ORCID Profile
0000-0003-4610-9848
Current Organisations
UNSW Sydney
,
The George Institute for Global Health
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Mary Ann Liebert Inc
Date: 11-2017
Abstract: The Observational Registry of Basal Insulin Treatment (ORBIT) study evaluated the safety of basal insulin (BI) in real-world settings in China. We analyzed 9002 patients with type 2 diabetes (T2D) inadequately controlled with oral hypoglycemic agents from 8 geographic regions and 2 hospital tiers in China who initiated and maintained BI treatment. Body weight and hypoglycemic episodes were recorded at baseline and 3 and 6 months. Serious adverse events (SAEs) were recorded at 3 and 6 months. Age, gender, inpatient/outpatient status, body mass index, glycated hemoglobin (HbA1c) at baseline and at the end of study, T2D duration, microvascular complications, BI type, combination with insulin secretagogues, self-monitoring of blood glucose frequency, and insulin dosage, all predicted hypoglycemia. BI use generally did not induce significant weight gain (0.02 kg) weight gain with insulin detemir (-0.30 kg) was less than that with neutral protamine Hagedorn (NPH) insulin (0.20 kg) or insulin glargine (0.05 kg). Overall, general hypoglycemia incidence (5.6% vs. 7.7%) and annual event rate (1.6 vs. 1.8) were similar before and after BI initiation, whereas a slight decrease was noted in severe hypoglycemia incidence (0.6%-0.3%) and frequency (0.05-0.03 events atient-year). The general hypoglycemia rate was lowest with insulin glargine, whereas there was no significant difference in severe hypoglycemia among the three BI groups. Overall, 3.5% of patients had at least one SAE during the study. Most SAEs were found to be unrelated to BI treatment. Real-world BI use, particularly insulin detemir and glargine, was associated with only slight weight gain and low hypoglycemia risk in patients with T2D in China.
Publisher: WHO Press
Date: 07-2023
Publisher: Springer Science and Business Media LLC
Date: 17-04-2018
Publisher: Wiley
Date: 03-04-2017
DOI: 10.1111/DOM.12920
Abstract: To compare glucose control and safety of different basal insulin therapies (BI, including Insulin NPH, glargine and detemir) in real-world clinical settings based on a large-scale registry study. In this multi-center 6-month prospective observational study, patients with type 2 diabetes (HbA1c ≥ 7%) who were uncontrolled by oral anti-diabetic drugs (OADs) and were willing to initiate BI therapy were enrolled from 209 hospitals within 8 regions of China. Type and dose of BI were at the physician's discretion and the patients' willingness. Interviews were conducted at 0 months (visit 1), 3 months (visit 2) and 6 months (visit 3). Outcomes included change in HbA1c, hypoglycemia rate and body weight from baseline at 6 months. A total of 16 341 and 9002 subjects were involved in Intention-To-Treat (ITT) and per-protocol (PP) analysis, respectively. After PS regression adjustment, ITT analysis showed that reduction in HbA1c in glargine (2.2% ± 2.1%) and detemir groups (2.2% ± 2.1%) was higher than that in the NPH group (2.0% ± 2.2%) (P < .01). The detemir group had the lowest weight gain (-0.1 ± 2.9 kg) compared with the glargine (+0.1 ± 3.0 kg) and NPH (+0.3 ± 3.1 kg) groups (P < .05). The glargine group had the lowest rate of minor hypoglycaemia, while there was no difference in severe hypoglycaemia among the 3 groups. The results observed in PP analyses were consistent with those in ITT analysis. In a real-world clinical setting in China, treatment with long-acting insulin analogues was associated with better glycaemic control, as well as less hypoglycaemia and weight gain than treatment with NPH insulin in type 2 diabetes patients. However, the clinical relevance of these observations must be interpreted with caution.
Publisher: JMIR Publications Inc.
Date: 20-09-2017
Abstract: he application of mobile health (mHealth) technology in reproductive, maternal, newborn, and child health (RMNCH) is increasing worldwide. However, best practice and the most effective mHealth interventions have not been reviewed systematically. systematic review and meta-analysis of studies of mHealth interventions for RMNCH around the world were conducted to investigate their characteristics as well as the features and effectiveness of mHealth interventions. tudies of mHealth interventions for RMNCH between January 2011 and December 2016 were retrieved from 6 databases (PubMed, EMBASE, Global Health, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, and Wanfang Data Knowledge Service Medium). Comparable studies were included in a random-effects meta-analysis for both exclusive breastfeeding (EBF) and antenatal checks (ANC). Descriptive analyses were conducted for mHealth studies with a range of study designs. nalyses of 245 studies were included, including 51 randomized controlled trials (RCTs). Results showed that there are increasing numbers of studies on mHealth interventions for RMNCH. Although 2 meta-analysis, one with 2 RCTs on EBF (odds ratio [OR] 2.03, 95% CI 1.34-3.08, I2=25%) and the other with 3 RCTs on ANC (OR 1.43, 95% CI 1.13-1.79, I2=78%), showed that mHealth interventions are more effective than usual care, almost half (43%) of RCTs showed negative or unclear results on mHealth interventions. Functions described in mHealth interventions were erse, and the health stages covered were broad. However, single function or single stage appeared to be dominant among mHealth interventions compared with multiple functions or stages. ore rigorous evaluations are needed to draw consistent conclusions and to analyze mHealth products with multiple functions, especially those popular in the app markets.
Publisher: Wiley
Date: 17-03-2017
DOI: 10.1111/DOM.12886
Abstract: To examine treatment patterns following basal insulin (BI) introduction in type 2 diabetes mellitus (T2DM) patients under real-world conditions across China. Overall, 18 995 patients inadequately controlled (HbA1c ≥ 53 mmol/mol [7%]) with oral antihyperglycaemic drugs (OADs) and willing to receive BI treatment were registered at 209 hospitals and followed at baseline (visit 1), 3 months (visit 2) and 6 months (visit 3). Type of BI was initiated at physicians' discretion. Retention with BI therapy at 6 months was 75.6%. Use of long-acting BI predominated, with insulin glargine accounting for 71%, detemir 13% and Neutral Protamine Hagedorn (NPH) insulin 16%. Over 70% of long-acting users maintained the same initial BI at visit 3, while 40% of NPH users switched treatment and 24.4% of participants initiated BI with prandial insulin. The initial mean (± SD) dose of BI and total insulin was 0.18 ± 0.07 and 0.25 ± 0.19 IU/kg, respectively, with a mean increase of daily dose by 0.03 and 0.02 IU/kg after 6 months, respectively. Only 56.6% of insulin users reported dose titration at visit 3. Mean HbA1c was 81 mmol/mol (9.6%) at baseline and 57 mmol/mol (7.4%) at 6 months. The frequency of hypoglycaemia was 1.61 and 2.07 episodes atient-year at baseline and 6 months, respectively. In real-world clinical settings, add-on BI therapy in T2DM patients is associated with significant improvement in glycaemic control without overtly compromising safety related to hypoglycaemia and weight gain. Evolution of insulin treatment regimens varied among patients, but dose titration was suboptimal. More active BI dose titration might further improve glycaemic outcome in patients receiving BI therapy. A free Video Abstract to accompany this article is available at 12655959.
Publisher: Frontiers Media SA
Date: 03-05-2021
DOI: 10.3389/FPUBH.2021.658706
Abstract: Objective: Metabolic diseases have been a clinical challenge worldwide and a major public health issue. Very few studies from China investigated the impact of metabolic multimorbidity on healthcare and health outcomes at the national level. This study aims to examine the association of metabolic multimorbidity with health service utilization, spending, functional and mental health. Materials and Methods: This is a nationally representative cross-sectional study, utilizing the data from the China Health and Retirement Longitudinal Study in 2015, including 11,377 participants aged 45 years and older. Multivariable regression models were used to assess the association of metabolic multimorbidity with healthcare, out-of-pocket expenditure (OOPE), the activities of daily living (ADL) limitation, the instrumental activities of daily living (IADL) limitation, and depression. Results: Overall, 30.50% of total participants had metabolic multimorbidity in 2015 in China. Compared with single disease, metabolic multimorbidity were associated with the number of outpatient visits [incident rate ratio (IRR) = 1.30, 95% CI = 1.05, 1.62] and days of inpatient care (IRR = 1.52, 95% CI = 1.28, 1.81). Metabolic multimorbidity was positively associated with the OOPE on outpatient care (coefficient = 82.99, 95% CI = 17.70, 148.27) and physical functional difficulties, including ADL limitation (odds ratio = 1.36, 95% CI = 1.18, 1.57). Conclusions: Metabolic multimorbidity is associated with higher levels of health-care service use, greater expenditure for outpatient care, and more difficulties in ADL among Chinese adults. China's health-care systems need to shift from single-disease models to new financing and service delivery models to effectively manage metabolic multimorbidity.
Publisher: BMJ
Date: 05-2020
DOI: 10.1136/BMJOPEN-2019-033842
Abstract: Salt intake in China is twice the upper limit recommended by the WHO, and nearly 80% of salt is added during cooking. This study will develop a package of salt reduction interventions targeting home cooks and evaluate its effectiveness and feasibility for scale-up. A cluster randomised controlled trial design is adopted in this study, which will be conducted in six provinces covering northern, central and southern China. For each province, 10 communities/villages (clusters) with 13 families (one cook and one adult family member) will be selected in each cluster for evaluation. In total, 780 home cooks and 780 adult family members will be recruited. The home cooks in the intervention group will be provided with the intervention package, including community-based standardised offline and online health education and salt intake monitoring. The duration of the intervention will be 1 year. The primary outcome is the difference between the intervention and control group in change in salt intake as measured by 24 hours urinary sodium from baseline to the end of the trial. The secondary outcome is the difference between the two groups in the change in salt-related knowledge, attitude and practice and blood pressure (BP). The study has been approved by The Queen Mary Research Ethics Committee (QMERC2018/13) and Institutional Review Board of the Chinese Center for Disease Control and Prevention (No. 201801). The study findings will be disseminated widely through conference presentations and peer-reviewed publications and the general media. ChiCTR1800016804.
Publisher: Wiley
Date: 30-05-2020
DOI: 10.1111/JDI.13282
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.DIABRES.2017.02.027
Abstract: The paucity of data on Type 1 diabetes in China hinders progress in care and policy-making. This study compares Type 1 diabetes care and clinical outcomes in Beijing and Shantou with current clinical guidelines. The 3C Study was a cross-sectional study of the clinical practices and outcomes of people with Type 1 diabetes. The study sequentially enrolled 849 participants from hospital records, inpatient wards, and outpatient clinics. Data were collected via face-to-face interviews with patients and health professionals, the Summary of Diabetes Self-Care Activities, medical records, and venous blood s les. Care was audited using ISPAD/IDF indicators. Data underwent descriptive analysis and tests for association. The median age was 22years (IQR=13-34years), and 48.4% of the s le had diabetes less than six years. The median HbA1c was 8.5% (69mmol/mol) (IQR 7.2-10.5%), with significant regional variance (p=0.002). Insulin treatment was predominantly two injections/day (45% of patients). The highest incidence of diabetic ketoacidosis was 14.4 events/100 patient years among adolescents. Of the 57.3% of patients with LDL-C>2.6mmol/L, only 11.2% received treatment. Of the 10.6% considered hypertensive, 47.1% received treatment. Rates of documented screening for retinopathy, nephropathy, and peripheral neuropathy were 35.2%, 42.3%, and 25.0%, respectively. The median number of days of self-monitoring/week was 3.0 (IQR=1.0-7.0). There were significant differences in care practices across regions. The study documented an overall deficit in care with significant regional differences noted compared to practice guidelines. Modifications to treatment modalities and the structure of care may improve outcomes.
Publisher: Elsevier BV
Date: 04-2006
DOI: 10.1016/J.BRAINRESBULL.2005.12.008
Abstract: The objective of this study is to determine if and how cerebral blood flow velocity and stroke risk factors are related in a stroke free population. This cross-sectional study recruited 1323 stroke-free subjects, aged 42-73 years, from a county region in China. Systolic blood flow velocities in cerebral arteries were detected with trans-cranial Doppler. Key factors, such as anthropometry, life-style, medication use, blood pressure and blood biochemical analysis were investigated at the same time. In women, even controlled for major cardiovascular risk factors, cerebral blood flow velocities of common carotid artery, internal carotid artery, middle cerebral artery, anterior cerebral artery and posterior cerebral arteries decreased significantly with age (from 43.8 to 39.3, 48.0 to 42.6, 97.7 to 82.8, 79.2 to 69.4 and 44.1 to 39.7 cm/s in the range of 42-73 years old, p < 0.01 for each). In men, however, this inverse trend only existed in common carotid artery (from 45.6 to 41.7 cm/s, p < 0.01). Multivariate regression showed that most established cardiovascular risk factors (e.g. hypertension, hypercholesterolemia, diabetes mellitus and overweight/obesity) were associated with decreased blood flow velocity in the extra-cranial arteries. However, this association was not present (e.g. diabetes and overweight/obesity) or was inversed (e.g. hypertension and hypercholesterolemia) in the intra-cranial arteries. Extra-cranial blood flow velocity is significantly and inversely related to age and cardiovascular risk factors. The relationship between intra-cranial blood flow and risk factors changes and may depend on gender. These finding may have importance in the determination of mechanisms of stroke.
Publisher: Informa UK Limited
Date: 10-2022
DOI: 10.2147/DMSO.S386230
Publisher: MDPI AG
Date: 22-01-2015
DOI: 10.3390/NU7020751
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-053122
Abstract: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent erse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and diabetes outcomes. A systematic inquiry of these projects will provide necessary scientific insights into the enablers and challenges in the scale up of complex NCD interventions. We will apply systems thinking (a holistic approach to analyse the inter-relationship between constituent parts of scaleup interventions and the context in which the interventions are implemented) and adopt a longitudinal mixed-methods study design to explore the planning and early implementation phases of scale up projects. Data will be gathered at three time periods, namely, at planning (T P ), initiation of implementation (T 0 ) and 1-year postinitiation (T 1 ). We will extract project-related data from secondary documents at T P and conduct multistakeholder qualitative interviews to gather data at T 0 and T 1. We will undertake descriptive statistical analysis of T P data and analyse T 0 and T 1 data using inductive thematic coding. The data extraction tool and interview guides were developed based on a literature review of scale-up frameworks. The current protocol was approved by the Monash University Human Research Ethics Committee (HREC number 23482). Informed consent will be obtained from all participants. The study findings will be disseminated through peer-reviewed publications and more broadly through the GACD network.
Publisher: JMIR Publications Inc.
Date: 25-01-2022
DOI: 10.2196/29644
Abstract: Maternal and child health (MCH)–related mobile apps are becoming increasingly popular among pregnant women however, few apps have demonstrated that they lead to improvements in pregnancy outcomes. This study aims to investigate the use of MCH apps among pregnant women in China and explore associations with pregnancy outcomes. A retrospective study was conducted at 6 MCH hospitals in northern China. Women who delivered a singleton baby at weeks’ gestation at the study hospitals were sequentially recruited from postnatal wards from October 2017 to January 2018. Information was collected on the women’s self-reported MCH app use during their pregnancy, along with clinical outcomes. Women were categorized as nonusers of MCH apps and users (further ided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight g, birth defects, stillbirth, and neonatal asphyxia. The association between app use and CAPO was explored using multivariable logistic analysis. The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 24.7% (457/1850) intermittent, 47.4% (876/1850) and continuous, 27.9% (517/1850). Among app users, the most common reasons for app use were health education (1393/1393, 100%), self-monitoring (755/1393, 54.2%), and antenatal appointment reminders (602/1393, 43.2%). Nonusers were older, with fewer years of education, lower incomes, and higher parity (P .01). No association was found between any app use and CAPO (6.8% in nonusers compared with 6.3% in any app users odds ratio 0.77, 95% CI 0.48-1.25). Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. Any app use was not found to be associated with improved pregnancy outcomes, highlighting the need for rigorous development and testing of apps before recommendation for use in clinical settings.
Publisher: Springer Science and Business Media LLC
Date: 17-02-2022
DOI: 10.1186/S12937-022-00762-4
Abstract: Sodium intake in China is extremely high and eating in restaurants is increasingly popular. Little research has explored the sodium level of restaurant dishes. The present study aims to assess the content and sources of sodium in Chinese restaurants. Cross-sectional data were obtained from the baseline survey of the Restaurant-based Intervention Study (RIS) in 2019. A total of 8131 best-selling restaurant dishes with detailed recipes from 192 restaurants in China were included. Sodium content per 100 g and per serving were calculated according to the Chinese Food Composition Table. The proportion of restaurant dishes exceeding the daily sodium reference intake level in a single serving and the major sources of sodium were determined. Median sodium content in restaurant dishes were 487.3 mg per 100 g, 3.4 mg per kcal, and 2543.7 mg per serving. For a single serving, 74.9% of the dishes exceeded the Chinese adults’ daily adequate intake for sodium (AI, 1500 mg per day), and 62.6% of dishes exceeded the proposed intake for preventing non-communicable chronic diseases (PI, 2000 mg per day). Cooking salt was the leading source of sodium in Chinese restaurant dishes (45.8%), followed by monosodium glutamate (17.5%), food ingredients (17.1%), soy sauce (9.4%), and other condiments/seasonings (10.2%). More types of salted condiments/seasonings use were related to higher sodium level. The sodium levels in Chinese restaurant dishes are extremely high and variable. In addition to cooking salt, other salted condiments/seasonings also contribute a large proportion of sodium. Coordinated sodium reduction initiatives targeting the main sources of sodium in restaurant dishes are urgently needed.
Publisher: Frontiers Media SA
Date: 17-04-2023
DOI: 10.3389/FNUT.2023.1161282
Abstract: High-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpose, a study was launched to support the development and scale-up of an mHealth-based system (EduSaltS) that integrated routine health education and salt reduction and was delivered through primary schools. This study aims to elaborate the framework, development process, features, and preliminary scaling-up of the EduSaltS system. The EduSaltS system evolved from previously successfully tested interventions to reduce family salt intake by empowering schoolchildren through school health education. EduSaltS was designed by following the WHO’s conceptual framework for developing a scaling-up strategy which accounted for the nature of the innovation, the capacity of the implementing organizations, the characteristics of the environment, the resources available, and type of scaling up. The system was then developed step by step from determination of online platform architecture, definition of component interventions and activities, development of specific educational materials and tools, to the development of the online/offline hybridized system. The system was tested and refined by a pilot in two schools and a preliminary scale-up in two cities in China. EduSaltS was developed as an innovative health education system, including an online WeChat-based education platform, a set of offline activities, and an actual administrative website showing the progress and setting the system. The WeChat platform could be installed on users’ smartphones to automatically deliver 20 sessions of five-minute well-structured cartoon video classes, followed by other online interactive activities. It also helps support project implementation and real-time performance evaluation. As a first-stage roll-out, a one-year course has been successfully implemented among 54,538 children and their families from 209 schools in two cities, and the average course completion rate was 89.1%. As an innovative mHealth-based health education system, EduSaltS was developed based on successfully tested interventions and an appropriate framework for scaling up. The early-stage roll-out has shown its preliminary scalability, and further evaluation is ongoing.
Publisher: JMIR Publications Inc.
Date: 30-12-2018
Abstract: here are an increasing number of mobile applications that provide dietary guidance in supporting healthy lifestyle and disease management. However, the characteristics of these nutrition-related apps are not well analyzed. his study aimed to evaluate the functionality and quality of nutrition-related apps in China. obile apps providing dietary guidance were screened in Chinese iOS and android app stores using stepwise searching criteria in November 2017. Primary review was conducted by extracting information from the description of apps. Free apps that contain all the information of diet and nutrition, with the last update after 1st Jan 2016 were downloaded for further analysis on the nutritional functionality features based on the framework of Chinese Dietary Guidelines and on the market related features as well. The user version of the Mobile Application Rating Scale (uMARS) was used to assess the quality of apps. mong the 44 downloaded nutrition-related apps screened from 628 apps with dietary guidance content, only 11(25%) were aimed exclusively for dietary guidance, the others were aimed for fitness guidance (17, 39%), disease management (11, 25%) and maternal health (5, 11%) respectively. The nutritional functionalities of the 44 apps included nutritional information enquiry (40, 91%), nutrition education (35, 80%), food record (34, 77%), diet analysis (34, 77%), and personalized recipes (21, 48%). Twelve out of 44 apps contained all of the above five nutrition related functionalities. The diet analysis and suggestions were mainly focused on energy (33/44, 75%), less on other factors like dietary structure (10/44, 23%). About 96% (42/44) of the apps provided social communication functionality and 59% (26/44) of the apps supported user incentives. Eight out of 44 apps (18%) also applied intelligent recognition technology. Using 5-point uMARS as scales of quality, the median scores of the 44 apps was 3.6 (IQR = 0.7). ost nutrition-related apps are developed in the service of health management other than for dietary guidance exclusively. Although basic energy balance theory was generally applied, the nutritional functionality of the nutrition-related apps is relatively limited and not in idualized. More efforts should be taken to integrate with the scientific nutritional knowledge and innovative technology in developing an app followed with complete and personalized dietary guidance.
Publisher: Wiley
Date: 12-03-2020
DOI: 10.1002/EDM2.122
Publisher: JMIR Publications Inc.
Date: 09-04-2020
DOI: 10.2196/15933
Abstract: Salt intake in China is over twice the maximum recommendation of the World Health Organization. Unlike most developed countries where salt intake is mainly derived from prepackaged foods, around 80% of the salt consumed in China is added during cooking. Action on Salt China (ASC), initiated in 2017, aims to develop, implement, and evaluate a comprehensive and tailored salt reduction program for national scaling-up. ASC consists of six programs working in synergy to increase salt awareness and to reduce the amount of salt used during cooking at home and in restaurants, as well as in processed foods. Since September 2018, two health c aigns on health education and processed foods have respectively started, in parallel with four open-label cluster randomized controlled trials (RCTs) in six provinces across China: (1) app-based intervention study (AIS), in which a mobile app is used to achieve and sustain salt reduction in school children and their families (2) home cook-based intervention study (HIS), in which family cooks receive support in using less salt (3) restaurant-based intervention study (RIS) targeting restaurant consumers, cooks, and managers and (4) comprehensive intervention study (CIS), which is a real-world implementation and evaluation of all available interventions in the three other RCTs. To explore the barriers, facilitators, and effectiveness of delivering a comprehensive salt reduction intervention, these RCTs will last for 1 year (stage 1), followed by nationwide implementation (stage 2). In AIS, HIS, and CIS, the primary outcome of salt reduction will be evaluated by 24-hour urinary sodium excretion in 6030 participants, including 5436 adults and 594 school children around 8-9 years old. In RIS, the salt content of meals will be measured by laboratory food analysis of the 5 best-selling dishes from 192 restaurants. Secondary outcomes will include process evaluation changes in knowledge, attitude, and practice on salt intake and economic evaluation. All RCTs have been approved by Queen Mary Research Ethics Committee and the Institutional Review Boards of leading institutes in China. The research started in June 2017 and is expected to be completed around March 2021. The baseline investigations of the four RCTs were completed in May 2019. The ASC project is progressing smoothly. The intervention packages and tailored components will be promoted for salt reduction in China, and could be adopted by other countries. Chinese Clinical Trial Registry. AIS: ChiCTR1800017553 dr8rpr. HIS: ChiCTR1800016804 8c7x3w. RIS: ChiCTR1800019694 qkjgfw. CIS: ChiCTR1800018119 3ajldw. DERR1-10.2196/15933
Publisher: Springer Science and Business Media LLC
Date: 29-06-2006
Abstract: In order to verify the relationship between blood pressure and cerebral blood flow velocity in sub-clinical natural population, 1294 middle-aged and old Beijing rural residents were investigated in autumn 2002. For all subjects, systolic blood flow velocities (V(s)) in common carotid artery (CCA), internal carotid artery (ICA) and middle cerebral artery (MCA) were detected with trans-cranial Doppler. Key factors such as anthropometry, medication use, blood pressure and blood biochemical analysis were investigated at the same time. After controlling for age, gender, diabetes, hypercholesterolaemia, smoking and body mass index, multivariate analysis showed that systolic blood pressure (SBP) correlated positively with V(s) at MCA and slight negatively correlated with at CCA. As blood pressure rose by 10 mm Hg, the V(s) at MCA increased by 1.63 cm/s. Duration of hypertension (HD) negatively correlated with V(s) at MCA (P<0.01). The V(s) at MCA in early-stage and chronic hypertensive patients were 92.9+/-1.9 and 84.1+/-2.3 cm/s, respectively. Antihypertensive treatment could modify the V(s) at MCA towards a normal level by lowering blood pressure. In conclusion, the effect of hypertension on cerebral blood flow is complex. V(s) at MCA positively correlated with SBP, but negatively related to HD. Antihypertensive treatment might be helpful to keep cerebral blood flow at a normal level.
Publisher: Springer Science and Business Media LLC
Date: 23-08-2010
Abstract: Since men with chronic kidney disease (CKD) progress faster than women, an accurate assessment of CKD progression rates should be based on gender differences in age-related decline of glomerular filtration rate (GFR) in healthy in iduals. A Chinese s le population from a stratified, multistage, and clustered CKD screening study was classified into healthy, at-risk, and CKD groups. The gender differences in estimated GFR (eGFR) and age-related eGFR decline were calculated for each group after controlling for blood pressure, fasting glucose levels, serum lipids levels, education level, and smoking status. After referencing to the healthy group, gender-specific multivariate-adjusted rates of decline in eGFR and differences in the rates of decline were calculated for both CKD and at-risk groups. The healthy, at-risk, and CKD groups consisted of 4569, 7434, and 1573 people, respectively. In all the 3 groups, the multivariate-adjusted eGFRs in men were lower than the corresponding eGFRs in women. In addition, in the healthy and at-risk groups, the rates of decline in eGFR in men were lower than the corresponding rates of decline in women (healthy group: 0.51 mL·min -1 ·1.73 m -2 ·yr -1 vs . 0.74 mL·min -1 ·1.73 m -2 ·yr -1 and at-risk group: 0.60 mL·min -1 ·1.73 m -2 ·yr -1 vs . 0.73 mL·min -1 ·1.73 m -2 ·yr -1 ). However, in the CKD group, the rates of decline in eGFR in men were similar to those in women (0.96 mL·min -1 ·1.73 m -2 ·yr -1 vs . 0.91 mL·min -1 ·1.73 m -2 ·yr -1 ). However, after referencing to the healthy group, the rates of decline in eGFR in men in the at-risk and CKD groups were greater faster than the corresponding rates in women (at-risk group: 0.10 mL·min -1 ·1.73 m -2 ·yr -1 vs . -0.03 mL·min -1 ·1.73 m -2 ·yr -1 and CKD group: 0.44 mL·min -1 ·1.73 m -2 ·yr -1 vs . 0.15 mL·min -1 ·1.73 m -2 ·yr -1 ). To accurately assess gender differences in CKD progression rates, gender differences in age-related decline in GFR should be considered.
Publisher: BMJ
Date: 10-2021
DOI: 10.1136/BMJOPEN-2020-046412
Abstract: Reducing sodium intake has been identified as a highly cost-effective strategy to prevent and control high blood pressure and reduce cardiovascular mortality. This study aims to compare the sodium content in processed meat and fish products among five countries, which will contribute to the evidence-base for feasible strategies of sodium reduction in such products. Sodium content on product labels of 26 500 prepackaged products, 19 601 meat and 6899 fish, was collected in supermarkets from five countries using the FoodSwitch mobile application from 2012 to 2018. To be specific, it was 1898 products in China, 885 in the UK, 5673 in Australia, 946 in South Africa and 17 098 in the USA. Cross-sectional comparisons of sodium levels and proportions meeting 2017 UK sodium reduction targets were conducted using Kruskal-Wallis H and the χ 2 test, respectively across the five countries. The results showed that processed meat and fish products combined in China had the highest sodium level (median 1050 mg/100 g, IQR: 774–1473), followed by the USA, South Africa, Australia, with the lowest levels found in UK (432 mg/100 g, IQR: 236–786) (p .001). Similar variations, that is, a twofold to threefold difference of sodium content between the highest and the lowest countries were found among processed meat and fish products separately. Large sodium content variations were also found in certain specific food subcategories across the five countries, as well as across different food subcategories within each country. Processed meat and fish products differ greatly in sodium content across different countries and across different food subcategories. This indicates great potential for food producers to reformulate the products in sodium content, as well as for consumers to select less salted food.
Publisher: JMIR Publications Inc.
Date: 07-11-2019
DOI: 10.2196/13236
Abstract: Mental disorders have been a great burden on health care systems, affecting the quality of life of millions of people worldwide. Developing countries, including China, suffer from the double burden of both the increasing mental health issues in population and the deficiency in mental health care resources. The use of mobile health technologies, especially for mobile phone apps, can be a possible solution. This review aimed to describe the features and assess the quality of mental health apps in major mobile phone app markets in China and further discuss the priorities for mental health app development. Keywords including psychology, psychological health, psychological hygiene, psychological health service(s), mental, mental health, mental hygiene, mental health service(s), depression, and anxiety were searched in Chinese in 3 Android app markets (Baidu Mobile Assistant, Tencent MyApp, and 360 Mobile Assistant) and iOS App Store independently. Mental health apps were then selected according to established criteria for in-depth analysis and quality assessment by the Mobile App Rating Scale. In total, 63 of 997 mental health apps were analyzed in depth, of which 78% (49/63) were developed by commercial entities for general population, 17% (11/63) were for patients or clients of specialized psychiatric hospitals or counseling agencies, 3% (2/63) were by government or local Centers for Disease Control and Prevention for general information, and 2% (1/63) for students of a university. Major built-in features of the apps included counseling services, mental health education, and self-assessment of mental health status by validated self-rating scales. The overall quality score of the MH apps was acceptable. Mental health apps are emerging in the area of mobile health in China. Popular mental health apps usually provide a synthetic platform organizing resources of information, knowledge, counseling services, self-tests, and management for the general population with mental health-related inquiries. The quality of the apps was rated as acceptable on average, suggesting some space for improvement. Official guidelines and regulations are urgently required for the field in the future.
Publisher: MDPI AG
Date: 21-12-2020
Abstract: As the catering sector has increasingly contributed to population-level salt intake, many countries have begun developing salt-reduction strategies for restaurants. This paper aims to provide an overview of global salt reduction policies in restaurants. Scientific papers and website materials were systematically searched from Web of Science, Science Direct, and PubMed, as well as official websites of government departments and organizations. A total of 78 full-text papers and grey literature works were included. From 58 countries and regions, 62 independent policies were identified, 27 of which were mandatory (3 with fines). The most common strategy was menu labeling, which was a component of 40 policies. Target setting (n = 23) and reformulation (n = 13) of dishes were also widely implemented. Other salt-reduction strategies included education c aign, chef training, toolkits delivery, table salt removal, media c aign, and government assistance such as free nutrition analysis and toolkits distribution. Most policies focused on chain restaurants. Evaluations of these policies were limited and showed inconsistent results, and more time is needed to demonstrate the clear long-term effects. Attention has been paid to salt reduction in restaurants around the world but is still at its early stage. The feasibility and effectiveness of the strategies need to be further explored.
Publisher: Mary Ann Liebert Inc
Date: 10-2015
Abstract: Efficacy of basal insulin (BI) has been well studied by randomized controlled trials, but the impact of BI on glycemic control in the real world has not been well documented. The Observational Registry for BI Treatment (ORBIT) study is designed to evaluate the real-life outcomes of BI in China. Participants with type 2 diabetes (n=19,894), from December 2011 to June 2013, inadequately controlled on oral hypoglycemic agents (OHAs) were initiated on BI treatment from 209 hospitals in all the eight regions in Mainland China. Data for each patient on use of OHAs and insulin (type and dose), glycemic control, hypoglycemic episodes, body weight, quality of life, and costs were collected at baseline and 3 and 6 months. For the 18,995 participants who were eligible for baseline analysis, mean±SD age was 55.4±10.4 years, with 52.5% males. The mean duration of diabetes was 6.4±5.3 years and was positively associated with the economic level of eight regions. Before initiation of BI, patients had a mean hemoglobin A1c level of 9.6±2.0% with a fasting plasma glucose level of 11.7±4.0 mmol/L. Of the patients, 35.5% had some diabetes complications. Metformin, sulfonylureas, and α-glycosidase inhibitors were the most commonly used OHAs. The proportions of patients using one, two, or more than two OHAs before BI initiation were 48.4%, 42.7%, and 8.9%, respectively. To the best of our knowledge, the ORBIT study is the largest registry study to evaluate glycemic outcomes and safety of BI in real-world China. Baseline data indicate delays in initiation of BI in the majority of patients with type 2 diabetes in China.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.BBRC.2017.12.148
Abstract: Autophagy is thought to be a key mechanism in maintaining the balance of liver lipid metabolism. However, the relationship between apolipoprotein M (ApoM) and autophagy has not been reported, and the role of ApoM in triglyceride metabolism is still unclear. In this study, we investigated the correlation between ApoM and autophagy and liver triglyceride metabolism in ApoM-knockout animal and cellular models. First, we observed that spontaneous hepatic steatosis developed in the liver of adult ApoM
Publisher: MDPI AG
Date: 07-11-2022
DOI: 10.3390/NU14214698
Abstract: We determined whether a town-level comprehensive intervention program could lower the salt intake of a population. The parallel, cluster randomized controlled trial was carried out between October 2018 and January 2020 in 48 towns from 12 counties across 6 provinces in China. All participants were asked to complete the 24 h urine collections, anthropometric measurements and questionnaires at the baseline and one-year post-intervention survey. A total of 2693 participants aged 18 to 75 years were recruited at the baseline. A total of 1347 in iduals in 24 towns were allocated to the intervention group and the others were allocated to the control group. Valid information from 2335 respondents was collected in the follow-up survey. The 24-h urinary sodium excretion was 189.7 mmol/24 h for the intervention group and 196.1 mmol/24 h for the control group at baseline. At a one-year follow-up, the mean effect of salt intake did not show a significant change (p = 0.31) in the intervention group compared to the control group. However, the mean result of potassium excretion in the intervention group increased by 2.18 mmol/24 h (85.03 mg/24 h) (p = 0.004) and systolic blood pressure decreased by 2.95 mmHg (p 0.001). The salt-related knowledge and attitude toward salt reduction improved significantly in the intervention group (p 0.05). A longer period of intervention and follow-up assessment might be needed to evaluate the long-term effectiveness of the program on salt reduction.
Publisher: BMJ
Date: 09-02-2022
Abstract: To determine whether a smartphone application based education programme can lower salt intake in schoolchildren and their families. Parallel, cluster randomised controlled trial, with schools randomly assigned to either intervention or control group (1:1). 54 primary schools from three provinces in northern, central, and southern China, from 15 September 2018 to 27 December 2019. 592 children (308 (52.0%) boys mean age 8.58 (standard deviation 0.41) years) in grade 3 of primary school (about 11 children per school) and 1184 adult family members (551 (46.5%) men mean age 45.80 (12.87) years). Children in the intervention group were taught, with support of the app, about salt reduction and assigned homework to encourage their families to participate in activities to reduce salt consumption. Primary outcome was the difference in salt intake change (measured by 24 hour urinary sodium excretion) at 12 month follow-up, between the intervention and control groups. After baseline assessment, 297 children and 594 adult family members (from 27 schools) were allocated to the intervention group, and 295 children and 590 adult family members (from 27 schools) were allocated to the control group. During the trial, 27 (4.6%) children and 112 (9.5%) adults were lost to follow-up, owing to children having moved to another school or adults unable to attend follow-up assessments. The remaining 287 children and 546 adults (from 27 schools) in the intervention group and 278 children and 526 adults (from 27 schools) in the control group completed the 12 month follow-up assessment. Mean salt intake at baseline was 5.5 g/day (standard deviation 1.9) in children and 10.0 g/day (3.5) in adults in the intervention group, and 5.6 g/day (2.1) in children and 10.0 g/day (3.6) in adults in the control group. During the study, salt intake of the children increased in both intervention and control groups but to a lesser extent in the intervention group (mean effect of intervention after adjusting for confounding factors −0.25 g/day, 95% confidence interval −0.61 to 0.12, P=0.18). In adults, salt intake decreased in both intervention and control groups but to a greater extent in the intervention group (mean effect −0.82 g/day, −1.24 to −0.40, P .001). The mean effect on systolic blood pressure was −0.76 mm Hg (−2.37 to 0.86, P=0.36) in children and −1.64 mm Hg (−3.01 to −0.27, P=0.02) in adults. The app based education programme delivered through primary school, using a child-to-parent approach, was effective in lowering salt intake and systolic blood pressure in adults, but the effects were not significant in children. Although this novel approach could potentially be scaled up to larger populations, the programme needs further strengthening to reduce salt intake across the whole population, including schoolchildren. Chinese Clinical Trial Registry ChiCTR1800017553.
Publisher: MDPI AG
Date: 30-06-2023
DOI: 10.3390/NU15133000
Abstract: The use of low-sodium salt substitute (LSSS) has the potential to reduce sodium and increase potassium intake. LSSS has been available in the Chinese market for years. However, its real-world use and impact on sodium otassium intake is unclear. Baseline data of 4000 adult in iduals who participated in three similarly designed randomized controlled trials were pooled together for this analysis. Self-reported awareness and use of LSSS were collected using a standardized questionnaire, and the participants’ 24-h urinary sodium and potassium excretion was used to estimate their dietary intake. Mixed-effects models were developed to assess the relationship between LSSS and 24-h urinary sodium and potassium excretion. 32.0% of the participants reported awareness of LSSS and 11.7% reported its current use. After adjusting for location, sex, age, and education, compared with the group of participants unaware of LSSS, participants who were aware of but not using LSSS and those who were using LSSS had a lower 24-h urinary sodium excretion by −356.1 (95% CI: −503.9, −205.9) mg/d and −490.6 (95% CI: −679.2, −293.7) mg/d, respectively (p 0.001). No significant difference was found for 24-h urinary potassium excretion or sodium-to-potassium ratio among the three groups (p 0.05). In conclusion, the findings of low usage of LSSS and the reduced urinary sodium excretion associated with the awareness and use of LSSS provide further support for the prometon of LSSS as a key salt reduction strategy in China.
Publisher: JMIR Publications Inc.
Date: 08-03-2017
DOI: 10.2196/JMIR.6978
Publisher: Springer Science and Business Media LLC
Date: 02-05-2013
Abstract: Prevalence of metabolic syndrome is high and increasing in China. The causation of this disorder is, yet, to be fully understood. Several studies with confirmatory factor analysis have been performed to investigate the core of the disease in some races other than Chinese, and amongst the other studies, they have yielded a sound model fit. This study was to evaluate and compare two single-factor models of the underlying factor structure of metabolic syndrome in a Chinese population using confirmatory factor analysis. Findings showed that in a Chinese s le of 7,472 in iduals, Model 1 (with waist circumference, triglycerides/HDL-C ratio, fasting plasma glucose and mean artery pressure) yielded good level of fitness (SRMR 0.08, CFI 0.96 and RMSEA 0.10) in men and women of all age groups and Model 2 (with waist circumference, triglycerides, fasting plasma glucose and systolic blood pressure) fitted well in men aged 18–34 and over 60 and in all women, except in men of 35–59 (RMSEA = 0.142). In comparison, Model 2 were shown to be better fit (with relative larger GFI and smaller AIC, BIC, CAIC, and EVIC) in women of all age groups and in men of 18–34 and over 60 years old Model 1 had a better fit in men between 35 and 59. This study suggests that the single-factor model of metabolic syndrome with waist circumference, triglycerides, fasting plasma glucose and systolic blood pressure are plausible in women of all age groups and young and senior men in Beijing. The model with waist circumference, triglycerides/HDL-C ratio, fasting plasma glucose and mean artery pressure fits middle-aged men.
Publisher: MDPI AG
Date: 29-06-2022
DOI: 10.3390/NU14132700
Abstract: This study used various nutrient profile models (NPMs) to evaluate the nutritional quality of pre-packaged foods in China to inform future food policy development. Nutrition data for pre-packaged foods were collected through FoodSwitch China in 2017–2020. The analyses included 73,885 pre-packaged foods, including 8236 beverages and 65,649 foods. Processed foods (PFs) and ultra-processed foods (UPFs) accounted for 8222 (11.4%) and 47,003 (63.6%) of all products, respectively. Among the 55,425 PFs and UPFs, the overall proportion of products with an excessive quantity of at least one negative nutrient was 86.0% according to the Chilean NPM (2019), 83.3% for the Pan American Health Organization NPM (PAHO NPM), and 90.6% for the Western Pacific Region NPM for protecting children from food marketing (WPHO NPM), respectively. In all NPMs, 70.4% of PFs and UPFs were identified as containing an excessive quantity of at least one negative nutrient, with higher proportions of UPFs compared to PFs. Food groups exceeding nutrient thresholds in most NPMs included snack foods, meat and meat products, bread and bakery products, non-alcoholic beverages, confectionery, and convenience foods. In conclusion, PFs and UPFs accounted for three-fourths of pre-packaged foods in China, and the majority of PFs and UPFs exceeded the threshold for at least one negative nutrient under all three NPMs. Given the need to prevent obesity and other diet-related chronic diseases, efforts are warranted to improve the healthiness of foods in China through evidence-based food policy.
Publisher: JMIR Publications Inc.
Date: 19-04-2020
Abstract: he app-based salt reduction intervention program in school children and their families (AppSalt) is a multicomponent mobile health (mHealth) intervention program, which involves multiple stakeholders, including students, parents, teachers, school heads, and local health and education authorities. The complexity of the AppSalt program highlights the need for process evaluation to investigate how the implementation will be achieved at different sites. his paper presents a process evaluation protocol of the AppSalt program, which aims to monitor the implementation of the program, explain its causal mechanisms, and provide evidence for scaling up the program nationwide. mixed methods approach will be used to collect data relating to five process evaluation dimensions: fidelity, dose delivered, dose received, reach, and context. Quantitative data, including app use logs, activity logs, and routine monitoring data, will be collected alongside the intervention process to evaluate the quantity and quality of intervention activities. The quantitative data will be summarized as medians, means, and proportions as appropriate. Qualitative data will be collected through semistructured interviews of purposely selected intervention participants and key stakeholders from local health and education authorities. The thematic analysis technique will be used for analyzing the qualitative data with the support of NVivo 12. The qualitative data will be triangulated with the quantitative data during the interpretation phase to explain the 5 process evaluation dimensions. he intervention activities of the AppSalt program were initiated at 27 primary schools in three cities since October 2018. We have completed the 1-year intervention of this program. The quantitative data for this study, including app use log, activity logs, and the routine monitoring data, were collected and organized during the intervention process. After completing the intervention, we conducted semistructured interviews with 32 students, 32 parents, 9 teachers, 9 school heads, and 8 stakeholders from local health and education departments. Data analysis is currently underway. sing mHealth technology for salt reduction among primary school students is an innovation in China. The findings of this study will help researchers understand the implementation of the AppSalt program and similar mHealth interventions in real-world settings. Furthermore, this process evaluation will be informative for other researchers and policy makers interested in replicating the AppSalt program and designing their salt reduction intervention. ERR1-10.2196/19430
Publisher: MDPI AG
Date: 29-09-2021
DOI: 10.3390/NU13103456
Abstract: Mixed evidence was published regarding the association of sodium, potassium and sodium-to-potassium ratio (Na/K ratio) with renal function impairment. This study was conducted to further explore the relationship between sodium, potassium, NA/K ratio and kidney function in the general adult Chinese population. We performed a cross-sectional analysis using the baseline data from the Action on Salt China (ASC) study. 5185 eligible general adult participants from the baseline investigation of the ASC study were included in this analysis. Sodium, potassium and albumin excretion were examined from 24-h urine collection. Albuminuria was defined as albumin excretion rate (AER) greater than or equal to 30 mg/24-h. Mixed linear regression models, adjusted for confounders, were fitted to analyze the association between sodium, potassium and Na/K ratio, and natural log transformed AER. Mixed effects logistic regression models were performed to analyze the odds ratio of albuminuria at each quintile of sodium, potassium and Na/K ratio. The mean age of the participants was 49.5 ± 12.8 years, and 48.2% were male. The proportion of albuminuria was 7.5%.The adjusted mixed linear models indicated that sodium and Na/K ratio was positively associated with natural log transformed AER (Sodium: β = 0.069, 95%CI [0.050, 0.087], p 0.001 Na/K ratio: β = 0.026, 95%CI [0.012, 0.040], p 0.001). Mixed effects logistic regression models showed that the odds of albuminuria significantly increased with the quintiles of sodium (p 0.001) and Na/K ratio (p = 0.001). No significant association was found between potassium and the outcome indicators. Higher sodium intake and higher Na/K ratio are associated with early renal function impairment, while potassium intake was not associated with kidney function measured by albumin excretion.
Publisher: Frontiers Media SA
Date: 14-03-2022
DOI: 10.3389/FPUBH.2022.744881
Abstract: Salt reduction is a cost-effective, and rather challenging public health strategy for controlling chronic diseases. The AppSalt program is a school-based multi-component mobile health (mhealth) salt reduction program designed to tackle the high salt intake in China. This mixed-methods process evaluation was conducted to investigate the implementation of this program across sites, identify factors associated with the implementation, and collect evidence to optimize the intervention design for future scale-up. Mixed methods were used sequentially to collect data regarding five process evaluation dimensions: fidelity, dose delivered, dose received, reach, and context. Quantitative data were collected during the intervention process. Participation rate of intervention activities was calculated and compared across cities. The quantitative data was used for the selection of representative intervention participants for the qualitative interviews. Qualitative data were collected in face-to-face semi-structured interviews with purposively selected students ( n = 33), adult family members ( n = 33), teachers ( n = 9), heads of schools ( n = 9), key informants from local health, and education departments ( n = 8). Thematic analysis technique was applied to analyze the interview transcripts using NVivo. The qualitative data were triangulated with the quantitative data during the interpretation phase. The total number of families recruited for the intervention was 1,124. The overall retention rate of the AppSalt program was 97%. The intervention was implemented to a high level of fidelity against the protocol. About 80% of intervention participants completed all the app-based salt reduction courses, with a significant difference across the three cities (Shijiazhuang: 95% Luzhou: 73% Yueyang: 64%). The smartphone app in this program was perceived as a feasible and engaging health education tool by most intervention participants and key stakeholders. Through the interviews with participants and key stakeholders, we identified some barriers to implementing this program at primary schools, including the left-behind children who usually live with their grandparents and have limited access of smartphones perceived adverse effects of smartphones on children (e.g., eyesight damage) and overlooked health education curriculum at Chinese primary schools. This process evaluation demonstrated the feasibility and acceptability of using smartphone applications delivered through the education system to engage families in China to reduce excessive salt intake. The AppSalt study was registered at www.chictr.org.cn , identifier: ChiCTR1800017553. The date of registration is August 3, 2018.
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1053/J.AJKD.2007.11.009
Abstract: Chronic kidney disease (CKD) is considered a serious worldwide public health problem, but data from developing countries are extremely limited. Cross-sectional study. A representative s le of 13,925 adults in Beijing, China. Age (18 to 39, 40 to 59, 60 to 69, and >70 years), sex, urban or rural area, history of chronic respiratory infection and cardiovascular disease, hepatitis B virus infection, smoking, family history (diabetes, hypertension, and CKD), nephrotoxic medications, central obesity, diabetic and hypertension status, and dyslipidemia. CKD was defined as estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) or markers of kidney damage. Glomerular filtration rate was estimated by using calibrated serum creatinine level and a formula specific for China. Persistent albuminuria and hematuria were considered markers of kidney damage. The prevalence of CKD in adults in Beijing was 13.0% (95% confidence interval [CI], 11.9 to 14.2). It therefore was estimated that the number of adults in Beijing with CKD was 1.43 million. In subjects aged 18 to 39, 40 to 59, 60 to 69, and older than 70 years, prevalences of CKD were 10.0% (95% CI, 8.9 to 11.3), 14.2% (95% CI, 13.0 to 15.4), 20.8% (95% CI, 18.1 to 23.9), and 30.5% (95% CI, 26.6 to 34.7), respectively. Factors independently associated with decreased kidney function included older age (odds ratio [OR], 1.83 95% CI, 1.51 to 2.22 per 10-year increase), nephrotoxic medications (OR, 2.19 95% CI, 1.21 to 3.97), rural area (versus urban area OR, 0.47 95% CI, 0.28 to 0.78), history of cardiovascular disease (OR, 2.04 95% CI, 1.24 to 3.38), high-density lipoprotein cholesterol level less than 40 mg/dL (OR, 3.00 95% CI, 1.39 to 6.51), and hypertension status (with duration > 10 years OR, 1.85 95% CI, 1.19 to 2.88). Kidney function and indicators of kidney damage were based on single measurements. CKD is a public health burden in Beijing.
Publisher: BMJ
Date: 02-2021
DOI: 10.1136/BMJGH-2020-004042
Abstract: Multimorbidity is a growing challenge in low-income and middle-income countries. This study investigates the effects of multimorbidity on annual medical costs and the out-of-pocket expenditures (OOPEs) along the cost distribution. Data from the nationally representative China Health and Retirement Longitudinal Study (CHARLS 2015), including 10 592 participants aged ≥45 years and 15 physical and mental chronic diseases, were used for this nationally representative cross-sectional study. Quantile multivariable regressions were employed to understand variations in the association of chronic disease multimorbidity with medical cost and OOPE. Overall, 69.5% of middle-aged and elderly Chinese had multimorbidity in 2015. Increased number of chronic diseases was significantly associated with greater health expenditures across every cost quantile groups. The effect of chronic diseases on total medical cost was found to be larger among the upper tail than those in the lower tail of the cost distributions (coefficients 12, 95% CI 6 to 17 for 10th percentile coefficients 296, 95% CI 71 to 522 for 90th percentile). Annual OOPE also increased with chronic diseases from the 10th percentile to the 90th percentile. Multimorbidity had larger effects on OOPE and was more pronounced at the upper tail of the health expenditure distribution (regression coefficients of 8 and 84 at the 10th percentile and 75th percentile, respectively). Multimorbidity is associated with escalating healthcare costs in China. Further research is required to understand the impact of multimorbidity across different population groups.
Publisher: Frontiers Media SA
Date: 25-03-2021
Abstract: Background: Targeted urinalysis has been suggested to improve screening efficiency in adults. However, there is no well-defined target population in children yet, with limited information on the risk factors for urinalysis abnormalities. Methods: Children from infants to 17 years old were randomly selected. Dipstick urinalysis was initially performed. Among those who were abnormal, a repeat dipstick or dipstick with microscopic urinalysis was performed for confirmation. Results: In total, 70,822 children were included, with 37,866 boys and 32,956 girls. Prevalence of abnormal urinalysis was 4.3%. Age was significantly associated with abnormal urinalysis, with the highest prevalence among 12–14-year-olds. Girls were 2.0 times more likely to exhibit abnormalities. Compared with children whose guardians had a college degree or higher, those whose guardians had a high school degree or lower had a higher likelihood of abnormalities. Geographic location was also associated with abnormal results. Conclusion: Girls, children aged 12–14 years old, and children whose guardians had a low educational level and children in certain geographic locations were significantly associated with abnormal urinalysis. Identification of children at high risk would contribute to targeted urinalysis screening.
Publisher: Elsevier BV
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 19-03-2021
DOI: 10.1186/S12872-021-01948-0
Abstract: Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT ( 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT ( P for trend 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m 2 ) (χ 2 = 52,228, P 0.001), alcohol drinking (χ 2 = 100,730, P 0.001) and cigarette smoking (χ 2 = 105,347, P 0.001). Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.
Publisher: Wiley
Date: 16-10-2021
DOI: 10.1002/GPS.5445
Abstract: In China, little evidence exists on the effect of mental and physical multimorbidity on in iduals and the health system. This study aims to examine the prevalence of mental–physical multimorbidity and its impact on health service utilization and health expenditures. We conducted a panel study using two waves of data (in 2011 and 2015) from the China Health and Retirement Longitudinal Study, including 10,181 participants aged 45 years and older. Generalized linear regression models were used to assess the association of multimorbidity with total health expenditure and out‐of‐pocket expenditure (OOPE) on outpatient and inpatient care. Random‐effects logistic regression models were used to examine the impact of multimorbidity on outpatient visits, admission to hospital and incidence of catastrophic health expenditure (CHE). Overall, 3210 participants (31.53% of 10,181) had mental–physical multimorbidity in 2015 in China. Compared to patients with a single physical disease, in iduals with physical‐mental multimorbidity had over 150% of the increase in the number of outpatient visits and days of hospitalization. The percentage change of OOPE for outpatient and inpatient care was 156.8% and 163.6%, respectively. Mental–physical multimorbidity was associated with an increased likelihood of experiencing CHE (OR = 2.205, 95% CI = 2.048, 2.051). Multimorbidity, particularly mental–physical multimorbidity, is associated with higher levels of health service use and a greater financial burden to in iduals in China. Healthcare system needs to shift from single‐disease models to new financing and service delivery models to more effectively manage mental–physical multimorbidity.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
Publisher: Elsevier BV
Date: 11-2016
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-027793
Abstract: Salt intake is very high in China, with ≈80% being added by the consumers. It is difficult to reduce salt in such settings. Our previous study (School-based Education programme to reduce Salt(School-EduSalt)) demonstrated that educating schoolchildren, who then instructed their families to reduce the amount of salt used at home, is effective in lowering salt intake in both children and adults. Our team also developed an app called ‘KnowSalt’, which could help in iduals to estimate their salt intake and the major sources of salt in the diet. Building on School-EduSalt and KnowSalt, we propose to develop a new app (AppSalt) focusing on salt reduction through education, target setting, monitoring, evaluation, decision support and management to achieve a progressive lower salt intake for long term. To evaluate the effectiveness of the AppSalt programme, we will carry out a cluster randomised controlled trial. We will recruit 54 primary schools from urban and rural areas of three provinces in China. A total of 594 children aged 8–9 years and 1188 adult family members will be randomly selected for evaluation. After baseline assessment, schools will be randomly allocated to either the intervention or control group. Children in the intervention group will be taught, with support of AppSalt, about salt reduction and assigned homework to get the whole family involved in the activities to reduce salt consumption. The duration of the intervention is two school terms (ie, 1 year). The primary outcome is the difference between the intervention and control group in the change of salt intake as measured by 24-hour urinary sodium. The study has been approved by Queen Mary Research Ethics Committee and Peking University Health Science Centre IRB. Results will be disseminated through presentations, publications and social media. ChiCTR1800017553.
Publisher: JMIR Publications Inc.
Date: 08-03-2020
Abstract: lectronic sphygmomanometer is widely used in the households, medical institutions, and can be applied to the measurement of blood pressure and pulse at the same time. Currently, there are few studies on accuracy comparison among different sphygmomanometers, and strict standardized verification is needed to ensure the comparability of blood pressure data. he aim of the present study was to validate the Omron HEM-7120, Yuwell YE680A, and Cofoe KF-65B for monitoring upper arm blood pressure (BP) according to the European Society of Hypertension International Protocol revision 2010 (ESH-IP revision 2010). hree trained medical doctors validated the performance of these devices by comparing the data obtained from the devices with those of a standard mercury sphygmomanometer. e included 33 participants for each experiment and the mean age of the participants was 50.0±11.2(Omron HEM-7120 experiment), 49.5±13.7(Yuwell YE680A experiment), and 48.8±15.0 years (Cofoe KF-65B experiment) in the respective studies. The absolute differences between the devices and the mercury readings within 5, 10, and 15 mmHg were as follows: HEM-7120, 73/99, 94/99 and 96/99, respectively, for systolic BP and 73/99, 91/99, 96/99, respectively, for diastolic BP Yuwell YE680A, 50/99, 79/99 and 91/99, respectively, for systolic BP and 67/99, 87/99, 95/99, respectively, for diastolic BP and Cofoe KF-65B, 53/99, 79/99 and 91/99, respectively, for systolic BP and 65/99, 89/99, 96/99, respectively, for diastolic BP. The findings also indicated that the devices’ systolic blood pressure readings were higher than mercury (1.3 mmHg, 1.0 mmHg and 4.1 mmHg higher for the Omron, Yuwell and Cofoe devices, respectively), while diastolic readings were lower than mercury (2.0 mmHg, 1.1 mmHg and 3.3 mmHg lower, respectively). he Omron HEM-7120 passed the requirements of the ESH-IP 2010 revision, while the Yuwell YE680A and Cofoe KF-65B failed.
Publisher: MDPI AG
Date: 20-10-2022
DOI: 10.3390/NU14204404
Abstract: Salt intake in China is very high, which increases the risk of hypertension and cardiovascular disease. This study aimed to assess the levels of salt-related knowledge, attitudes, and behaviors (KABs) and the factors that influence them and to explore the relationship between the scores of salt-related KAB and 24-h urinary sodium excretion. In 2018, we collected data from 5453 in iduals aged 18–75 years from six provinces in China. A face-to-face survey was carried out, focusing on the KAB related to salt reduction. All participants were asked to collect one 24-h urine s le. Of the 5453 participants, 5352 completed urine collection. The mean score for overall KAB was 31.27 (SD = 9.18), which was composed of three elements: knowledge 4.80 (SD = 5.14), attitude 9.33 (SD = 3.93), and behavior 17.14 (SD = 4.43). The average 24-h urinary sodium excretion was 187.70 (SD = 77.48) mmol, which was equivalent to a urinary sodium excretion of 4.32 (SD = 1.78) g/d. We found that salt-related knowledge, attitude, behavior, and overall KAB scores were all inversely associated with 24-h urinary sodium excretion. For every one-point increase in the KAB score, the 24-h urinary sodium excretion decreased by 0.851 mmol (95% CI: −1.095, −0.602). We also found that location (rural/urban), sex, age, and education are associated with salt-related KAB scores. These results suggest that large-scale health education is needed to reduce salt intake in the Chinese population. In particular, efforts should be focused on reaching those who live in rural areas with low educational levels and older people.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-05-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2016
Publisher: MDPI AG
Date: 14-12-2022
DOI: 10.3390/NU14245313
Abstract: Restaurant food is one of the important sources of sodium intake in China. We aimed to determine whether a restaurant-based comprehensive intervention program may induce lower sodium content in restaurant food. A randomized controlled trial was implemented between 2019 and 2020 in 192 restaurants in China. After baseline assessment, the restaurants were randomly assigned to either an intervention or a control group (1:1). Comprehensive activities designed for intervention restaurants were conducted for one year. The primary outcome was the difference in change of sodium content estimated by the mean values of five best-selling dishes for each restaurant, from baseline to the end of the trial between groups. In total, 66 control restaurants and 80 intervention restaurants completed the follow-up assessment. The average sodium content of dishes at baseline was 540.9 ± 176.8 mg/100 g in control and 551.9 ± 149.0 mg/100 g in intervention restaurants. The mean effect of intervention after adjusting for confounding factors was −43.63 mg/100 g (95% CI: from −92.94 to 5.66, p = 0.08), representing an 8% reduction in sodium content. The restaurant-based intervention led to a modest but not significant reduction in the sodium content of restaurant food. There is great urgency for implementing effective and sustainable salt reduction programs, due to the rapid increase in the consumption of restaurant food in China.
Publisher: JMIR Publications Inc.
Date: 20-02-2020
Abstract: s the management of type 2 diabetes remains suboptimal in primary care, the Road to Hierarchical Diabetes Management at Primary Care (ROADMAP) study was designed and conducted in erse primary care settings to test the effectiveness of a three-tiered diabetes management model of care in China. his paper aims to predetermine the detailed analytical methods for the ROADMAP study before the database lock to reduce potential bias and facilitate transparent analyses. he ROADMAP study adopts a community-based, cluster randomized controlled trial design that compares the effectiveness of a tiered diabetes management model on diabetes control with usual care among patients with diabetes over a 1-year study period. The primary outcome is the control rate of glycated hemoglobin (HbA sub c /sub ) & % at 1 year. Secondary outcomes include the control rates of ABC (HbA sub c /sub , blood pressure, and low-density lipoprotein cholesterol [LDL-C], in idual and combined) and fasting blood glucose, and the change in each outcome. The primary analysis will be the log-binomial regression with generalized estimating equation (GEE), which accounts for the clustering within communities, for binary outcomes and linear regression with GEE for continuous outcomes. For both, the baseline value of the analyzed outcome will be the covariate. The other covariate further adjusted models and the repetitive models after multiple imputation (when more than 10% of observations in HbA sub c /sub after 1 year are missing) will be used for sensitivity analysis. Five prespecified subgroup analyses have also been planned to explore the heterogeneity of the intervention effects by adding the subgroup variable and its interaction with the intervention to the primary model. his plan has been finalized, approved, and signed off by the principle investigator, co-principle investigator, and lead statisticians as of November 22, 2019, and made public on the institutional website without any knowledge of intervention allocation. Templates for the main figure and tables are presented. his statistical analysis protocol was developed for the main results of the ROADMAP study by authors blinded to group allocation and with no access to study data, which will guarantee the transparency and reduce potential bias during statistical analysis. hinese Clinical Trial Registry ChiCTR-IOC-17011325 bpr9xrq ERR1-10.2196/18333
Publisher: Mary Ann Liebert Inc
Date: 07-2016
Abstract: Obstructive sleep apnea (OSA) is prevalent in patients with type 2 diabetes, but the influence of OSA on diabetes complications is not clear. We aimed to investigate the association of OSA with chronic diabetes complications in Chinese patients with type 2 diabetes. In total, 880 hospitalized patients were enrolled in a multicenter, cross-sectional study that involved 12 hospitals from six cities in the People's Republic of China. Overnight sleep monitoring with a portable monitor was used to record respiratory parameters, including the apnea-hypopnea index (AHI), the oxygen desaturation index (ODI), the oxygen saturation (SPO2), and the cumulative time of SPO2 below 90% or 85% (CT90% and CT85%, respectively). Chronic diabetes complications were recorded from medical charts. CT90% was independently associated with diabetic nephropathy (DN) after adjusting for age, sex, diabetes duration, glycosylated hemoglobin, body mass index, hypertension, and the use of angiotensin converting enzyme inhibitor/angiotensin receptor blocker drugs within 1 week. The associated parameters increased from two (the average SPO2 and CT90%) to three (ODI, the lowest SPO2, and CT85%) when the severity of DN increased from microalbuminuria to renal insufficiency. The estimated glomerular filtration rate was independently correlated with ODI (β = -0.172, P = 0.029) and the lowest SPO2 (β = 0.354, P = 0.004) after adjustments. The lowest SPO2 was associated with proliferative diabetic retinopathy by univariate logistic regression but was not significant in multivariate regression after adjustment. Parameters of nocturnal hypoxemia are associated with DN and renal function of patients with type 2 diabetes. The parameters of hypoxemia may more sensitively reflect the association of OSA and diabetic microvascular complications than AHI.
Publisher: JMIR Publications Inc.
Date: 17-04-2019
DOI: 10.2196/13250
Publisher: JMIR Publications Inc.
Date: 21-08-2019
Abstract: alt intake in China is over twice the maximum recommendation of the World Health Organization. Unlike most developed countries where salt intake is mainly derived from prepackaged foods, around 80% of the salt consumed in China is added during cooking. ction on Salt China (ASC), initiated in 2017, aims to develop, implement, and evaluate a comprehensive and tailored salt reduction program for national scaling-up. SC consists of six programs working in synergy to increase salt awareness and to reduce the amount of salt used during cooking at home and in restaurants, as well as in processed foods. Since September 2018, two health c aigns on health education and processed foods have respectively started, in parallel with four open-label cluster randomized controlled trials (RCTs) in six provinces across China: (1) app-based intervention study (AIS), in which a mobile app is used to achieve and sustain salt reduction in school children and their families (2) home cook-based intervention study (HIS), in which family cooks receive support in using less salt (3) restaurant-based intervention study (RIS) targeting restaurant consumers, cooks, and managers and (4) comprehensive intervention study (CIS), which is a real-world implementation and evaluation of all available interventions in the three other RCTs. To explore the barriers, facilitators, and effectiveness of delivering a comprehensive salt reduction intervention, these RCTs will last for 1 year (stage 1), followed by nationwide implementation (stage 2). In AIS, HIS, and CIS, the primary outcome of salt reduction will be evaluated by 24-hour urinary sodium excretion in 6030 participants, including 5436 adults and 594 school children around 8-9 years old. In RIS, the salt content of meals will be measured by laboratory food analysis of the 5 best-selling dishes from 192 restaurants. Secondary outcomes will include process evaluation changes in knowledge, attitude, and practice on salt intake and economic evaluation. ll RCTs have been approved by Queen Mary Research Ethics Committee and the Institutional Review Boards of leading institutes in China. The research started in June 2017 and is expected to be completed around March 2021. The baseline investigations of the four RCTs were completed in May 2019. he ASC project is progressing smoothly. The intervention packages and tailored components will be promoted for salt reduction in China, and could be adopted by other countries. hinese Clinical Trial Registry. AIS: ChiCTR1800017553 dr8rpr. HIS: ChiCTR1800016804 8c7x3w. RIS: ChiCTR1800019694 qkjgfw. CIS: ChiCTR1800018119 3ajldw. ERR1-10.2196/15933
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJOPEN-2018-025623
Abstract: (1) To assess the changes in the salt content of sauces in the UK in the past 10 years (2) to compare the salt content of sauces in China with equivalent products sold in the UK and (3) to calculate the proportion of sauce products meeting the salt targets set by the UK Department of Health (DoH). Cross-sectional surveys from the nutrition information panels of sauces. Major retailers in London, Beijing and Shijiazhuang operating at data collection times. Salt content of sauces. Relative change in the median salt content of UK products ranged from −70.6% to +3.0% in sauces for which salt targets were set, whereas it ranged from −27.1% to +111.5% in sauces without targets. Median salt contents were on average 4.4-fold greater in Chinese sauces compared with their UK equivalents surveyed during the same period (2015–2017). Only 13.4% of the Chinese products met the UK 2017 salt targets, compared with 70.0% of UK products. In the UK, the target-based approach contributed to the reduction in the salt content of sauces over the course of the past 10 years. Currently, large variations in salt content exist within the same categories of sauces and 70% of the products have met DoH’s 2017 targets, demonstrating that further reductions are possible and lower salt targets should be set. In China, salt content of sauces is extremely high with similarly large variations within same categories of sauces, demonstrating the feasibility of reducing their salt content. As processed foods (including sauces) are expected to become an important contributor to salt intake in China, national salt reduction efforts such as setting salt targets would be a valuable, proactive strategy.
Publisher: JMIR Publications Inc.
Date: 24-12-2018
Abstract: ental disorders have been a great burden on health care systems, affecting the quality of life of millions of people worldwide. Developing countries, including China, suffer from the double burden of both the increasing mental health issues in population and the deficiency in mental health care resources. The use of mobile health technologies, especially for mobile phone apps, can be a possible solution. his review aimed to describe the features and assess the quality of mental health apps in major mobile phone app markets in China and further discuss the priorities for mental health app development. eywords including italic sychology /italic , italic sychological health /italic , italic sychological hygiene /italic , italic sychological health service(s) /italic , italic mental /italic , italic mental health /italic , italic mental hygiene /italic , italic mental health service(s) /italic , italic depression /italic , and italic anxiety /italic were searched in Chinese in 3 Android app markets ( italic Baidu Mobile Assistant /italic , italic Tencent MyApp /italic , and italic Mobile Assistant /italic ) and iOS App Store independently. Mental health apps were then selected according to established criteria for in-depth analysis and quality assessment by the Mobile App Rating Scale. n total, 63 of 997 mental health apps were analyzed in depth, of which 78% (49/63) were developed by commercial entities for general population, 17% (11/63) were for patients or clients of specialized psychiatric hospitals or counseling agencies, 3% (2/63) were by government or local Centers for Disease Control and Prevention for general information, and 2% (1/63) for students of a university. Major built-in features of the apps included counseling services, mental health education, and self-assessment of mental health status by validated self-rating scales. The overall quality score of the MH apps was italic acceptable. /italic ental health apps are emerging in the area of mobile health in China. Popular mental health apps usually provide a synthetic platform organizing resources of information, knowledge, counseling services, self-tests, and management for the general population with mental health-related inquiries. The quality of the apps was rated as italic acceptable /italic on average, suggesting some space for improvement. Official guidelines and regulations are urgently required for the field in the future.
Publisher: Oxford University Press (OUP)
Date: 04-12-2008
DOI: 10.1093/NDT/GFN609
Abstract: It is unclear whether ethnic disparity of the prevalence of chronic kidney disease (CKD) exists among native Chinese and American ethnicities. A stratified multistage clustered screening for CKD performed in Beijing in 2006 was compared with data from the National Health and Nutrition Examination Survey (NHANES) between 1999-2006 (participants aged > or =20 years, 13 626 Chinese, 9006 whites, 3447 African Americans, 4626 Hispanics). Serum creatinine from Beijing and NHANES were calibrated at the Cleveland Clinic Laboratory. The re-expressed abbreviated MDRD equation for Americans and its modified form for Chinese were used to estimate glomerular filtration rate (eGFR). Subjects with eGFR 17 mg/g for males or >25 mg/g for females. CKD was diagnosed if CRI or albuminuria was present. Compared with American whites, African Americans and Hispanics, Chinese had a lower prevalence of adjusted albuminuria (12.10%, 16.33% and 14.16% versus 9.27%), CRI (9.46%, 5.18% and 3.11% versus 1.38%) and CKD (19.03%, 19.00% and 15.99% versus 10.25%). Moreover, Chinese hold the lowest risk of albuminuria when exposed to diabetes the risk of CRI among Chinese when exposed to diabetes or hypertension was lower than that among African Americans, but similar to that among whites and Hispanics. The CKD prevalence was significantly different among native Chinese and American ethnicities.
Publisher: Springer Science and Business Media LLC
Date: 13-10-2010
Abstract: Prevalence of dyslipidemia is high and increases even in younger people. The key aim of this study was to explore the group characteristics of patients in different durations of dyslipidemia and provide clues for the management of dyslipidemia in Beijing. Patients with short duration of dyslipidemia were mainly characterized by relatively young age, occupational groups, not eating or irregular eating breakfast, less physical activities, having the habit of smoking, and 53.8% is with abnormal LDL-c, 10.4% is with abnormal HDL-c, and 51.5% is with abnormal TG. 54.6% of patients with longer duration is with abnormal LDL-c, 12.8% of them is with abnormal HDL-c, and 57.1% is with abnormal TG. They paid much more attentions to their health, tried to eat breakfast regularly and do more physical activities, gave up smoking, and had regular breakfast, but increasing physiological disorders such as elevated blood pressure and glucose appeared. Severe sequelaes (stroke, myocardial infarction) were mainly observed in patients with the duration of more than 10 years. And in this group the proportions of patients with LDL-c ≥ 4.15 mmol/L and TG ≥ 4.53 mmol/L are the highest among the three groups. we should strengthen the tertiary prevention and improve the control rate of dyslipidemia in Beijing. Health promotion programs such as tobacco control and physical exercise should be carried out for younger patients.
Publisher: JMIR Publications Inc.
Date: 30-07-2019
DOI: 10.2196/13261
Abstract: There are an increasing number of mobile apps that provide dietary guidance to support a healthy lifestyle and disease management. However, the characteristics of these nutrition-related apps are not well analyzed. This study aimed to evaluate the functionality and quality of nutrition-related apps in China. Mobile apps providing dietary guidance were screened in the Chinese iOS and Android app stores in November 2017, using stepwise searching criteria. The first screening consisted of extracting information from the app descriptions. Apps that (1) were free, (2) contain information on diet and nutrition, and (3) were last updated after January 1, 2016, were downloaded for further analysis. Nutritional functionalities were determined according to the Chinese Dietary Guidelines framework. Market-related functionalities were developed from previous studies and tailored to downloaded apps. The quality of apps was assessed with the user version of the Mobile App Rating Scale (uMARS). Out of 628 dietary guidance apps screened, 44 were nutrition-related. Of these, guidance was provided on diet exclusively (11/44, 25%), fitness (17/44, 39%), disease management (11/44, 25%), or maternal health (5/44, 11%). Nutritional functionalities included nutritional information inquiry (40/44, 91%), nutrition education (35/44, 80%), food record (34/44, 77%), diet analysis (34/44, 77%), and personalized recipes (21/44, 48%). Dietary analysis and suggestions mainly focused on energy intake (33/44, 75%) and less on other factors such as dietary structure (10/44, 23%). Social communication functionalities were available in 42 apps (96%), user incentives were supported in 26 apps (59%), and intelligent recognition technology was available in 8 apps (18%). The median score for the quality of the 44 apps, as determined on a 5-point uMARS scale, was 3.6 (interquartile range 0.7). Most nutrition-related apps are developed for health management rather than for dietary guidance exclusively. Although basic principles of energy balance are used, their nutritional functionality was relatively limited and not in idualized. More efforts should be made to develop nutrition-related apps with evidence-based nutritional knowledge, comprehensive and personalized dietary guidance, and innovative technology.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2016
Publisher: Springer Science and Business Media LLC
Date: 29-05-2021
Publisher: Research Square Platform LLC
Date: 20-12-2019
Abstract: Background: To explore the proportion and characteristics of patients with Type 2 diabetes mellitus (T2DM) uncontrolled by oral antidiabetic drugs (OADs) who initiated basal insulin (BI) therapy using a basal-bolus regimen. Methods: This multicenter, observational, prospective study included a representative s le of 18,995 Chinese insulin-naïve T2DM patients who initiated BI therapy due to uncontrolled hyperglycemia by OADs. The type and dose of BI as well as other treatment regimens depended on physician’s discretion and patient’s willingness. Proportion of patients initiating basal-bolus insulin and associated factors were analyzed. Results: Basal-bolus accounted for 24.6% of patients initiating BI, of whom 97.8% initiated a full basal-bolus regimen. In the multivariate logistic regression, factors significantly associated with initiating basal-bolus regimen were tertiary hospital, in-patients, younger age, higher BMI, longer diabetes duration, more complications, higher HbA1c level, low self-monitoring of blood glucose (SMBG) frequency before, one OAD used before, no concomitant OAD, and initiating Neutral Protamine Hagedorn (NPH). About half of patients initiating basal-bolus persisted on the same insulin regimen at 3-month. Glycemic control rates (HbA1c %) at 6 months were 37.6% and 41.8% in basal-bolus and BI alone, respectively (p .0001). In patients with at least one complication, basal-bolus showed significantly lower glycemic control compared with BI alone (33.4% vs 39.8%, P .0001). Conclusions: The findings suggest a high proportion of patients with T2DM initiating basal-bolus insulin. Tertiary hospital, in-patients, younger age, higher BMI, longer diabetes duration, more complications, higher HbA1c level, low SMBG frequency before, one OAD used before, no concomitant OAD, and concomitant NPH were related to higher odds of initiating basal-bolus.
Publisher: Public Library of Science (PLoS)
Date: 11-08-2016
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/10641960802621309
Abstract: To investigate combination patterns of cardiovascular risks and sequelae at different stages of hypertension, all 6176 newly or previously diagnosed hypertensives were selected from a randomized s ling surveillance data to perform a multiple correspondence analysis. Short duration hypertensives are characterized by relatively young age, less physical exercise, normal fruits and vegetable intakes, high salt diet, and nearly normal blood lipid and glucose. Middle duration hypertensives begin to pursue more physical exercise and less salt, although increasing physiological disorders are found. Severe sequelae such as stroke and myocardial infraction mainly occurred in long duration hypertensives. Results imply that great efforts should be taken in health education and lifestyle interventions on prehypertensive and early stage hypertensive patients.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Public Library of Science (PLoS)
Date: 21-09-2021
DOI: 10.1371/JOURNAL.PMED.1003754
Abstract: Glycemic control remains suboptimal in developing countries due to critical system deficiencies. An innovative mobile health (mHealth)-enabled hierarchical diabetes management intervention was introduced and evaluated in China with the purpose of achieving better control of type 2 diabetes in primary care. A community-based cluster randomized controlled trial was conducted among registered patients with type 2 diabetes in primary care from June 2017 to July 2019. A total of 19,601 participants were recruited from 864 communities (clusters) across 25 provinces in China, and 19,546 completed baseline assessment. Moreover, 576 communities (13,037 participants) were centrally randomized to the intervention and 288 communities (6,509 participants) to usual care. The intervention was centered on a tiered care team–delivered mHealth-mediated service package, initiated by monthly blood glucose monitoring at each structured clinic visit. Capacity building and quarterly performance review strategies upheld the quality of delivered primary care. The primary outcome was control of glycated hemoglobin (HbA1c .0%), assessed at baseline and 12 months. The secondary outcomes include the in idual/combined control rates of blood glucose, blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) changes in levels of HbA1c, BP, LDL-C, fasting blood glucose (FBG), and body weight and episodes of hypoglycemia. Data were analyzed using intention-to-treat (ITT) generalized estimating equation (GEE) models, accounting for clustering and baseline values of the analyzed outcomes. After 1-year follow-up, 17,554 participants (89.8%) completed the end-of-study (EOS) assessment, with 45.1% of them from economically developed areas, 49.9% from urban areas, 60.5 (standard deviation [SD] 8.4) years of age, 41.2% male, 6.0 years of median diabetes duration, HbA1c level of 7.87% (SD 1.92%), and 37.3% with HbA1c .0% at baseline. Compared with usual care, the intervention led to an absolute improvement in the HbA1c control rate of 7.0% (95% confidence interval [CI] 4.0% to 10.0%) and a relative improvement of 18.6% (relative risk [RR] 1.186, 95% CI 1.105 to 1.267) and an absolute improvement in the composite ABC control (HbA1c .0%, BP /80 mm Hg, and LDL-C .6 mmol/L) rate of 1.9% (95% CI 0.5 to 3.5) and a relative improvement of 21.8% (RR 1.218, 95% CI 1.062 to 1.395). No difference was found on hypoglycemia episode and weight gain between groups. Study limitations include noncentralized laboratory tests except for HbA1c, and caution should be exercised when extrapolating the findings to patients not registered in primary care system. The mHealth-enabled hierarchical diabetes management intervention effectively improved diabetes control in primary care and has the potential to be transferred to other chronic conditions management in similar contexts. Chinese Clinical Trial Registry (ChiCTR) IOC-17011325 .
Publisher: Oxford University Press (OUP)
Date: 08-11-2011
DOI: 10.1093/NDT/GFQ679
Abstract: Prescription drug abuse is an important global health concern. Our previous survey in Beijing indicates that nephrotoxic medication use is independently associated with chronic kidney disease (CKD). In the present study, the study population consisted of participants from our previous survey with a confirmed history of nephrotoxic medication use. Nephrotoxic mediations included three antipyretic analgesics (58.2%) and three Chinese traditional medicines containing aristolochic acids (CTM-AAs, 47.3%). Prevalence of CKD (defined by presence of albuminuria and/or reduced estimated glomerular filtration rate) as well as markers of tubular injury was analysed, and compared with 109 age- and sex-matched controls. The prevalence of CKD was higher among medication users compared with controls, which was 18.3% and 8.5%, respectively. Among participants with medication use without CKD, markers of tubular injury including N-acetyl-β-d-glucosaminidase, transferrin and α(1)-microglobulin, were present in 26.6%. CKD was associated with CTM-AA use (cumulative AA-I dose > 0.5 g, OR = 5.625, P 2.0 kg, OR = 3.848, P = 0.063) in a dose-dependent manner. Albuminuria and tubular injury persisted among CTM-AA users, but not among analgesic users after cessation of drug. Our study suggests that education about rational analgesic use and CTM-AA banning may constitute an effective CKD prevention strategy.
Publisher: Wiley
Date: 29-05-2020
Publisher: Mary Ann Liebert Inc
Date: 09-2017
Publisher: BMJ
Date: 14-02-2022
DOI: 10.1136/BMJ.O381
Publisher: Springer Science and Business Media LLC
Date: 16-07-2019
Publisher: Springer Science and Business Media LLC
Date: 19-01-2022
DOI: 10.1186/S12902-021-00892-6
Abstract: Though many randomized control trials had examined the effectiveness and safety of taking insulin therapy with or without metformin, there are limited real-world data, especially among Chinese type 2 diabetes patients initiating basal insulin (BI) with uncontrolled hyperglycemia by oral agents. This study was designed to assess the effectiveness and safety of BI therapy combined with or without metformin in a real-world national cohort study. Patients with type 2 diabetes mellitus who initiated BI treatment due to uncontrolled hyperglycemia (HbA1c≥7 %) by oral antidiabetic drugs (OADs) were recruited in Chinese real-world settings between 2011 and 2013. A total of 12,358 patients initiated BI without bolus insulin and completed a 6-month follow-up were selected as the study population and ided into BI with metformin or BI without metformin group based on whether metformin was simultaneously prescribed or not at baseline. Propensity score adjustment was used to balance baseline covariates between two groups. A sub-analysis was also conducted among 8,086 patients who kept baseline treatment regimen during the follow-up. Outcomes were HbA1c, hypoglycemia, weight gain and insulin dose in two groups. 53.6 % (6,621 out of 12,358) patients initiated BI therapy concomitant with metformin. After propensity score adjustment, multivariate regression analysis controlled with number of OADs, total insulin dose, physical activity and diet consumption showed that BI with metformin group had a slightly higher control rate of HbA1c .0 % (39.9 % vs. 36.4 %, P = 0.0011) at 6-month follow-up, and lower dose increment from baseline to 6-month (0.0064 vs. 0.0068 U/day/kg, P = 0.0035). The sub-analysis with patients remained at same BI therapy further showed that BI with metformin group had higher HbA1c control rate (47.9 % vs. 41.9 %, P = 0.0001), less weight gain (-0.12 vs. 0.15 kg P = 0.0013), and lower dose increment during 6-month follow-up (0.0033 vs. 0.0037 U/day/kg, P = 0.0073) when compared with BI without metformin group. In alliance with current guidelines, the real-world findings also support the insulin initiation together with metformin. Continuous patients’ education and clinicians training are needed to improve the use of metformin when initiating BI treatment.
Publisher: JMIR Publications Inc.
Date: 15-04-2021
Abstract: aternal and child health (MCH)–related mobile apps are becoming increasingly popular among pregnant women however, few apps have demonstrated that they lead to improvements in pregnancy outcomes. his study aims to investigate the use of MCH apps among pregnant women in China and explore associations with pregnancy outcomes. retrospective study was conducted at 6 MCH hospitals in northern China. Women who delivered a singleton baby at & weeks’ gestation at the study hospitals were sequentially recruited from postnatal wards from October 2017 to January 2018. Information was collected on the women’s self-reported MCH app use during their pregnancy, along with clinical outcomes. Women were categorized as nonusers of MCH apps and users (further ided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight & g, birth defects, stillbirth, and neonatal asphyxia. The association between app use and CAPO was explored using multivariable logistic analysis. he 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 24.7% (457/1850) intermittent, 47.4% (876/1850) and continuous, 27.9% (517/1850). Among app users, the most common reasons for app use were health education (1393/1393, 100%), self-monitoring (755/1393, 54.2%), and antenatal appointment reminders (602/1393, 43.2%). Nonusers were older, with fewer years of education, lower incomes, and higher parity ( i P /i & .01). No association was found between i any app /i use and CAPO (6.8% in nonusers compared with 6.3% in any app users odds ratio 0.77, 95% CI 0.48-1.25). omen in China access a large number of different MCH apps, with social disparities in access and frequency of use. i Any app /i use was not found to be associated with improved pregnancy outcomes, highlighting the need for rigorous development and testing of apps before recommendation for use in clinical settings.
Publisher: JMIR Publications Inc.
Date: 08-06-2018
DOI: 10.2196/MHEALTH.9302
Publisher: Springer Science and Business Media LLC
Date: 26-06-2021
DOI: 10.1186/S12978-021-01180-1
Abstract: Gestational diabetes (GDM) is a global problem affecting millions of pregnant women, including in mainland China. These women are at high risk of Type II diabetes (T2DM). Cost-effective and clinically effective interventions are needed. We aimed to explore Chinese women’s perspectives, concerns and motivations towards participation in early postpartum interventions and/or research to prevent the development of T2DM after a GDM-affected pregnancy. We conducted a qualitative study in two hospitals in Chengdu, Southwest China. Face-to-face semi-structured interviews were conducted with 20 women with recent experience of GDM: 16 postpartum women and 4 pregnant women. Women were asked about their attitudes towards postpartum screening for type 2 diabetes, lifestyle interventions, mHealth delivered interventions and pharmacologic interventions (specifically metformin). An inductive approach to analysis was used. Interviews were recorded, transcribed, and coded using NVivo 12 Pro. Most women held positive attitudes towards participating in T2DM screening, and were willing to participate in postpartum interventions to prevent T2DM through lifestyle change or mHealth interventions. Women were less likely to agree to pharmacological intervention, unless they had family members with diabetes or needed medication themselves during pregnancy. We identified seven domains influencing women’s attitudes towards future interventions: (1) experiences with the health system during pregnancy (2) living in an enabling environment (3) the experience of T2DM in family members (4) knowledge of diabetes and perception of risk (5) concerns about personal and baby health (6) feelings and emotions, and (7) lifestyle constraints. Those with more severe GDM, an enabling environment and health knowledge, and with experience of T2DM in family members expressed more favourable views of postpartum interventions and research participation to prevent T2DM after GDM. Those who perceived themselves as having mild GDM and those with time/lifestyle constraints were less likely to participate. Women with experiences of GDM in Chengdu are generally willing to participate in early postpartum interventions and/or research to reduce their risk of T2DM, with a preference for non-drug, mHealth based interventions, integrating lifestyle change strategies, blood glucose monitoring, postpartum recovery and mental health.
Publisher: Public Library of Science (PLoS)
Date: 08-04-2019
Publisher: JMIR Publications Inc.
Date: 31-10-2017
Abstract: obile health services are thriving in the field of maternal and child health in China due to expansions in the field of electronic health and the introduction of the two-child policy. There are numerous maternal and child health apps in computer stores, but the exact number of apps, number of downloads, and features of these apps is not known. his study aimed to explore the use of maternal and child health apps in Android and iOS app stores and to describe the key functional features of the most popular apps, with the purpose of providing insight into further research and development of maternal and child health mobile health products. he researchers conducted a search in the 3 most popular Android app stores (Tencent MyApp, Baidu Mobile Assistant, and 360 Mobile Assistant) and the iTunes App Store in China. All apps regarding family planning (contraception and preparing for pregnancy), pregnancy and perinatal care, neonatal care and health, and development for children under 6 years were included in the initial analysis. Maternal and child health mobile apps with predominant features of product marketing, children’s songs, animation, or games were excluded from the study. The 50 most frequently used apps in each of the Android stores as well as the iTunes store (a total of 78 deduplicated apps) were selected and downloaded for an in-depth analysis. total of 5276 Android apps and 877 iOS apps developed for maternal and child health care were identified. Of the 78 most frequently used apps, 43 (55%) apps focused on one stage of MCH care, mainly targeting child care (25 apps) and before pregnancy care (11 apps), whereas 35 (45%) of the apps covered 2 or more stages, most of which (32 apps) included both pregnancy and child care services. The app features that were commonly adopted by the popular apps were health education, communication, health status self-monitoring, a diary, reminders, and counseling. Within the app feature of “health status self-monitoring,” the researchers found 47 specific tools supporting activities such as pregnancy preparation, fetal heart monitoring, blood glucose and blood pressure monitoring, and doctor visits. A few apps were equipped with external devices (n=3) or sensors. No app with intelligent decision-support features to support disease management for conditions such as gestational diabetes and pregnancy-induced hypertension was found. A small number of apps (n=5) had a Web connection with hospital information systems to support appointment making, payments, hospital service guidance, or checking of laboratory results. here are thousands of maternal and child health apps in the Chinese market. Child care, pregnancy, and before pregnancy were the mostly covered maternal and child health stages, in that order. Various app features and tools were adopted by maternal and child health apps, but the use of internal or external sensors, intelligent decision support, and tethering with existing hospital information systems was rare and these features need more research and development.
Publisher: MDPI AG
Date: 20-08-2021
DOI: 10.3390/NU13082864
Abstract: This cross-sectional study aimed to assess 24-h urinary sodium and potassium excretion in children and the relationships with their family excretion. Using the baseline data of a randomized trial conducted in three cities of China in 2018, a total of 590 children (mean age 8.6 ± 0.4 years) and 1180 adults (mean age 45.8 ± 12.9 years) from 592 families had one or two complete 24-h urine collections. The average sodium, potassium excretion and sodium-to-potassium molar ratio of children were 2180.9 ± 787.1 mg/d (equivalent to 5.5 ± 2.0 g/d of salt), 955.6 ± 310.1 mg/d and 4.2 ± 1.7 respectively, with 77.1% of the participants exceeding the sodium recommendation and 100% below the proposed potassium intake. In mixed models adjusting for confounders, every 1 mg/d increase in sodium excretion of adult family members was associated with a 0.11 mg/d (95% CI: 0.06 to 0.16, p 0.0001) increase in sodium excretion of children. The family-child regression coefficient corresponds to 0.20 mg/d (95% CI: 0.15 to 0.26, p 0.0001) per 1 mg/d in potassium and to 0.36 (95% CI: 0.26 to 0.45, p 0.0001) in sodium-to-potassium molar ratio. Children in China are consuming too much sodium and significantly inadequate potassium. The sodium, potassium excretion and sodium-to-potassium ratio of children are associated with their family excretions in small to moderate extent. Efforts are warranted to support salt reduction and potassium enhancement in children through comprehensive strategies engaging with families, schools and food environments.
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.CCA.2008.09.002
Abstract: The reference value of urine albumin-creatinine ratio (ACR) has racial disparities. The ACR reference value in a healthy Beijing population is reported. A reference Beijing population was s led via a multistage, clustered complex s ling method. By excluding subjects with self-reported kidney disease, hypertension, diabetes, dyslipidemia, cardiovascular disease, obesity or underweight condition, overt proteinuria, hematuria, or pyuria, as well as those with an estimated glomerular filtration rate (eGFR) > 200ml/min/1.73m2 or < 60ml/min/1.73m2, apparently healthy subjects (1260 males, 2305 females, aged 18-84y) were selected to be included in the current analysis. Urine albumin was measured using the immunoturbidimetic method, creatinine was measured using Jaffe's kinetic method on a morning spot-urine s le, and ACR was calculated. The 95th percentile of ACR was used as the normal upper limit. The association between ACR and each of gender, age, systolic blood pressure, body mass index, serum glucose, lipids, and eGFR was examined. The normal upper limit of ACR was 14mg/g (1.58mg/mmol) for males and 20mg/g (2.26mg/mmol) for females. Females had higher ACR values than males, and age, systolic blood pressure, and eGFR were positively correlated with ACR. The ACR reference value in the healthy Beijing population is lower than that of the Western population. Age, systolic blood pressure, and eGFR were found to correlate with ACR.
Publisher: JMIR Publications Inc.
Date: 10-02-2021
DOI: 10.2196/19430
Abstract: The app-based salt reduction intervention program in school children and their families (AppSalt) is a multicomponent mobile health (mHealth) intervention program, which involves multiple stakeholders, including students, parents, teachers, school heads, and local health and education authorities. The complexity of the AppSalt program highlights the need for process evaluation to investigate how the implementation will be achieved at different sites. This paper presents a process evaluation protocol of the AppSalt program, which aims to monitor the implementation of the program, explain its causal mechanisms, and provide evidence for scaling up the program nationwide. A mixed methods approach will be used to collect data relating to five process evaluation dimensions: fidelity, dose delivered, dose received, reach, and context. Quantitative data, including app use logs, activity logs, and routine monitoring data, will be collected alongside the intervention process to evaluate the quantity and quality of intervention activities. The quantitative data will be summarized as medians, means, and proportions as appropriate. Qualitative data will be collected through semistructured interviews of purposely selected intervention participants and key stakeholders from local health and education authorities. The thematic analysis technique will be used for analyzing the qualitative data with the support of NVivo 12. The qualitative data will be triangulated with the quantitative data during the interpretation phase to explain the 5 process evaluation dimensions. The intervention activities of the AppSalt program were initiated at 27 primary schools in three cities since October 2018. We have completed the 1-year intervention of this program. The quantitative data for this study, including app use log, activity logs, and the routine monitoring data, were collected and organized during the intervention process. After completing the intervention, we conducted semistructured interviews with 32 students, 32 parents, 9 teachers, 9 school heads, and 8 stakeholders from local health and education departments. Data analysis is currently underway. Using mHealth technology for salt reduction among primary school students is an innovation in China. The findings of this study will help researchers understand the implementation of the AppSalt program and similar mHealth interventions in real-world settings. Furthermore, this process evaluation will be informative for other researchers and policy makers interested in replicating the AppSalt program and designing their salt reduction intervention. DERR1-10.2196/19430
Publisher: Elsevier BV
Date: 10-2005
Abstract: This research examined the association of baseline pulmonary function with future quality of life (QOL). We collected baseline pulmonary function data in 1993 and 1994, and assessed QOL using the Chinese 35-Item Quality of Life Instrument in 2002 in a cohort of 1,356 participants. We used Pearson correlation analysis, multivariate analysis of variance, and multivariate linear regression analysis to assess the relationship between pulmonary function and QOL. The baseline percentage of age- and height-predicted FEV1 (FEV1%) was significantly correlated with the resurvey total QOL score (r = 0.126, p < 0.001) and with QOL scores for the general (r = 0.074, p = 0.006), physical (r = 0.085, p = 0.002), independence (r = 0.178, p < 0.001), and psychological (r = 0.064, p = 0.018) domains but not with the social and environmental domains after adjusting for age and sex. These associations were weaker for the percentage of age- and height-predicted FVC. Multiple linear regression showed that the above associations were independent of baseline and resurvey smoking status. Inclusion of respiratory symptoms in the model reduced the regression coefficients from 0.82 to 0.41 for the total QOL score and from 1.43 to 0.94 for the independence domain score, for a 10% change in FEV1%. The age- and sex-adjusted mean total QOL scores were 78, 76, 76, and 69, respectively (p < 0.001), for the groups of normal, symptomatic only, impaired pulmonary function only, and both symptomatic and impaired pulmonary function. This trend was also significant for the general, physical, independence, and psychological domain scores. Impaired baseline pulmonary function has a significant negative impact on QOL in later life that is independent of age, sex, height, and smoking status and is largely mediated through the development of chronic respiratory symptoms.
Publisher: JMIR Publications Inc.
Date: 28-12-2018
Abstract: igh salt consumption has contributed to the rise of noncommunicable diseases around the world. The application of mobile health (mHealth) technologies has witnessed rapid growth in recent years. However, evidence to support mHealth interventions to confront the challenge of salt reduction has not yet been critically reviewed. he aim of this study was to identify, characterize, and evaluate mHealth interventions aimed at salt reduction across the world. systematic search of studies in English or Chinese language published from January 1, 1992 to July 31, 2017 was conducted using 4 English databases (PubMed, MEDLINE, Global Health, and Cochrane) and 3 Chinese databases (Wanfang, China Science and Technology Journal, and China National Knowledge of Infrastructure). All studies directly using mobile technologies in health care with a primary or secondary objective of reducing dietary salt consumption were included. total of 1609 articles were found using the search strategy, with 11 full articles (8 English and 3 Chinese) being included for data extraction, including 11 interventional studies. Overall, few high-quality interventions were identified. Most interventions were limited by small study population s le sizes, lack of control groups, and short follow-up times, all of which were obstacles in generating long-term scalable approaches. Most interventions employed short message service as a platform for mHealth interventions, whereas some innovative mHealth technologies were also explored. Most interventions had a primary focus of improving awareness of dietary salt consumption. The outcome variables used to measure intervention effectiveness included 24-hour urinary sodium excretion, spot urine s ling, dietary records, and indirect behavior or knowledge indicators targeting salt consumption. Although most interventions displayed positive outcome results, none of them provided reliable evidence to evaluate the effectiveness of salt reduction. alt reduction in mHealth initiatives remains relatively unexplored however, studies that did intervene on salt-reduction show the potential of mHealth as an effective intervention method. We provide 3 recommendations for future mHealth interventions in salt reduction—(1) increased use of new, innovative, and interactive mHealth technologies (2) development of mHealth interventions with primary prevention measures and goals of salt reduction and (3) large-scale, rigorously designed, and object-targeted clinical trials of mHealth interventions with appropriate quantitative outcome variables, in particular 24-hour urine sodium.
Publisher: Oxford University Press (OUP)
Date: 02-02-2012
Abstract: To investigate the relationship between electrocardiogram (ECG) parameters [J wave, fragmented QRS (fQRS), QTc, the peak-to-end interval of T wave (Tp-Te)], and sudden cardiac death (SCD) in chronic heart failure (CHF). The ECGs of 1570 CHF patients, 572 cases with dilated cardiomyopathy (DCM) and 998 cases with ischaemic cardiomyopathy (ICM) were analysed with the endpoint being an SCD or non-SCD (NSCD). During a median follow-up period of 36 months (0.40-65 months), 438 (27.89%) patients died, of which 158 (35.84%) were SCD. Overall, the occurrence of J wave, fQRS, and long Tp-Te were greater in SCD patients than that of NSCD patients (all P< 0.01). For DCM cases, more SCD patients had J waves observed in the inferior leads than that in the NSCD group (26.78 vs. 13.07%, P<0.001). However, ICM cases with SCD did have more fQRS in the inferior leads than that with NSCD (42.16 vs. 26.67%, P= 0.01). After adjusting for other risk factors, Cox regression analysis revealed that presence of J wave or fQRS in the inferior leads predicted a higher risk for SCD in DCM [hazard ratio (HR), 4.095 95% confidence interval (CI), 2.132-7.863] and ICM (HR, 2.714 95% CI, 1.809-4.072) patients. A left ventricular ejection fraction ≤ 30% also predicted SCD and NSCD in DCM and ICM patients. In contrast, the predictive value of QTc and Tp-Te for SCD was not significant. Presence of J wave or fQRS in the inferior leads predicted higher risk of SCD in DCM and ICM patients and might serve as independent predictors for SCD in patients with CHF.
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.DIABRES.2010.01.022
Abstract: In the modified ATP III definition for metabolic syndrome (MS), the cut-off values for central obesity were set to > or =90 cm for male and > or =80 cm for women. Recently, a new Chinese definition for central obesity was set to > or =90 cm for male and > or =85 cm for women according to the corresponding BMI value of 25 kg/m(2). The purpose of this study was to explore the optimal WC cut-off points to reflect the cluster of multiple risk factors for adults in Beijing. The data collected during the surveillance of risk factors for non-communicable diseases in Beijing 2005 were used, with a total of 16,711 adults studied. Subjects with two or more components from the modified ATP III definition other than central obesity were considered to have multiple risk factors. The optimal WC cut-off points were 87 cm in men and 80 cm for women. When applied the WC advised definition for MS, the age-standardized prevalence was 38.0% for male and 32.3% for women, which is significantly higher than using the original one for men (34.7% vs 32.3%, P<0.001). The present study indicated that optimal waist circumference cut-off points were lower than that proposed in the modified ATP III definition, especially for men.
Publisher: Wiley
Date: 30-03-2018
DOI: 10.1111/DME.13616
Abstract: To examine whether the age profile of people with Type 1 diabetes differs from that of the general population and in what manner, and to study the clinical characteristics related to metabolic disorders among people with Type 1 diabetes in China. We sequentially enrolled 849 people with Type 1 diabetes from hospital records review, inpatient wards and outpatient clinics. Data were collected via face-to-face interviews, medical records and venous blood s les. Beijing census data for 2011 were used to provide the general population statistics. Descriptive analysis of the results and tests for differences were performed. The median (interquartile range) age at diagnosis of diabetes was 16 (9-28) years and the duration of diabetes was 4 (1-8) years. The mean ± sd HbA Compared with the general population, people with Type 1 diabetes comprised more young and fewer elderly in iduals. The prevalence of metabolic syndrome in the Type 1 diabetes population was 10.1%. Hypertension and dyslipidaemia were more prevalent in obese than non-obese in iduals.
Publisher: Wiley
Date: 26-01-2018
DOI: 10.1002/DMRR.2977
Abstract: We aimed to determine the clinical characteristics of type 2 diabetes patients on basal insulin therapy with inadequate glucose control due to discordance between glycated haemoglobin (HbA This was a retrospective analysis of data from the ORBIT study in China. Clinical characteristics of patients with discordance between HbA Overall, of 6721 patients initiated on basal insulin, 853 achieved HbA Patients treated with insulin analogues (glargine or detemir), instead of neutral protamine Hagedorn, and with more frequent SMBG are more likely to exhibit concordance between HbA
Publisher: BMJ
Date: 2020
DOI: 10.1136/BMJOPEN-2019-032734
Abstract: Diabetes management in primary care remains suboptimal in China, despite its inclusion in the essential public health service (EPHS). We aimed to evaluate the effectiveness of a mobile health (mHealth) based and three-tiered diabetes management system in erse Chinese contexts. This is a cluster randomised controlled trial, named road to hierarchical diabetes management at primary care (ROADMAP). 19 008 patients with type 2 diabetes (T2D) were recruited from primary care clinics in 864 communities across 144 counties/districts of 24 provinces. Eligible participants were adult patients diagnosed with T2D and registered for diabetes management in communities. Patients within the same communities (clusters) were randomly allocated into the intervention or control arm for 1 year in a 2:1 ratio. The control arm patients received usual care as EPHS packaged: at least four blood glucose (BG) and blood pressure (BP) tests, and lifestyle and medication instruction, yearly, from primary care providers. The intervention arm patients received at least two BG and one BP tests, monthly, and lifestyle and treatment instruction from a three-tiered contracted team. A mHealth platform, Graded ROADMAP, enabled test results uploading and sharing, and patient referral within the team. The intervention participants will be further ided into basic or intensive intervention group according to whether they were actively using the Your Doctor App. The primary outcome is the BG control rate with glycated haemoglobin (HbA1c) .0%. Secondary outcomes include control rates and changes of ABC (HbA1c, BP and low-density lipoprotein cholesterol) and fasting BG, hypoglycaemia episodes and health-related quality of life (EuroQol (EQ-5D)). The trial has been approved by the Institutional Review Board at Shanghai Sixth People's Hospital. Findings on the intervention effectiveness will be disseminated through peer-reviewed journals, conference presentations and other relevant mechanisms. ChiCTR-IOC-17011325.
Publisher: BMJ
Date: 2020
DOI: 10.1136/BMJOPEN-2019-032976
Abstract: Salt intake in China (≈12 g/day) is more than twice the upper limit recommended by the WHO (5 g/day). To reduce salt intake, Action on Salt China (ASC) was launched in 2017. As one of four randomised controlled trials (RCTs) in the ASC programme, a comprehensive intervention study was designed to test whether all the components of the interventions adopted by other RCTs are acceptable, scalable and effective when provided to a region in the real world. Using a cluster RCT design, 2688 participants were selected from 48 towns (clusters) in 12 counties in 6 provinces and assigned to the intervention group or the control group. Randomisation was performed after the baseline survey was completed. Information on salt-related knowledge, attitude and practice (KAP), blood pressure and 24-hour urinary sodium were collected. The intervention includes government engagement, health education and other intervention components targeting restaurants, home cooks and primary school students and their families that have been used in other RCTs. The control group will not receive the intervention. The project will be followed up for 2 years, with the intervention being carried out for the first year only. The primary outcome is salt intake measured by 24-hour urinary sodium excretion after 1 year. The secondary outcomes are the long-lasting effectiveness on salt intake and blood pressure measured by the same method, as well as salt-related KAP and blood pressure at the 1-year and 2-year follow-ups. Process evaluation and health economics analysis will be conducted as well. The study was reviewed and approved by the Institutional Review Board of the National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, and Queen Mary Research Ethics Committee. Results will be disseminated through presentations, publications and social media. ChiCTR1800018119
Publisher: Elsevier BV
Date: 04-2023
Publisher: MDPI AG
Date: 12-06-2023
DOI: 10.20944/PREPRINTS202306.0794.V1
Abstract: Low-sodium salt substitute (LSSS) has the potential in regulating sodium and potassium intake and has been available in China market for years. However, its real-world use and impact to sodium\\potassium intake is unclear. Baseline data of 4000 adult participants who participated in three similar-designed randomized controlled trails were pooled together for this study. Self-reported awareness and use of LSSS were collected using the uniform questionnaire, and the 24-h urinary sodium and potassium excretion was used to estimate their dietary intake. Mixed-effects models were developed to assess the relationship between LSSS and 24-h urinary sodium and potassium excretion. 32.0% of the participants reported awareness of LSSS and 11.7% reported its current use. After adjusting location, sex, age, and education, compared with the group of participants unaware of LSSS, participants who were aware but not using LSSS and those who were using LSSS had a lower 24-h urinary sodium excretion by –356.1(95% CI: –503.9, –205.9) mg/d and –490.6(95% CI: –679.2, –293.7), respectively (p& .001). No significant difference was found for 24-h urinary potassium excretion and sodium-to-potassium ratio among the three groups (p& .05). In conclusion, although associated with lower sodium intake, the awareness and real-world use of LSSS are still very low in China.
Publisher: VM Media SP. zo.o VM Group SK
Date: 21-08-2018
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2020-038744
Abstract: Salt intake in China is high, and most of it comes from that added by consumers. Nevertheless, recent years have seen a rapid increase in the frequency at which people eat out. The aim of this study is to evaluate the effectiveness of interventions designed for salt reduction in restaurants through a randomised controlled trial in China. As a randomised controlled trial with restaurants as study subjects, we recruited 192 restaurants from 12 counties of 6 provinces in China. After the baseline survey, restaurants were randomly assigned to intervention or control group. Using social cognitive theory, comprehensive intervention activities were designed to encourage salt reduction in all restaurant foods, and at the same time, to encourage consumers to choose lower salt options when eating out. The interventions will be conducted only in restaurants of the intervention group during the first year. The follow-up assessment will be conducted at the end of the trial. The primary outcome is the change in the average salt content of the five best-selling dishes of the restaurant, as measured by laboratory tests. Secondary outcomes include differences in the monthly use of salt and salty condiments between intervention and control restaurants, and the knowledge, attitude and practice on salt among restaurant consumers. The study was reviewed and approved by the Review Board of the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention and Queen Mary Research Ethics Committee. Results will be disseminated through presentations, publications and social media. ChiCTR1800019694 Pre-results.
Publisher: MDPI AG
Date: 10-04-2015
DOI: 10.3390/NU7042719
Publisher: JMIR Publications Inc.
Date: 28-04-2020
DOI: 10.2196/18333
Abstract: As the management of type 2 diabetes remains suboptimal in primary care, the Road to Hierarchical Diabetes Management at Primary Care (ROADMAP) study was designed and conducted in erse primary care settings to test the effectiveness of a three-tiered diabetes management model of care in China. This paper aims to predetermine the detailed analytical methods for the ROADMAP study before the database lock to reduce potential bias and facilitate transparent analyses. The ROADMAP study adopts a community-based, cluster randomized controlled trial design that compares the effectiveness of a tiered diabetes management model on diabetes control with usual care among patients with diabetes over a 1-year study period. The primary outcome is the control rate of glycated hemoglobin (HbA1c) % at 1 year. Secondary outcomes include the control rates of ABC (HbA1c, blood pressure, and low-density lipoprotein cholesterol [LDL-C], in idual and combined) and fasting blood glucose, and the change in each outcome. The primary analysis will be the log-binomial regression with generalized estimating equation (GEE), which accounts for the clustering within communities, for binary outcomes and linear regression with GEE for continuous outcomes. For both, the baseline value of the analyzed outcome will be the covariate. The other covariate further adjusted models and the repetitive models after multiple imputation (when more than 10% of observations in HbA1c after 1 year are missing) will be used for sensitivity analysis. Five prespecified subgroup analyses have also been planned to explore the heterogeneity of the intervention effects by adding the subgroup variable and its interaction with the intervention to the primary model. This plan has been finalized, approved, and signed off by the principle investigator, co-principle investigator, and lead statisticians as of November 22, 2019, and made public on the institutional website without any knowledge of intervention allocation. Templates for the main figure and tables are presented. This statistical analysis protocol was developed for the main results of the ROADMAP study by authors blinded to group allocation and with no access to study data, which will guarantee the transparency and reduce potential bias during statistical analysis. Chinese Clinical Trial Registry ChiCTR-IOC-17011325 bpr9xrq DERR1-10.2196/18333
Publisher: Elsevier BV
Date: 07-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2020
DOI: 10.1161/HYPERTENSIONAHA.120.15238
Abstract: This study aimed to assess current level of sodium and potassium intake and their associations with blood pressure (BP) using the 24-hour urinary data in a large s le of China. Data from participants aged 18 to 75 years were collected as the baseline survey of Action on Salt China in 2018. Of 5454 adults, 5353 completed 24-hour urine collection. The average sodium, potassium excretion, and sodium-to-potassium molar ratio were 4318.1±1814.1 mg/d (equivalent to 11.0±4.6 g/d of salt), 1573.7±627.1 mg/d, and 5.0±2.1, respectively. After adjusting for potential confounding factors and correcting for regression dilution, each 1000-mg increase in sodium excretion was associated with increased systolic BP (1.32 mm Hg [95% CI, 0.92–1.81]) and diastolic BP (0.34 mm Hg [95% CI, 0.09–0.60]). Each 1000-mg increase in potassium excretion was inversely associated with systolic BP (−3.19 mm Hg [95% CI, −4.38 to −2.20]) and diastolic BP (−1.56 mm Hg [95% CI, −2.29 to −0.90]). Each unit increase in sodium-to-potassium molar ratio was associated with an increase of systolic BP by 1.21 mm Hg (95% CI, 0.91–1.60) and diastolic BP by 0.44 mm Hg (95% CI, 0.24–0.64). The relationships between sodium and BP mostly increase with the rise of BP quantiles. Potassium shows the opposite trend. The current sodium intake in Chinese adults remains high and potassium intake is low. Sodium and sodium-to-potassium ratio were positively associated with BP, whereas potassium was inversely associated with BP. URL: dr8rpr Unique identifier: ChiCTR1800017553. URL: 8c7x3w Unique identifier: ChiCTR1800016804. URL: 3ajldw Unique identifier: ChiCTR1800018119.
Publisher: WHO Press
Date: 09-2021
Publisher: JMIR Publications Inc.
Date: 09-01-2018
DOI: 10.2196/MHEALTH.8998
Publisher: Mary Ann Liebert Inc
Date: 12-2018
Location: China
Location: China
Start Date: 2021
End Date: 2026
Funder: Medical Research Council
View Funded ActivityStart Date: 2019
End Date: 2021
Funder: Medical Research Council
View Funded ActivityStart Date: Start date not available
End Date: End date not available
Funder: National Institute for Health Research
View Funded ActivityStart Date: 2016
End Date: 2021
Funder: Ministry of Science and Technology of the People's Republic of China
View Funded ActivityStart Date: 2011
End Date: 2013
Funder: ResMed Foundation
View Funded Activity