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Xueyu Li,1,* Kaushik Chattopadhyay,2,* Xiaoting Chen,3 Jialin Li,1 Miao Xu,1 Xueqin Chen,4 Li Li1 1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China; 2Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK; 3School of Medicine, Ningbo University, Ningbo, People’s Republic of China; 4Department of Traditional Chinese Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China*These authors contributed equally to this workCorrespondence: Li Li, Email lilyningbo@163.comAim: The study aimed to investigate the association between physical activity and arterial stiffness in patients with type 2 diabetes mellitus (T2DM) in Ningbo, China.Methods: A cross-sectional study was conducted using the Metabolic Management Center (MMC) dataset of The First Affiliated Hospital of Ningbo University from 1st March 2018 to 28th February 2023. 4444 adults with T2DM were included in the study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ)-Short and was categorized into high, moderate, and low. Arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥ 1800cm/s or common carotid artery intima-media thickness (CCA IMT) ≥ 1mm. Multiple logistic regression analyses were performed to identify the association between physical activity and arterial stiffness.Results: 6.5%, 47.0%, and 46.5% of patients with T2DM had high, moderate, and low physical activity, respectively. 18.8% and 17.5% of patients had arterial stiffness based on baPWV and CCA IMT, respectively. The odds of arterial stiffness (based on baPWV) were lower in patients having moderate to high physical activity (OR 0.82, 95% CI 0.68 to 0.98 and OR 0.58, 95% CI 0.39 to 0.87, respectively). The odds of arterial stiffness (based on CCA IMT) were found to be lower in patients having high physical activity (OR 0.49, 95% CI 0.33 to 0.74).Conclusion: Higher physical activity was found to be associated with lower arterial stiffness in patients with T2DM in Ningbo, China. This was a cross-sectional study, and there is a need to conduct longitudinal studies on this topic.Keywords: type 2 diabetes mellitus, physical activity, arterial stiffness, China

Miao Xu1 *, Kaushik Chattopadhyay2 *, Xingjun Qian,3 Jialin Li,1 Xueyu Li,1 Jing Sun,4 Li Li1 1Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China; 2Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; 3Health Management Center, Ningbo First Hospital, Ningbo, People’s Republic of China; 4School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia*These authors contributed equally to this workCorrespondence: Li Li, Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China, Tel +8613757426626, Email lilyningbo@163.comAim: The study aimed to investigate the association between the nocturnal sleep duration and five obesity indicators, namely, visceral fat area (VFA), subcutaneous fat area (SFA), bodyweight, body mass index (BMI) and waist circumference (WC), among people with type 2 diabetes mellitus (T2DM) in Ningbo, China.Methods: A cross-sectional study was conducted using the National Metabolic Management Centre (MMC) - Ningbo First Hospital data from 1st March 2018 to 28th February 2021. Adults with T2DM were included in the study. Simple and multiple (adjusted for sociodemographic and lifestyle factors and health conditions) linear regression analyses were performed to identify the associations.Results: In terms of VFA, SFA, bodyweight, BMI and WC, the eligibility criteria were satisfied by 2771, 2771, 2863, 2863 and 2862 patients, respectively. In the unadjusted model, the shorter nocturnal sleep duration was associated with higher VFA, SFA, bodyweight, BMI and WC. In other words, an hour increase in the nocturnal sleep duration was associated with a decrease of 2.07 cm2 in VFA (regression coefficient = − 2.07; 95% CI = − 3.25 to − 0.88), 2.67 cm2 in SFA (− 2.67; − 4.55 to − 0.78); 0.82 kg in bodyweight (− 0.82; − 1.2 to − 0.43), 0.2 kg/m2 in BMI (− 0.2; − 0.31 to − 0.09) and 0.46 cm in WC (− 0.46; − 0.76 to − 0.16). In the adjusted models, the shorter nocturnal sleep duration was still found to be associated with higher VFA, SFA, bodyweight, BMI and WC (except SFA and WC in models where we further adjusted for health conditions).Conclusion: The nocturnal sleep duration among people with T2DM in Ningbo, China is negatively associated with visceral and general obesity indicators (VFA, bodyweight and BMI). Thus, there is a need for appropriate interventions to address the issue of sleep deprivation.Keywords: type 2 diabetes mellitus, nocturnal sleep, obesity, China

Xueyu Li,1,2,* Kaushik Chattopadhyay,3,* Xingjun Qian,4 Jingjia Yu,1 Miao Xu,1 Li Li,1 Jing Sun,5,6 Jialin Li1 1Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, People’s Republic of China; 2Medical School, Ningbo University, Ningbo, People’s Republic of China; 3Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK; 4Health Management Centre, Ningbo First Hospital, Ningbo, People’s Republic of China; 5School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia; 6Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia*These authors contributed equally to this workCorrespondence: Jialin Li; Jing Sun, Email lijialin@sina.com; j.sun@griffith.edu.auPurpose: Type 2 diabetes mellitus (T2DM) can lead to microvascular complications including diabetic kidney disease. Albuminuria is an important marker to diagnose kidney injury in T2DM patients and healthy sleep duration is important for maintaining good health in patients with T2DM. However, the association between sleep duration and albuminuria in T2DM patients is unclear. Thus, this study aimed to investigate the association between sleep duration and albuminuria in patients with T2DM in Ningbo, China.Methods: A cross-sectional study was conducted at National Metabolic Management Centre (MMC) - Ningbo First Hospital from March 2018 to February 2021. Adult patients with T2DM were included in the study. The sleep duration (daytime and nocturnal) was self-reported. Albuminuria was defined as the presence of urinary albumin-creatinine ratio ≥ 30 mg/g. Logistic regression analyses were performed to identify the association.Results: There were 2688 T2DM patients in the study. In the unadjusted model (1), the odds of albuminuria increased with the daytime sleep duration (31– 60 minutes: OR 1.36, 95% CI 1.09– 1.71; ≥ 61 minutes: 1.73, 1.33– 2.24). Similarly, after adjusting for age and sex (model 2), the odds of albuminuria increased with the daytime sleep duration (31– 60 minutes: 1.34, 1.07– 1.68; ≥ 61 minutes: 1.69, 1.30– 2.20). After adjusting for age, sex, physical activity, smoking, alcohol drinking, overweight/obesity, hypertension, hyperuricaemia, duration of T2DM, glycated haemoglobin, angiotensin-converting enzyme inhibitors/angiotensin receptor blocker usage and nocturnal sleep duration (model 3), the odds of albuminuria increased with the daytime sleep duration (31– 60 minutes: 1.33, 1.04– 1.71; ≥ 61 minutes: 1.71, 1.29– 2.26). However, no relationship was found between nocturnal sleep duration and albuminuria.Conclusion: Longer daytime sleep is found to be associated with albuminuria in patients with T2DM in Ningbo, China but no association is found between nocturnal sleep duration and albuminuria. The findings are exploratory, and there is a need for longitudinal studies on this topic.Keywords: type 2 diabetes mellitus, sleep, albuminuria, China

Yi Lin,1 Kaushik Chattopadhyay,2 Xi Yang,3 Jia-Lin Li,4 Yan-Shu Chen,4 Ye Zhou,4 Li Li4 1Center for Health Economics, Faculty of Humanities and Social Sciences, University of Nottingham, Ningbo, Zhejiang Province, People’s Republic of China; 2Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; 3Department of Nutrition, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of China; 4Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People’s Republic of ChinaCorrespondence: Li LiDepartment of Endocrinology and Metabolism, Ningbo First Hospital, 59, Liuting Street, Ningbo, 315010, Zhejiang Province, People’s Republic of ChinaTel +86 13757426626Email lilyningbo@163.comYi LinCenter for Health Economics, Faculty of Humanities and Social Sciences, University of Nottingham, 199, Taikang East Road, University Park, Ningbo, 315100, People’s Republic of ChinaTel +86-13916608572Email Lily.Lin@nottingham.edu.cnPurpose: Type 2 diabetes (T2D) is one of the major public health concerns in China. Studies on the association between dietary salt intake and the glycemic response of T2D are lacking in China. The aim was to investigate the association between the levels of dietary salt intake and the plasma glucose, insulin and hemoglobin A1c (HbA1c) levels in T2D patients.Methods: Patients with T2D, who accepted management and treatment by the National Standardized Metabolic Disease Management Center at Ningbo First Hospital from March 2018 to January 2020, were included in this study. Dietary salt intake was assessed through a standardized food frequency questionnaire. Anthropometry, blood pressure and biomarkers were measured by well-trained endocrinology nurses. Generalized linear models (GLMs) were used to examine the associations.Results: A total of 1145 eligible T2D patients with a mean age of 51.4 years were included in the study. Fasting plasma glucose (FPG), 2-hour postprandial plasma glucose and 2-hour postprandial insulin were significantly increased across dietary salt categories. The GLMs further showed that dietary salt intake > 8 g/day was positively associated with FPG and HbA1c.Conclusion: Higher daily salt intake was found to be associated with FPG and HbA1c in T2D patients. Lifestyle education and promotion of salt reduction should be provided to T2D patients.Keywords: dietary salt, type 2 diabetes, blood glucose, insulin, glycated hemoglobin A1c, China

A cost-effective method has been developed with utmost efficiency for the determination of density of a liquid. The experimental setup for this purpose is a Polyvinyl chloride (PVC) cylinder fitted with an overflow spout, a volume measuring cylinder, a wooden block along with a hook and a known mass taken from scientific weight box. For this purpose, a PVC cylinder is filled up to the neck of the over flow spout with the liquid whose density is to be measured. A wooden block along with the hook is entered gently inside the cylinder, so that the wooden block along with the hook floats inside the liquid. As a result, some liquid will overflow through the overflow tube, and is collected in the volume measuring cylinder. The volume of the measuring cylinder is noted. Now the wooden block along with the hook is taken out from the liquid and a known mass from the weight box is fixed with the hook. The PVC cylinder again filled up with the liquid up to the neck of the overflow tube and put gently the wooden block fixed with the known mass by the hook inside the liquid. The fixed mass is such that the mass with the block floats inside the liquid, as a result some liquid will overflow again through the overflow tube and is collected in the volume measuring cylinder. The volume is recorded. This volume will be greater than the earlier one. From differences of volume and the mass associated with the block the density of the liquid used can easily be determined.