2DM compared with the reference (7- h) was 1.28 (1.08-1.51) for longer (≥ 10 h) night sleep duration. The combination of late midpoint of sleep and night sleep duration (≥ 9 h) increased 38% (95% CI 10-74%) prevalence of T2DM. These associations were more obvious in women than men., Conclusions: Late and early midpoint of sleep and long night sleep duration were all associated with higher prevalence of T2DM. Meanwhile, midpoint of sleep and night sleep duration might have combined effects on the prevalence of T2DM, which provided potential health implications for T2DM prevention, especially in rural women., Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699 ). Date of registration: 2015-07-06.

Objectives: The study aimed to explore the association between Ideal cardiovascular health (ICH) and health-related quality of life (HRQoL) using the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) among rural population. Methods: This study included 20,683 participants aged 18-79 years from "the Henan Rural Cohort study". Generalized linear and Tobit regression models were employed to explore the associations of ICH with EQ-5D-5L utility scores and visual analogue scale (VAS) scores, respectively. Results: The mean EQ-5D-5L utility scores and VAS scores were 0.962 ± 0.095 and 79.52 ± 14.02, respectively. Comparing with poor CVH participants (EQ-5D-5L utility scores and VAS scores: 0.954 ± 0.111 and 78.44 ± 14.29), people with intermediate and ideal CVH had higher EQ-5D-5L utility scores (0.969 ± 0.079 and 0.959 ± 0.099) and VAS scores (80.43 ± 13.65 and 79.28 ± 14.14). ICH scores were positively correlated with EQ-5D-5L utility scores (0.007 (0.004, 0.009)) and VAS scores (0.295 (0.143, 0.446)), respectively. Conclusions: Higher ICH scores is positive associated with better HRQoL in rural population, which suggests that improvement of cardiovascular health may help to enhance HRQoL among rural population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wu, Liu, Liao, Kang, Sang, Abdulai, Niu, He, Zhai, Pan, Wang and Li.)

Background: Copper and zinc are both essential elements in humans, that play various biological roles in body functions. Population-based reference values have not yet been established in China especially in childbearing women. The aim of this study is to establish a reference value of Zn, Cu and Cu/Zn ratios in childbearing women aged 18-44 from a representative population in China. Method: A total of 191 healthy childbearing women aged 18-44 years old were enrolled from the China Adult Chronic Disease and Nutrition Surveillance (2015) in this study with a series strict inclusion criteria. Basic biological indicators (weight, height, waist, blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein, total cholesterol, triglyceride, fast glycose, HbA1c, blood pressure, uric acid) and elements levels in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Cu, Zn and Cu/Zn ratio. Results: The reference range of Zn, Cu and Cu/Zn ratio in plasma were 70.46-177.53 µg/dL, 74.30-170.68 µg/dL and 0.54-1.68, respectively. The reference range of Zn, Cu and Cu/Zn ratios in whole blood were 402.49-738.05, 74.63-124.52 and 0.13-0.25 µg/dL, respectively. Conclusion: The reference range of Zn, Cu and Cu/Zn ratios in plasma and whole blood of healthy Chinese childbearing women could be used as an indicator to evaluate the status of element deficiency and overload.

Objective: To explore the association between different types of obesity and blood pressure in adolescents aged 12-17 years in eastern China., Methods: Using multi-stage stratified random sampling, a total of 8279 adolescents aged between 12 and 17 years in eastern China were selected as the research objects from the "Nutrition and Health Surveillance for Chinese Children and Nursing Mothers" project from 2016 to 2017. According to BMI and WHtR, the subjects were divided into four types: non-obesity, general obesity, simple abdominal obesity and combined obesity. The normal high blood pressure and high blood pressure of people with different types of obesity were determined according to Blood Pressure Standards for Children at 3-17 Years Old Per Year and Height in China. The relationship between different types of obesity and the prevalence of high blood pressure was analyzed by χ~2 test, analysis of variance, multi-level linear model and multi-level Logistic regression model., Results: The prevalence of high normal blood pressure was 13. 66%(1069), and the prevalence of high blood pressure was 18. 79%(1782) in adolescents aged 12 to 17 years in eastern China. In the non-obese group, the prevalence of high normal blood pressure was 12. 85%(732), and the prevalence of high blood pressure was 13. 79%(999). In the general obesity group, the prevalence of high normal blood pressure was 20. 45%(99), and the prevalence of high blood pressure was 23. 62%(160). In the central obesity group, the prevalence of high normal blood pressure was 6. 95%(32), and the prevalence of high blood pressure was 14. 64%(87). The prevalence of high normal blood pressure was 16. 68%(206), and the prevalence of high blood pressure was 42. 42%(536) in the complex obesity group. The prevalence of high blood pressure(χ~2=8. 05, P&lt;0. 01) the difference was statistically significant. Results of the multi-level model showed that the risk of high blood pressure in central obesity group was significantly higher in girls than in non-obese group(OR=1. 50, 95%CI 1. 12-2. 02). The risk of high normal blood pressure(OR=2. 05, 95%CI 1. 62-2. 58; OR=1. 83, 95%CI 1. 38-2. 42) and high blood pressure(OR=2. 06, 95%CI 1. 59-2. 67; OR=1. 57, 95%CI 1. 15-2. 14) in obese boys and girls were significantly higher than those in non-obese group. The risk of high normal blood pressure(OR=3. 80, 95%CI 3. 19-4. 51; OR=2. 79, 95%CI 2. 30-3. 37), high blood pressure(OR=4. 07, 95%CI 3. 39-4. 88; OR=2. 84, 95%CI 2. 32-3. 46) in both boys and girls with compound obesity was significantly higher than that in the non-obese group., Conclusion: Different types of obesity have varying degrees of correction with different blood pressure levels in adolescents aged 12-17 years, combined obesity has the highest risk of elevated blood pressure.