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Using detailed exposure information on COVID-19 cases, we estimated the mean latent period to be 5.5 (95% CI: 5.1–5.9) days, shorter than the mean incubation period (6.9 days). Laboratory testing may allow shorter quarantines since 95% of COVID-19 cases shed virus within 10.6 (95% CI: 9.6–11.6) days of infection.

Incubation period is an important parameter to inform quarantine period and to study transmission dynamics of infectious diseases. We conducted a systematic review and meta-analysis on published estimates of the incubation period distribution of coronavirus disease 2019, and showed that the pooled median of the point estimates of the mean, median and 95th percentile for incubation period are 6.3 days (range, 1.8–11.9 days), 5.4 days (range, 2.0–17.9 days), and 13.1 days (range, 3.2–17.8 days), respectively. Estimates of the mean and 95th percentile of the incubation period distribution were considerably shorter before the epidemic peak in China compared to after the peak, and variation was also noticed for different choices of methodological approach in estimation. Our findings implied that corrections may be needed before directly applying estimates of incubation period into control of or further studies on emerging infectious diseases.

Background The Delta variant of SARS-CoV-2 had become predominant globally by November 2021. Aim We evaluated transmission dynamics and epidemiological characteristics of the Delta variant in an outbreak in southern China. Methods Data on confirmed COVID-19 cases and their close contacts were retrospectively collected from the outbreak that occurred in Guangdong, China in May and June 2021. Key epidemiological parameters, temporal trend of viral loads and secondary attack rates were estimated. We also evaluated the association of vaccination with viral load and transmission. Results We identified 167 patients infected with the Delta variant in the Guangdong outbreak. Mean estimates of latent and incubation period were 3.9 days and 5.8 days, respectively. Relatively higher viral load was observed in infections with Delta than in infections with wild-type SARS-CoV-2. Secondary attack rate among close contacts of cases with Delta was 1.4%, and 73.1% (95% credible interval (CrI): 32.9–91.4) of the transmissions occurred before onset. Index cases without vaccination (adjusted odds ratio (aOR): 2.84; 95% CI: 1.19–8.45) or with an incomplete vaccination series (aOR: 6.02; 95% CI: 2.45–18.16) were more likely to transmit infection to their contacts than those who had received the complete primary vaccination series. Discussion Patients infected with the Delta variant had more rapid symptom onset compared with the wild type. The time-varying serial interval should be accounted for in estimation of reproduction numbers. The higher viral load and higher risk of pre-symptomatic transmission indicated the challenges in control of infections with the Delta variant.

Tracing and isolation of close contacts is used to control outbreaks of coronavirus disease 2019 (COVID-19) in China. However, risk factors associated with the occurrence of COVID-19 among close contacts have not been well described. A total of 106 household contacts were included in this study, of whom 19 developed into COVID-19 cases, and the secondary attack rate was 17.9%. Multivariable analysis showed that increasing risk of occurrence of COVID-19 among household contacts was associated with female index patients (adjusted hazard ratio [aHR] = 3.84, 95% CI = 1.07-13.78), critical disease index patients (aHR = 7.58, 95% CI = 1.66-34.66), effective contact duration with index patients > 2 days (aHR = 4.21, 95% CI = 1.29-13.73), and effective contact duration > 11 days (aHR = 17.88, 95% CI = 3.26-98.01). The sex and disease severity of index patients with COVID-19 and longer effective contact duration with patients with confirmed COVID-19 could help epidemiologists to identify potential COVID-19 cases among household contacts at an early stage.

Scrub typhus is a life-threatening vector-borne disease. During the past decade, the number of areas affected by this disease has expanded in many countries. In this study, we aim to identify the spatiotemporal and demographic characteristics of scrub typhus in Southwest China, an emerging endemic region for scrub typhus. Population-based surveillance data capturing scrub typhus cases in two provinces of Southwest China during 2006-2017 were retrieved. Descriptive temporal and spatial analyses were conducted and stratified by age group. The space-time scan statistic was used to identify spatiotemporal clusters of scrub typhus occurrence at the county level. During the study period, 30,001 scrub typhus cases were recorded in Southwest China, with a total of 61.0% (191/313) of counties being affected; most cases (94.3%) occurred in rural areas. The annual incidence rate increased substantially from 0.25/100,000 in 2006 to 5.38/100,000 in 2017 (>21-fold change). The 0- to 4-year-old and 45- to 64-year-old subgroups had the highest cumulative incidence rates (57.46 and 32.98/100,000, respectively). Furthermore, since 2006, the 0- to 4-year-old (slope = 0.83, p < .01) and 45-64-year-old (slope = 0.69, p < .01) age groups have had the highest increases in incidence of all age groups. The most likely spatial cluster of overall cases (relative risk = 4.13, p < .01) occurred in the southern region of Southwest China and included 41 high-risk counties. In conclusion, scrub typhus appears to be widely distributed and rapidly increasing in Southwest China. Young children and middle-aged adults were the most severely affected groups, and the disease appeared to predominantly cluster in the southern part of Southwest China. Further in-depth surveys to determine the epidemiological characteristics and driving factors of this emerging disease and to facilitate effective control programmes among high-risk groups in the affected areas should be promoted.

Objective: In July 2018, recurrent hepatitis E cases were reported from a factory in Qingdao City, China. The aim of this study was to identify additional cases, and help prevent future incidents by identifying possible risk factors for infection. Methods: Participants were asked to provide blood samples for hepatitis E virus (HEV) IgM and IgG antibodies screening, as well as liver function test. A questionnaire that assessed demographics, potential risk factors, and clinical symptoms was completed by participants. HEV RNA genotyping was performed using a nested Reverse Transcriptional Polymerase Chain Reaction (RT-PCR) method. Adjusted Poisson regression model for participant characteristics and risk factors was constructed for multivariate analysis. Results: Overall, 41(14.5%, 41/283) participants had recent acute infection (21 of these were symptomatic). The result of multivariate analysis demonstrated a significant association of acute HEV infection with consumption of pig liver within the past two months (Relative Risk 2.61, 95% confidence interval (CI) 1.10–6.17, p = 0.0294). Sequencing of HEV RNA from seventeen acute cases indicated three HEV isolates of genotype 4 induced this outbreak. Conclusions: This was probably a common-source foodborne hepatitis E outbreak, related to the consumption of undercooked pig liver. Keywords: Hepatitis E, Foodborne diseases, Zoonoses

BackgroundThe Delta variant of SARS-CoV-2 has become predominant globally. We evaluated the transmission dynamics and epidemiological characteristics of the Delta variant in an outbreak in southern China.MethodsData on confirmed cases and their close contacts were retrospectively collected from the outbreak that occurred in Guangdong, China in May-June 2021. Key epidemiological parameters, temporal trend of viral loads and secondary attack rates were estimated and compared between the Delta variant and the wild-type SARS-CoV-2 virus. We also evaluated the association of vaccination with viral load and transmission.ResultsWe identified 167 patients infected with the Delta variant in the Guangdong outbreak. The mean estimates of the latent period and the incubation period were 4.0 days and 5.8 days, respectively. A relatively higher viral load was observed in Delta cases than in wild-type infections. The secondary attack rate among close contacts of Delta cases was 1.4%, and 73.9% (95% confidence interval: 67.2%, 81.3%) of the transmissions occurred before onset. Index cases without vaccination (OR: 2.84, 95% confidence interval: 1.19, 8.45) or with one dose of vaccination (OR: 6.02, 95% confidence interval: 2.45, 18.16) were more likely to transmit infection to their contacts than those who had received 2 doses of vaccination.DiscussionPatients infected with the Delta variant had more rapid symptom onset. The shorter and time-varying serial interval should be accounted in estimation of reproductive numbers. The higher viral load and higher risk of pre-symptomatic transmission indicated the challenges in control of infections with the Delta variant.

Background: This study will investigate effect of famine exposure in early life associated with the risk of type 2 diabetes in adulthood during the Chinese Famine.Methods: A total of 3,418 individuals aged 35-74 years free of diabetes in 2006 and in 2009 study surveys, were prospectively followed up to 2009 and 2012, respectively. Individuals were grouped into non-exposed (1962-1978), fetal-exposed (1959-1961), childhood-exposed (1949-1958) and adolescence/adult-exposed cohorts (1931-1948). Logistic regression model was employed to assess effect of famine exposure on diabetes incidence, adjusting for potential covariates.Results: During a mean follow up of 3 years, the age-adjusted cumulative incidences of type 2 diabetes were 6.3%, 13.0% 11.0% and 13.8% in non-exposed, fetal, child and adolescence/adult-exposed cohorts, respectively (P=0.026). Compared with non-exposed individuals, relative risks (95% confidence intervals) for diabetes incidence were 2.15(1.29-3.60), 1.53(0.93-2.51), and 1.65(0.75-3.63) in those exposure in fetal, child and adolescence/adult, controlling for covariates. The interactions between famine exposure and obesity, education, family history of diabetes were not observed, except for famine exposure and residential areas. Individuals lived in rural areas increased risk for type 2 diabetes in fetal and child exposure, with an incidence relative risk (95% confidence interval) of 8.79(1.82-42.54) and 2.33(1.17-4.65), respectively.Conclusions: Our findings indicate that famine exposure in early life is an independent predictor on type 2 diabetes, particularly in women. The identification and intervention on critical time can prevent residents from diabetes in later life.The clinical trial was registered, more detail linked in https://clinicaltrials.gov/ct2/home, as registration no. NCT01053195.

Background To understand Clonorchis sinensis reinfection and the determinants of reinfection in endemic areas is important in establishment of control measures. Methods A prospective cohort study was implemented in Hengxian County, Guangxi, China. Individuals with C. sinensis infection were completely treated, and those cured were enrolled as study subjects and followed up for 3, 6, and 12 months. The reinfection frequency and incidence were calculated, and a multivariable Cox proportional hazard model was constructed to capture reinfection determinants. Results Among 635 enrolled subjects, 436 (68.7%) completed follow-up. Of these, 177 (40.6%) were reinfected; 133 (75.1%) were reinfected once, 41 (23.2%) twice, and 3 (1.7%) three times. The incidence of reinfection was 64.0 per 100 person-years. Men (adjusted hazard ratio [aHR], 1.67; 95% confidence interval [CI], 1.14–2.44), those with underlying diseases (aHR, 1.41; 95% CI, 1.02–1.95), and those with moderate- or heavy-intensity infections (aHR, 1.45; 95% CI, 1.14–1.85) had increasing reinfection probabilities. Conclusions C. sinensis reinfection is high in endemic areas. Men and high-intensity infection are important determinants of reinfection. Repeated chemotherapy is necessary to control reinfection and its associated morbidities, especially in high-risk individuals. In addition, behavioral education is advised to decrease overall reinfection in endemic areas.

Background: In China, hand, foot, and mouth disease (HFMD) outbreaks have become an important issue recent years. We analyzed the epidemiological characteristics of HFMD outbreaks in Qingdao during 2009- 2018, and provided evidences for prevention and control of the disease. Methods: Data were analyzed by descriptive analysis and correlation analysis, and throat swabs were detected for enterovirus RNA using RT-PCR. Results: Overall, 116 HFMD outbreaks were reported in Qingdao during 2009-2018, with the epidemic of the outbreaks exhibiting a decreasing tendency. The characteristics of outbreaks presented two patterns, including two-peak pattern and rural area to urban-rural fringe area to urban areas pattern. Male patients were predominant in these outbreaks. The location of the outbreaks changed from nursery to community. Non-EV71/CA16 enteroviruses were gradually becoming predominant enteroviruses serotypes. The durations of outbreaks were positively correlated with response times and the number of cases. Conclusion: The epidemiological characteristics analysis of HFMD outbreaks could provide a scientific basis for the prevention and control the disease. Reporting and handling promptly are the keys to control epidemic outbreaks of HFMD.

The Qingdao diabetes risk score (QDRS) is an accurate tool for identifying individuals who are at a high risk for diabetes. This study was designed to determine the association of the QDRS with the incidence of diabetes in the general population in urban and rural settings. A stratified, random, cluster-sampling method was used to select representative individuals in 2006 and 2009, and the follow-up survey was conducted from 2012 to 2015. Of 5851 participants, 3248 were available in cohort study. The individuals without data of FPG, 2 h PG was excluded in follow-up survey. Finally, a total of 3033 participants were included. Waist circumference, age, and family history of diabetes were collected to determine the QDRS. Cox proportional hazards regression models were used to evaluate the association of QDRS and BMI with the incidence of diabetes. Further, we assessed the relative excess risk due to interaction (RERI), synergy index (S), and attributable proportion due to interaction (AP). Their age-standardized cumulative incidence of diabetes was 16.9% and 10.8% among the urban and rural populations, respectively. In both urban and rural settings, individuals with a QDRS ≥ 14 had a significantly higher risk for diabetes than the individuals with a QDRS

Background The emergence and re-emergence of scrub typhus has been reported in the past decade in many global regions. In this study, we aim to identify potential scrub typhus infection risk zones with high spatial resolution in Qingdao city, in which scrub typhus is endemic, to guide local prevention and control strategies. Methodology/Principal findings Scrub typhus cases in Qingdao city during 2006–2018 were retrieved from the Chinese National Infectious Diseases Reporting System. We divided Qingdao city into 1,101 gridded squares and classified them into two categories: areas with and without recorded scrub typhus cases. A boosted regression tree model was used to explore environmental and socioeconomic covariates associated with scrub typhus occurrence and predict the risk of scrub typhus infection across the whole area of Qingdao city. A total of 989 scrub typhus cases were reported in Qingdao from 2006–2018, with most cases located in rural and suburban areas. The predicted risk map generated by the boosted regression tree models indicated that the highest infection risk areas were mainly concentrated in the mid-east and northeast regions of Qingdao, with gross domestic product (20.9%±1.8% standard error) and annual cumulative precipitation (20.3%±1.1%) contributing the most to the variation in the models. By using a threshold environmental suitability value of 0.26, we identified 757 squares (68.7% of the total) with a favourable environment for scrub typhus infection; 66.2% (501/757) of the squares had not yet recorded cases. It is estimated that 6.32 million people (72.5% of the total population) reside in areas with a high risk of scrub typhus infection. Conclusions/Significance Many locations in Qingdao city with no recorded scrub typhus cases were identified as being at risk for scrub typhus occurrence. In these at-risk areas, awareness and capacity for case diagnosis and treatment should be enhanced in the local medical service institutes., Author summary Scrub typhus is a bacterial zoonosis caused by Orientia tsutsugamushi, which is mostly carried by rodents and chigger mites, and occasionally transmitted to humans by bites of infected larval mites. Scrub typhus is geographically endemic across broad areas of south and southeastern Asia, the Pacific islands and northern Australia. In recent years, an obvious increasing trend of the incidence of this disease has been noticed all around the world. China is one of the most endemic country for this disease, with an approximate 10-fold increase of the annual case number from 2006 to 2013. In this study, by using a prediction model for infectious diseases, we found that the highest infection risk area was located at the mid-east and northeast regions of Qingdao, with gross domestic product and precipitation might developed the greatest impact for the occurrence of scrub typhus. Furthermore, 68.7% of the region in Qingdao might have a suitable environment for the occurrence of scrub typhus, with most of them hadn’t reported cases yet. This study highlights the emergency to enhance the awareness of this disease and improve the capacity of diagnosis and treatment among medical institutions in high risk areas in Qingdao.

High-intensity clonorchiasis infection is associated with serious outcomes, including cancer. Understanding the infection intensity of Clonorchis sinensis and its risk factors in local endemic regions could facilitate effective control measures. In a county located in a highly endemic area in Guangxi Province, P. R. China, local residents were randomly enrolled in the study; helminth egg examinations were performed with the Kato-Katz method, and the intensity of infection was identified as mild, moderate or heavy. Knowledge, attitudes, and high-risk behaviours were investigated among those infected with Clonorchis sinensis. A total of 2521 local residents participated in this study, and the Clonorchis sinensis-positive proportion was 28.9% (728 persons). Among the infected persons, the percentages of mild, moderate and heavy infections were 66.2%, 28.4% and 5.4%, respectively. Males experienced a higher proportion of moderate and heavy infections (37.5%) than females (18.1%) (p50 times in the last year (aOR = 2.89, 95%CI: 1.20–7.50) were risk factors for high-intensity infections (moderate and heavy). The overall infection proportion was high in the study area, with a large group of residents experiencing high-intensity infections. High frequency of raw fish consumption was associated with high-intensity infections. Intervention strategies targeting people with a high frequency of raw fish consumption should be implemented to reduce the probability of severe consequences., Author summary Clonorchiasis, which is caused by Clonorchis sinensis, is one of the most endemic parasite diseases in China. Humans get infected by eating the raw or undercooked freshwater fish that contain the nymphal stage of Clonorchis sinensis. There are about 15 million cases globally with 85% of those in China. Two major endemic areas were found in China, including Guangdong and Guangxi Province in the south part of China, and Heilongjiang, Jilin and Liaoning Province in the north part of China. In this study, by analysing the dataset from one county in Guangxi Province, we found the overall proportion of infection was high, with one third of infection persons were classified as high intensity of infection. Male and persons aged 30–59 years developed higher burden of infection. Besides, persons who eat high frequency of raw fish developed high intensity of infection. Health education on the high risk populations should be strengthened to change the diet custom. Other measure such as examination of freshwater fish in the market should also be implemented.

BackgroundCase isolation and contacts tracing are the most widely used strategies to control the outbreak of COVID-19. However, little attention has been paid to the infectiousness of recovered patients with COVID-19.Case presentationIn this study, we reported a confirmed case of COVID-19 whose nasopharyngeal swab test of SARS-CoV-2 RNA turned positive 28 days after hospital discharged.ConclusionsSARS-CoV-2 RNA can be detected in respiratory tract sample 28 days after hospital discharged. Further studies about consecutive detection of SARS-CoV-2 combined with viral isolation among COVID-19 cases should be designed to determine the accurate contagious period.

Scrub typhus, a miteborne rickettsiosis, has emerged in many areas globally. We analyzed the incidence and spatial-temporal distribution of scrub typhus in China during 1952-1989 and 2006-2016 using national disease surveillance data. A total of 133,623 cases and 174 deaths were recorded. The average annual incidence was 0.13 cases/100,000 population during 1952-1989; incidence increased sharply from 0.09/100,000 population in 2006 to 1.60/100,000 population in 2016. The disease, historically endemic to southern China, has expanded to all the provinces across both rural and urban areas. We identified 3 distinct seasonal patterns nationwide; infections peaked in summer in the southwest, summer-autumn in the southeast, and autumn in the middle-east. Persons >40 years of age and in nonfarming occupations had a higher risk for death. The changing epidemiology of scrub typhus in China warrants an enhanced disease control and prevention program.

To effectively promote the implementation of interventions, the identification of high-risk groups and the characteristics of Clonorchis sinensis infection in endemic regions are needed. In a clonorchiasis-endemic area, local residents were randomly enrolled for helminth egg examination in June 2016. The prevalence in subpopulations as well as the knowledge, attitudes, and behaviours and the factors influencing clonorchiasis in egg-positive populations were analysed. A total of 2282 local residents participated in the survey; the C. sinensis prevalence was 48.6% (1109 persons). A higher prevalence was found in males (62.6%) than in females (29.7%). People older than 30 years had the highest prevalence (52.7%–57.6%). Among the 888 persons who were infected with C. sinensis and participated the questionnaire investigation, 19.0% (169/888) knew that it could cause cancer. In addition, 60.6% of people reported that they intended to keep eating raw fish despite knowing the risk of infection. The two primary reasons for continuing to eat raw fish were the disease being regarded as not serious (38.3%) and the belief that anti-parasite medications are effective (39.6%). A total of 94.4% (797/844) of responders reported eating raw fish more frequently in the home than outside of the home. Our study revealed a notably high C. sinensis prevalence in the study area. Awareness of clonorchiasis disease severity should be increased among high-risk individuals and families in highly endemic areas., Highlights • The overall prevalence of Clonorchis sinensis was high in our study area. • Males and people over 30 were more likely infected by Clonorchis sinensis. • Limited proportion of infected people knew that Clonorchis sinensis could lead to cancer. • People tended to keep eating raw fish even knowing it caused clonorchiasis.

Background Scrub typhus is a life-threatening disease caused by Orientia tsutsugamushi, and specific antimicrobial medicine is available. Early and accurate diagnosis is essential for reducing the risk of severe complications and death. In this study, we aimed to evaluate the case diagnosis situation among medical care institutions and geographical regions in China, and the results will benefit both clinical practice and the disease surveillance system. Methods We extracted individual scrub typhus case data 2006–2016 from a national disease surveillance system in China. The diagnosis category and interval time from illness onset to diagnosis were compared among three levels of medical care institutions and provinces. The descriptive analysis method was performed in our study. Results During the 11-year study period, 93 481 scrub typhus cases, including 57 deaths, were recorded in the nationwide surveillance system. The overall proportion of laboratory-confirmed cases was only 4.7%, and this proportion varied greatly among primary medical centres (2.8%), county level hospitals (4.2%), and city level hospitals (6.3%). Notably, the proportion of laboratory-confirmed cases has consistently decreased from 16.3% in 2006 to 2.6% in 2016, and the same decreasing trend was found among all three levels of medical care institutions. The interval from illness onset to case diagnosis (Tdiag) for all cases was 5 days (interquartile range [IQR]: 2–9 days) and decreased from 7 days (IQR: 3–11 days) in 2006 to 5 days (IQR: 2–8 days) in 2016. The risk of death for patients with a Tdiag of > 7 days was 2.2 times higher (OR = 2.21, 95% CI: 1.05–5.21) than that of patients with a Tdiag of

Background: To investigative the association of triglycerides (TG) and total cholesterol (TC) concentrations with impaired fasting glucose/impaired glucose tolerance (IFG/IGT) in Chinese adults. Methods: The population-based cross-sectional diabetes survey was conducted in 2006 and 2009 in Qingdao, separately. 4400 participants (1 793 men and 2607 women) were include in current analysis. IFG/IGT was defined according to fasting plasma glucose (FPG) and/or 2 h post-load plasma glucose (2 h PG). Logistic regression models and areas under receiver operating characteristic curves (AUROC) were performed to estimate the associations between TG, TC levels and IFG/IGT. Results: Spearman analysis showed that serum TG and TC was independently and positively associated with FPG and 2 h PG. As compared with normoglycaemia, the odds ratio[(95% confidence intervals), OR(95% CI)] for IFG/IGT corresponding to hypertriglyceridemia (HTG) were 1.61 (1.17, 2.22) in men and 1.57(1.15, 2.14) in women for TG and accompany with Hypercholesterolemia (HTC) 1.56 (1.15, 2.13) and 1.20 (0.93, 1.54) for TC, when adjusting for confounding factor. The AUROCs of TG, TC for IFG/IGT were relatively smaller (0.50

// Jing Cui 1, 2, 3, * , Jianping Sun 1, 2, 3, * , Wei Wang 1, 5 , Hualei Xin 2, 3 , Qing Qiao 6 , Zulqarnain Baloch 4, * and Aiguo Ma 1, * 1 Department of Nutrition and Food Hygiene, Medical College of Qingdao University, Qingdao, China 2 Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China 3 Qingdao Institute of Preventive Medicine, Qingdao, China 4 College of Veterinary Medicine, South China Agricultural University, Guangzhou, China 5 Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China 6 Department of Public Health, University of Helsinki, Helsinki, Finland * These authors contributed equally to this work Correspondence to: Aiguo Ma, email: magfood@126.com Zulqarnain Baloch, email: znbalooch@yahoo.com Keywords: triglycerides, total cholesterol, newly diagnosed, adult onset diabetes, waist circumference Received: July 29, 2017 Accepted: September 22, 2017 Published: October 19, 2017 ABSTRACT Background: It has already been suggested that high abnormal blood lipid concentration is associated with hyperglycaemia. However, no data is available about the roles of triglycerides (TG) and total cholesterol (TC) levels in diabetes. Here, for the first time we investigated the roles of TG and TC levels, gender and abdominal fat in the development of newly diagnosed diabetes in China. Materials and Methods: Two population-based cross-sectional surveys were conducted from 2006 to 2009 in Qingdao, China. Newly diagnosed diabetes was defined according to FPG and/or 2 h PG criteria. The associations between diabetes and TG, and TC levels were assessed by multi-variable logistic regression models. Results: As compared with non-diabetes, the odds ratio[(95% confidence intervals), OR(95% CI)] for diabetes corresponding to hypertriglyceridemia (HTG) were 1.54 (1.01, 2.35) in men and 2.02 (1.49, 3.10) in women for TG and accompany with Hypercholesterolemia (HTC) 2.93 (1.97, 4.37) and 2.13 (1.49, 3.05) for TC, when both were fitted simultaneously in the model adjusting for age, geographic division, marital status, school years, family history of diabetes, monthly income, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), high density lipoprotein cholesterol (HDL-C), alanine amino transferase (ALT) and gamma-glutamyltransferase (GGT). Conclusions: HTG in both gender, borderline high TC and HTC in men were an independent risk factor for diabetes in this Chinese population, however, HTC was mediated through abdominal fat for diabetes in women. Our findings may help to enhance the current knowledge of diabetes patho-physiology, and the associations between TG, TC level and diabetes is also clinically informative.