ORCID Profile
0000-0002-5839-743X
Current Organisation
Menzies School of Health Research
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Publisher: Oxford University Press (OUP)
Date: 29-12-2016
Abstract: Understanding the urban-rural gap in childhood blood pressure (BP) is crucial to alleviate the urban-rural disparity in burden of hypertension in the future. This study investigated trends in urban-rural BP disparity and the influence of body mass index among Chinese children between 1985 and 2010. Data included 1 010 153 children aged 8-17 years enrolled in the Chinese National Survey on Students' Constitution and Health, a successive national cross-sectional survey. High BP was defined according to age-sex- and height-specific 95th percentile. Multi-variable linear and logistic regression models were used to assess the urban-rural BP differentials. Although urban children had greater prevalence of overweight and obesity than rural counterparts, rural children revealed higher levels of BP across the consecutive 25-year periods. The urban-rural disparity in prevalence of high systolic BP decreased from 2.3 (95% confidence interval: 2.3, 2.6) % to 0.2 (-0.1, 0.4) % in boys and 3.7 (3.5, 4.0) % to 0.6 (0.3, 0.8) % in girls between 1985 and 2010 after adjusting for confounding factors. Further adjustment of body mass index did not change the urban-rural disparity and its trend. The similar results were also observed for diastolic BP. Despite the urban-rural disparity in BP decreased between 1985 and 2010, rural children constantly showed higher BP levels than their urban counterparts. Since these differentials in BP cannot be explained by obesity, study of other potential factors could provide further opportunity to bridge this gap.
Publisher: Springer Science and Business Media LLC
Date: 12-08-2017
DOI: 10.1007/S11356-017-9812-9
Abstract: The purpose of this study was to estimate the association between Chinese children's forced vital capacity (FVC) and particulate matter with aerodynamic diameter ≤10 μm (PM
Publisher: Wiley
Date: 03-1930
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.PCD.2008.06.001
Abstract: (1) To determine the incidence of type 1 diabetes mellitus in children aged<15 years in Harbin, China and (2) to examine the trend in incidence over the period from 1990 to 2000. Newly diagnosed cases of type 1 diabetes from 1990 to 2000 were identified among 1,286,154 Chinese children aged 0-14 years in Harbin. The primary source of case ascertainment was from hospital records and the secondary source from the health records of school clinics. One hundred and three cases were identified during 1990 and 2000. The annual incidence rate was 0.73 per 100,000 (95% CI: 0.59-0.88 per 100,000). No significant difference between males and females in the incidence of type 1 diabetes was observed. The incidence was significantly associated with age. With those aged<5 years as reference, the rate ratios were 2.06 and 4.1 for those aged 5-9 and 10-14 years, respectively. The incidence was higher in urban than in suburban regions, particularly among those aged 10-14 years. No significant seasonality was observed. There was a significant increasing trend in the incidence of type 1 diabetes during the period of 1990 and 2000, with an annual increase of 7.4% (95% CI: 1.6-13.5%). There is a significantly increasing trend in the incidence of type 1 diabetes among children in Harbin. Increased number of cases has important implications for diabetes care providers. Understanding the etiology of this rise is critical for developing preventive measures to halt the trend.
Publisher: Wiley
Date: 09-08-2016
DOI: 10.1111/NEP.12841
Abstract: Indigenous Australians are significantly burdened by chronic kidney disease (CKD). Elevated levels of C-reactive protein (CRP) have been associated with diabetes and cardiovascular incidence in previous studies. Elevated CRP has been associated with albuminuria and reduced eGFR in cross-sectional studies. This study investigated the long-term predictive association between CRP measured at a baseline exam and the incidence of a CKD-related hospitalization. Health screening examinations were conducted in in iduals of a remote indigenous Australian community between 1992 and 1998. The risk of subsequent CKD hospitalisations, documented through Northern Territory hospital records up to 2010, was estimated with Cox proportional hazard models in people aged over 18 years at the baseline screen and who had albumin-creatinine ratios (ACRs) less than 34g/mol. 546 participants were eligible for our study. In iduals in the highest CRP tertile at baseline had increased levels of traditional cardiovascular risk factors. They also had almost 4 times the risk of a CKD-related hospitalisation compared with participants in the lowest CRP tertile (HR=3.91, 95%CI 1.01-15.20, P=0.049) after adjustment for potential confounding factors. Participants with CRP concentrations greater than 3mg/L had almost 3 times the risk of CKD hospitalisations than those ≤3mg/L (HR=2.84, 95%CI 1.00-8.00, P=0.049). Furthermore, risk of CKD hospitalisations increased 34% per doubling of baseline CRP (HR=1.34, 95%CI 1.04-1.74, P=0.024). In in iduals in this remote indigenous community without overt albuminuria at baseline the risk for incident CKD related hospitalisations was predicted by elevated C-reactive protein levels almost a decade earlier. Further research is needed to understand the roles that CRP and systemic inflammation play in CKD risk.
Publisher: JMIR Publications Inc.
Date: 27-04-2015
DOI: 10.2196/RESPROT.3960
Publisher: Springer Science and Business Media LLC
Date: 15-07-2015
DOI: 10.1007/S00431-014-2377-4
Abstract: Resting heart rate (RHR) is an accessible index of sympathetic activity. The objective of this study was to assess the associations between blood pressure (BP) and RHR in children with different waist circumferences (WCs). The data of the Chinese National Survey on Students' Constitution and Health in 2010 were used. A total of 91,762 participates aged 9 to 18 years with complete records were included. RHR was categorised into quintile groups and WC was stratified into small (<-1.035), medium (≥-1.035 and <1.035) and large (≥1.035) groups respectively, after they were converted into age- and sex-specific z-score. Multivariate linear regression revealed that the association between RHR z-score and BP was similar before and after WC was adjusted for. With 1 standard deviation variation in RHR, BP changed from 2.22 (95 % confidence interval (CI): 1.51, 2.93) to 3.58 mmHg (95 % CI: 2.54, 4.62) in small WC group and 1.83 (95 % CI: 1.10, 2.56) to 4.23 mmHg (95 % CI: 3.38, 5.09) in large WC group respectively. This study revealed that BP was positively associated with RHR among children with different WCs, which implied the positive association between sympathetic activity and BP in children regardless of the amount of abdominal fat.
Publisher: Oxford University Press (OUP)
Date: 28-07-2014
DOI: 10.1093/IJE/DYU154
Publisher: Springer Science and Business Media LLC
Date: 03-05-2017
DOI: 10.1038/IJO.2017.107
Abstract: It is debatable whether the body mass index (BMI) value that is associated with the lowest all-cause mortality has increased over time. Such an increase might indicate that the WHO BMI categories for normal weight and overweight need to be revised over time. This study assessed whether the BMI associated with the lowest all-cause mortality increased over time among US adults in the National Health Interview Survey. This survey with up to 25 years of follow-up included 901 197 participants, aged 20 to 79 years with baseline BMI between 18.5 and 39.9 kg m Among 901 197 participants, 130 495 died during over 14.5 million person-years of follow-up. There was a U-shaped BMI-mortality association in all the survey periods. When we used the original follow-up durations, the BMI associated with the lowest mortality increased monotonically from 23.9 kg m With a fixed long-term follow-up duration, the BMI value associated with the lowest mortality remains relatively stable over time.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/5342304
Abstract: Objectives . This study investigates the burden of cardiovascular risk markers in people with and without diabetes in a remote Indigenous Australian community, based on their HbA1c concentration. Methods . This study included health screening exams of 1187 remote Indigenous residents over 15 years old who represented 70% of the age-eligible community. The participants were stratified by HbA1c into 5 groups using cut-off points recommended by international organisations. The associations of traditional cardiovascular risk markers with HbA1c groups were assessed using logistic and linear regressions and ANOVA models. Results . Of the 1187 participants, 158 (13%) had a previous diabetes diagnosis, up to 568 (48%) were at high risk (5.7–6.4% (39–46 mmol/mol) HbA1c), and 67 (6%) potential new cases of diabetes (≥6.5% (48 mmol/mol)) were identified. In iduals with higher HbA1c levels were more likely to have albuminuria (OR 3.14, 95% CI 1.26–7.82) and dyslipidaemia (OR 2.37, 95% CI 1.29–4.34) and visited the clinic more often (OR 2.52, 95% CI 1.26–4.99). Almost all traditional CVD risk factors showed a positive association with HbA1c. Conclusions . Screening in this remote Indigenous Australian community highlights the high proportion of in iduals who are at high risk of diabetes as indicated by HbA1c and who also had an accentuated cardiovascular risk profile.
Publisher: Oxford University Press (OUP)
Date: 19-03-2014
DOI: 10.1093/AJE/KWU047
Publisher: BMJ
Date: 02-2004
Publisher: Springer Science and Business Media LLC
Date: 08-01-2013
Abstract: Obesity is regarded as a potential risk factor for atopy. The aim of this study was to assess the associations of obesity with atopic dermatitis, rhinitis, asthma and food allergy in Chinese adults. Two hundred and sixty six (266) atopic cases in Harbin, China, were identified according to the current Chinese guidelines for the diagnosis of atopic diseases. All cases had a previous diagnosis of atopic disorders (atopic dermatitis, rhinitis, asthma or food allergy) and were positive in one or more allergen specific IgE tests to 16 common allergens in the region. Each case was in idually matched to two healthy controls based on their age, sex, and residential regions. All 532 healthy controls were negative in allergen specific IgE tests. The associations of obesity with four atopic disorders were assessed using a conditional logistic regression method. Obesity was significantly associated with the presence of atopic diseases (OR = 3.2, 95% CI: 1.8, 5.7). Males and females had a similar association (OR = 3.1 for males and 3.2 for females). The associations of obesity with atopic dermatitis (OR = 2.7, 95% CI: 1.2, 6.3) and atopic rhinitis (OR = 3.1, 95% CI: 1.1, 8.7) were statistically significant. Although obesity was positively associated with atopic asthma, this association was not statistically significant (OR = 3.4, 95% CI: 0.6, 19.9). The association between obesity and food allergy was weak and not significant (OR = 1.1, 95% CI: 0.4, 3.7). Obesity is positively associated with the presence of atopic diseases in Chinese adults. Specifically, obesity is significantly associated with atopic dermatitis and rhinitis. Our findings warrant further investigation on the causal nature between obesity and atopic diseases and the effect of weight reduction on preventing atopic diseases.
Publisher: BMJ
Date: 11-2013
Publisher: Oxford University Press (OUP)
Date: 19-01-2016
Publisher: BMJ
Date: 2013
Publisher: BMJ
Date: 08-2011
Publisher: BMJ
Date: 13-11-2015
Publisher: BMJ
Date: 09-2015
Publisher: Korean Stroke Society
Date: 30-09-2016
Publisher: Elsevier BV
Date: 09-1999
DOI: 10.1046/J.1523-1755.1999.00633.X
Abstract: There is an epidemic of renal failure among Aborigines in the Australia's Northern Territory. The incidence is more than 1000 per million, and is doubling every three to four years. We evaluated the relationship of birthweight to renal disease in adults in one high-risk community. We screened more than 80% of people in the community for renal disease, using the urine albumin/creatinine ratio (ACR, g/mol) as the marker, and reviewed records for birthweights. Birthweights were available with increasing frequency for people born after 1956. In 317 adults aged 20 to 38 years at screening, the mean birthweight (SD) was 2.712+/-0.4 kg, and 35% had been low birthweight (LBW, less than 2.5 kg). Birthweight was positively correlated with body mass index (BMI), blood pressure, and diabetes rates, but was inversely correlated with ACR. The odds ratio for overt albuminuria in LBW persons compared with those of higher birthweights was 2.82 (CI, 1.26 to 6.31) after adjusting for other factors, and LBW contributed to an estimated 27% (CI, 3 to 45%) of the population-based prevalence of overt albuminuria. Multivariate models suggest that increasing BMI and blood pressure and decreasing birthweight act in concert to lify the increases in ACR that accompany increasing age. LBW contributes to renal disease in this high-risk population. The association might be mediated through impaired nephrogenesis caused by intrauterine malnutrition. The renal disease epidemic in Aborigines may partly be the legacy of greatly improved survival of LBW babies over the last four decades. Disease rates should eventually plateau as birthweights continue to improve, if postnatal risk factors can also be contained.
Publisher: Springer Science and Business Media LLC
Date: 17-06-2010
Publisher: JCFCorp SG PTE LTD
Date: 2014
Publisher: Wiley
Date: 02-2010
DOI: 10.1002/DMRR.1060
Abstract: China has experienced a rapid increase in diabetes. In this study, we assessed whether the associations of two adipocyte-derived hormones, leptin and adiponectin, with type 2 diabetes are independent of obesity in older Chinese adults. In this matched case-control study, each of the 619 diabetes and impaired fasting glucose (IFG) cases aged 60-96 years was matched to a control by age, sex, waist circumference and body mass index (BMI). Before matching, IFG and diabetes cases had significantly lower adiponectin and higher leptin concentrations than the participants with normal glucose. After matching for age, sex, waist circumference and BMI, the differences between cases and controls remained significant (p < 0.001) in adiponectin but not in leptin (p = 0.77). Adjusted odds ratios for the combined outcome of diabetes and IFG were 1.03 (95% confidence interval: 0.88, 1.21 p = 0.71) for one standard deviation increase in plasma leptin and 0.79 (95% confidence interval: 0.69, 0.91 p < 0.001) for one standard deviation increase in plasma adiponectin. Without adjustment for obesity related body size measurements of waist circumference and BMI, both adiponectin and leptin are associated with diabetes and IFG. After adjustment, adiponectin is independently associated with diabetes and IFG, but there is no independent association between leptin and either diabetes or IFG. Our findings suggest that adiponectin provides extra-predictive power beyond obesity while leptin does not independently predict the risk of diabetes and IFG in older Chinese adults.
Publisher: Springer Science and Business Media LLC
Date: 31-08-2004
Publisher: WHO Press
Date: 13-07-2016
Publisher: Elsevier BV
Date: 03-2006
DOI: 10.1016/J.CLINBIOCHEM.2005.11.016
Abstract: To examine the distribution of C-reactive protein (CRP) values in Aboriginal Australians and its relation to age and gender. High sensitivity CRP levels were measured in 954 Aboriginal participants aged 5-74 years. Fractional polynomial regressions were used to explore the relationship between CRP and age. CRP values changed with age and reached its lowest level around 10 years and then increased with age. Geometric means of CRP were 7.3 (95% confidence interval (CI): 6.6, 8.1) and 4.1 (95% CI: 3.7, 4.6) for female and male adults, respectively. Adjusting for age, the ratio of female to male CRP concentrations was 1.67 (95% CI: 1.45, 1.99) for adults, and 1.09 (95% CI: 0.84, 1.42) for children 5 to 19 years. CRP changes with age. Females have higher CRP values than males. CRP values in Aboriginal people are substantially higher than other populations.
Publisher: Wiley
Date: 12-10-2016
DOI: 10.1111/JCH.12712
Publisher: Wiley
Date: 08-1999
DOI: 10.1046/J.1440-1681.1999.03104.X
Abstract: 1. Predictors of natural and cardiovascular death were examined in a cohort from a remote Australian Aboriginal community with high mortality rates. The cohort was marked by high prevalences of diabetes (17%), hypertension (19% diastolic blood pressure (BP) > 90 mmHg), obesity (16% body mass index (BMI) > 30), albuminuria (26% albumin/creatinine ratio (ACR) > or = 34 g/mol) and renal failure (26% calculated glomerular filtration rate or = 34, 3.2 (range 1.6-6.5) for diastolic BP > or = 100 and 3.7 (range 1.5-8.9) for diabetes. 4. The relative risk associated with albuminuria was independent of diabetes and hypertension. Albuminuria was more common than either diabetes or hypertension and represents a target for intervention to reduce not only progression to renal disease, but also overall mortality.
Publisher: Elsevier BV
Date: 12-2012
Publisher: Elsevier BV
Date: 12-2000
DOI: 10.1111/J.1467-842X.2000.TB00519.X
Abstract: To describe the distribution of body mass index (BMI) and estimate the prevalence of potential chronic energy deficiency (CED) and obesity in Aborigines in remote communities (ARC) in the Top End of the Northern Territory, Australia. Centile charts were constructed for BMI from 1,631 sets of measurements from 1,138 Aborigines, aged five to 77 years, in three remote communities on the Tiwi Islands, using Cole's LMS method. These were compared with European, American white and American black reference charts. The prevalences of CED and obesity were also compared to the corresponding values from a national Indigenous s le. The BMI centiles change with age. Compared with reference populations, BMIs are lower in ARC children and adult males. Young adult females have similar BMIs to American black and higher BMIs than American white and French counterparts up to 45 years. Aborigines older than 50 years are 'thinner'. Compared with a national s le of Indigenous Australians, our s le has a higher prevalence of CED and a lower prevalence of obesity. The BMI centile curves describe the contemporary nutritional status in the remote communities. Nutritional status measured by BMI is different in ARC than in other populations. The difference in nutritional status between ARC and other populations should be considered when planning nutritional intervention strategies. The centile charts will allow health workers to determine the relative ranking of BMI for in idual Aborigines in the remote communities.
Publisher: Oxford University Press (OUP)
Date: 24-01-2013
Abstract: For Aboriginal populations, predicting in iduals at risk of cardiovascular disease (CVD) is difficult due to limitations and inaccuracy in existing risk-prediction algorithms. We examined conventional and novel risk factors associated with insulin resistance and the metabolic syndrome and assessed their relationships with subsequent CVD events. Longitudinal cohort. Aboriginal people (n = 739) from Central Australia completed population-based risk-factor surveys in 1995 and were followed up in 2005. Principal components analysis (PCA), regression and univariate analyses (using ROC defined cut-off points) were used to identify useful clinical predictors of primary CVD. PCA yielded five components: (1) lipids and liver function (2) insulin resistance (3) blood pressure and kidney function (4) glucose tolerance and (5) anti-inflammatory (low fibrinogen, high HDL cholesterol). Components 2, 3 and 4, and age were significant independent predictors of incident CVD, and smoking approached significance. In univariate analysis fasting glucose ≥ 4.8 mmol/l, total:HDL cholesterol ratio ≥ 5.7, non-HDL cholesterol ≥ 4.3 mmol/l, gamma-glutamyl transferase ≥ 70 U/l, albumin creatinine ratio ≥ 5.7 mg/mmol, systolic blood pressure ≥ 120 mmHg and diastolic blood pressure ≥ 70 mmHg were useful predictors of CVD. The co-occurrence of three or more risk variables (fasting glucose ≥ 4.8 mmol/l, total:HDL cholesterol ratio ≥ 5.7, blood pressure (systolic ≥ 120 mmHg diastolic ≥ 70 mmHg albumin:creatinine ratio ≥ 5.7 mg/mmol and smoking) had sensitivity of 82.0% and specificity of 59.9% for predicting incident CVD. Age is the strongest predictor of CVD for this population. For clinical identification of in iduals at high risk, screening for the combination of three or more of hyperglycaemia, dyslipidaemia, hypertension, albuminuria and smoking may prove a useful and efficient strategy.
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1111/J.1753-6405.2010.00548.X
Abstract: We assessed the independent contribution of C-reactive protein to the risk of cardiovascular disease in Aboriginal Australians. High sensitivity CRP levels were measured in 705 Aboriginal participants aged 20-74 years free from CVD at baseline. Participants were followed for a median of 11 years. Cox proportional hazards models were used to assess the association of CRP with the risk of developing CVD events. A total of 114 participants were diagnosed with CVD. Incidence rates were 5.4 and 21.4 per 1,000 person-years for the lower ( or=3 mg/l) CRP groups, respectively. After adjusting for age, sex, total cholesterol, systolic blood pressure, smoking status, diabetes, BMI and waist circumference, the association between CRP and CVD remained significant, with a hazard ratio of 2.40 (95% CI: 1.25, 4.62) for the higher CRP group relative to the lower CRP group. The population attributable risk was 52% (95% CI: 14%, 74%). CRP is an independent predictor of CVD in Aboriginal people. A large proportion of CVD cases are associated with elevated CRP levels. Therefore, controlling the conditions that cause inflammation may be beneficial to cardiovascular health in Aboriginal communities.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2016
Publisher: AMPCo
Date: 05-2014
DOI: 10.5694/MJA13.11052
Abstract: To estimate the prevalence and incidence of dementia in Northern Territory Indigenous and non-Indigenous populations. Four data sources were used to identify clients with a diagnosis of dementia, from 1 January 2008 to 31 December 2011. The data sources included hospital admissions, aged care services, primary care and death registration. A capture-recapture method was used to estimate prevalence and incidence, including both diagnosed and unknown cases. Prevalence and incidence of dementia among the NT Indigenous and non-Indigenous populations. In 2011, the estimated prevalence in the NT Indigenous population aged 45 years and over was 3.7 per 100, and 1.1 per 100 in the corresponding NT non-Indigenous population. The age-adjusted prevalence for the NT Indigenous population was 6.5 per 100, compared with the NT non-Indigenous prevalence of 2.6 per 100, which was similar to the national rate. The prevalence rate ratios of NT Indigenous to NT non-Indigenous men and women, respectively, were: 6.5 and 5.5 for the 45-64-years age group, 4.0 and 4.1 for those aged 65-74 years and 2.1 and 1.9 for those aged 75 years and over. The age-adjusted incidence among the NT Indigenous population aged 45 years and over (27.3 per 1000 person-years) was higher than that among the NT non-Indigenous population (10.7 per 1000 person-years). The NT Indigenous population has a much higher prevalence and incidence of dementia and younger onset of disease compared with their non-Indigenous counterparts. The results highlight the urgent need for interventions to moderate the emerging impact of dementia in the Australian Indigenous population.
Publisher: Elsevier BV
Date: 12-1998
Publisher: Elsevier BV
Date: 08-2002
DOI: 10.1111/J.1467-842X.2002.TB00176.X
Abstract: To assess the association between body mass index and the risk of all-cause and disease-specific mortalities in Australian Aborigines in a remote community. A community based cohort study. 744 Aboriginal adults aged 20 to 77 years in a remote community in Northern Territory. Eighty-seven deaths occurred during the follow-up period of 5,040.8 person-years. Mortality data for the period of 1992 and June 2000 were collected. Mortality rate ratios for each body mass index quartile was determined using a Cox proportional hazards model with adjustment for age, sex, and smoking and drinking status. An inverse relationship between BMI quartiles and the risk of all-cause, natural, and non-CVD mortality was found. Adjusted rate ratios (95% CI) of all-cause mortality were 0.92 (0.54-1.59), 0.71 (0.40-1.26) and 0.38 (0.19-0.75) for second, third and fourth BMI quartiles, respectively, with the first quartile as the reference. The fourth BMI quartile had the lowest risk of mortality with adjusted rate ratios of 0.38, 0.28, and 0.16 for deaths from all-cause, natural, and non-CVD, respectively. However, the associations between BMI and CVD and renal deaths did not reach statistical significance. BMI and mortality are inversely associated in Aboriginal adults in a remote community. In iduals with relatively higher BMI have a lower risk of death.
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.DIABRES.2016.06.015
Abstract: Previous estimates of life-years lost to diabetes are highly inconsistent. This study provided the updated estimates of life-years lost to diabetes in the United States. Each of a nationally representative s le of 21,829 adults with diabetes in the U.S. National Health Interview Survey 1997-2009 was in idually matched to one without diabetes by age, sex, race, survey year, BMI, smoking status, pre-existing cardiovascular disease and pre-existing cancer. All-cause mortality from original surveys to 31 December 2011 and median survival ages were estimated for those with diabetes and their matched controls. Overall median survival age for adults with diabetes was 10.5years shorter than that for matched controls without diabetes. Estimated life-years lost associated with diabetes decreased with increasing age at diagnosis from 20.0years for those diagnosed before age 20years to no difference for those diagnosed after 80years. Hazard ratios for mortality decreased from 3.03 (95% CI: 2.41, 3.80) for those with diabetes diagnosed before 20years to 1.04 (95% CI: 0.78, 1.39) for those diagnosed after 80years. The estimate of life-years lost associated with diabetes was much higher among those with pre-existing cardiovascular disease (20.3years) than among those without cardiovascular disease (8.5years). The effect of diabetes on survival depends on age at first diagnosis of diabetes and the presence of pre-existing diseases. The life-years lost are higher for those with diabetes diagnosed at younger ages. This study provided the updated estimates of life-years lost associated with diabetes in the United States.
Publisher: Wiley
Date: 19-12-2013
DOI: 10.1002/OBY.20676
Abstract: To identify gender differences among Chinese school-aged children from 1995 to 2010, and to project the future BMI-for-age Z-score distribution and prevalence of obesity. The data were from four cross-sectional surveys (1995, 2000, 2005, and 2010) of Chinese National Surveys on Students Constitution and Health (CNSSCH) with a national representative s le of Chinese children, involving more than 200,000 participants at each survey. BMI-for-age Z-score distributional shifts overall and in percentiles were compared by gender. Average shift was calculated for four survey periods and used for projecting future distributions and obesity prevalence. BMI-for-age Z-score increased more in their upper percentile distribution, indicating that Chinese children have become heavier over the past 15 years. Gender disparity in BMI-for-age Z-score has become wider during the period. Over a 15-year period, BMI-for-age Z-score shift among girls has been stable, while boy's BMI-for-age Z-score shifts has increased linearly. By 2020, the obesity prevalence is predicted to be 10.18% and 4.99% for boys and girls, respectively. The wider gender disparity suggested a larger proportion of obesity in boys than in girls. Therefore, gender-specific preventive guidelines and public health policies for childhood obesity and cardiovascular diseases are urgently needed in China.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2003
DOI: 10.1097/01.ASN.0000070033.86955.48
Abstract: Australian Aborigines are experiencing an epidemic of renal and cardiovascular disease. In late 1995 we introduced a treatment program into the Tiwi community, which has a three- to fivefold increase in death rates and a recent annual incidence of treated ESRD of 2760 per million. Eligible for treatment were people with hypertension, diabetics with micro or overt albuminuria, and all people with overt albuminuria. Treatment centered around use of perindopril (Coversyl, Servier), with other agents added to reach BP goals attempts to control glucose and lipid levels and health education. Thirty percent of the adult population, or 267 people, were enrolled, with a mean follow up of 3.39 yr. Clinical parameters were followed every 6 mo, and rates of terminal endpoints were compared with those of 327 historical controls matched for baseline disease severity, followed in the pretreatment program era. There was a dramatic reduction in BP in the treatment group, which was sustained through 3 yr of treatment. Albuminuria and GFR stabilized or improved. Rates of natural deaths were reduced by an estimated 50% (P = 0.012) renal deaths were reduced by 57% (P = 0.038) and nonrenal deaths by 46% (P = 0.085). Survival benefit was suggested at all levels of overt albuminuria, and regardless of diabetes status, baseline BP, or prior administration of angiotensin converting enzyme inhibitors (ACEI). No significant benefit was apparent among people without overt albuminuria, nor among those with GFR less than 60 ml/min. An estimated 13 renal deaths and 10 nonrenal deaths were prevented, with the number-needed-to-treat to avoid one terminal event of only 11.6. Falling deaths and renal failure in the whole community support these estimates. The program was extremely cost-effective. Programs like this should be introduced to all high-risk communities as a matter of urgency.
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.PUHE.2013.04.016
Abstract: To estimate the proportion of smokers that could potentially have been prevented from smoking by limiting the amount of pocket money received by Chinese adolescents. Cross-sectional study. Current smoking, ever smoking and the amount of pocket money were determined through self-administered questionnaires among 12,708 adolescents (aged 12-18 years) from 21 schools in Shanghai, China. Adjusted odds ratios for current smoking ranged from 2.0 [95% confidence interval (CI) 1.5-2.7] for adolescents receiving 200-399 Reminbin (RMB)/month as pocket money to 6.5 (95% CI 3.3-12.7) for those receiving ≥1000 RMB/month, compared with those receiving <200 RMB/month. The crude population-attributable risk percentage (PAR%) due to higher pocket money (≥200 RMB/month) for current smoking was 50.4% (95% CI 42.2-57.4), and adjusted PAR% was 43.3% (95% CI 30.7-53.1). Approximately half of current smokers may have been prevented from smoking if pocket money was limited to <200 RMB/month among Chinese adolescents. An even larger proportion could have been prevented from smoking if pocket money was reduced further. It is recommended that future intervention programmes should target parents to reduce the amount of pocket money in China.
Publisher: Public Library of Science (PLoS)
Date: 24-09-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2012
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.IJCARD.2016.06.024
Abstract: The relationships between serum folate levels and all-cause, cardiovascular disease (CVD), and cancer mortality are controversial. Utilizing 1999-2010 National Health and Nutrition Examination Survey (NHANES) and linked mortality data, we performed a cohort study with 28,845 participants and used Cox proportional hazards models and restricted cubic spline plots to elucidate the dose-response relationships between serum folate status and all-cause, CVD and cancer mortality. During an average follow-up for 6.2years, 2821, 545 and 628 deaths were attributed to all-causes, CVD and cancer, respectively. Lower folate levels were associated with increased mortality, with hazards ratios of 1.30 (95% confidence interval [CI]: 1.16-1.47) for all-cause mortality, 1.33 (95% CI: 1.01-1.76) for CVD mortality, and 1.47 (95% CI: 1.16-1.87) for cancer mortality (first quartiles versus second quartiles). A reversed J-shaped pattern was apparently observed in males and younger participants when analyzing all-cause mortality and in younger participants when it comes to CVD and cancer mortality. Lower folate levels, but not restricted to folate deficiency, are linked with higher rates of all-cause, CVD and cancer mortality. Adverse effects of excess folate as well as age and gender differences on mortality need further investigation.
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.ORCP.2015.04.002
Abstract: Abdominal adiposity is an important risk factor for childhood hypertension. The present study aimed to compare the strength of the association between waist circumference (WC) and hypertension in children with different WC levels. A total of 82,413 Chinese children aged 9-17 years were selected. An abdominally overweight child was defined as a child with WC ≥75th sex- and age-specific percentile. Hypertension was categorised as ≥95th sex-, age- and height-specific percentile. Logistic regression model was applied to calculate the odds ratio (OR) and 95% confidence interval (CI) of WC for hypertension after WC was transformed into sex- and age-specific z-score. Abdominally overweight children presented a higher risk of hypertension (OR: 2.39 95% CI: 2.26, 2.54) than children with normal WC. In children with normal WC, one sex- and age-specific standard deviation increase in WC was associated with a 42% increase in odds of hypertension (OR: 1.42 95% CI: 1.30, 1.55). That increase was elevated to 74% in abdominally overweight children (OR: 1.74 95% CI: 1.66, 1.82). A similar pattern was also observed in different sex and area groups, and in children 9-14 years old. An intensified association between WC and hypertension was observed in abdominally overweight Chinese children. The gain in WC was associated with greater increase in hypertensive risk in abdominally overweight children than that of children with normal WC. These findings could improve intervention strategies for hypertension risk reduction in children.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/PY15076
Abstract: Non-prescribed antibiotic use occurs worldwide and is an important contributor to antibiotic resistance. Social and health system factors were related to the practice of self-medication with antibiotics. This study aims to investigate the practice of non-prescribed antibiotic use, and to assess the impact of primary health service access and use on this practice among Australian Chinese migrants. Four-hundred and twenty-six participants, who self-identified as Chinese and who had been residing in Australia for at least 12 months, were recruited through several Australian Chinese social websites to participate in an online health survey about antibiotic use and health services use from July to October 2013. Logistic regression analyses were conducted to assess the associations between health services utilisation factors and the use of non-prescribed antibiotics. In total, 20.2% (86/426) participants reported having used antibiotics without medical consultation in the last 12 months. Of 170 antibiotic users, 50.6% (86/170) used antibiotics without medical consultation. Chinese migrants who self-evaluated as ‘satisfied’ with the experiences of GP services were less likely to self-medicate with antibiotics. In addition, Chinese migrants without any perceived barriers to using primary health services in Australia were less likely to use non-prescribed antibiotics. Among Australian Chinese migrants, over half of antibiotic users admitted that they had used antibiotics without medical consultation. Participants with positive experience and perception of primary health services, primarily GP services, had a lower risk of using non-prescribed antibiotics.
Publisher: Elsevier BV
Date: 02-2014
Abstract: To determine trends in health status over a 10-year interval in a high-risk remote Australian Aboriginal community. Two health surveys were performed, one between 1992 and 1997 and the other between 2004 and 2006, on people aged five years or older. Outcomes were compared across age-matched and sex-matched pairs. There were 1,209 matched pairs. In the second survey, birthweights tended to be higher, and there were significant increases in heights of adolescents and young adults, and high density lipoprotein cholesterol (HDL-C) levels generally. Young adult males were lighter, had lower measurements for waist circumference and blood pressure and less frequently had overt-albuminuria, while elevated blood pressure was less common in older males. However, females≥15 years had higher measurements for waist circumference, waist to hip ratio (WHR), body mass index (BMI) and diastolic blood pressure and a higher proportion of diabetes, notably in those aged older than 45 years. Males aged 15-24 years were less likely to be smokers while women aged less than 45 years were more often current drinkers. Results indicative of better nutrition among youth, better health of young adult males, stable or lower levels of albuminuria and improved HDL levels are all encouraging. The waist circumference increase in females might reflect better food access. An increase in diabetes in older subjects probably reflects recent enhanced survival of middle-aged and older people with--and at risk for--diabetes.
Publisher: American Diabetes Association
Date: 2008
DOI: 10.2337/DC07-1170
Abstract: OBJECTIVE—The purpose of this study was to examine the association of birth weight with indexes of glycemia in a population-based survey. RESEARCH DESIGN AND METHODS—A total of 10,788 participants in the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study were asked to complete a birth weight questionnaire. Fasting plasma glucose (FPG), postload glucose (PLG), and A1C were modeled against birth weight. World Health Organization criteria were used to define impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes. RESULTS—Among 7,157 participants who responded to the questionnaire, 4,502 reported their birth weights, with a mean ± SD of 3.4 ± 0.7 kg. FPG, PLG, and A1C were strongly and inversely correlated with birth weight. The odds ratios (95% CI) for high (& th sex-specific percentile) FPG, PLG, and A1C were 0.83 (0.71–0.96), 0.74 (0.65–0.84), and 0.81 (0.70–0.94), respectively, for a 1-kg increase in birth weight after adjustment for age and sex. In those with low birth weight (LBW), the risks for having IFG, IGT, and diabetes and for all abnormalities combined were increased by 1.75, 2.22, 2.76, and 2.28, respectively, for women and by 1.40, 1.32, 1.98, and 1.49 for men compared with risks for those with normal birth weight. These trends applied across categories of age and BMI. CONCLUSIONS—In an affluent Western country with a good adult health profile, birth weight has an inverse relationship with indexes of glycemia, and in iduals with LBW were predisposed to higher rates of glycemic dysregulation in adult life. These associations were independent of BMI and of other factors significantly correlated with glycemic dysregulation.
Publisher: Cambridge University Press (CUP)
Date: 13-01-2009
DOI: 10.1017/S0007114508184732
Abstract: China is experiencing a rapid increase in overweight and related conditions. This study describes the geographic variation in BMI levels and the prevalence of overweight and underweight in Chinese adults, and assesses their relations with regional Gross Domestic Product (GDP) per capita levels. BMI values and the prevalence of overweight and underweight in 143 522 adults from the Chinese National Nutrition and Health Survey (2002) were calculated according to geographic regions in China. Their correlations with GDP were assessed. Linear and logistic regressions were used to adjust for age, sex and city–country composition. BMI and the prevalence of overweight were highest in the Bohai coastal regions while lowest in southern provinces such as Guangdong, Guangxi, Yunnan, Hunan and Fujian. Mean BMI values ranged from 20·72 to 25·48 kg/m 2 , and the prevalence of overweight ranged from 6·6 to 53·9 %. BMI and the prevalence of overweight were positively correlated with economic development, particularly in the northern regions. However, for regions with similar GDP per capita levels, those in the south had substantially lower BMI and lower prevalence of overweight than those in the north. Interestingly, some southern regions with high GDP per capita had low BMI and low prevalence of overweight. The prevalence of underweight was highest in the south. Substantial geographic variations in the prevalence of overweight and underweight exist in China. Such variations cannot be fully explained by the differences in economic status. China is currently facing challenges of both overweight and underweight but priorities vary in different regions.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Wiley
Date: 08-2003
DOI: 10.1046/J.1444-0903.2003.00405.X
Abstract: Heavy kava use in Aboriginal communities has been linked to various health effects, including anecdotes of sudden cardiac deaths. To examine associations between kava use and potential health effects. A cross-sectional study was carried out within a kava-using east Arnhem Land Aboriginal community in tropical northern Australia. One-hundred-and-one adults who were current, recent or non-users of kava were enrolled in March 2000. Main outcome measures were physical, anthropometric, biochemical, haematological, immunological and neurocognitive assessments. Kava users more frequently showed a characteristic dermopathy (P<0.001). They had increased levels of gamma-glutamyl transferase and alkaline phosphatase (P<0.001). Lymphocyte counts were significantly lower in kava users (P<0.001). Fibrinogen, plasminogen activator inhibitor-1 and neurocognitive tests were not different between kava use categories. IgE and IgG antibodies were elevated across the whole group, as were C-reactive protein and homocysteine. Kava use was associated with dermopathy, liver function abnormalities and decreased lymphocytes. If kava continues to be used by Aboriginal populations, monitoring should focus on the health consequences of these findings, including a possible increase in serious infections. The interaction between kava, alcohol and other substances requires further study. Although markers of cardiovascular risk are increased across the population, these were not higher in kava users, and this increase may be linked to the large infectious pathogen burden reflective of the socioeconomic disadvantage seen in many remote Aboriginal communities.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
Publisher: Informa UK Limited
Date: 14-05-2016
DOI: 10.1080/08037051.2016.1182420
Abstract: This study aimed to evaluate whether waist measures, including waist circumference (WC) and waist-to-height ratio (WHtR), can improve the ability of body mass index (BMI) to assess the hypertension risk when used as continuous variables. In this cross-sectional study, 82 432 Chinese children aged 9-17 years were included. Elevated BP was defined using age-sex-and-height-specific references. Logistic regression model and area under the receiver operating characteristic curve (AUC) were performed after BMI and waist measures were converted into age-and-sex-based z-scores. WHtR, but not WC, was associated with elevated BP after adjusting for BMI, with the odds ratios ranging between 1.14 (95% confidence interval: 1.04, 1.25) and 1.30 (1.21, 1.39) for one unit increase in WHtR z-score. Combined use of BMI and WHtR z-scores showed a significantly larger AUC than BMI alone (p < 0.05), while joint use of BMI and WC was not better than BMI alone. WHtR, rather than WC, provided further information on hypertension risk beyond that provided by BMI alone when used as a continuous variable. This study suggests WHtR, in addition to BMI, should be included for the assessment of childhood adiposity in routine paediatric practice.
Publisher: Elsevier BV
Date: 06-2000
Publisher: Springer Science and Business Media LLC
Date: 29-01-2015
DOI: 10.1038/JHH.2014.133
Abstract: The diagnosis of hypertension in children is complicated because of the multiple age-, sex- and height-specific thresholds. To simplify the process of diagnosis, blood pressure-to-height ratio (BPHR) was employed in this study. Data were obtained from a Chinese national survey conducted in 2010, and 197 191 children aged 7-17 years were included. High normal and elevated blood pressure (BP) were defined according to the National High Blood Pressure Education Program (NHBPEP) Working Group definition. The optimal thresholds were selected by Youden's index. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and area under the curve (AUC) were assessed for the performance of these thresholds. The systolic and diastolic BPHR thresholds for identifying high normal BP were 0.84/0.55, 0.78/0.50 and 0.75/0.46 for children aged 7-8 years, 9-11 years and 12-17 years, respectively. The corresponding thresholds for identifying elevated BP were 0.87/0.57, 0.81/0.53 and 0.76/0.49, respectively. These proposed thresholds revealed high sensitivity and NPVs, all above 0.96, moderate to high specificity and AUCs, and low PPVs. Our finding suggested the proposed BPHR thresholds were accurate for identifying children without high normal or elevated BP, and could be employed to simplify the procedure of screening prehypertension and hypertension in children.
Publisher: BMJ
Date: 07-2017
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.NUMECD.2018.08.002
Abstract: The American Heart Association has outlined seven cardiovascular health (CVH) metrics, including smoking, body mass index, physical activity, dietary pattern, total cholesterol, and fasting plasma glucose, to define and monitor CVH status. Our study was to evaluate the global CVH in adults. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and reference lists of relevant articles for studies published between 1 January 2010 and 30 June 2018. Included studies should report the proportions of ideal status for the seven CVH metrics and/or provide the prevalence of overall poor (having 0-2 ideal metrics) or ideal (having 5-7 ideal metrics) CVH status in adults. 88 articles were identified: 75 for the prevalence of ideal CVH metrics, 58 for the proportion of overall poor CVH status, and 55 for the proportion of overall ideal CVH status. Smoking had the highest prevalence of ideal status (69.1%) while dietary pattern has the lowest (12.1%). 32.2% and 19.6% of participants had overall poor and ideal CVH, respectively. Females and young adults had better CVH status when compared to males and older adults. There existed regional variations in ideal CVH metrics and overall CVH status. The overall CVH status had improved over study time. The prevalence of ideal status was low for some metrics, such as dietary pattern, and the overall CVH status was still unsatisfactory. We should continue to measure the CVH status and carry out lifestyle interventions to improve the CVH status in the whole population.
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1111/J.1753-6405.2007.00038.X
Abstract: To estimate the magnitude of excess risk for proteinuria, high blood pressure and diabetes in Australian Aboriginal adults in three remote communities by comparing them with nationwide Australian data. Adult volunteers from three remote communities in the Northern Territory were screened for proteinuria, high blood pressure, and diabetes between 2000 and mid 2003. Rates for people age 25 to 74 years were compared with those from the AusDiab study conducted in 1999 and 2000. Compared with AusDiab, rates of these conditions were elevated in all Aboriginal communities, but differed among them. With adjustment for age and sex, rates of proteinuria were elevated 2.5- to 5.3-fold, rates of high blood pressure were elevated 3.1- to 8.1-fold and rates of diabetes were elevated 5.4- to 10-fold (p < 0.001 for all). The risk of having any condition ranged from 3.0- to 8.7-fold and the risk of having two or more conditions ranged from 5.8- to 14.2-fold. The data are compatible with the excess morbidity and mortality from cardiovascular disease, diabetes and renal disease in these Aboriginal groups. They reflect the multitude of risk factors operating in these environments. They dictate urgent and systematic intervention to modify outcomes of established disease and to prevent their development. However, the resources required for effective secondary intervention will differ among communities according to the disease burden.
Publisher: BMJ
Date: 02-2016
Publisher: American Public Health Association
Date: 04-2014
Publisher: Oxford University Press (OUP)
Date: 12-01-2014
DOI: 10.1093/AJE/KWT329
Publisher: Elsevier BV
Date: 08-2012
Publisher: AMPCo
Date: 07-2015
DOI: 10.5694/MJA14.01707
Publisher: Elsevier BV
Date: 08-2001
DOI: 10.1111/J.1467-842X.2001.TB00587.X
Abstract: To evaluate variation in the incidence of end-stage renal disease (ESRD) within Australian capital cities. To explore the relation between the incidence of ESRD and socioeconomic disadvantage. We obtained data from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) regarding 5,013 patients from capital cities who started ESRD treatment between 1 April 1993 and 31 December 1998. We used the postcode at the start of treatment to calculate the average annual incidence of ESRD for each of 51 capital city regions using 1996 Census counts based on place of usual residence. We calculated standardised incidence ratios with 95% confidence intervals for each region. The standardised incidence ratios were examined in relation to the SEIFA Index of Relative Socio-economic Disadvantage (IRSD), derived from the 1996 Census. Low IRSD values indicate more disadvantaged areas. There is significant variation in the standardised incidence of ESRD within capital cities. There was a significant correlation (r=-0.41, p=0.003) between the standardised incidence ratio for ESRD and the SEIFA IRSD. Capital city areas that are more disadvantaged have a higher incidence of ESRD. Socioeconomic factors may be important determinants of the risk of developing ESRD.
Publisher: Springer Science and Business Media LLC
Date: 07-07-2016
DOI: 10.1038/HR.2016.84
Abstract: Increased body mass index (BMI) has been related to both low grip strength and high blood pressure (BP) in adolescents. Previous reports of high BP associated with decreased grip strength could be due to the inherent increase in BP in youths with high BMI. This cross-sectional study aimed to examine the association between grip strength and BP in adolescents independent of BMI. A total of 88 865 Chinese adolescents aged 13-17 years were included in this study. Sex-, age- and height-specific references were applied to calculate the BP z-score and define elevated BP. Grip strength was evaluated as handgrip (kg)/weight (kg) and converted into a sex- and age-specific z-score for analysis. Using fractional polynomial regression, we found that increased BMI was associated with enhanced BP and decreased grip strength however, after stratification by or adjustment for BMI, strong grip strength was related to an increased BP. Logistic regression models revealed that a one s.d. increase in boys' grip strength z-score was associated with an 18% (95% confidence interval: 12, 25) to 37% (19, 59) higher risk of elevated BP when adjusted for BMI. These associations remained significant after further adjustment for cardiorespiratory fitness. A similar pattern was also observed in girls. These results indicated that strong grip strength was associated with increased adolescent BP after adjustment for BMI. Our findings raise questions about using muscle-strengthening training as an approach to improve the BP profile in adolescents.
Publisher: Elsevier BV
Date: 08-2014
Abstract: To estimate the lifetime risk of developing hospital-diagnosed chronic obstructive pulmonary disease (COPD) in Aboriginal people living in remote areas. A total of 1,374 participants in a remote community were followed up to 20 years. In iduals with hospital-diagnosed COPD were identified through hospital records. The lifetime risk of hospital-diagnosed COPD was estimated using a modified technique of survival analysis. Of the 1,374 participants, 164 were identified as having incident hospital-diagnosed COPD during 21,614 person years of follow-up. After adjusting for the presence of competing risk of death from non-COPD causes, the lifetime risk of COPD was 53% for the overall population, higher in women (61%) than in men (45%). Adjusting for baseline age and smoking status, women had a significantly higher risk of COPD than men with a hazard ratio (HR) = 1.55 (95%CI 1.13-2.14), while men were more likely to die from non-COPD causes than women before being diagnosed as having COPD, HR = 2.30 (95%CI 1.64-3.23). These Aboriginal people have a high lifetime risk of COPD, and one in two have hospital-diagnosed COPD during their lifetime. Our findings warrant further efforts and resources to combat this condition in remote Aboriginal communities.
Publisher: Elsevier BV
Date: 02-2010
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.DIABRES.2008.12.019
Abstract: The aim of this study was to compare the strength of association between metabolic syndrome (MetS) and adiponectin, leptin and leptin to adiponectin ratio (L/A) in older Chinese. This study included 950 males (220 with MetS) and 1096 females (452 with MetS), aged 60-96 years from 18 major cities of the 2002 China National Nutrition and Health Survey. The associations of adiponectin, leptin and L/A with components of MetS and MetS were examined using logistic regression and the receiver operating characteristic (ROC) curves. The correlation coefficients of MetS components except fasting glucose with leptin were similar to those with L/A and higher than those with adiponectin. After adjusting for age and BMI, the odds ratio for MetS corresponding to 1 SD change in L/A was higher than those for leptin and adiponectin. L/A had highest area under the curve (AUC) for MetS. However, there was no statistically significant difference in AUC between leptin and L/A, and both indices produced a significantly higher AUC than adiponectin. In conclusion, L/A and leptin may be better diagnostic markers for MetS than adiponectin. After adjusting for BMI, L/A has better ability for correctly classifying subjects with and without MetS than adiponectin or leptin alone.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2016
DOI: 10.1007/S00268-016-3499-9
Abstract: Disruption of normal gut function is a common side effect post abdominal surgery. It may result in reduced tolerance to oral nutrition and progress to postoperative ileus. Microbial cell preparation is beneficial as a pre-surgical nutritional supplement to aid in bowel recovery and promote the return of normal gut function following abdominal surgery. The aim of this study was to evaluate the efficacy of pre-surgical administration of microbial cell preparation in promoting the return of normal gut function. The study is a randomized, double-blind, placebo-controlled trial. In total, 40 patients were recruited. Patients were randomized to receive either microbial cell preparation (n = 20) or placebo (n = 20) for 7 days prior to elective surgery. The primary end point was the time to return of normal gut function, while the secondary end point was the duration of hospital stay. The treatment group demonstrated significantly faster return of normal gut function with a median of 108.5 h (80-250 h) which was 48 h earlier than the placebo group at a median of 156.5 h (94-220 h), p = 0.022. The duration of hospital stay in the treatment group was also shorter at a median of 6.5 days (4-30 days), in comparison to the placebo group at 13 days (5-25 days), p = 0.012. Pre-surgical administration of microbial cell preparation promotes the return of normal gut function in patients after colorectal cancer surgery, thus associated with faster recovery and shorter duration of hospital stay.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.ORCP.2015.02.005
Abstract: To evaluate the associations of different anthropometric measurements on earlier exam with subsequent gestational diabetes mellitus (GDM) in Aboriginal women. This is a nested case-control study. Anthropometric measurements were conducted at baseline from 1992 to 1995 in a remote Aboriginal community. All subsequent pregnancies among the original participants were identified through review of hospital records of 20 years. Thirty-two women developed GDM and 99 women were hospitalised for pregnancy-related conditions other than GDM. The association between body mass index (BMI), weight, height, waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio with subsequent GDM was examined. Our results showed an increased risk of GDM with increase in one standard deviation of BMI (OR=2.0 95% CI: 1.3, 3.1), weight (OR=1.7 95% CI: 1.1, 2.7), waist circumference (OR=1.8 95% CI: 1.1, 3.0) and waist-to-height ratio (OR=2.3 95% CI: 1.4, 3.9). High BMI (BMI≥25kg/m(2)) was associated with subsequent GDM (OR=2.8 95% CI: 1.0, 7.8). BMI and waist-to-height ratio are better predictors than other anthropometric indices of GDM in Aboriginal women. Given that these measures are associated with future GDM, interventions to reduce BMI, weight and waist circumference in young women need to be assessed for their potential to prevent GDM.
Publisher: Informa UK Limited
Date: 06-2016
DOI: 10.1111/AJPY.12099
Publisher: Chinese Journal of Cancer Research
Date: 12-2011
Publisher: BMJ
Date: 09-2016
Publisher: Springer Science and Business Media LLC
Date: 23-10-2015
DOI: 10.1038/JHH.2014.95
Abstract: Adiposity is closely related to elevated blood pressure (BP) however, which adiposity indicator is the best predictor of elevated BP among children and adolescents is unclear. To clarify this, 99,366 participants aged 7-17 years from the Chinese National Survey on Students' Constitution and Health in 2010 were included in this study. The adiposity indicators, including weight, body mass index (BMI), waist circumference, waist-to-height ratio (WHtR), hip circumference, body adiposity index (BAI), waist-to-hip ratio (WHR) and skinfold thickness, were converted into z-scores before use. The associations between elevated BP and adiposity indicators z-scores were assessed by using logistic regression model and area under the receiver operating characteristic curve (AUC). In general, BAI, BMI and WHtR z-scores were superior for predicting elevated BP compared with weight, waist circumference, hip circumference, WHR and skinfold thickness z-scores. In both sexes, BMI z-score revealed slightly higher AUCs than other indicators. Our findings suggest that general adiposity indicators were equivalent, if not superior, to abdominal adiposity indicators to predict elevated BP. BMI could be a better predictor of elevated BP than other studied adiposity indicators in children.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.ORCP.2016.06.003
Abstract: Although elevated body mass index (BMI) and waist circumference (WC) have been identified as risk factors for mortality, data from the Australian Aboriginal communities are scarce. This study examined the associations of BMI and WC with all-cause mortality in an Australian Aboriginal community. A total of 934 Aboriginal adults, aged 18-76 years, who participated in a community-wide screening programme in Australia's Northern Territory from 1992 to 1998, were followed-up prospectively for up to 18 years for death outcomes. The hazard ratios for mortality were estimated by baseline BMI and WC. Age, sex, smoking and alcohol consumption status were adjusted for in multivariable analysis. In 14,750 person-years of follow-up, 216 deaths were recorded. For each standard deviation increase in BMI, the risk of all-cause death decreased by 9% (95% CI: 0.80-1.05) whereas for each SD increase in WC, the risk of all-cause mortality increased by 17% (95% CI: 1.03-1.33). The risk of mortality was lower in the 3rd BMI tertile compared to the 1st tertile for mortality after adjusting for WC, age, sex, smoking and alcohol consumption. Risk of death was higher in WC tertile 3 compared to tertile 1 after adjusting for BMI, age, sex, smoking and alcohol consumption. The risk of all-cause mortality among participants increased with higher WC, while participants with relatively higher BMI had a lower mortality risk. WC had stronger association with mortality than did BMI. The results indicate the importance of assessing WC measures in studies conducted in Aboriginal Australia.
Publisher: Elsevier BV
Date: 07-2001
DOI: 10.1046/J.1523-1755.2001.00793.X
Abstract: The purpose of this study was to describe the relationship of albuminuria and glomerular filtration rate (GFR) with natural death and renal failure in an Australian Aboriginal community with high rates of renal disease. Study subjects were 825 adults (18+ years, mean 33.6 years) or 88% of adults in a remote community who participated in a health screening program offered between 1990 and 1997. The urinary albumin:creatinine ratio (ACR g/mol) was used as the renal disease marker. Participants were followed for 1.0 to 9.8 years (mean 5.8 years) until renal failure, death, the start of systematic antihypertensive/renal-protective treatment or June 30, 2000. Sixty-five people reached a terminal end point of renal failure or natural death. Sixteen people developed terminal renal failure, all of whom had an ACR of 34+ at baseline exam. There were 49 other natural deaths, which were also strongly correlated with increasing ACR and decreasing GFR over a wide range. This was observed in people without diabetes and in people with normal and elevated blood pressures. It applied to deaths associated with cardiovascular disease and to deaths without an assigned primary or underlying cardiovascular or renal cause. With adjustment for age, the association with death was more robust with ACR than GFR. When compared with people with an ACR 400-fold increase in renal deaths, a 4-fold increase in cardiovascular deaths, and a 2.2-fold increase in nonrenal noncardiovascular deaths. Eighty-four percent of all-cause natural death was associated with pathologic albuminuria. All renal failure develops out of a background of persistent albuminuria in this population. More important, albuminuria and, inversely, GFR are powerful markers of risk for nonrenal natural death, including, but not restricted to, cardiovascular deaths. Most of the risk for premature death can be assessed by a simple urine test, and interventions that prevent development and progression of albuminuria and loss of GFR should not only prevent renal insufficiency, but powerfully reduce mortality from natural causes as well.
Publisher: Wiley
Date: 03-06-2022
DOI: 10.1111/JPC.16050
Abstract: To describe the incidence and aetiology of early and late‐onset neonatal sepsis and compare rates in Aboriginal and Torres Strait Islander infants against non‐Indigenous infants in the Top End of the Northern Territory. This was a retrospective case series of infants with positive blood or cerebrospinal fluid cultures at Royal Darwin Hospital between 2012 and 2016. Cultures from infants during initial hospital admission up to 120 days of age were included for analysis. Demographic, clinical, laboratory and treatment data were collected from medical records. Published definitions of sepsis and criteria for organism pathogenicity and were used to determine cases of sepsis. There were 52 episodes of sepsis in 45 infants. There were eight cases of early onset sepsis, with an incidence of 0.51 per 1000 live births. The incidence was similar for Aboriginal and non‐Indigenous infants. The case fatality rate was 25%. Late‐onset sepsis occurred in 44 cases, comprising 1.3% of all infants admitted to the special care nursery. Coagulase‐negative Staphylococcus was the most frequently cultured organism. Case fatality rate was 11%. Aboriginal and Torres Strait Islander infants had a five‐time higher risk of late‐onset sepsis compared with non‐Indigenous infants however, their increased risk was not independent of other sepsis risk factors of low rates and prematurity. The incidence of culture‐confirmed early and late‐onset sepsis was low, but case fatality was high. Bacteraemia is an important contributor to neonatal and infant mortality in our setting.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.DIABRES.2013.12.048
Abstract: The remaining lifetime risks for end stage renal disease among Aboriginal people with and without diabetes were estimated. The value for young adults with diabetes was high, about 1 in 2 at the age of 30 years, while it decreased with age to 1 in 7 at 60 years.
Publisher: Springer Science and Business Media LLC
Date: 16-08-2013
Abstract: Albuminuria marks renal disease and cardiovascular risk. It was estimated to contribute 75% of the risk of all-cause natural death in one Aboriginal group. The urine albumin/creatinine ratio (ACR) is commonly used as an index of albuminuria. This study aims to examine the associations between demographic factors, anthropometric index, blood pressure, lipid-protein measurements and other biomarkers and albuminuria in a cross-sectional study in a high-risk Australian Aboriginal population. The models will be evaluated for albuminuria at or above the microalbuminuria threshold, and at or above the “overt albuminuria” threshold with the potential to distinguish associations they have in common and those that differ. This was a cross-sectional study of 598 adults aged 18–76 years. All participants were grouped into quartiles by age. Logistic regression models were used to explore the correlates of ACR categories. The significant correlates were systolic blood pressure (SBP), C-reactive protein (CRP), uric acid, diabetes, gamma-glutamyl transferase (GGT) (marginally significant, p = 0.054) and serum albumin (negative association) for ACR 17+ (mg/g) for men and 25+ for women. Independent correlates were SBP, uric acid, diabetes, total cholesterol, alanine amino transferase (ALT), Cystatin C and serum albumin (negative association) for overt albuminuria and SBP, CRP and serum albumin only for microalbuminuria. This is the most detailed modelling of pathologic albuminuria in this setting to date. The somewhat variable association with risk factors suggests that microalbuminuria and overt albuminuria might reflect different as well as shared phenomena.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Elsevier BV
Date: 10-1998
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1016/J.DIABRES.2006.07.018
Abstract: To investigate the association between C-reactive protein (CRP) and the risk of developing diabetes in Aboriginal Australians. High sensitivity CRP levels were measured in 620 Aboriginal participants aged 20-74 years free from diabetes at baseline in a remote community in the Northern Territory of Australia. Participants were followed for a median of 11 years to identify newly diagnosed cases of diabetes. Cox proportional hazards models were used to assess the relationship of CRP levels with the risk of developing diabetes over the follow-up period. A total of 109 participants were newly diagnosed with diabetes. Incident rates were 10.8, 16.6 and 28.8 per 1000 person-years for people in the lower, middle and upper tertile groups of baseline CRP levels, respectively. After adjusting for age, sex, BMI, baseline glucose regulation status, total cholesterol, urine albumin to creatinine ratio, systolic blood pressure, smoking and alcohol drinking, the association between diabetes and CRP remained significant, with a hazard ratio of 1.23 (95% confidence interval (CI) 1.05, 1.45) corresponding to a doubling in CRP values. Similarly, the adjusted hazard ratio for development of diabetes in people in the upper tertile versus the bottom two tertiles of CRP was 1.75 (95% CI 1.19, 2.56). CRP is independently associated with the development of diabetes in Aboriginal people. Our findings support a role of inflammation in the etiology of diabetes in the high risk population of Aboriginal Australians.
Publisher: Springer Science and Business Media LLC
Date: 05-03-2014
Publisher: Elsevier BV
Date: 03-2021
Publisher: Oxford University Press (OUP)
Date: 12-11-2015
Abstract: Quality indicators for Chinese patients with chronic heart failure (CHF) have been developed. However, little is known about the compliance with quality indicators and the association between process indicators and in-hospital mortality in China. Data from 1862 CHF admissions between 1 January 2009 and 31 October 2010 at 20 tertiary hospitals in Heilongjiang Province were analyzed. Hierarchical generalized linear models were used to examine the association between six process indicators and in-hospital mortality in eligible patients. The in-hospital mortality for the 1862 patients was 4.7%. The compliance with six process indicators were: evaluation of left ventricular function, 66.4% angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), 54.9% diuretic, 86.2% beta-blocker, 45.1% aldosterone-receptor antagonist, 64.0% and warfarin, 17.1%. Rates of compliance at the hospital level varied from 0 to 100%. After the adjustment for confounding factors, evaluation of left ventricular function, ACEI/ARB and aldosterone receptor antagonist were significantly associated with in-hospital mortality ([OR, 0.55 95% CI, 0.33-0.93 P = 0.027], [OR, 0.33 95% CI, 0.12-0.94 P = 0.040] and [OR, 0.35 95% CI, 0.13-0.98 P = 0.046], respectively). There are considerable gaps between guidelines and clinical practice and variations across hospitals for the treatment of patients with CHF. Evaluation of left ventricular function, ACEI/ARB and aldosterone receptor antagonist will reduce the risk of in-hospital mortality. The association of other process indicators with clinical outcomes remain to be established.
Publisher: American Diabetes Association
Date: 03-2008
DOI: 10.2337/DC07-1156
Abstract: OBJECTIVE—To quantify the risk for type 2 diabetes by body habitus measurements among remote-living Australian Aborigines relative to that measured in the general Australian population (as characterized by the Australian Diabetes, Obesity and Lifestyle [AusDiab] study). RESEARCH DESIGN AND METHODS—Anthropometric measurements and diabetes status were assessed by standard procedures among Aborigines (n = 1,456) and Australians aged ≥25 years (n = 11,247). Age-adjusted odds ratios (ORs) for diabetes among Aborigines relative to AusDiab participants were calculated by commonly used categories of body size measurements. RESULTS—The OR (95% CI) values for diabetes among normal, overweight, and obese (by waist) Aboriginal women relative to AusDiab women were 2.6 (0.6–11.5), 13.1 (6.7–25.7), and 6.1 (4.6–8.0), respectively, and for Aboriginal men relative to AusDiab men, they were 7.6 (4.6–12.5), 7.6 (4.3–13.4), and 5.2 (3.4–8.0), respectively. Rates of diabetes were also excessive in Aborigines for each standard category of BMI. CONCLUSIONS—Higher rates of diabetes, even at normal and lower body habitus measurements, among Aborigines suggest that strategies for prevention should expand beyond exclusive focus on diet and weight management.
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.IJID.2014.04.017
Abstract: To estimate the prevalence of in-home antibiotic storage among Australian Chinese migrants and to identify the risk factors associated with storing antibiotics at home. Four hundred and sixty-nine Chinese migrants in Australia who were recruited through Chinese social websites completed an online questionnaire about antibiotic use. Logistic regression analysis was conducted to assess the associations between possible risk factors and storing antibiotics at home. According to the web-based survey, 220 (47%) out of 469 participants reported having antibiotics stored at home. Previous use of antibiotics, bringing antibiotics in from outside Australia, and a pro-attitude to the use of leftover antibiotics were significantly associated with storing antibiotics at home after adjusting for age, gender, and household annual income. Participants who self-reported an awareness of antibiotic side effects or resistance had a slightly higher but not significant risk of storing antibiotics at home. Approximately half of the participants in this study had antibiotics stored at home. The risk of using the antibiotics stored at home without medical consultation is of concern. Education programs need to target those with high-risk behaviours to curtail the inappropriate practice of antibiotic use and storage among Australian Chinese migrants.
Publisher: Wiley
Date: 04-09-2020
DOI: 10.1002/PPUL.25044
Publisher: Wiley
Date: 17-12-2015
DOI: 10.1002/OBY.20938
Abstract: To examine the trend of urban-rural disparity in obesity prevalence among Chinese children from 1985 to 2010. The data were from five cross-sectional surveys (1985, 1995, 2000, 2005, and 2010) of Chinese National Surveys on Students' Constitution and Health. Logistic regression was used to estimate the prevalence odds ratio (POR) of urban-rural areas for obesity prevalence in different surveys. The standardized prevalence of obesity in Chinese children increased rapidly from 0.1% in 1985 to 5.0% in 2010, and significant differences were found between two adjacent surveys in most of the age subgroups (P<0.01). Although the obesity prevalence was significantly higher in urban than in rural children of all age subgroups at different survey points, the changing pace was faster in rural than in urban areas from 1995 to 2010. The PORs had increased in 1995 in most age subgroups and then began to decline in all age subgroups after 1995. The gradually decreasing urban-rural disparity suggests that the obesity prevalence in rural areas would contribute to a growing proportion of obese children. Therefore, rural children should be included in obesity prevention efforts even though obesity rates are still lower in rural than in urban areas.
Publisher: BMJ
Date: 16-01-2020
DOI: 10.1136/HEARTJNL-2019-315889
Abstract: To assess the performance of cardiovascular disease (CVD) risk equations in Indigenous Australians. We conducted an in idual participant meta-analysis using longitudinal data of 3618 Indigenous Australians (55% women) aged 30–74 years without CVD from population-based cohorts of the Cardiovascular Risk in IndigenouS People(CRISP) consortium. Predicted risk was calculated using: 1991 and 2008 Framingham Heart Study (FHS), the Pooled Cohorts (PC), GloboRisk and the Central Australian Rural Practitioners Association (CARPA) modification of the FHS equation. Calibration, discrimination and diagnostic accuracy were evaluated. Risks were calculated with and without the use of clinical criteria to identify high-risk in iduals. When applied without clinical criteria, all equations, except the CARPA-adjusted FHS, underestimated CVD risk (range of percentage difference between observed and predicted CVD risks: −55% to −14%), with underestimation greater in women (−63% to −13%) than men (−47% to −18%) and in younger age groups. Discrimination ranged from 0.66 to 0.72. The CARPA-adjusted FHS equation showed good calibration but overestimated risk in younger people, those without diabetes and those not at high clinical risk. When clinical criteria were used with risk equations, the CARPA-adjusted FHS algorithm scored 64% of those who had CVD events as high risk corresponding figures for the 1991-FHS were 58% and were 87% for the PC equation for non-Hispanic whites. However, specificity fell. The CARPA-adjusted FHS CVD risk equation and clinical criteria performed the best, achieving higher combined sensitivity and specificity than other equations. However, future research should investigate whether modifications to this algorithm combination might lead to improved risk prediction.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.JPEDS.2014.08.013
Abstract: To estimate the shifts in age at menarche from 1985 to 2010, compare the differences of average age at menarche between urban and rural groups, and determine the association of menarche with body mass index (BMI). The data were obtained from 4 cross-sectional Chinese National Surveys on Students' Constitution and Health (1985, 1995, 2005, and 2010). In this representative s le of Chinese school-aged girls, the average age at menarche was determined using probit analysis and compared between urban and rural areas. Logistic regression was used to assess the association of BMI with the likelihood of having reached menarche. The age at menarche in Chinese girls dropped from 13.41 years to 12.47 years from 1985 to 2010. There was a significant difference in age at menarche between urban and rural girls over time, with urban girls having their menarche earlier than rural girls. Logistic regression showed that a higher BMI was strongly associated with an increased likelihood of having reached menarche, even after controlling for age, urban or rural residence, province, social economic status, and school. The analysis suggests a drop of about 4.5 months per decade in the average age at menarche over the past 25 years, and a significant inverse association between BMI and having reached menarche. Considering that both early menarche and higher BMI are significant risk factors for chronic diseases, and may act together in later years to the detriment of a woman's health, greater attention should be paid to the health of girls with earlier menarche and higher BMI.
Publisher: BMJ
Date: 23-09-2021
DOI: 10.1136/TOBACCOCONTROL-2020-055865
Abstract: There is strong evidence from many settings that tobacco tax rises which increase prices reduce tobacco consumption, but only limited evidence from Indigenous settings. We analysed 3 years (2016–2018) of weekly sales data from 32 stores in remote Aboriginal communities. We used interrupted time series analysis to estimate the immediate impact of the price rice following annual 12.5% tobacco tax rises on sales on (A) stick equivalents of tobacco and (B) fruit and vegetables (kg) per $A1000 of grocery sales, and on the trend in sales between price rises. We detected 5.8% and 8.2% immediate declines in tobacco sales following the price rises associated with annual 12.5% tax rises in 2016 and 2018, and a non-significant decline (1.6%) following the 2017 tax rise. Decreased sales were mainly driven by declines in mainstream and premium factory-made cigarettes. Fruit and vegetable sales did not change at the time of tobacco price rises. For the first time, we demonstrated evidence of price-sensitivity and the immediate impact of price rises from tobacco tax rises on tobacco sales in remote Aboriginal communities. We acknowledge that Australia already has very high tobacco taxation and prices, but recommend further increases to the taxation of roll-your-own (RYO) tobacco to prevent smokers and industry using cheaper RYO cigarettes to undermine this impact of high tobacco taxes and prices.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1071/HI14034
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.DIABRES.2013.03.020
Abstract: We investigated if the metabolic syndrome (MetS) and its component risk factors predict cardiovascular disease (CVD) for Aboriginal people from central Australia. WHO (HR 2.83), NCEP (1.80) and IDF (2.47) definitions of the MetS all had positive associations with CVD, however offered little above in idual MetS components for hyperglycaemia.
Publisher: Elsevier BV
Date: 09-2007
DOI: 10.1016/J.PCD.2007.05.001
Abstract: To examine the recent trend in the incidence of clinically diagnosed type 2 diabetes during the period of 1999-2005 in Harbin, China. The records of newly diagnosed type 2 diabetes from hospitals and clinics in Harbin were reported to the Harbin Centre for Disease Control and Prevention. About 3 million (33%) of the total population were from six metropolitan districts and over 6 million (67%) from the surrounding counties. Incidence rates and incidence rate ratios (IRR) were estimated using Poisson regression. During the observational period, 26,953 new cases of diagnosed type 2 diabetes were reported. Among them, 16,367 were from the metropolitan region and 10,586 from the surrounding counties. The incidence rate of type 2 diabetes in the metropolitan region was 3.19 (95% CI: 3.11, 3.27) times as high as that in the surrounding counties. Females had higher incidence rates in younger age groups (<54 years) and lower rates in older age groups (55+ years) than their male counterparts. The incidence increased over time during the period of 1999-2005 by an average of 12% per year (IRR=1.12, 95% CI: 1.11, 1.13). Similar increasing rates were observed in both the county and metropolitan regions. The incidence of diagnosed type 2 diabetes has increased dramatically in recent years. Although an increasing trend in the incidence of type 2 diabetes exists in both metropolitan and county regions, the county region currently has a substantially lower incidence rate than the metropolitan region.
Publisher: Wiley
Date: 30-01-2019
DOI: 10.1002/OBY.22391
Abstract: This study aimed to examine the association between birth weight (BW) and metabolic syndrome (MetS) in adolescents and to further investigate whether having a healthy body weight could modify the potential adverse influence of abnormal BW on MetS risk. A total of 6,206 participants aged 10 to 17 years were recruited using data from a Chinese national survey conducted in 2012. Gestational age-specific BW percentiles were used to classify small for gestational age (SGA), appropriate for gestational age, and large for gestational age (LGA). Fractional polynomial regression, logistic regression, and population-attributable risk (PAR) were used to assess the relationship between BMI and BW with MetS. MetS risk increased by 73% (OR = 1.73, 95% CI: 1.06-2.84) in SGA adolescents with overweight or obesity, but not in those without overweight, compared with their counterparts with BW appropriate for gestational age. A huge difference between PAR percent of MetS because of SGA and PAR percent because of overweight or obesity was detected. For ex le, PAR percent of SGA was 2.4% (95% CI: 0.1%-4.6%) in adolescents with overweight or obesity, while PAR percent of overweight or obesity was 44.2% (95% CI: 33.3%-53.2%) in those who were SGA infants. These findings suggest that healthy body weight could relieve the adverse impact of SGA on MetS in adolescents.
Publisher: Wiley
Date: 06-2015
DOI: 10.1002/CLC.22405
Publisher: Elsevier BV
Date: 07-2006
Publisher: Wiley
Date: 02-2001
Publisher: Wiley
Date: 03-01-2021
DOI: 10.1111/AJO.13281
Abstract: Antenatal ultrasound is used frequently in pregnancies complicated by hyperglycaemia however, it is unclear which measurements have the greatest association with adverse neonatal outcomes. To assess the association between third trimester ultrasound parameters with adverse neonatal outcomes in pregnancies complicated by hyperglycaemia. All pregnant women with gestational or type 2 diabetes who birthed in a regional hospital over 12 months were included. A composite adverse neonatal outcome was defined by one or more: admission to special care nursery, acidosis, hypoglycaemia, jaundice, shoulder dystocia, respiratory distress syndrome or 5‐minute Apgar score 5. Logistic regression was used to determine odds ratios (OR) for an adverse neonatal outcome, according to pre‐specified cut points in both lower and upper percentiles of abdominal circumference (AC) and estimated fetal weight (EFW). Of 275 births an adverse outcome occurred in 122 (44%). Unadjusted OR (95% CI) for AC ≤30 th was 3.2 (1.1–8.8) and th percentile was 3.1 (1.5–6.0) compared with the reference group of 31–70 th percentile. Unadjusted OR for EFW ≤30 th was 1.5 (0.7–3.1) and th percentile was 3.0 (1.4–6.3). After adjusting for maternal age, body mass index, diabetes type, ethnicity, gravidity, mode of delivery and gestation at birth the OR (95% CI) were as follows: AC ≤30 th percentile, 3.7 (1.1–12.4) AC th , 2.2 (1.1–4.8) EFW ≤30 th , 2.6 (1.1–6.1) EFW th , 2.5 (1.1–6.1). An AC and EFW up to the 30 th percentile may pose just as great a risk to the fetus as an AC or EFW th percentile in pregnancies complicated by hyperglycaemia.
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1111/J.1753-6405.2008.00248.X
Abstract: To assess the impacts of survey languages on participation and representativeness of the study subjects in a health survey in a Chinese community in Australia. A random s le of 500 ethnic Chinese in Brisbane, Queensland, Australia was surveyed during November 2005 to February 2006 by using a bilingual survey questionnaire in their preferred languages, i.e. English or Chinese. 210 questionnaires were returned. Two-thirds of the participants chose to answer the questionnaires in Chinese. Besides being older with relatively lower income, they were more likely to be married, have a Chinese family doctor, and visit a Chinese medicine practitioner. Fewer of them have visited the Diabetes Australia website or read any educational information materials about diabetes. The multilingual approach is crucial to improving participation and representativeness of s les from ethnic populations.
Publisher: Wiley
Date: 29-08-2016
DOI: 10.1002/AJHB.22894
Abstract: The current age- and sex-specific waist circumference (WC) reference for defining abdominal adiposity in Chinese children is quite complex. This study aimed to evaluate the optimal waist-to-height ratio (WHtR) thresholds based on the estimated WC references. A cross-sectional analysis of data from 121,025 Chinese children aged 7-18 years collected in 2010 was performed. Optimal WHtR thresholds were selected by Youden's index using receiver operating characteristic (ROC) curve analysis, with the estimated references of WC in Chinese children used as the gold standard. The optimal cut-off values for identifying abdominally overweight and obese children were 0.44 and 0.46, respectively. Across the different sex and age groups, the proposed thresholds revealed high negative predictive values and areas under the ROC curve (≥0.857), and moderate to high sensitivity, specificity, and positive predictive values, ranging from 0.48 to 1.00. The proposed WHtR thresholds reduce the number of cut-off values from 48 to 2, and have a high discriminatory ability to identify abdominal adiposity in Chinese children. Am. J. Hum. Biol. 28:945-949, 2016. © 2016Wiley Periodicals, Inc.
Publisher: Cambridge University Press (CUP)
Date: 18-03-2013
DOI: 10.1017/S0950268813000605
Abstract: This study examined the relationship between body mass index (BMI) and the risk of pneumonia in Aboriginal Australians. A total of 677 adults aged 20–60 years were followed up from the baseline examination during 1992–1995 to June 2012. The pneumonia events were identified through hospital records. Pneumonia incident rates were calculated according to BMI groups. Hazard ratios were computed using Cox regression adjusting for age, smoking and alcohol consumption status. The incident rate of pneumonia was 13·3/1000 person-years, and this rate was significantly higher in females than males (hazard ratio = 1·5). Compared to males with normal BMI (18·5–24·9 kg/m 2 ), the adjusted hazard ratio was 3·5 for males with lowest BMI ( P 0·01). Low BMI was significantly associated with a higher risk of hospitalized pneumonia for Aboriginal males. However, the U-shaped trend of this association indicates that the risk of pneumonia is likely to be associated with both low and high BMI.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1111/J.1753-6405.2009.00451.X
Abstract: To analyse rates of avoidable mortality in Aboriginal and non-Aboriginal residents of the Northern Territory (NT) from 1985 to 2004, in order to assess the contribution of health care to life expectancy improvements. Australian Bureau of Statistics (ABS) death registration data for NT residents were used to identify 'avoidable' deaths, with further separation into three categories of conditions amenable to either medical care or health policy, and a category for ischaemic heart disease (IHD). A Poisson regression model was used to calculate the average annual change in avoidable mortality by sex and Aboriginality in the NT compared with Australia as a whole. In the 20 years between 1985 and 2004, avoidable mortality rates fell 18.9% in NT Aboriginal people, 61.1% in NT non-Aboriginal people and 59.5% in Australians overall. NT Aboriginal people continued to experience higher avoidable mortality than other Australians and the disparity increased over time. Most of the decline in avoidable mortality for Aboriginal Territorians occurred for conditions amenable to medical care. Medical care has made a significant contribution to improvements in Aboriginal life expectancy in the NT however, reductions in avoidable mortality from IHD and conditions amenable to health policy have been variable. The results highlight the need for ongoing investment in comprehensive programs incorporating appropriate health policy interventions and management of chronic diseases.
Publisher: Wiley
Date: 25-06-2013
DOI: 10.1111/OBR.12055
Abstract: The aims of our meta-analysis were to examine the pattern and gender's influence on body mass index (BMI) - pneumonia relationship. Published studies were searched from PubMed, Web of Science, Cochrane Library databases using keywords of pneumonia, BMI and epidemiologic studies. Random-effects analysis was applied to estimate pooled effect sizes from in idual studies. The Cochrane Q-test and index of heterogeneity (I(2) ) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Random-effects meta-regression was applied to examine the pattern and gender's influence on BMI-pneumonia relationship. A total of 1,531 studies were initially identified, and 25 studies finally were included. The pooled relative risk (RR) and meta-regression model revealed a J-shaped relationship between BMI and risk of community-acquired pneumonia (underweight, RR 1.8, 95% confidence interval [CI], 1.4-2.2, P < 0.01 overweight, 0.89, 95%CI, 0.8-1.03, P, 0.1 obesity, 1.03, 95% CI, 0.8-1.3, p. 8) and U-shaped relationship between BMI and risk of influenza-related pneumonia (underweight, RR 1.9, 95% CI, 1.2-3, P < 0.01 overweight, 0.89, 95% CI, 0.79-0.99, P, 0.03 obesity, 1.3, 95% CI, 1.05-1.63, p. 2 morbidity obesity, 4.6, 95% CI, 2.2-9.8, P < 0.01) whereas, no difference in risk of nosocomial pneumonia was found across the BMI groups. Gender difference did not make significant contribution in modifying BMI-pneumonia risk relationship.
Publisher: Elsevier BV
Date: 09-2005
DOI: 10.1111/J.1523-1755.2005.00526.X
Abstract: It has been suggested that albuminuria is useful in identifying persons at increased risk of coronary heart disease (CHD). Australian Aborigines have exceedingly high rates of renal failure together with increased CHD mortality. We undertook this prospective cohort study to assess the independent effect of albuminuria on CHD risk in Aboriginal people in the Northern Territory of Australia. We examined the relation between micro- and macroalbuminuria and incident CHD in a s le of 870 Aboriginal adults aged 20 to 74 years old without prevalent baseline CHD. Cox proportional hazards models were used to assess the association between baseline albuminuria and CHD incidence. During a median of 9.2 years of follow-up, 89 CHD events occurred during the follow-up period (1992 to 2003). The incidence of CHD increased significantly across categories of albuminuria (4.4, 10.9, and 29.8 per 1000 person-years for normoalbuminuria, microalbuminuria, and macroalbuminuria, respectively). The multiple Cox proportional hazards regression showed the hazard ratio was 3.4 (95% CI 1.6, 7.3), adjusting for age, gender, body mass index (BMI), blood pressure, total cholesterol, diabetes status, cigarette smoking, and alcohol consumption, for macroalbuminuria group. Hazard ratio for microalbuminuria group was not significantly different from unity during the first 6 years of follow-up but significantly higher during the follow-up period > or = 6 years with adjusted hazard ratio 9.0 (95% CI 2.0, 40.0). Independent of traditional cardiovascular risk factors, both microalbuminuria and macroalbuminuria may be useful in identifying persons at increased risk of CHD in Aboriginal people.
Publisher: Hindawi Limited
Date: 11-06-2019
DOI: 10.1111/TBJ.13414
Publisher: Cambridge University Press (CUP)
Date: 20-07-2010
DOI: 10.1017/S0954422410000120
Abstract: Abdominal obesity is a risk factor for cardiometabolic disease, and has become a major public health problem in the world. Waist circumference is generally used as a simple surrogate marker to define abdominal obesity for population screening. An increasing number of publications solely rely on the method that maximises sensitivity and specificity to define ‘optimal’ cut-off values. It is well documented that the optimal cut-off values of waist circumference vary across different ethnicities. However, it is not clear if the variation in cut-off values is a true biological phenomenon or an artifact of the method for identifying optimal cut-off points. The objective of the present review was to assess the relationship between optimal cut-offs and population waist circumference levels. Among sixty-one research papers, optimal cut-off values ranged from 65·5 to 101·2 cm for women and 72·5 to 103·0 cm for men. Reported optimal cut-off values were highly correlated with population means (correlation coefficient: 0·91 for men and 0·93 for women). Such a strong association was independent of waist circumference measurement techniques or the health outcomes (dyslipidaemia, hypertension or hyperglycaemia), and existed in some homogeneous populations such as the Chinese and Japanese. Our findings raised some concerns about applying the sensitivity and specificity approach to determine cut-off values. Further research is needed to understand whether the differences among populations in waist circumference were genetically or environmentally determined, and to understand whether using region-specific cut-off points can identify in iduals with the same absolute risk levels of metabolic and cardiovascular outcomes among different populations.
Publisher: Elsevier BV
Date: 07-2001
DOI: 10.1046/J.1523-1755.2001.00792.X
Abstract: The purpose of this study was to describe changes over time in albuminuria and glomerular filtration rate (GFR) in a cohort of Australian Aborigines from a community with high rates of renal disease and renal failure. Participants were 486 adult community members (20+ years at first exam) who were screened for renal disease and related factors on at least two occasions (mean 2.7 occasions), at least a year apart, between 1990 and 1997. Renal function was assessed by the albumin:creatinine ratio (ACR g/mol) on a random urine specimen and by the GFR estimated from the Cockcroft-Gault formula. Evolution over time was expressed as the average annual changes in these parameters. On baseline examination, 70% of participants had albuminuria (ACR 1.1+ g/mol) There was a significant net increase in ACR and a fall in GFR in the cohort over time. Among in iduals, however, changes were strongly correlated with ACR levels at baseline. There was no loss of GFR in persons with normal renal parameters at baseline and a rapid loss of GFR in those with substantial levels of albuminuria at baseline. Other factors significantly correlated with progression of ACR included age, baseline body mass index and systolic blood pressure, the presence of diabetes (or levels of fasting glucose), and elevated levels of serum gamma glutamyl transferase. Factors significantly associated with loss of GFR included body mass index, diabetes, systolic and diastolic blood pressures, microscopic hematuria, and marginally high cholesterol levels. Albuminuria progresses and GFR is lost over time in in iduals in this community, at rates that are strongly dependent on levels of pre-existing albuminuria. Much loss of GFR and all renal failure should be avoided by preventing the development of albuminuria and minimizing its progression. This depends on improving the weight, blood pressure, and metabolic profile of the entire community and reducing infections. Modification of the course in people with established disease depends on vigorous control of blood pressure and the metabolic profile and the specific use of angiotensin-converting enzyme inhibitors.
Publisher: Oxford University Press (OUP)
Date: 04-2007
Publisher: Springer Science and Business Media LLC
Date: 12-05-2012
DOI: 10.1038/JHH.2011.45
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.ORCP.2014.01.006
Abstract: It is debatable if the strength of obesity-mortality association depends on age. The objective of this study was to investigate the influence of age on the obesity-mortality association in men and women, and to assess if adjusting for major confounding factors altered the age-dependent trend of the obesity-mortality association. Articles were identified by searches of PubMed through 15 August 2013. Twenty studies which reported two or more age-specific effect estimates were identified. A random-effect approach was applied to estimate pooled effect sizes for different age groups. There was a significant heterogeneity among studies within each age group in the effect estimates for the association between obesity and mortality. The pooled hazard ratio estimates decreased with increasing age from 1.59 (95% confidence interval, 1.46-1.72) for men and 1.60 (1.49-1.72) for women under 35 years to 1.11 (1.08-1.15) for men and 1.11 (1.09-1.14) for women 75 years or older. On average, the effect estimate was decreased by about 10% with every 10 years increase in age. Adjusting for known confounding factors of smoking, pre-existing illness, hypertension and diabetes has little impact on the age-dependent decline trend of the obesity-mortality association. Therefore, the strength of the association between obesity and mortality weakens with increasing age.
Publisher: Cambridge University Press (CUP)
Date: 08-2003
DOI: 10.1017/S0950268803008628
Abstract: Pneumonia causes significant morbidity and mortality in Aboriginal populations in Australia's Northern Territory (NT). Kava, consumed in Arnhem Land since 1982, may be a risk factor for infectious disease including pneumonia. A case–control study ( n =115 cases n =415 controls) was conducted in 7001 Aboriginal people (4217 over 15 years). Odds ratios (OR) were calculated by conditional logistic regression with substance use and social factors as confounders. Pneumonia was not associated with kava use. Crude OR=1·26 (0·74–2·14, P =0·386), increased after controlling for confounders (OR=1·98, 0·63–6·23, P =0·237) but was not significant. Adjusted OR for pneumonia cases involving kava and alcohol users was 1·19 (0·39–3·62, P =0·756). In communities with longer kava-using histories, adjusted OR was 2·19 (0·67–7·14, P =0·187). There was no kava dose–response relationship. Crude ORs for associations between pneumonia and cannabis use (OR=2·27, 1·18–4·37, P =0·014) and alcohol use (OR=1·95, 1·07–3·53, P =0·026) were statistically significant and approached significance for petrol sniffing (OR=1·98, 0·99–3·95, P =0·056).
Publisher: Elsevier BV
Date: 02-2003
DOI: 10.1046/J.1523-1755.63.S83.14.X
Abstract: Australian Aborigines in remote areas are experiencing an epidemic of renal and cardiovascular disease. In November 1995, we introduced a renal and cardiovascular treatment program into the Tiwi community, which has a three- to fivefold increase in death rates and a recent annual incidence of treated end-stage renal disease (ESRD) of 2760 per million. Our previous study described an estimated 50% reduction in renal failure and all-cause natural deaths in the treatment group through December 31, 1998. We now describe a reduction in these events through mid 2000. People eligible for treatment were those with confirmed hypertension, diabetics with microalbuminuria or overt albuminuria, and people with overt albuminuria, regardless of blood pressure and diabetes. Treatment centered around the use of perindopril (Coversyl, Servier), with additional agents as needed to reach defined blood pressure goals, attempts at control of glucose and lipid levels, and health education. Two hundred and sixty-seven people, or 30% of the adult population, have been enrolled, with mean follow up of 3.39 years. Rates of terminal endpoints were compared on an intention-to-treat basis with those of 327 historical controls matched for baseline disease severity, who were followed for a mean of 3.18 years in the pre-treatment program era, against a background of no treatment or inconsistent changing treatment. Terminal events occurred in 38 controls and 23 people in the treatment group. The estimated rate of natural deaths in the treatment group was 50% that of the controls, (P=0.012) the rate of renal deaths was 47% (P=0.038) and the rate of non-renal deaths was 54% that of controls (P=0.085). Survival benefit in the treatment group was observed at all levels of overt albuminuria, in non-diabetics and diabetics, in normotensive as well as hypertensive people, and in people who had been taking angiotensin converting enzyme-inhibitors (ACEi) in the pre-program era, as well as those who had not. Benefit was absent among the low death rates of people without overt albuminuria, and questionable among people with glomerular filtration rates (GFRs) <60 mL/min. The number of people needed to treat (NNT) to avoid one terminal event of natural causes was calculated at only 11.6. Falling rates of deaths and renal failure in the whole community support marked benefit of the program. Millions of dollars have been saved, based on avoidance of dialysis alone, but the reduction in premature death is the greater benefit. Chronic disease programs like this are enormously effective, and should be introduced into to all high-risk communities as a matter of urgency.
Publisher: Oxford University Press (OUP)
Date: 21-01-2020
Abstract: It has been reported that current smoking, overweight/obesity and physical inactivity are significant modifiable risk factors of all-cause mortality, cardiovascular disease and cancer. However, the effects of age, period and cohort on the prevalence of the three lifestyle factors among Australian adults are still unclear. Our study analysed data from 2004 to 2005, 2007 to 2008, 2011 to 2012, 2014 to 2015 and 2017 to 2018 National Health Survey. We employed the age–period–cohort models to analyze the in idual effects of age, period and cohort on the prevalence of current smoking, overweight/obesity and physical inactivity among Australian adults. A total of 76 489 adults were included. Age, period and cohort all showed significant independent effects on prevalence of current smoking, overweight/obesity and physical inactivity (P & 0.01) except the cohort effect on physical inactivity in females (P = 0.31). The prevalence of current smoking decreased with age and period, and it first increased with birth cohort and then declined. For overweight/obesity prevalence, it increased with age until early-60s and then dropped. We found a positive period effect on overweight/obesity however, the prevalence of overweight/obesity experienced several shifts with birth cohort. Physical activity prevalence raised with age, and it has several fluctuations for curves of period and cohort. Age effects showed a distinct pattern for the prevalence of the three lifestyle factors. The prevalence of overweight/obesity continued to rise during the study period. The raised physical inactivity prevalence in recent study cycles is also concerning. Recent birth cohorts may be at increased risk of overweight/obesity and physical inactivity.
Publisher: Elsevier BV
Date: 09-2006
DOI: 10.1016/J.SOCSCIMED.2006.04.010
Abstract: This study examines trends in chronic disease outcomes from initiation of a specialised chronic disease treatment programme through to incorporation of programme activities into routine service delivery. We reviewed clinical records of 98 participants with confirmed renal disease or hypertension in a remote indigenous community health centre in Northern Australia. For each participant the review period spanned an initial three years while participating in a specialised cardiovascular and renal disease treatment programme and a subsequent three years following withdrawal of the treatment programme. Responsibility for care was incorporated into the comprehensive primary care service which had been recently redeveloped to implement best practice care plans. The time series analysis included at least six measures prior to handover of the specialised programme and six following handover. Main outcome measures were trends in blood pressure (BP) control, and systolic and diastolic BP. We found an improvement in BP control in the first 6-12 months of the programme, followed by a steady declining trend. There was no significant difference in this trend between the pre- compared to the post-programme withdrawal period. This finding was consistent for control at levels below 130/80 and 140/90, and for trends in mean systolic and diastolic BP. Investigation of the sustainability of programme outcomes presents major challenges for research design. Sustained success in the management of chronic disease through primary care services requires better understanding of the causal mechanisms related to clinical intervention, the basis upon which they can be 'institutionalised' in a given context, and the extent to which they require regular revitalisation to maintain their effect.
Publisher: Elsevier BV
Date: 09-2007
Publisher: Wiley
Date: 06-1999
DOI: 10.1111/J.1445-5994.1999.TB00746.X
Abstract: An epidemic of cardiovascular disease (CVD) and end stage renal disease (ESRD) has developed among Aborigines in the Northern Territory CVD deaths increased over the 1980s (tripling among women!), and are now more than five times those of non-Aboriginal people, while ESRD rates are increasing more than 20-fold and are doubling every three to four years. Dialysis costs (>$75,000 per person/year) pose a crisis for health care budgets, but premature mortality is the greater human catastrophe. Health services are not meeting the challenge of timely diagnosis, prevention and containment. We screened 90% of adults (20+ years) in one community, with CVD mortality among the highest in Australia, and ESRD rates increased 60-fold. Seventy-five per cent of persons were smokers. Central obesity was common, but BMIs only modestly increased by Caucasian standards, 23% had hypertension (>140/90), 29% had diabetes or impaired glucose tolerance (IGT) (peaking at 65% of persons aged 40-49 years), high triglyceride and insulin levels were common, and 55% had albuminuria (albumin/creatinine ratio (ACR), >3.4 gm/moL). Progressive albuminuria predicted renal failure. ACR was correlated with age, BMI, blood pressure, lipid, glucose and insulin levels, heavy drinking and past and current skin infections, and, inversely with birth weight. ACR correlated strongly with a composite CV risk score, and in a two to five year follow-up, microalbuminuria (ACR 3.4-33) and overt albuminuria (ACR 34+) have both predicted increased rate of premature death from natural causes of lower ACRs. Thus albuminuria marks CV risk/disease. This implies that renal and CV disease share common risk factors, and should respond to the same interventions, and that this response might be monitored through ACR levels. Robust public health programmes could reduce all these reversible risk factors, lowering disease rates over the intermediate term, however, few such programmes are in place. Modification of disease in persons already afflicted is a parallel responsibility. To this end, in November 1995, we introduced a treatment programme with Coversyl (perindopril, Servier) for all persons in the study community with hypertension (>140/90), for all diabetics with ACR 3.4+ and for all nondiabetic, non-hypertensive persons with progressive overt albuminuria (ACR 34+). One-quarter of all adults, or 224 persons have enrolled 162 have reached one year of treatment and 100 have passed two years. Compliance is reasonable and enthusiasm high. Average SBP has fallen 12 mmHg (24 mmHg in hypertensive persons), while average ACR and estimated glomerular filtration rate (GFR) have stabilised. This contrasts favourably with the pretreatment course (average 2.7 years) in the same persons, when SBP had increased by 3 mmHg, ACR had increased by 15% and GFR had decreased by 3.5 mL/min each year. Cautious estimates suggest a >50% fall in ESRD, and a reduction in all-cause and CV deaths, even at this early stage, although more extended observation is needed. These data predict a dramatic and rapid fall in morbidity, premature deaths and health care costs if these basic principles of medical care are extended to all Aboriginal people. A national, concerted, multi-disciplinary effort to implement a coherent, effective strategy to this end is of great urgency.
Publisher: Public Library of Science (PLoS)
Date: 13-04-2015
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.JPEDS.2017.01.012
Abstract: To assess the trend of sex disparity in hemoglobin concentration and prevalence of anemia among Chinese school-aged children from 1995 to 2010. Data were collected from 360 866 children aged 7, 9, 12, 14, and 17 years during 4 cross-sectional surveys (1995, 2000, 2005, and 2010) of the Chinese National Surveys on Students Constitution and Health. Shifts in hemoglobin concentration distributions were compared by sex. Average shifts and sex differences were calculated with quantile regression models. Logistic regression was used to estimate the prevalence odds ratio of sex for prevalence of anemia in different surveys. The mean hemoglobin concentration increased among Chinese children between 1995 and 2010, from 132.7 to 138.3 g/L in boys, and from 127.7 to 132.3 g/L in girls. The prevalence of anemia decreased from 18.8% in 1995 to 9.9% in 2010. It was higher in rural than urban children among all age groups. The prevalence odds ratios of girls versus boys for anemia increased in both urban and rural areas over time. Hemoglobin concentration and prevalence of anemia improved among Chinese school-aged children over time. Hemoglobin concentration improved faster in boys than girls and as a result the relative prevalence of anemia in girls compared with boys increased. Sex-specific preventive guidelines and public health policies for childhood anemia are needed in China.
Publisher: American Public Health Association
Date: 07-2014
Publisher: Springer Science and Business Media LLC
Date: 02-03-2017
DOI: 10.1038/SREP43672
Abstract: To assess the associations of obesity with newly diagnosed and previously known atopic disorders in Chinese adults. 4,629 adults aged 18 years or older were recruited in Harbin, China. Among them, 1,114 were previously diagnosed atopic cases, 1,298 were newly diagnosed cases, and 2,217 non-atopic controls. Obesity and overweight are defined according to the criteria established by the Working Group on Obesity in China. The associations of obesity with known and newly diagnosed atopic disorders were assessed using logistic regressions. Obesity was significantly associated with known atopic disorders (adjusted OR = 2.41 (95% CI: 1.81, 3.22)). The association of obesity with newly diagnosed atopic cases was not as strong as that with known cases, and was not statistically significant (adjusted OR = 1.27 (95% CI: 0.94, 1.72)). The similar pattern was observed in different allergic diseases, gender and age stratifications. The association between overweight and atopic diseases were not significant. Obesity is strongly associated with previously diagnosed atopic cases but not so with newly diagnosed atopic cases in Chinese adults. It is likely that people with atopic disorders have a higher risk of developing obesity. Our findings are important for the management of atopic disorders and chronic disease prevention among atopic disease patients.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2013
DOI: 10.1007/S12529-013-9326-X
Abstract: Evaluating the progress of tobacco control across the world heavily relies on smoking prevalence estimates. Those estimates are often based on surveys of self-reported cigarette smoking status. The accuracy varies among populations with different social and cultural backgrounds. The objective of this study was to estimate the prevalence of smoking and assess the accuracy of self-report smoking status in Chinese adolescents. This population-based cross-sectional survey included 10,934 adolescents aged 12 to 18 years from 17 schools in Shanghai, China. Data on adolescents' smoking status were collected from adolescents' self-reporting and from parents' questionnaires, separately. Based on the data of two sources, the total number of smokers among the study participants was estimated using a capture-recapture method. Among 5,452 girls and 5,482 boys, the prevalence estimates of self-reported smoking were 13.6% (748) and 5.2% (284) for boys and girls, respectively. Parents only identified smaller proportions of smoking adolescents: 2.9% (160) boys and 0.6% (30) girls. Using the capture-recapture method, we estimated the prevalence of smoking as 18.3% (95% CI 16.4, 20.3) for boys and 14.2% (95% CI 7.6, 20.8) for girls. Reliance on self-reporting to identify smokers among Chinese adolescents significantly underestimates the number of smokers, particularly among Chinese girls. Self-reported smokers only represent less than half of actual smokers in girls. Our findings are important for monitoring smoking trends and evaluating tobacco control interventions among Chinese adolescents.
Publisher: Springer Science and Business Media LLC
Date: 11-02-2014
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.NUMECD.2017.07.007
Abstract: Folate is involved in a number of metabolic pathways. Red blood cell (RBC) folate is a well-established indicator of folate intake. However, studies focused on the association between RBC folate and coronary heart disease (CHD) are limited. The aim of the current study was to investigate the effect of RBC folate concentrations on the presence of CHD in a nationally representative s le of American adults. In the 1999-2012 National Health and Nutrition Examination Survey (NHANES), 22,499 subjects aged 30-74 years with RBC folate concentrations, CHD status and responses to co-variates questions were included 822 (3.65%) participants were identified as having CHD. Bio-Rad Quanta Phase II radioassay and microbiological assay were used to measure RBC folate concentrations. Firstly, we treated RBC folate as a categorical variable, based on RBC folate tertiles, and used logistic regression analysis to display the RBC folate and CHD relationship. Secondly, we explored associations using a combination of restricted cubic spline and logistic regression models, stratified by sex. After adjusting for several well-established traditional CHD risk factors, RBC folate was positively related to CHD presence in the total population and the association was more pronounced among males than females. A J-shaped pattern was observed in RBC folate concentrations for females. Elevated RBC folate concentrations were associated with higher CHD risk. Further investigation is needed to test the association in large-scale follow-up studies.
Publisher: Oxford University Press (OUP)
Date: 18-04-2013
DOI: 10.1093/AJH/HPT050
Abstract: The prevalence of obesity, based on body mass index (BMI), among Chinese children and adolescents has increased for decades, but the relationship between trends in blood pressure (BP) and increasing BMI has not been studied. BMI and BP measurements of 391,982 children aged 7-17 years were obtained from surveys in 2005 and 2010. The mean change and 95% confidence intervals (CIs) of BP were calculated, and the association between BMI and BP was assessed by using analysis of covariance and direct adjustment with the BMI distribution of 2005 survey. The mean systolic BP (SBP) and diastolic BP (DBP) increased 1.5 mm Hg (95% CI = 1.4-1.7 mm Hg) and 1.1 mm Hg (95%CI = 1.1-1.2 mm Hg) for boys and 1.2 mm Hg (95% CI = 1.1-1.3 mm Hg) and 1.0 mm Hg (95% CI = 1.0-1.1 mm Hg) for girls from 2005 to 2010, respectively. After adjustment for BMI, SBP and DBP in 2010 were 0.8mm Hg (95% CI = 0.8-0.9mm Hg) and 0.8mm Hg (95% CI = 0.7-0.8mm Hg) higher than in 2005, respectively (all P < 0.01). With adjustment for difference in BMI distribution in 2005 and 2010, the mean increase of SBP decreased by 40.5% and that of DBP by 26.9%. BP among Chinese children and adolescents was on the rise from 2005 to 2010, which was consistent with the hypothesis that the rise in BP was in part attributable to the rise in BMI.
Publisher: Springer Science and Business Media LLC
Date: 26-10-2014
Publisher: Elsevier BV
Date: 2023
Publisher: Wiley
Date: 18-04-2016
DOI: 10.1111/DME.12892
Publisher: Elsevier BV
Date: 02-2004
DOI: 10.1016/S0277-9536(03)00243-0
Abstract: Indigenous Australians are disadvantaged, relative to other Australians, over a range of socio-economic and health measures. The age- and sex-adjusted incidence of end-stage renal disease (ESRD)--the irreversible preterminal phase of chronic renal failure--is almost nine times higher amongst Indigenous than it is amongst non-indigenous Australians. A striking gradient exists from urban to remote regions, where the standardised ESRD incidence is from 20 to more than 30 times the national incidence. We discuss the profound impact of renal disease on Indigenous Australians and their communities. We explore the linkages between disadvantage, often accompanied by geographic isolation, and both the initiation of renal disease, and its progression to ESRD. Purported explanations for the excess burden of renal disease in indigenous populations can be categorised as: primary renal disease explanations genetic explanations early development explanations and socio-economic explanations. We discuss the strengths and weaknesses of these explanations and suggest a new hypothesis which integrates the existing evidence. We use this hypothesis to illuminate the pathways between disadvantage and the human biological processes which culminate in ESRD, and to propose prevention strategies across the life-course of Indigenous Australians to reduce their ESRD risk. Our hypothesis is likely to be relevant to an understanding of patterns of renal disease in other high-risk populations, particularly indigenous people in the developed world and people in developing countries. Furthermore, analogous pathways might be relevant to other chronic diseases, such as diabetes and cardiovascular disease. If we are able to confirm the various pathways from disadvantage to human biology, we will be better placed to advocate evidence-based interventions, both within and beyond the scope of the health-care system, to address the excess burden of renal and other chronic diseases among affected populations.
Publisher: Wiley
Date: 2008
DOI: 10.1002/AJHB.20729
Abstract: To compare body size measurements in Australian Aboriginals living in three remote communities in the Northern Territory of Australia with those of the general Australian population. Height, weight, waist and hip circumferences and derivative values of body mass index (BMI), waist-hip ratio (WHR), waist-height ratio (WHT), and waist-weight ratios (WWT) of adult Aboriginal volunteers (n = 814), aged 25 to 74 years were compared with participants in the nationally representative 'AusDiab' survey (n = 10,434). The Aboriginal body habitus profiles differed considerably from the Australian profile. When compared to Australian females, Aboriginal females were taller and had lower hip circumference but had higher WC, WHR, WHT, and WWT (P < 0.01 for all). When compared with their Australian counterparts, Aboriginal males were shorter, had lower body weight, WC, hip circumference, BMI, and WHT but had higher WHR and WWT (P < 0.001 for all). Significantly more Aboriginal females were classified as overweight and or obese using cutoffs defined by WC and by WHR than by BMI. Aboriginal males were less often overweight and/or obese by BMI than their counterparts, but were significantly more often overweight or obese by WHR. There were significant variations in body size profiles between Aboriginal communities. However, the theme of excess waist measurements relative to their weight was uniform. Aboriginal people had preferential central fat deposition in relation to their overall weight. BMI significantly underestimated overweight and obesity as assessed by waist measurements among Aboriginals. This relationship of preferential central fat deposition to the current epidemic of chronic diseases needs to be explored further.
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1016/J.DIABRES.2006.01.007
Abstract: This article reviews and describes trends and differences in prevalence of type 2 diabetes mellitus of Chinese populations in Mainland China, Hong Kong and Taiwan based on literatures published in the MEDLINE Advanced database (January 1966-October 2005) in both Chinese and English languages. Chinese populations in Hong Kong and Taiwan have significant higher prevalence rates of diabetes than their Mainland counterparts, with odds ratios 1.5 (95% confidence intervals: 1.4, 1.7) and 2.0 (95% confidence intervals: 1.8, 2.2), respectively in 1995-2003 adjusted for age and diagnostic criteria. Using stratified diagnostic criteria the odds ratios in Hong Kong and Taiwan were consistently higher than Mainland China for the periods of 1985-1994 and 1995-2003. A large proportion, i.e. 68.6% (95% confidence intervals: 67.4%, 69.7%) of diabetic patients remains undiagnosed in Mainland China as compared to 52.6% (95% confidence intervals: 49.8%, 55.5%) undiagnosed in Hong Kong and Taiwan. The prevalence rates of diabetes and impaired glucose tolerance of the Chinese populations rise in older age groups. In tandem with economic development and change toward lifestyle that is lack of physical activity and rich in high-fat diet, prevalence of diabetes of the Chinese populations are on the rise. If the undiagnosed in iduals left uncontrolled, they are subject to higher risks of developing diabetes and its complications. These will increase the burdens of diabetes medically and financially.
Publisher: Elsevier BV
Date: 11-2010
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1053/J.AJKD.2008.03.007
Abstract: Urine albumin assays by high-performance liquid chromatography (HPLC) yield greater values than immunoassays at lower albumin levels. We compared predictive values of albumin-creatinine ratios (ACRs) by these 2 techniques for mortality in Aboriginal people. This was a longitudinal study of 741 adults in a remote Aboriginal community who participated in a baseline health survey between 1992 and 1998 at ages ranging from 18 to 84 years (mean, 34 years). All natural deaths were documented on follow-up until 2006. Urine albumin concentrations were measured simultaneously by using both nephelometric and HPLC techniques on baseline urine s les retrieved from -70 degrees C storage, as well as creatinine concentrations, and ACRs were derived. Age- and sex-specific tertiles of ACR were compiled. Cox regression analyses were used to evaluate the predictive value of ACR for natural deaths by ACR tertiles and again by z score changes in ACRs as continuous variables. Participants were followed up for a median of 11 years, during which a total of 119 natural deaths were documented. ACRs on baseline urine s les were greater by HPLC than immunoassay at lower ACR ranges, but were fairly concordant at levels greater than 100 mg/mmol. Levels of ACR by both techniques were strong predictors of death, but correlations of death with ACR tertiles and with ACR levels on a continuum were similar for the 2 techniques. The age- and sex-specific tertiles used might introduce some risk of bias in the assessment of predictive value. In addition, assays were performed on urine after more than 10 years of cold storage. Despite different absolute values, this study did not show that ACR level by either technique was superior in predicting deaths.
Publisher: Informa UK Limited
Date: 17-06-2015
DOI: 10.3109/08037051.2015.1030904
Abstract: Little is known about whether eliminating overweight and obesity could effectively reduce the prevalence of high blood pressure (HBP) in Chinese children. This study aimed to estimate the magnitude of contribution of overweight and obesity associated with HBP in Chinese children, and assess the theoretical HBP prevalence if overweight and obesity were eliminated. Data on 197,191 participants aged 7-17 years with complete records from the Chinese National Survey on Students' Constitution and Health conducted in 2010 were included. The population attributable risk of overweight and obesity for HBP was calculated. The prevalence of HBP was 6.8% and 5.8% for boys and girls, respectively. HBP in about 22.9% (95% CI 21.5, 24.2%) of boys and 14.7% (95% CI 13.5, 15.8%) of girls could be attributable to overweight and obesity. If both overweight and obesity were eliminated, the prevalence of HBP theoretically could be reduced to 5.2% in boys and 5.0% in girls. Similar results were found in different age and urban/rural area groups. Eliminating overweight and obesity could theoretically lead to a moderate reduction in the prevalence of HBP in Chinese children.
Publisher: Wiley
Date: 04-2002
Publisher: American Society for Microbiology
Date: 11-2003
DOI: 10.1128/IAI.71.11.6354-6357.2003
Abstract: Interleukin-12 (IL-12) has been inversely associated with disease severity in human and murine malaria, and a polymorphism in the IL-12 p40 subunit gene ( IL12B ) has been associated with susceptibility to human cerebral malaria and reduced nitric oxide (NO) production. To better define the relationships between IL-12, NO, malaria parasitemia, and IL12B polymorphisms during malarial tolerance, plasma IL-12 levels and peripheral blood mononuclear cell NO synthase (NOS) activity were measured in asymptomatic Papua New Guineans exposed to intense malaria transmission. The IL-12 level was strongly inversely correlated with the density of Plasmodium falciparum parasitemia (ρ = −0.45 P 0.001) and was predicted to decrease by 19% (95% confidence interval [CI], 10 to 27%) for each twofold increase in P. falciparum parasitemia. This is consistent with a suppressive effect of parasitemia on IL-12 production, an effect previously shown in vitro and in rodent models of disease. The IL-12 level was inversely correlated with NOS activity ( r = −0.22 P = 0.007), with each twofold increase in NOS activity being predictive of a 25% (95% CI, 7 to 38%) decrease in plasma IL-12 levels. This probably reflects additional down-regulation of IL-12 by the high basal NO production and monocyte NOS expression found in the malaria-tolerant state. Neither the IL-12 level nor NOS activity was associated with either of two IL12B polymorphisms, reflecting the ersity of genetic control over immune responses in different populations.
Publisher: MDPI AG
Date: 23-03-2015
Publisher: Informa UK Limited
Date: 2018
DOI: 10.2147/CLEP.S155783
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.ORCP.2013.11.009
Abstract: To compare gender-specific waist circumference (WC) levels of Aboriginal Australians with non-Aboriginal Australians. A systematic search on Medline, PubMed, EMBASE and Google Scholar databases was conducted to identify papers that reported gender-specific waist circumference (WC) estimates of participants from the age of 15 years and above among Aboriginal and non-Aboriginal Australians. Means and their 95% confidence intervals of gender differences in WC, height and weight were recorded or calculated where they were not provided. Gender-specific WC, height and weight mean estimates were pooled and the I(2) statistic was used to test heterogeneity among Aboriginal and non-Aboriginal Australians. Of 17 selected cross-sectional studies, 9 focused on Aboriginal and 8 on non-Aboriginal Australians. Seven studies reported significantly higher WC estimates among indigenous females than males. On the other hand, non-indigenous males had significantly higher WC levels than females. Males had greater height and weight estimates than females in both groups. Although indigenous women were shorter and had lower weight estimates, they had greater WC levels than indigenous men. This is the first systematic review to assess the gender-specific differences between Aboriginal and non-Aboriginal Australians. The findings of this review warrant more efforts to understand and reduce the high prevalence of central obesity and related chronic diseases among Aboriginal women.
Publisher: Public Library of Science (PLoS)
Date: 03-09-2015
Publisher: Springer Science and Business Media LLC
Date: 27-05-2004
Publisher: Elsevier BV
Date: 04-2016
Abstract: To investigate the association between low birthweight (LBW <2,500 grams) and cardiovascular disease (CVD) hospitalisations in adult life in a remote Indigenous Australian community. This was a prospective cohort of 852 participants with recorded birthweight using community-wide health screening examinations conducted between 1992 and 1999 and hospitalisation records up to 2012. Cox proportional hazard models assessed the association between LBW and hypertension, major CVD (heart failure, myocardial infarction and stroke) and any CVD hospitalisations. There were 236 participants (28%) who had a low birthweight. The LBW group had a higher risk of developing any CVD (HR = 1.43, 95%CI 1.01-2.03), major CVD (HR = 1.51, 95%CI 0.93-2.47) and hypertension (HR = 1.83, 95%CI 1.09-2.96) than the normal birthweight (NBW) group (≥2,500 g). Women with LBW had more than 2.6 times the risk of a hospitalisation associated with hypertension compared to their NBW counterparts (HR = 2.61, 95%CI 1.38-4.93), but this relationship was not seen in men. LBW increased the risk of cardiovascular disease hospitalisations in adult life in this group. Further CVD prevention initiatives should continue to include LBW as a key predictor of CVD in this community. The mechanisms of gender influence on the hypertension relationship are unknown and require further investigation in indigenous populations worldwide.
Publisher: Elsevier BV
Date: 05-2001
DOI: 10.1016/S0272-6386(05)80006-X
Abstract: Low birth weight predisposes to renal disease in Aboriginal adults. This could be due to reduced nephron numbers, which might be reflected in lower kidney volumes, at least early in life. In this study we evaluated the association of birth weight with renal volume in 174 children and in adolescents 5 to 18 years old in an Aboriginal community with high rates of renal disease. Their mean birth weight was 2.9 kg, and 19% had been low birth weight (<2.5 kg). Kidney dimensions were measured by ultrasound by a single observer, and kidney volume (KV) was calculated from the formula KV (mL) = length x (depth 1 + depth 2)/2 x 0.523. Combined kidney volume, corrected for body surface area (corrKV), was independent of age and averaged 240 +/- 45 mL/1.73 m(2). The average corrKV was significantly lower (by about 20 mL) in low birth weight children than in those with "normal" birth weight. There was a difference of 32 mL in combined corrKV between children in the lowest versus the highest quintile of birth weight. Disparities in calculated kidney volume were driven more by lower kidney depth than length in low birth weight children. We conclude that low birth weight children have lower renal volumes than children of higher birth weights, after correction for current body size. This conclusion is compatible with the theory that intrauterine growth retardation is associated with reduced nephron endowment. The susceptibility to renal disease associated with low birth weight in this population might be mediated in part through this mechanism.
Publisher: Cambridge University Press (CUP)
Date: 04-2010
Publisher: Wiley
Date: 27-11-2017
DOI: 10.1002/OBY.21976
Abstract: The aim of this study was to evaluate the previously reported finding that the association between obesity and mortality strengthens with increasing age. The data were derived from the National Health Interview Survey. Age-specific hazard ratios of mortality for grade 2/3 obesity (BMI ≥ 35 kg/m When the model included interaction terms between obesity and age at the survey, hazard ratios appeared to increase with age if those interaction terms were ignored by fixing age at the survey as a single value. However, when recalculated for adults with various ages at the survey, according to model specifications, hazard ratios were higher for younger adults than for older adults with the same follow-up duration. Based on matched data, hazard ratios were also higher for younger adults (2.14 [95% CI: 1.90-2.40] for those 40-49 years of age) than for older adults (1.22 [95%: 0.91-1.63] for those 90+ years of age). For any given follow-up duration, the association between obesity and mortality weakens with age. The previously reported strengthening of the obesity-mortality association with increasing age was caused by the failure to take all the model specifications into consideration when calculating adjusted hazard ratios.
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1053/J.AJKD.2008.04.028
Abstract: In view of recent reports of the relationship of kidney disease to birth weight, we evaluate the relationship between birth weight and chronic kidney disease (CKD), including end-stage kidney disease, in Australian adults. A case-control study. Patients attending the nephrology department at a major metropolitan hospital in Australia were asked to recall their birth weight, excluding those with structural kidney abnormalities. Two controls for each patient, matched for sex and within 5 years of age, were selected from participants from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study, who had also been asked to report their birth weight. Birth weight in kilograms. CKD and stages were defined using the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative classification, proteinuria as a marker of kidney damage, and glomerular filtration rate estimates, by using the Modification of Diet in Renal Disease Study equation. Of 189 patients with CKD who reported their birth weights for whom controls were identified, 106 were men. Mean age was 60.3 +/- 15 (SD) years. Mean birth weight overall was 3.27 +/- 0.6 versus 3.46 +/- 0.6 kg for their controls (P < 0.001), and proportions with birth weights less than 2.5 kg were 12.2% and 4.4% (P < 0.001). In patients with CKD, 22.8%, 21.7%, 18%, and 37.6% were in CKD stages 2 (n = 43), 3 (n = 41), 4 (n = 34), and 5 (n = 71), respectively. Birth weights by CKD stage and their AusDiab controls were as follows: stage 2, 3.38 +/- 0.52 versus 3.49 +/- 0.52 kg P = 0.2 stage 3, 3.28 +/- 0.54 versus 3.44 +/- 0.54 kg P = 0.1 stage 4, 3.19 +/- 0.72 versus 3.43 +/- 0.56 kg P = 0.1 and stage 5, 3.09 +/- 0.65 versus 3.47 +/- 0.67 kg P < 0.001. Differences in birth weights applied to women and men and people younger than 60 and 60 years and older and were present in the major "causal" categories of renal disease. Birth weight is by self-recall with a significant nonresponse rate to the questionnaire in both cases and controls. Urban Australian patients with CKD had lower birth weights than their matched Australian controls. In addition, the more advanced the CKD stage, the lower the birth weight. Thus, lower birth weights appear to predispose to CKD and to its progression. Among possible explanations is the documented association between birth weight and nephron number.
Publisher: Public Library of Science (PLoS)
Date: 08-01-2013
Publisher: Wiley
Date: 1990
Abstract: Systolic and diastolic blood pressures and body-size indices such as body height, body weight, sitting height, chest circumference, skinfold thickness, and body mass index (BMI) were assessed in 110 pairs of like-sex Chinese twins (75 monozygotic and 35 dizygotic) aged 7-12 years. Significant correlations of blood pressure with body-size indices were found. Prior to adjusting for body-size effects, three twin methods yielded low heritability estimates for both systolic (0.32-0.41) and diastolic (0.32-0.51) pressures. Adjusting systolic pressure for body height and BMI via multiple regression nearly halved heritability estimates, but adjusting diastolic pressure for body height and skinfold thickness only changed the estimates slightly.
Publisher: Elsevier BV
Date: 09-2003
DOI: 10.1016/S1353-8292(02)00037-0
Abstract: This paper explores the relationship between area level measures of social disadvantage and the late referral of patients with end-stage renal disease (ESRD) to a nephrologist. Patients who were referred late were those who needed to commence dialysis within 3 months of referral to a nephrologist. Late referral has been associated with increased morbidity and mortality. We studied 3334 patients who started ESRD treatment in Australian capital cities between 1 April 1995 and 31 December 1998. The proportion referred late varied between areas, was higher in areas of greater disadvantage and was significantly related to the age- and sex-standardised incidence of ESRD. This may indicate inequitable access to optimal pre-ESRD care.
Publisher: Public Library of Science (PLoS)
Date: 26-10-2017
Publisher: Springer Science and Business Media LLC
Date: 31-01-2015
Publisher: Wiley
Date: 30-03-2016
DOI: 10.1111/DME.13111
Abstract: To assess the non-linear relationship between BMI and mortality and to determine the BMI values with the lowest mortality risk in adults with and without diabetes. This observational study assessed the relationship between BMI and mortality with flexible parametric survival models using data from the US National Health Interview Survey. Participants included 25 458 adults with diabetes and 315 939 adults without diabetes, aged 18-84 years at baseline surveys, conducted from 1997 to 2009. Mortality status data were obtained from the linked mortality data up to 2011. We observed a U-shaped relationship between BMI and mortality in both adults with and without diabetes. With the BMI 25-29.9 kg/m Regardless of the presence of diabetes, there is a U-shaped relationship between BMI and mortality. The BMI values associated with the lowest mortality were above the current 'normal' range for adults with and without diabetes.
Publisher: Wiley
Date: 09-2021
DOI: 10.1111/IMJ.15199
Abstract: There are no contemporary published data on the frequency of the ABO and Rhesus D (RhD) blood groups in the Northern Territory (NT) of Australia, particularly for the large Aboriginal population. To establish the frequencies of ABO and RhD blood groups in the NT Aboriginal and non‐Aboriginal populations in order to aid transfusion inventory management and clinical practice. Retrospective data were collected from 1 January 2012 to 31 December 2012. All patients with a blood group s le processed by the NT public hospital laboratories and a recorded ABO and RhD report were included. Results were analysed using Stata 14. The Aboriginal and non‐Aboriginal populations had significantly different ABO and RhD distributions ( P 0.001). For Aboriginal in iduals, 955/1686 (56.6%) were group O and 669/1686 (39.7%) were group A. In non‐Aboriginal in iduals, 1201/2657 (45.2%) were group O and 986/2657 (37.1%) were group A. We found that 1646/1686 (97.6%) of Aboriginal in iduals were RhD positive, compared with 2225/2657 (83.7%) of non‐Aboriginal in iduals. Only 62/1686 (3.7%) of Aboriginal in iduals were group B or AB, compared with 470/2657 (17.7%) of non‐Aboriginal in iduals. In Aboriginal in iduals we found that group O was more common than A in the ‘Northern’ NT, whereas there was similar distribution of the groups in ‘Central Australia’. We found a significant difference in ABO and RhD blood groups between Aboriginal and non‐Aboriginal in iduals in the NT ( P 0.001). These findings will aid transfusion inventory management, allowing us to plan supply of blood products and reduce waste.
Publisher: Cambridge University Press (CUP)
Date: 16-01-2012
DOI: 10.1017/S0007114511007136
Abstract: Children in China are experiencing a rapid increase in the prevalence of obesity, which is associated with hypertension. To compare the effect of body fat on blood pressure (BP) with that of the normal physical growth, we compared BP levels in Chinese children with different body fat levels. In the present population-based study, 13 972 children in the highest-skinfold-thickness-quartile group were in idually matched to 13 972 children in the lowest-skinfold-thickness-quartile group by height and weight. Similarly, 5103 children in the highest-waist-circumference-quartile group were matched to the same number of children in the lowest-waist-circumference-quartile group. The high- and low-fat groups had similar height and weight but the high-fat group had significantly higher skinfold and waist circumference measurements. The differences in systolic BP (SBP) between the high- and low-skinfold-thickness groups were small: 0·01 (95 % CI − 0·41, 0·44) mmHg in boys and 0·20 (95 % CI − 0·15, 0·54) mmHg in girls. The differences in diastolic BP (DBP) were also small (0·39 and 0·38 mmHg for boys and girls, respectively) but were statistically significant. The differences in both SBP and DBP between the high- and low-waist-circumference groups were small but not statistically significant. For a given body size as measured by height and weight, relative body fat had little impact on BP levels in these children. Fat mass and lean mass may have a similar quantitative impact on BP in healthy-weight children.
Publisher: Oxford University Press (OUP)
Date: 16-06-2006
DOI: 10.1093/IJE/DYL115
Abstract: Aboriginal Australians experience a higher risk of diabetes than the general Australian population. In this paper, we conducted a nested case-control study to determine whether the presence of microalbuminuria and macroalbuminuria is associated with the development of diabetes among diabetes-free Aboriginal people at baseline. Urine albumin to creatinine ratios (ACRs) were obtained from 882 Aboriginal people aged 20-74 years from one community. Among them 750 were free of either clinical known diabetes or newly diagnosed diabetes according to WHO 1999 criteria. Over an 11 year follow-up period, 117 participants developed diabetes. They were defined as cases. Each case was matched by an in idual control with same sex and body mass index (BMI) category, and age within 2 years. Conditional logistic regression was used to assess the association between albuminuria and diabetes. The baseline level of ACR was significantly higher among cases than among controls. The odds ratios for future diabetes were 2.36 [95% confidence interval (95% CI) 1.01-5.50] and 3.27 (95% CI 1.38-7.77) for middle and upper tertiles, respectively, with adjustment for age, BMI, serum total cholesterol, serum C-reactive protein values, and fasting plasma glucose at the baseline. The adjusted odds ratios were 1.90 (95% CI 0.88-4.06) and 2.51 (95% CI 1.08-5.87) for those with microalbuminuria and macroalbuminuria, respectively. The presence of microalbuminuria and macroalbuminuria predicts diabetes independent of other known risk markers of development of type 2 diabetes in Aboriginal people.
Publisher: BMJ
Date: 09-2015
Publisher: Wiley
Date: 25-09-2016
DOI: 10.1111/IJPO.12073
Abstract: Little is known about the secular trends in age at spermarche among boys, and the association between body mass index (BMI) and male puberty is controversial. This study aimed to estimate the trend in age at spermarche in China and explore the association of spermarche with BMI. We used four cross-sectional Chinese National Surveys on Students' Constitution and Health (CNSSCH 1995, 2000, 2005 and 2010). Median age at spermarche was determined using probit analysis. Logistic regression was used to assess the association of spermarche with BMI. Age at spermarche among Chinese boys dropped from 14.57 to 14.03 years from 1995 to 2010 with a decrease of 4.3 months per decade. Boys with BMI-for-age z-score lower than -2 had the latest age at spermarche. A higher BMI or BMI-for-age z-score was associated with an increased likelihood of having reached spermarche, and this association was consistently observed at all survey points. This study provides important evidence of a secular trend of earlier age at spermarche over the past 15 years in China, and this decrease was accompanied by a simultaneous increase in BMI. Strategies and interventions focusing on thinness may promote both their nutritional status and puberty development among Chinese boys.
Publisher: Informa UK Limited
Date: 05-2003
Abstract: To assess Indigenous Australians' access to renal transplantation, compared with non-Indigenous Australians. To examine whether disparities are due to a lower rate of acceptance onto the waiting list and/or a lower rate of moving from the list to transplantation. National cohort study using data from the Australian and New Zealand Dialysis and Transplant Registry. We included all end-stage renal disease (ESRD) patients under 65 years of age who started treatment in Australia between January 1993 and December 1998. We used survival analysis to examine the time from commencement of renal replacement therapy (RRT) to transplantation. We measured time from commencement of RRT to acceptance onto the waiting list (stage 1), and time from acceptance onto the waiting list to transplantation (stage 2). The main outcome measures were (1) acceptance onto the waiting list and (2) receipt of a transplant, before 31 March 2000. Indigenous patients had a lower transplantation rate (adjusted Indigenous: non-Indigenous rate ratio 0.32, 95% CI 0.25-0.40). They had both a lower rate of acceptance onto the waiting list (adjusted rate ratio 0.50, 95% CI 0.44-0.57) and a lower rate of moving from the list to transplantation (adjusted rate ratio 0.50, 95% CI 0.38-0.65). The disparities were not explained by differences in age, sex, co-morbidities or cause of renal disease. Indigenous Australians face barriers to acceptance onto the waiting list and to moving from the list to transplantation. Further research to identify the causes could facilitate strategies to improve equity in transplantation.
Publisher: Informa UK Limited
Date: 11-2017
DOI: 10.2147/CLEP.S148101
Publisher: Elsevier BV
Date: 10-2013
Publisher: Elsevier BV
Date: 09-2007
Publisher: Medknow
Date: 2013
Abstract: Chromosome 7 aberrations in renal cell carcinoma (RCC) have been reported in papillary renal cell carcinoma (pRCC) and clear cell renal cell carcinoma (ccRCC). However, the implication of these anomalies on prognosis and survival is still unclear. RCC Chromosome 7 aberrations have commonly been detected by fluorescent in situ hybridization and chromogenic in situ hybridization but not silver in situ hybridization (SISH). The purpose was to report chromosome 7 aberrations in ccRCC and pRCC using SISH in paraffin-embedded tissues and determine the association between the anomalies with clinical and pathological features. Cases of ccRCC and pRCC from University Malaya Medical Centre (2001-2009) were analyzed. Chromosome 7 staining was performed using an automated SISH method and association tests between chromosomal anomalies, clinical features and survival were performed. SISH is a feasible technique to detect chromosome 7 aberration in RCC. Chromosome 7 aberrations with nuclear grading, staging and survival yielded no significant correlation. Surprisingly, there was a significant association between gender and chromosome 7 expressions. Though grade did not reach statistical significance for survival in our RCC cases, there was a significant correlation between overall survival with race and stage. Chromosome 7 aberrations in ccRCC showed no prognostic significance. Nevertheless, staging and grading systems that include prognostic variables could hold better promise.
Publisher: American Medical Association (AMA)
Date: 06-09-2016
Publisher: Wiley
Date: 03-11-2012
DOI: 10.1111/J.1440-1754.2011.02221.X
Abstract: The aim of this study was to quantify the relationships of height, weight and body mass index (BMI) with blood pressure (BP) levels in Chinese children and adolescents. Height, weight, BMI and BP measurements were obtained from a nationally representative s le of 231,227 children aged 7-18 years. Body size measurements were converted to age- and sex-specific standard deviation (SD) scores. The relationships between body size and BP measurements were assessed using linear regression analysis. All body size measurements were significantly associated with BP levels. Systolic BP increased 4.14, 3.70 and 2.88 mmHg in boys and 2.98, 2.63 and 1.87 mmHg in girls, corresponding to 1 SD increase in weight, BMI and height, respectively. A similar pattern was also observed for diastolic BP. After adjustment for height, systolic BP increased substantially with increasing weight (3.96 mmHg/SD increase for boys and 2.92 mmHg for girls). With adjustment for weight, systolic BP increased slightly with 1 SD increase in height (0.27 mmHg for boys and 0.10 mmHg for girls). The strength of the association between a body size measurement and BP varied among different ages, peaked at 10-11 years in girls and around 12-14 years in boys. Weight is the most powerful driving force of BP in children and adolescents, followed by BMI and height. Height has little impact on BP in children with a given weight, while weight has considerable impact on BP in children with a given height.
Publisher: Springer Science and Business Media LLC
Date: 17-08-2010
Abstract: Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community. Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI). One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.
No related grants have been discovered for Zhiqiang Wang.