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Wang C.,Shanghai JiaoTong University | Hou X.,Shanghai JiaoTong University | Bao Y.,Shanghai JiaoTong University | Pan J.,Shanghai JiaoTong University | And 4 more authors.
International Journal of Cardiology | Year: 2010

Background: Whether metabolic syndrome (MetS) could serve as a valid indicator for cardiovascular disease (CVD) is in controversy. The aim of the study was to prospectively evaluate the predictive value of the MetS for CVD events in Chinese population by different MetS definitions. Methods: This was a community-based cohort study. MetS was defined according to the World Health Organization (WHO), the International Diabetes Federation (IDF), the National Cholesterol Education Program Adult Treatment Panel III (NCEPIII) and Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG), respectively. 2788 subjects were included. The incidence of CVD events was monitored during a 5.5-year period. Results: The proportion of MetS defined by the WHO, IDF, NCEPIII and JCDCG criteria was 25.9%, 15.4%, 22.0% and 26.1%, respectively in men, and 24.5%, 28.0%, 31.1% and 23.0%, respectively in women. After adjusting for age, all four definitions were associated with increased risk of CVD events in women, but not in men. The corresponding hazard ratios (HRs) [95% confidence intervals (CIs)] in women were 2.13 (1.44-3.16), 1.49 (1.01-2.19), 1.50 (1.02-2.21) and 2.10 (1.41-3.11). The HRs remained significant with WHO and JCDCG definitions, not with the IDF and NCEPIII definitions, when factors of LDL cholesterol, and smoking were adjusted. Conclusion: The MetS by the WHO and JCDCG definition was associated with increased risk of CVD events in Chinese women after adjustment for age, total cholesterol, LDL cholesterol, and smoking. © 2008 Elsevier Ireland Ltd. All rights reserved. Source

Pang C.,Shanghai JiaoTong University | Jia L.,Shanghai JiaoTong University | Jiang S.,Fudan University | Liu W.,Shanghai JiaoTong University | And 8 more authors.
Diabetes/Metabolism Research and Reviews | Year: 2012

Background: The prevalence of diabetic retinopathy is not well studied in the Chinese pre-diabetic population, also known as impaired glucose regulation. Hence, we investigated the prevalence of and risk factors associated with retinopathy in diabetic and pre-diabetic subjects from Chinese communities. Methods: A total of 3736 Chinese subjects were recruited from urban communities in Shanghai. The participants were classified as normal glucose tolerance, impaired glucose regulation (IGR) and diabetes based on the 75g oral glucose tolerance test. The levels of diabetic retinopathy (DR) were assessed with non-mydriatic retinal photographs according to the Diabetic Retinopathy Disease Severity Scale. Results: The prevalence of diabetic retinopathy in patients with diabetes and impaired glucose regulation subjects was 9.4% and 2.5%, respectively. In subjects with IGR, hypertension (odds ratio: 3.54, p=0.028), including elevated systolic and diastolic blood pressure and obesity (odds ratio: 3.53, p=0.028) were significantly associated with diabetic retinopathy after age and sex adjustments. The factors associated with retinopathy in diabetes included diabetes duration, blood glucose levels, glycated hemoglobin levels, and the presence of albuminuria. Diabetic retinopathy was significantly associated with fasting plasma glucose in known diabetes, whereas in newly-diagnosed subjects, diabetic neuropathy was closely correlated to postprandial plasma glucose. Conclusions: Hyperglycemia was a strong risk factor for diabetic retinopathy. In pre-diabetic subjects, diabetic retinopathy was also associated with hypertension and obesity. © 2011 John Wiley & Sons, Ltd. Source

Wang C.,Shanghai JiaoTong University | Hou X.-H.,Shanghai JiaoTong University | Zhang M.-L.,Shanghai JiaoTong University | Bao Y.-Q.,Shanghai JiaoTong University | And 4 more authors.
Biomedical and Environmental Sciences | Year: 2010

Objective: To evaluate the present Chinese body mass index (BMI) criteria with body fat percentage (BF%) in determining obesity in Chinese population. Methods: A total of 4 907 subjects (age: 20-90 yrs) were enrolled in the baseline survey of a longitudinal epidemiological study, and 2 638 of them were reevaluated in 5.5 years later. The Chinese BMI and WHO BF% were used to define obesity, respectively. Results: The diagnostic agreement between the Chinese BMI and WHO BF% definitions for obesity was poor for both men (kappa: 0.210, 95% CI: 0.179-0.241) and women (kappa: 0.327, 95% CI: 0.296-0.358). However, BMI had a good correlation with BF% both in men (r: 0.785, P<0.01) and women (r: 0.864, P<0.01). The age and sex-adjusted relative risks (RR) for incidence of type 2 diabetes (T2DM) were significantly higher in subjects with intermediate BF% (BF%:20.1%-25% for men, 30.1%-35% for women) (RR: 2.35, 95% CI: 1.23-4.48) and high BF%(BF%>25% for men and > 35% for women)(RR: 2.89, 95% CI: 1.43-5.81), or in subjects with high BMI (BMI≥28 kg/m2) (RR: 2.46, 95% CI: 1.31-4.63) when compared to those with low BF% (BF%≤20% for men and≤30% for women) or low BMI (BMI<24 kg/m2) respectively. No difference in risk could be found in those with intermediate BMI (BMI: 24-27.9 kg/m2) (RR: 1.44, 95% CI: 0.86-2.40), as compared to those with low BMI (BMI<24 kg/m2), whose BF% ranged widely from 7.8 to 50.3%. Conclusion: BMI was correlated with BF%. Both BMI and BF% were associated with high risk for T2DM. However, BMI had its limitations in the interpretation of subjects with BMI between 24 and 27.9 kg/m2. Copyright © 2010 by China CDC. Source

Li L.,Shanghai JiaoTong University | Li L.,Mellitus | Wang C.,Shanghai JiaoTong University | Wang C.,Mellitus | And 7 more authors.
Clinical and Experimental Pharmacology and Physiology | Year: 2012

Obesity results in an increased risk of metabolic syndrome (MetS) and Type 2 diabetes (T2DM). Body fat percentage (BF%) is a common index of body composition. The aim of the present study was to determine the optimal BF% cut-offs for obesity to predict MetS and T2DM in Chinese adults. The baseline study group comprised 3916 Chinese adults (age 30-70 years of age); 2033 subjects without MetS or T2DM were followed up for a maximum of 5.5 years. The BF% was estimated using bioelectrical impedance analysis. Optimal BF% cut-offs were analysed by receiver operating characteristic (ROC) curves. Binary logistic regression analysis was performed to measure the association between obesity at baseline defined by BF% and newly developed MetS and T2DM. Mean BF% levels were lower in men than in women (23.9 ± 6.1% vs 33.5 ± 7.1%, respectively; P < 0.01). For men, the optimal BF% cut-offs for the prediction of MetS and T2DM were 25.45% and 26.65%, respectively; for women, the corresponding values were 34.95% and 36.55%. Subjects with high BF% (≥ 25% in men; ≥ 35% in women) had higher risks of incident MetS or T2DM than those with low BF% (< 25% in men; < 35% in women). The relative risks were 3.43 (95% confidence intervals (CI) 2.59-4.54) and 2.92 (95% CI 1.85-4.60), respectively. The optimal BF% cut-offs for obesity for the prediction of MetS and T2DM in Chinese men and women were around 25% and 35%, respectively. © 2012 Blackwell Publishing Asia Pty Ltd. Source

Gao F.,Shanghai JiaoTong University | Pan J.M.,Shanghai JiaoTong University | Hou X.H.,Shanghai JiaoTong University | Fang Q.C.,Shanghai JiaoTong University | And 7 more authors.
Biomedical and Environmental Sciences | Year: 2012

Objective: To investigate the relationship of liver enzymes with hyperglycemia in a large population in Shanghai and identify the association between liver enzymes and insulin resistance. Methods: A total of 3 756 participants were enrolled. Each participant underwent an oral glucose tolerance test and completed a questionnaire. Anthropometric indices were recorded and serum samples were collected for measurement. Results: Liver enzymes concentrations were independently associated with i-IGT, IFG+IGT, and diabetes. With the increase of ALT and GGT concentrations, ORs for i-IGT, IFG+IGT, and diabetes increased gradually. By comparing patients in the highest quartile of GGT concentrations or ALT concentrations with those in the lowest quartile (Q1), ORs for i-IGT, IFG+IGT, or diabetes was significant after adjustment. Both ALT and GGT concentrations were linearly correlated with HOMA-IR and independently associated with HOMA-IR [ALT OR (95 CI): 2.56 (1.51-4.34) P=0.00; GGT OR (95 CI): 2.66 (1.53-4.65) P=0.00]. Conclusion: Serum ALT and GGT concentrations were closely related to pre-diabetes and diabetes in the Shanghai population and positively associated with insulin resistance. © 2012 The Editorial Board of Biomedical and Environmental Sciences. Source

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