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Objectives: To explore obesity prevalence and its association with dietary patterns among Tibetan pastoralists during the urbanization transition in Qinghai Province. Methods: Using an open cohort study design, 1 003 subjects were enrolled at baseline in 2018, 599 were followed up, and 1 012 were newly recruited in 2022. A total of 1 913 adults over 18 years were included in the study, and a questionnaire survey and health examination were conducted. Factor analysis was used to identify dietary patterns, and a mixed-effects model was used to analyze the association between dietary patterns and obesity. Results: From 2018 to 2022, the prevalence rates of overweight, obesity, and central obesity were 27.6%, 33.8%, and 54.6%, respectively. Age-sex-standardized prevalence of obesity and central obesity increased. Three dietary patterns were identified: the modern pattern was characterized by frequent consumption of pork, poultry, processed meat, fresh fruits, sugary drinks, salty snacks, etcetera; the urban pattern was characterized by frequent consumption of refined carbohydrates, beef and mutton, vegetables and eggs, etcetera; and pastoral pattern featured frequent consumption of tsamba, Tibetan cheese, buttered/milk tea, and whole-fat dairy products. After adjusting for demographic characteristics, socioeconomic status, and lifestyle factors, compared with the T 1 , subjects in the T 3 of urban pattern scores were more likely to be overweight ( OR =2.09, 95% CI : 1.10-3.95) and overweight/obese ( OR =1.23, 95% CI : 1.00-1.51), whereas those in the T 3 of pastoral pattern scores had a lower risk of overweight ( OR =0.45, 95% CI : 0.24-0.84), obesity ( OR =0.81, 95% CI : 0.69-0.95), overweight/obesity ( OR =0.75, 95% CI : 0.61-0.91) and central obesity ( OR =0.58, 95% CI : 0.38-0.89). Conclusions: Prevalence of obesity and central obesity was high among Tibetan pastoralists during the urbanization transition. Urban dietary pattern was a risk factor for overweight and overweight/obesity, whereas pastoral dietary pattern was a protective factor for overweight, obesity, overweight/obesity, and central obesity. Tailored interventions are needed to improve local people's health.

Objective: To study the prevalence and associated factors of metabolic syndrome (MS) among Tibetan pastoralists in transition from high altitude nomadic to settled urbanized environment, especially dietary factors. Methods: The community-based cross-sectional study included 920 Tibetan adults (men 419, women 501). Data were collected using questionnaires, anthropometric measurements, and biomarker tests. Questionnaires included socio-economic, lifestyle characteristics and food consumption. Principal component analysis was used to identify dietary patterns. The risk factors of MS and its components were analyzed by logistic regression model. Results: The prevalence rates of MS and its components were 32.8% (MS), 83.7% (decreased HDL-C), 62.1% (central obesity), 36.7% (elevated blood pressure), 11.8% (elevated TG), and 7.9% (elevated blood glucose), respectively. The prevalence of overweight was 31.2%, obesity 30.3%. Multivariate analysis showed smoking was associated factor for both of decreased HDL-C ( OR =1.239, 95% CI : 1.025-1.496) and elevated TG ( OR =1.277, 95% CI : 1.038-1.571). Alcohol drinking appeared as associated factor of elevated TG ( OR =1.426, 95% CI : 1.055-1.927). However, physical activity showed as a protective factor for central obesity, decreased HDL-C, and elevated TG. With the increase of age, the adherence to the urban and western dietary patterns decreased, and that to the pastoral dietary pattern increased. By quintiles of dietary pattern scores, the urban dietary pattern was significantly associated with MS (trend test P =0.016). Conclusions: Tibetan pastoralists had high prevalence of both MS and obesity. Smoking, alcohol drinking, the transition from pastoral dietary pattern to urban dietary pattern and inadequate physical activity served as associated factors for MS and its components.

Objective: To understand the ecological behaviors of Anopheles pseudowillmori and A. willmori in medium or high altitude areas of Motuo County, Tibet Autonomous Region, and their transmission potential for malaria., Methods: The methods of human net traps, cow baited trap, house baited trap, pig baited trap and CDC light traps were adopted for investigating the mosquito density, biting activity at night and in or out door preference of biting. All mosquitoes morphologically identified as A. maculatus group were labeled in accordance with the capture time, place and method, and PCR were used to identify the species. The resting habits were investigated with the morning capture and daytime collecting methods, and the larvae collected in different wa- ter bodies were reared to adults to study the breeding place., Results: A total of 1,053 A. maculatus group were collected, and of which, 331 (31.43%) were identified as A. pseudowillmori, and 722 (68.57%) as A. willmori. The number of A. willmori were higher than A. pseudowillmori in both outer and inner doors (P < 0.01, P < 0.05) , while no statistically significant difference was found of the constituent ratio of the anopheles between outer and inner doors. The multiparous ratios of A. pseudowillmori and A. willmori were 65.90% and 69.86%, respectively, (P > 0.05). The A. pseudowillmori preferred to biting outer doors (P < 0.05), while A. willmori preferred both outer and inner doors (P > 0.05). Both mosquitoes had one biting activity peak in the night, and the biting activity peak of A. willmori was from 21 to 22 o'clock, while the peak of A. pseudowillmori was from 24 to next morning 1 o' clock., Conclusion: In the Anopheles, the constituent ratio and density of A. willmori are higher than those of A. pseudowillmori in semi-high altitudes area of Motuo County, Tibet, and there are obvious differences of ecological behaviors between A. willmori and A. pseudowillmori, and A. willmori has the more capacity of transmitting malaria than A. pseudowillmori.

Objective: To investigate Anopheline species in Chayu County of Linzhi Prefecture, Tibet., Methods: Four natural villages in Chayu County were selected in this study in 2010. The methods of overnight/semi-overnight trapping indoor and outdoor human-bait, and overnight trapping with light traps were used, and all the Anopheline mosquitoes were confirmed by morphological characteristics., Results: Totally 2 991 Anopheline mosquitoes were captured, with 76.36% (2 284/2 291) of An. peditaeniatus, 22.30% (667/2 291) of An. maculates group. The average densities of An. peditaeniatus by semi-overnight trapping were 56.2/per person indoor and 4/per person outdoor respectively, and the average densities of An. maculatus group by semi-overnight trapping were 17.8/per person indoor and 17.9/per person outdoor respectively. The man-biting rates of An. peditaeniatus by overnight trapping were 28.1/per person indoor and 2/per person outdoor respectively, and were both 8.9/per person to An. maculatus group., Conclusion: An. peditaeniatus and An. maculatus group are the possible transmission vectors of malaria in Chayu County.

Objective: To make an epidemiological investigation on malaria in Motuo County, Linzhi Prefecture of Tibet., Methods: In July of the year 2006, the following activities were conducted in 2 selected villages from each of the three townships, i.e., Motuo, Dexing and Beibeng: malaria history survey among inhabitants in recent 2 years; collection of blood samples of inhabitants for examining malaria parasites, IFAT and detecting G6PD, respectively; mosquito collection in human dwellings and cattle shelters at night and various resting sites at day-time; mosquito collection by outdoor human baiting capture; classification and composition calculation of mosquito species and man biting rates; ELISA for detecting sporozoite infection of Anopheles., Results: The mean rate of two-year malaria history was 8.98% (118/1314) and the parasite rate was 3.13% (38/1216, all P. vivax) in the inhabitants. The parasite positive rate among the feverish patients was 7.14% (3/42). IFAT revealed a malaria antibody rate of 40.24% (472/1173). The G6PD deficiency rate was 1.74% (21/1208). Five hundred and thirteen anopheline mosquitoes were caught. They were An. maculatus (474) which occupied 92.4% (474/513), An. peditaeniatus (35), An. kochi (3) and An. sinensis (1). The mean indoor density of An. maculatus was 4.75/night in human houses, and 69.5/night in cattle shelters. The outdoor human biting rate was 22.75/half-night/person, and the sporozoite rate of An. maculatus in anopheline saliva glands was 0 by ELISA., Conclusion: Motuo County is an endemic area of vivax malaria with An. maculatus as the potential vector.