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Abstract Background This study investigated the effects of early‐onset type 2 diabetes (EOD) vs late‐onset type 2 diabetes (LOD) on nonfatal cardiovascular diseases (CVD) in China. Methods We conducted a cross‐sectional survey of 46 239 participants from 14 provinces in China from 2007 to 2008, selecting 4949 participants with type 2 diabetes for analysis. Participants were categorized as EOD (

AIM:To investigate the association between different family history risk categories and prevalence of diabetes in the Chinese population. METHODS:The family history of diabetes was obtained from each subject, and an oral glucose tolerance test was performed for measuring the fasting and postload glucose and insulin levels based on a national representative cross-sectional survey of 46,239 individuals (age ≥ 20 years) in the 2007-2008 China National Diabetes and Metabolism Disorders Study. The family history risk categories of diabetes were high, moderate, and average (FH2 and FH1: at least two generations and one generation of first-degree relatives with diabetes, respectively; FH0: no first-degree relatives with diabetes). RESULTS:The age- and gender-adjusted prevalence rates of diabetes were 32.7% (95% confidence interval (CI): 26.4-39.7%) in FH2, 20.1% (95% CI: 18.2-22.1%) in FH1, and 8.4% (95% CI: 7.9-8.9%) in FH0 (P < 0.0001). The calculated homeostatic model assessment-estimated insulin resistance (HOMA-IR), Matsuda insulin sensitivity index (ISI), and insulinogenic index (ΔI30/ΔG30) values showed significant trending changes among the three risk categories, with the most negative effects in FH2. Multivariate logistic regression analysis showed that the odds ratios of having diabetes were 6.16 (95% CI: 4.46-8.50) and 2.86 (95% CI: 2.41-3.39) times higher in FH2 and FH1, respectively, than in FH0 after adjustment for classical risk factors for diabetes. CONCLUSIONS:Family history risk categories of diabetes have a significant, independent, and graded association with the prevalence of this disease in the Chinese population.

AimsThe present study aimed to assess the prevalence of hypertension among Chinese adults.MethodsData were obtained from sphygmomanometer measurements and a questionnaire administered to 46239 Chinese adults ≥20 years of age who participated in the 2007-2008 China National Diabetes and Metabolic Disorders Study. Hypertension was defined as blood pressure ≥140/90 mm Hg or use of antihypertensive medication.ResultsA total of 26.6% of Chinese adults had hypertension, and a significantly greater number of men were hypertensive than women (29.2% vs 24.1%, pConclusionsThe prevalence of hypertension in China is increasing. The trend of an increase in prevalence is striking in young people and rural populations. Hypertension awareness, treatment, and control are poor. Public health efforts for further improving awareness and enhancing effective control are urgently needed in China, especially in emerging populations.

BACKGROUND:Not all the people with metabolic syndrome (MS) have abdominal obesity (AO). The study aimed to investigate gender differences in the prevalence and development of MS in Chinese population with abdominal obesity, which has rarely been reported. METHODS:Data were obtained from the 2007-08 China National Diabetes and Metabolic Disorders Study, and participants were divided into two samples for analysis. Sample 1 consisted of 19,046 people with abdominal obesity, while sample 2 included 2,124 people meeting pre-specified requirements. Survival analysis was used to analyze the development of MS. RESULTS:The age-standardized prevalence of MS in Chinese population with AO was 49.5%. The prevalence in males (73.7%) was significantly higher than that in females (36.9%). Males had significantly higher proportions of combinations of three or four MS components than females (36.4% vs. 30.2% and 18.4% vs. 5%, respectively). MS developed quick at first and became slow down later. Half of the participants with AO developed to MS after 3.9 years (95% CI: 3.7-4.1) from the initial metabolic abnormal component, whereas 75% developed to MS after 7.7 years (95% CI: 7.5-7.9). CONCLUSION:Compared with females, Chinese males with AO should receive more attention because of their higher prevalence of MS and its components, more complex and risky combinations of abnormal components, and faster development of MS.

BACKGROUND: We updated the prevalence of obesity and evaluated the clinical utility of separate and combined waist circumference (WC) or body mass index (BMI) category increments in identifying cardiometabolic disorder (CMD) and cardiovascular disease (CVD) risk in Chinese adults. METHODS AND FINDINGS: 46,024 participants aged ≥20 years, a nationally representative sample surveyed in 2007-2008, were included in this analysis. Taking the cutoffs recommended by the Chinese Joint Committee for Developing Chinese Guidelines (JCDCG) and the Working Group on Obesity in China (WGOC) into account, the participants were divided into four WC and four BMI groups in 0.5-SD increments around the mean, and 16 cross-tabulated combination groups of WC and BMI. 27.1%, 31.4%, and 12.2% of Chinese adults are centrally obese, overweight, or obese according to JCDCG and WGOC criteria. After adjustment for confounders, after a 1-SD increment, WC is associated with a 1.7-fold or 2.2-fold greater risk of having DM or DM plus dyslipidemia than BMI, while BMI was associated with a 2.3-fold or 1.7-fold higher hypertension or hypertension plus dyslipidemia risk than WC. The combination of WC and BMI categories had stronger association with CMD risk, i.e., the adjusted ORs (95% CI) of having DM, hypertension, and dyslipidemia for the combined and separate highest WC and BMI categories were 2.19 (1.96-2.44) vs 1.88 (1.67-2.12) and 1.12 (0.99-1.26); 5.70 (5.24-6.19) vs 1.51 (1.39-1.65) and 1.69 (1.57-1.82); and 3.73 (3.42-4.07) vs 2.16 (1.98-2.35) and 1.33 (1.25-1.40), respectively. The combination of WC and BMI categories was more likely to identify individuals with lower WC and lower BMI at CVD risk, even after the effects of CMD were controlled (all P

Background: It is important to characterize distribution of cardiometabolic disease (CMD) based on different body mass index (BMI) levels in a population. This information remains scarce in China, so we investigated the proportions and related factors of cardiometabolic disease stages based on different BMI levels in Chinese adults.Methods: We included 45 093 participants aged ≥20 years from the National Diabetes and Metabolic Disorders Survey. Cardiometabolic disease (central obesity, elevated triglycerides, elevated blood pressure, elevated plasma glucose, reduced high-density lipoprotein cholesterol, and cardiovascular disease) was classified as stage 0 (no CMD), stage 1 (mild-to-moderate CMD), or stage 2 (severe CMD). Overweight/obesity was defined as BMI ≥25 kg/m2 .Results: The standardized proportions of stage 0, stage 1, and stage 2 were 32.6%, 36.4%, and 30.9% in normal-weight men, 29.9%, 42.5%, and 27.7% in normal-weight women, 4.9%, 31.7%, and 63.4% in overweight/obese men, and 6.9%, 31.4%, and 61.7% in overweight/obese women, respectively. Multinomial regression showed that regardless of gender or region, the probability of severe cardiometabolic disease rapidly increased with increasing BMI. Severe cardiometabolic disease risk was positively associated with ageing, family history of diabetes, hypertension, or cardiovascular disease, but was inversely associated with higher levels of education and increased physical activity.Conclusions: Of Chinese men and women with normal weight, more than one third had mild-to-moderate cardiometabolic disease, and less than one third had severe cardiometabolic disease, while of these with overweight or obesity, nearly one third had mild-to-moderate cardiometabolic disease, and nearly two thirds had severe cardiometabolic disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: Whether insulin secretion and insulin sensitivity in older Chinese differ from younger persons without diabetes has not been examined and is unknown to us. METHODS: Oral glucose tolerance test was performed in a total of 32,245 Chinese without diabetes history. Insulin sensitivity was estimated by Matsuda's insulin sensitivity index (Matsuda ISI), and insulin secretion was measured by the insulinogenic index. The insulin secretion and sensitivity were compared among three age groups: 20-39 (the young), 40-59 (the middle), and greater than or equal to 60 years (the older). RESULTS: A higher proportion of postchallenge hyperglycemia (PH), both in prediabetes and in diabetes stage, was associated with older age. In the young, middle, and older age groups, the insulinogenic index median was 10.64, 8.40, and 6.67, respectively, in individuals with normal glucose tolerance (NGT); it was 8.56, 6.12, and 4.98 in individuals with prediabetes, respectively (p < .001 vs the young group). In these three age groups, the Matsuda insulin sensitivity index was 8.20, 8.39, and 8.84 in individuals with normal glucose tolerance, and it was 5.23, 5.94, and 6.33 in individuals with prediabetes, respectively (p < .05 vs the young group). These differences were independent of body mass index and waist circumference. CONCLUSIONS: Older Chinese without diabetes are characterized with worse insulin secretion and better insulin sensitivity. Insulin insufficiency and insulin resistance may contribute disproportionately to abnormal glucose tolerance in people of different age. [ABSTRACT FROM AUTHOR]

Background: Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and associated factors of ECG abnormalities in a general population of Chinese adults.Methods: ECG data were obtained from 34,965 participants in the 2007-2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test.Results: The prevalences of major arrhythmias were 1.70, 2.37 and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96, 7.54 and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, older age significantly increased the odds of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left.Conclusions: This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases were significantly associated with ECG abnormalities. [ABSTRACT FROM AUTHOR]

Abstract Introduction To examine changes in the prevalence of diabetes and the control of risk factors for diabetes over 10 years among adults in China. Methods Two population‐based cross‐sectional surveys were used to obtain a nationally representative sample of adults aged 20 years and older in mainland China in 2007 (n = 46 239) and 2017 (n = 73 340). Changes in the prevalence of diabetes, impaired fasting glucose, impaired glucose tolerance, and prediabetes, as diagnosed by the World Health Organization criteria, were assessed over time. Results The weighted prevalence of diagnosed diabetes (3.8% vs 6.3%, p = .0001) and total diabetes (9.7% vs 11.7%, p = .005) increased among the overall population between 2007 and 2017. The weighted prevalence of undiagnosed diabetes (5.9% vs 5.4%, p = .7), impaired fasting glucose (2.7% vs 2.6%, p = .68), impaired glucose tolerance (12.7% vs 12.5%, p = .95), prediabetes (15.4% vs 15.1%, p = .79), the treatment of diabetes (34.1% vs 32.5%, p = .44), and the control of diabetes (31.1% vs 32.8%, p = .73) did not significantly change over this period. The awareness of diabetes (39.4% vs 53.6%, p = .0004) increased over 10 years among the overall population. The proportion of achieved high‐density lipoprotein cholesterol targets increased (p = .005), but the proportion of achieved body mass index (p = .01) and waist circumference (p = .0002) targets decreased significantly. Conclusions Between 2007 and 2017, the prevalence of total diabetes (diagnosed by the World Health Organization criteria), especially diagnosed diabetes, increased among adults in China. Although awareness of diabetes improved, effective interventions and clinical strategies are urgently required.