ORCID Profile
0000-0002-0697-7432
Current Organisations
Shandong University
,
University of Queensland
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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: Springer Science and Business Media LLC
Date: 07-05-2022
DOI: 10.1186/S13293-022-00431-5
Abstract: Whether the association of cardiovascular diseases (CVDs) with dementia differs by sex remains unclear, and the role of socioeconomic, lifestyle, genetic, and medical factors in their association is unknown. We used data from the UK Biobank, a population-based cohort study of 502,649 in iduals. We used Cox proportional hazards models to estimate sex-specific hazard ratios (HRs) and 95% confidence intervals (CI), and women-to-men ratio of HRs (RHR) for the association between CVD (coronary heart diseases (CHD), stroke, and heart failure) and incident dementia (all-cause dementia, Alzheimer's Disease (AD), and vascular dementia (VD)). The moderator roles of socioeconomic (education, income), lifestyle (smoking, BMI, leisure activities, and physical activity), genetic factors ( APOE allele status), and medical history were also analyzed. Compared to people who did not experience a CVD event, the HRs (95%CI) between CVD and all-cause dementia were higher in women compared to men, with an RHR (Female/Male) of 1.20 (1.13, 1.28). Specifically, the HRs for AD were higher in women with CHD and heart failure compared to men, with an RHR (95%CI) of 1.63 (1.39, 1.91) and 1.32 (1.07, 1.62) respectively. The HRs for VD were higher in men with heart failure than women, with RHR (95%CI) of 0.73 (0.57, 0.93). An interaction effect was observed between socioeconomic, lifestyle, genetic factors, and medical history in the sex-specific association between CVD and dementia. Women with CVD were 1.5 times more likely to experience AD than men, while had 15% lower risk of having VD than men.
Publisher: Springer Science and Business Media LLC
Date: 19-02-2018
DOI: 10.1007/S10654-018-0367-Y
Abstract: Current evidence on the association between body mass index (BMI) and age at menopause remains unclear. We investigated the relationship between BMI and age at menopause using data from 11 prospective studies. A total of 24,196 women who experienced menopause after recruitment was included. Baseline BMI was categorised according to the WHO criteria. Age at menopause, confirmed by natural cessation of menses for ≥ 12 months, was categorised as < 45 years (early menopause), 45-49, 50-51 (reference category), 52-53, 54-55, and ≥ 56 years (late age at menopause). We used multinomial logistic regression models to estimate multivariable relative risk ratios (RRRs) and 95% confidence intervals (CI) for the associations between BMI and age at menopause. The mean (standard deviation) age at menopause was 51.4 (3.3) years, with 2.5% of the women having early and 8.1% late menopause. Compared with those with normal BMI (18.5-24.9 kg/m
Publisher: Elsevier BV
Date: 2022
Publisher: ScopeMed
Date: 2014
Publisher: Springer Science and Business Media LLC
Date: 05-02-2019
DOI: 10.1007/S10654-019-00490-W
Abstract: Early menopause is associated with an increased risk of subsequent cardiovascular disease (CVD). Few studies have investigated the converse. We examined whether premenopausal CVD events are associated with early age at menopause. We pooled the in idual data of 177,131 women from nine studies. We used multinomial logistic regression models to estimate multivariable relative risk ratios (RRR) and 95% confidence intervals (CI) for the associations between age at onset of premenopausal CVD events-including coronary heart disease (CHD) and stroke-and age at natural menopause. Altogether 1561 (0.9%) premenopausal participants reported CVD events (including 1130 CHD and 469 stroke) at a mean age of 41.3 years. Compared with women without any premenopausal CVD events, women who experienced a first CVD event before age 35 years had a twofold risk of menopause before age 45 years (early menopause) adjusted RRR (95% CI) of 1.92 (1.17, 3.14) for any CVD, 1.86 (1.01, 3.43) for CHD and 2.17 (1.43, 3.30) for stroke. Women who experienced a first premenopausal CVD event after age 40 years underwent a natural menopause at the expected age (around 51 years). These associations were robust to adjustment for smoking status, BMI, educational level, race/ethnicity, age at menarche, parity, hypertension and family history of CVD. For premenopausal women, a first CVD event before age 35 years is associated with a doubling of the risk of an early menopause, while a first CVD event occurred after 35 years indicates a normal menopause at around 51 years. Shared genetic and environmental factors (such as smoking), as well as compromised vasculature following CVD events, may contribute to this outcome.
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: MDPI AG
Date: 13-10-2022
DOI: 10.3390/NU14204279
Abstract: (1) Objective: To examine the association between posterior-derived dietary patterns, food variety, and frailty measured by frailty index (FI) in Chinese elderly. (2) Method: A cohort study based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2014 to 2018 was conducted among older adults. The food variety was defined by the food variety score (FVS), which was calculated using the frequency of food categories consumption. Dietary patterns were obtained using factor analysis. A FI composed of 38 health deficits was used to measure subjects’ frailty status. Logistic regression analyses were performed to explore the correlation between dietary factors and the incidence of frailty. (3) Results: Compared with low FVS, a high dietary ersity score at baseline was not associated with a reduced incidence of frailty after four years. Regarding long-term food variety, compared with the low variety maintained group, people with high variety maintained were associated with a lower risk of frailty (0.59, 95%CI 0.39–0.90). Adherence to the “egg-bean-pickle-sugar pattern” and “fruit-vegetable-meat-fish pattern” was associated with a lower risk of frailty. (4) Conclusion: Maintaining high food variety and adherence to two patterns, i.e., the egg-bean-pickle-sugar pattern and fruit-vegetable-meat-fish pattern, could reduce the incidence of frailty among Chinese older adults.
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: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2021-048660
Abstract: To curb the spread of COVID-19, most countries have adopted measures such as banning shore leave at ports and placed restrictions on crew change. Seafarers may bear an excess pressure during the COVID-19 pandemic. This study aimed to investigate the prevalence and risk factors associated with depression symptoms among Chinese seafarers during the COVID-19 pandemic. Cross-sectional study. This field survey-based study was conducted at Rongcheng Port, Shandong Province, China, from 10 June 2020 to 25 July 2020. Sociodemographic and occupational characteristics and health-related behaviours were collected through a face-to-face questionnaire. The Self-Rating Depression Scale was used to evaluate depression status during the preceding week. Logistic regression models were used to explore factors related to depression. 441 male Chinese seafarers were enrolled. Overall, the proportions of seafarers with low, moderate and severe depression symptoms were 23.35%, 9.30% and 9.07%, respectively. Compared with those with good self-rated health (SRH), seafarers with poor SRH had higher odds of depression (OR, 2.24, 95% CI 1.22 to 4.11). Less leisure time or physical exercise was associated with more severe self-reported depression symptoms (1–3 per week vs ≥4 per week: OR, 1.72, 95% CI 0.71 to 4.14 none vs ≥4 per week: OR, 3.93, 95% CI 1.67 to 9.26). Poor sleep quality was associated with higher likelihood of reporting severe depression (fair vs good: OR, 2.78, 95% CI 1.54 to 5.01 poor vs good: OR, 4.30, 95% CI 1.65 to 11.24). The more frequent seafarers worked overtime a week, the higher the likelihood of reporting severe depression symptoms (1–2 per week vs none: OR, 1.82, 95% CI 1.04 to 3.18 ≥3 per week vs none: OR, 2.49, 95% CI 1.05 to 5.92). Also, high perceived work stress was linked to higher odds of being depressed (intermediate vs low: OR, 2.06, 95% CI 0.78 to 5.46 high vs low: OR, 3.83, 95% CI 1.35 to 10.90). There is a high burden of depression associated with COVID-19 among seafarers. Special interventions that protect the mental health of seafarers are more critical than ever in the context of the pandemic.
Publisher: Wiley
Date: 15-10-2023
DOI: 10.1111/DOM.15215
Abstract: To examine the effect of a healthy lifestyle score derived from seven lifestyle factors recommended by the diabetes management guidelines on all‐cause and cause‐specific dementia in in iduals with type 2 diabetes mellitus (T2DM), and how diabetes duration and insulin use status modify their association. This study analysed data of 459 840 participants from the UK Biobank. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals for the association of an overall healthy lifestyle score with all‐cause and cause‐specific dementia of Alzheimer's disease, vascular dementia and non‐Alzheimer non‐vascular dementia. Using diabetes‐free participants who scored 5‐7 as the reference group, in diabetes‐free participants, we observed higher healthy lifestyle score was related to lower risk of all‐cause and cause‐specific dementia. However, in people with T2DM, those scored 2‐3, 4 and 5‐7 all had around the two‐time risk of all‐cause dementia (HR: 2.20‐2.36), while those scored 0‐1 had over a three‐time risk (HR: 3.14, 95% confidence interval 2.34‐4.21). A dose‐response trend was observed with vascular dementia (each 2‐point increase: 0.75, 0.61‐0.93) and no significant association with Alzheimer's disease (0.95, 0.77‐1.16). The reduced risk of all‐cause and cause‐specific dementia with higher lifestyle score was observed in patients with a diabetes duration less than 10 years, or in patients with no insulin use. In people with T2DM, higher healthy lifestyle score was associated with lower risk of all‐cause dementia. Diabetes duration and insulin use moderated the association between healthy lifestyle score and risk of dementia.
Publisher: Springer Science and Business Media LLC
Date: 20-02-2023
DOI: 10.1186/S13293-023-00491-1
Abstract: Whether the association of type 2 diabetes (T2DM) with dementia was differed by sex remains unclear, and the roles of age at onset of disease, insulin use and diabetes’ complications in their association are unknown. This study analyzed data of 447 931 participants from the UK Biobank. We used Cox proportional hazards models to estimate sex-specific hazard ratios (HRs) and 95% confidence intervals (CI), and women-to-men ratio of HRs (RHR) for the association between T2DM and incident dementia [all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD)]. The roles of age at onset of disease, insulin use and diabetes’ complications in their association were also analyzed. Compared to people with no diabetes at all, people with T2DM had increased risk of all-cause dementia (HR 2.85, 95% CI 2.56–3.17). The HRs between T2DM and AD were higher in women than men, with an RHR (95%CI) of 1.56 (1.20, 2.02). There was a trend that people who experienced T2DM before age 55 had higher risk of VD than those who had T2DM after age 55. In addition, there was a trend that T2DM had higher effect on VD that occurred before age 75 years than events that occurred after age 75. Patients with T2DM using insulin had higher risk of all-cause dementia than those without insulin, with an RHR (95%CI) of 1.54 (1.00–2.37). People with complications had doubled risk of all-cause dementia, AD and VD. Adopting a sex-sensitive strategy to address the risk of dementia in patients with T2DM is instrumental for a precision medicine approach. Meanwhile, it is warranted to consider patients' age at onset of T2DM, insulin use status and complications conditions.
Publisher: Oxford University Press (OUP)
Date: 21-06-2023
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: Wiley
Date: 30-05-2020
DOI: 10.1111/JDI.13282
Publisher: Elsevier BV
Date: 12-2020
Publisher: Public Library of Science (PLoS)
Date: 27-11-2018
Publisher: Springer Science and Business Media LLC
Date: 05-07-2021
DOI: 10.1186/S40249-021-00880-X
Abstract: The transmission dynamics and severity of coronavirus disease 2019 (COVID-19) pandemic is different across countries or regions. Differences in governments’ policy responses may explain some of these differences. We aimed to compare worldwide government responses to the spread of COVID-19, to examine the relationship between response level, response timing and the epidemic trajectory. Free publicly-accessible data collected by the Coronavirus Government Response Tracker (OxCGRT) were used. Nine sub-indicators reflecting government response from 148 countries were collected systematically from January 1 to May 1, 2020. The sub-indicators were scored and were aggregated into a common Stringency Index (SI, a value between 0 and 100) that reflects the overall stringency of the government’s response in a daily basis. Group-based trajectory modelling method was used to identify trajectories of SI. Multivariable linear regression models were used to analyse the association between time to reach a high-level SI and time to the peak number of daily new cases. Our results identified four trajectories of response in the spread of COVID-19 based on when the response was initiated: before January 13, from January 13 to February 12, from February 12 to March 11, and the last stage—from March 11 (the day WHO declared a pandemic of COVID-19) on going. Governments’ responses were upgraded with further spread of COVID-19 but varied substantially across countries. After the adjustment of SI level, geographical region and initiation stages, each day earlier to a high SI level (SI 80) from the start of response was associated with 0.44 (standard error: 0.08, P 0.001, R 2 = 0.65) days earlier to the peak number of daily new case. Also, each day earlier to a high SI level from the date of first reported case was associated with 0.65 (standard error: 0.08, P 0.001, R 2 = 0.42) days earlier to the peak number of daily new case. Early start of a high-level response to COVID-19 is associated with early arrival of the peak number of daily new cases. This may help to reduce the delays in flattening the epidemic curve to the low spread level.
Publisher: Springer Science and Business Media LLC
Date: 21-07-2023
Publisher: Oxford University Press (OUP)
Date: 30-07-2020
DOI: 10.1093/JTM/TAAA125
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 11-2016
Publisher: Mary Ann Liebert Inc
Date: 09-2017
Publisher: University of Queensland Library
Date: 2020
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: MDPI AG
Date: 22-05-2023
DOI: 10.3390/NU15102412
Abstract: This study aims to examine the associations between midlife Life’s Simple 7 (LS7) status, psychosocial health (social isolation and loneliness), and late-life multidimensional frailty indicators, and to investigate their synergistic effect on frailty. We used cohort data from the UK Biobank. Frailty was assessed using physical frailty phenotype, hospital frailty risk score, and frailty index. Cox proportional-hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between the LS7 score, psychosocial health, and frailty. For the association of LS7 with physical and comprehensive frailty, 39,047 in iduals were included. After a median follow-up of 9.0 years, 1329 (3.4%) people were identified with physical frailty, and 5699 (14.6%) with comprehensive frailty. For the association of LS7 with hospital frailty, 366,570 people were included. After a median follow-up of 12.0 years, 18,737 (5.1%) people were identified with hospital frailty. Compared to people with a poor LS7 score, those with an intermediate (physical frailty: 0.64, 0.54–0.77 hospital frailty: 0.60, 0.58–0.62 and comprehensive frailty: 0.77, 0.69–0.86) and optimal LS7 score (physical frailty: 0.31, 0.25–0.39 hospital frailty: 0.39, 0.37–0.41 and comprehensive frailty: 0.62, 0.55–0.69) were associated with a lower risk of frailty. Poor psychosocial health was associated with an increased risk of frailty. People who had a poor psychosocial status and poor LS7 score had the highest risk of frailty. A better LS7 score in midlife was associated with a reduced risk of physical, hospital, and comprehensive frailty. There was a synergistic effect of psychosocial status and LS7 on frailty.
Publisher: Mary Ann Liebert Inc
Date: 06-2023
Location: China
No related grants have been discovered for Dongshan Zhu.