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Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Background: Micronutrients play a key role in type 2 diabetes mellitus (T2DM), but methodological difficulties arise from their collinearity and interdependencies with foods. The aim of the present study was to identify micronutrient dietary patterns in the E3N‐EPIC (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort and to investigate their association with risk of T2DM. Methods: Principal component analysis was used to identify micronutrient patterns among 71 270 women from the E3N‐EPIC cohort. Associations between micronutrient patterns and risk of T2DM were quantified by hazard ratios (HRs) and 95% confidence intervals (CIs) from Cox proportional hazards regression models, adjusted for potential confounders. Results: Six micronutrient patterns were identified explaining 78% of the total variance in micronutrient intake. A positive association was found between T2DM and a pattern highly correlated with intake of vitamins B2 and B5 (HR 1.34; 95% CI 1.16–1.56). Similarly, a positive association was found with a pattern characterized by high intakes of vitamin B12 and retinol, and a low intake of vitamin C (HR 1.30; 95% CI 1.15–1.48). An inverse association was observed between T2DM and another two patterns: one correlated with magnesium and vitamin B3 (HR 0.75; 95% CI 0.66–0.86), and the other correlated with manganese intake (HR 0.82; 95% CI 0.72–0.94). Conclusions: The findings of the present study identify micronutrients that have an effect on the risk of T2DM, and enable better understanding of the complexity of the diet when investigating the association between micronutrients and T2DM. [ABSTRACT FROM AUTHOR]

Abstract: Background: Inexpensive and easily measured indices are needed for the early prediction of type 2 diabetes mellitus (T2DM) in rural areas of China. The aim of this study was to compare triglyceride glucose (TyG), visceral adiposity (VAI), and lipid accumulation product (LAP) with traditional individual measures and their ratios for predicting T2DM. Methods: Data for 11 113 people with baseline normal fasting glucose in a rural Chinese cohort were followed for a median of 6.0 years. Cox proportional hazards regression was used to calculate covariate‐adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) and receiver operating characteristic analysis was used to compare the ability of traditional measures and TyG, VAI, and LAP at baseline to predict T2DM at follow‐up. Results: Among individual measures, fasting plasma glucose (FPG) and waist circumference (WC) were strongly associated with T2DM. Of all lipid ratios, an elevated triglycerides (TG) to high‐density lipoprotein cholesterol (HDL‐C) ratio was associated the most with T2DM. Compared with the first quartiles of TyG, VAI, and LAP, their fourth quartiles were associated with T2DM for men (aHR 3.54 [95% CI 2.08–6.03], 2.89 [1.72–4.87], and 5.02 [2.85–8.85], respectively) and women (6.15 [3.48–10.85], 4.40 [2.61–7.42], and 6.49 [3.48–12.12], respectively). For predicting T2DM risk, TyG, VAI, and LAP were mostly superior to the TG:  HDL‐C ratio, but did not differ from FPG and WC. Conclusions: Prediction of T2DM was not improved by TyG, VAI, and LAP versus FPG or WC alone. Therefore, TyG, VAI, and LAP may not be inexpensive tools for predicting T2DM in rural Chinese people. [ABSTRACT FROM AUTHOR]

Background Low-density lipoprotein receptor-related protein 5 ( LRP5) plays an important role in glucose and cholesterol metabolism. The present cohort study evaluated associations of LRP5 variants with the incidence of type 2 diabetes mellitus ( T2DM) in a rural adult Chinese population. Methods In all, 7751 subjects aged ≥18 years without T2DM underwent genotyping at baseline; 6326 subjects (81.62%) were followed-up, and 5511 with a clear disease outcome were eligible for analysis. The same questionnaire was administered and the same anthropometric and blood biochemical examinations were performed at baseline and follow-up. Association analysis was performed for five single nucleotide polymorphisms and haplotypes of LRP5. Results Cox proportional hazards testing of three different genetic models found no significant association between T2DM and LRP5 after adjusting for potential risk factors ( P > 0.05). However, the incidence of T2DM in subjects with LRP5 mutational genotypes was higher in the overweight/obese than normal weight population. Under the dominant model, the risk of T2DM was increased with an interaction between rs11228303 and the waist-to-height ratio adjusted for baseline age, sex, and family history of T2DM (synergy index [ SI] = 4.172; 95% confidence interval [ CI] 1.014-17.166)], and body mass index ( SI = 3.237; 95% CI 1.102-9.509). Furthermore, the A allele of rs3758644 was related to decreased fasting plasma insulin and homeostatic model assessment of β-cell function levels, whereas the T allele of rs12363572 was related to increased high-density lipoprotein cholesterol levels in new-onset diabetes patients ( P < 0.05). Conclusions The risk of T2DM may be associated with interactions between the LRP5 gene and overweight and obesity. Polymorphisms of LRP5 are related to β-cell function and lipid metabolism. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) infection is a global public health issue, especially in the Asian-Pacific region. At present, entecavir, tenofovir, and pegylated interferon are the first-line antiviral drugs recommended by related guidelines for the prevention and treatment of hepatitis B; however, different national/regional policies, economic level, coverage of health insurance, and medical level have caused the difference in antiviral regimens. Therefore, we have established a long-term follow-up cohort of hepatitis B to evaluate the efficacy of different treatment regimens, in order to improve the cure rate of hepatitis B and reduce the incidence rates of liver cirrhosis, liver cancer, and end-stage liver disease. Real-world data from cohort study help to understand the differences between guidelines and clinical practice, provide a reference for HBV guidelines, and balance clinical effect and cost-effectiveness. [ABSTRACT FROM AUTHOR]

To evaluate whether serum complement C3 concentration was associated with the prevalence and incidence of prediabetes in an adult population. Methods A cross-sectional (n=10 539) and prospective cohort (n= 3 064, followed up for -6 years, mean: 2.8 y) study was performed on subjects recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin. Measurements of serum C3 concentration, blood fasting glucose and other potential confounding factors were assessed at baseline and per year during the follow-up period. Prediabetes was defined according to the criteria of American Diabetes Association. Adjusted Logistic and Cox proportional hazards regression models were used to assess the associations between C3 quintiles and prediabetes. Results The prevalence and incidence of prediabetes were 19.9% and 99.5 per 1 000 person- year, respectively. In cross- sectional analysis, after adjusted for potential confounders, the odds ratios (95% confidence interval) of prediabetes for increasing quintiles of C3 were 1.00 (reference), 1.18 (0.98-1.42), 1.11 (0.92-1.34), 1.38 (1.15-1.65) and 1.63 (1.36-1.95) (P for trend <0.000 1). In cohort analysis, in the final multivariate models, the hazard ratios (95% confidence interval) for prediabetes across C3 quintiles were 1.00 (reference), 1.20 (0.94-1.54), 1.48 (1.16-1.88), 1.38 (1.09-1.76) and 1.53 (1.21-1.95) (P for trend < 0.001), respectively. Conclusion The study suggests that the elevated C3 level is significantly associated with the prevalence and incidence of prediabetes, which means that C3 can be used as a biomarker in early prevention of prediabetes and diabetes. [ABSTRACT FROM AUTHOR]

Objective It has been reported by some prospective studies that C-reactive protein (CRP) is associated with cancer risk. However, the correlation between CRP and digestive system cancers has not been evaluated in Chinese females. We conducted a large population-based cohort study to investigate whether elevated level of CRP in serum is associated with an increased risk of digestive system cancers in Chinese women. Methods From the Chinese Kailuan Female Cohort, 19,437 women were enrolled in this study in July 2006, and all of the subjects were followed up through 2014. At the baseline investigation, the serum levels of high-sensitivity CRP (hsCRP) were tested for all subjects, and demographic information and risk factor data were collected. Multivariate Cox proportional hazards regression model was used to calculate the hazard ratios (HR) and 95% confidence intervals (95% CI) for the haseline levels of hsCRP after adjusting for age, marital status, smoking, drinking, hody mass index (BMI), diabetes and physical activity, and risk of digestive system tumors (including colorectal cancer, stomach cancer, pancreas cancer, liver and gallbladder cancer, and other cancers). Results By Dec 31, 2014, a total of 100 incident cancer cases were observed, including 47 colorectal cancers, 17 stomach cancers, and altogether 29 pancreas, liver and gallbladder cancers. All the subjects investigated were divided into three groups according to the level of hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L). The 8-year cumulative incidence of digestive system cancers were 405/100 000, 520/100 000 and 787/100 000 in these 3 groups, respectively (Log rank test X2 = 8.37, P= 0.015). Compared to those with lower hsCRP levels (<1 mg/L), the women with higher hsCRP ( >3 mg/L) had a significantly increased risk of pancreas, liver and gallbladder cancers (HR = 2.70, 95% CI = 1.06-6.91 ;Plnml = 0.036). Conclusions Elevated levels of hsCRP at baseline may be associated with increased risk of certain digestive system cancers. [ABSTRACT FROM AUTHOR]

Objective To evaluate the 15 years changing trends of prevalence of high risk HPV (HR-HPV) infection and the risks of cervical cancer and precancerous lesions (CIN2+) among a Chinese rural population. Methods The screening cohort with 1 997 women aged 35 to 45 years old was built in 1999 in Xiangyuan County，Shanxi province (SPOCCS-I) and followed up by cytology and HR-HPV testing in the years of 2005， 2010， and 2014. The changes of HR-HPV prevalence and the risks of cervical precancerous lesions with CIN2+ as the endpoints were analyzed during the past 15 years. Results The detection rates of HPV infection and CIN2+ were 15.7%-22.3% and 1.1%-4.3% for the baseline visit and the other 3 follow-ups，respectively. The cumulative risk of CIN2+ in HR-HPV positive women at baseline was significantly higher than HR-HPV negative women ( P<0.01) during the 15-year follow-up. The risk of CIN2+ in the four-times HPV positive group was 40.0%, while the group with four-times negative HPV results was 0.6% (Adjusted RR = 55.0, 95% Cl： 11.3 to 268.4). Conclusions The prevalence of HR- HPV infection and CIN2+ lesions were high in Xiangyuan county during the 15 years. HR-HPV positivity elevated the risk of CIN2+ compared to women whose HR-HPV test was negative. The risks of CIN2+ incidence in 6 years were low among women with negative HR-HPV test. The risk of CIN2+ increased with the numbers of HPV infection events. The screening interval could be extended to 5-6 years. [ABSTRACT FROM AUTHOR]

Objective To explore the association between the count of lymphocyte and the occurrence of metabolic syndrome(Mets) in a cohort study in male and female Beijing adults specifically in gender. Methods Clinical data of7 489 cases who took at least 3 health examination from 1st January 2007 to 31th December 2012 were retrospectively analyzed in Beijing Electric Power Hospital and Beijing Xiaotangshan Hospital. The count of lymphocyte of research objects was obtained from the blood routine examination. And the lymphocytes were divided into 4 levels according to the quartile( Q1≤25%,Q2: 25%-50%,Q3: 50%-75%,Q4 > 75%) in gender. Metabolic syndrome was diagnosed by the last data of health examination. Generalized estimating equation model was used to assess the relationship between metabolic syndrome and the lymphocyte. Results During the 5 years’ follow-up,378 cases appeared Met S,including 203 males and 175 females. And the incidence density of Mets was 12. 67 per 1000 person-years. Compared with Q1,the males’ BMI increased in Q4( RR = 2. 200 8,95% CI: 1. 090 8-2. 045 7),and the males’ TG increased in Q1,Q2 and Q3( RR = 1. 208 4,1. 442 5,1. 707 7,95% CI: 1. 032 3-1. 414 6,1. 210 3-1. 7192,1. 406 5-2. 073 5). Compared with Q1,the females whose lymphocytes were Q4 increased the risk of Met S( RR = 2. 200 8,95% CI: 1. 221 9-3. 964 0). Conclusions The increase of males’ lymphocytes may associate with the increase of BMI and TG,and the increase of females’ lymphocytes may associate with the occurrence of MetS in Beijing adults. [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to estimate the incidence of type 2 diabetes (T2D) and the number of diabetes events attributable to abdominal obesity in China. Methods A cohort study was conducted in a sample of 24 996 Chinese adults aged 35-74 years, with 19.9% of subjects lost to follow-up. Waist circumference ( WC) was measured at baseline in 1998 and 2000-01, and abdominal obesity was defined as WC ≥ 90 cm in men and ≥80 cm in women. Information on incident diabetes was collected during follow-up in 2007-08. We estimated the number of T2D events attributed to abdominal obesity using confounder-adjusted population-attributable risk, incidence of diabetes, and the population size of China in 2010. Results After a mean follow-up of 8.0 years, the age-standardized incidence of T2D was 9.6 and 9.2 per 1000 person-years in men and women, respectively. Abdominal obesity accounted for 28.1% (95% confidence interval [ CI] 14.8%, 40.5%) of incident diabetes among men and 41.2% (95% CI 28.3%, 52.6%) among women using the diagnostic criteria of abdominal obesity recommended by the International Diabetes Federation. We estimated that, in 2010, 2.4 (95% CI 1.5, 3.2) million diabetes events were attributable to abdominal obesity: 1.0 (95% CI 0.5, 1.4) million in men and 1.4 (95% CI 1.0, 1.8) million in women. Conclusions Abdominal obesity is a major risk factor for T2D. Strengthening programs and initiatives for preventing and controlling obesity focusing on lifestyle changes should be a priority in the national strategy to reduce diabetes burden in China. [ABSTRACT FROM AUTHOR]

目的：探究并描述环卫工人所从事职业环境与其胸部X线片影像学表现的关系。方法选择2012~2014年在成都市第六人民医院体检的2534例患者胸部X线片临床资料，根据3年内是否暴露在城市街道的工作环境中将其分为暴露组1156例，非暴露组1378例。采用历史性队列研究方法分析暴露组与非暴露组人员的胸部X线片影像学表现差异。结果暴露组与非暴露组在肺纹理增多、肺纤维灶胸膜增厚、肺气肿、肺部占位等影像学改变有明显差异，且相对危险度关联强度为6.66。结论从事粉尘清扫工作的环卫工人或长期暴露于有害环境的人员与胸部的影像学表现有一定相关性，各级政府卫生行政部门应加强环卫工人职业危害的宣传教育，提高对职业病危害的认识，并制定相关管理规定，做好环卫工人的职业防护工作。 [ABSTRACT FROM AUTHOR]

目的 系统评价质子泵抑制剂(PPI)使用与胃底腺息肉发病的关系. 方法 计算机检索CBM、CNKI、WANFANG Data、VIP Data、PubMed、Embase数据库中PPI使用与胃底腺息肉发病关系的相关文献,检索时间截至2015年2月20日. 由2名研究者根据纳入标准与排除标准独立筛选文献,采用纽卡斯尔-渥太华量表标准评价纳入文献质量,运用RevMan5.3及STATA11.0软件进行Meta分析. 结果 共纳入6个队列研究,研究对象34 701例,其中胃底腺息肉1 513例. Meta分析结果显示,PPI使用与胃底腺息肉的发病存在关联(RR=2.46,95% CI为1.37~4.43,P<0.01);亚组分析显示,PPI服用1年以上者胃底腺息肉发生率高于不足1年者(RR=3.12,95%为CI为1.72~5.67,P<0.05);且随着PPI服用时间延长,二者相关性有增加趋势. 敏感性分析表明,本Meta分析结果稳定可靠,Egger检验提示可能存在发表偏倚. 结论 PPI使用可能与胃底腺息肉发病有关. [ABSTRACT FROM AUTHOR]

Background Population-based data for diabetic hand syndrome (DHS) are limited. The aim of the present epidemiological study was to estimate the overall and cause-specific prevalence and rate ratio (RR) of DHS in patients with diabetes. Methods The present study was a cross-sectional study based on a random sample of 57 093 diabetics and matched controls, both identified from Taiwan National Health Insurance claims in 2010. The DHS analyzed in the present study included carpal tunnel syndrome (CTS), stenosing flexor tenosynovitis (SFT), limited joint mobility (LJM), and Dupuytren's disease (DD). Results The prevalence of overall DHS was estimated at 2472 per 105 for the diabetics, compared with 1641 per 105 for the controls, representing a prevalence RR of 1.51 (95 % confidence interval [CI] 1.39-1.64). Stratified analyses further revealed that the significantly increased prevalence of overall DHS was more evident in females than males (1.59 vs 1.36) and was only noted in diabetics aged ≥35 years. Cause-specific analysis suggested that patients with diabetes had the highest prevalence of CTS (1244 per 105), followed by SFT (1209 per 105), LJM (39 per 105), and DD (6 per 105). In addition, diabetes was only significantly associated with CTS (RR 1.34; 95 % CI 1.20-1.51) and SFT (1.74; 95 % CI 1.54-1.97). Conclusion The prevalence of overall and certain cause-specific DHS was significantly elevated in patients with diabetes in Taiwan. [ABSTRACT FROM AUTHOR]