Middle-aged Chinese Men Research Articles

The association between lower urinary tract symptoms secondary to benign prostatic hyperplasia and multimorbidity among Chinese middle-aged and elderly males: evidence based on propensity score matching.

With the aging population, patients with lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH) often face multiple chronic conditions (multimorbidity), significantly impacting their quality of life. This study aims to determine the relationship between LUTS/BPH, multimorbidity, and various chronic diseases in middle-aged and elderly Chinese populations. This cross-sectional study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS), involving 6,645 residents aged 45 and above. Data on 14 chronic diseases were collected, with multimorbidity defined based on the presence of 2-5 chronic conditions. The number of chronic conditions was further categorized into five groups. Propensity score matching (PSM) was used to control for 11 confounding factors. Linear regression was employed to analyze the relationship between LUTS/BPH and the number of chronic conditions in middle-aged and elderly Chinese men before and after PSM. Both univariate and multivariate logistic regression analyses were used to explore the association between LUTS/BPH and multimorbidity as well as each chronic disease. The prevalence of multimorbidity was significantly higher among middle-aged and elderly individuals with LUTS/BPH compared to those without. Before PSM, LUTS/BPH was positively correlated with the number of chronic diseases (β=0.175, P<0.001), and the risk of multimorbidity significantly increased, showing a dose-response relationship. The risk of having at least two chronic diseases in patients with LUTS/BPH was 2.39 times higher than in those without LUTS/BPH [odds ratio (OR) =2.39, 95% confidence interval (CI): 2.04-2.80], and the risk of having five chronic diseases was 3.97 times higher (OR =3.97, 95% CI: 3.14-4.99). After PSM, 819 pairs were successfully matched. The positive correlation between LUTS/BPH and multimorbidity still existed, with the risks of having at least two and five chronic diseases being 2.37 times (OR =2.37, 95% CI: 1.94-2.90) and 3.69 times (OR =3.69, 95% CI: 2.62-5.29) higher, respectively. Among them, the risk of emotional/nervous/psychiatric problems was the highest in LUTS/BPH patients (OR =6.58, 95% CI: 2.22-28.13), while the risk of arthritis/rheumatism was the lowest (OR =1.60, 95% CI: 1.30-1.98). In the Chinese population, LUTS/BPH is closely associated with multimorbidity and each of the 14 chronic diseases examined, with a dose-response relationship based on the number of chronic diseases defined within multimorbidity. It is imperative to incorporate LUTS/BPH into multimorbidity research and management. We recommend that clinicians and policymakers consider the increased risk of multimorbidity and various chronic diseases among male LUTS/BPH patients.

Gender Disparities in the Association Between Educational Attainment and Cardiovascular-Kidney-Metabolic Syndrome: Cross-Sectional Study.

Cardiovascular-kidney-metabolic (CKM) health is affected by social determinants of health, especially education. CKM syndrome has not been evaluated in Chinese population, and the association of education with CKM syndrome in different sexes and its intertwined relation with lifestyles have not been explored. We aimed to explore the association between educational attainment and the prevalence of CKM syndrome stages in middle-aged and older Chinese men and women as well as the potential role of health behavior based on Life's Essential 8 construct. This study used data from the nationwide, community-based REACTION (Risk Evaluation of Cancers in Chinese diabetic individuals: a longitudinal study). A total of 132,085 participants with complete information to determine CKM syndrome stage and education level were included. Educational attainment was assessed by the self-reported highest educational level achieved by the participants and recategorized as low (elementary school or no formal education) or high (middle school, high school, technical school/college, or above). CKM syndrome was ascertained and classified into 5 stages according to the American Heart Association presidential advisory released in 2023. Among 132,085 participants (mean age 56.95, SD 9.19 years; n=86,675, 65.62% women) included, most had moderate-risk CKM syndrome (stages 1 and 2), and a lower proportion were at higher risk of CKM (stages 3 and 4). Along the CKM continuum, low education was associated with 34% increased odds of moderate-risk CKM syndrome for women (odds ratio 1.36, 95% CI 1.23-1.49) with a significant sex disparity, but was positively correlated with high-risk CKM for both sexes. The association between low education and high-risk CKM was more evident in women with poor health behavior but not in men, which was also interactive with and partly mediated by behavior. Low education was associated with adverse CKM health for both sexes but was especially detrimental to women. Such sex-specific educational disparity was closely correlated with health behavior but could not be completely attenuated by behavior modification. These findings highlight the disadvantage faced by women in CKM health ascribed to low education, underscoring the need for public health support to address this inequality.

Sex-specific aging patterns of gut microbiota guild in urban Chinese adults

Abstract Background The loss of gut microbial stability has been observed during aging. Previous studies have noted changes in the diversity of gut microbiota and richness of specific bacteria along with age, but rarely focused on alternations in microbial guild. Methods Included in this study were 2944 middle-aged and elderly Chinese adults (1473 men and 1471 women) from the Shanghai Men's and Women's Health Studies, of whom 1419 healthy subjects (747 men and 672 women) self-reported no common non-communicable diseases (NCD) were selected for evaluating the healthy aging pattern. Microbiome was profiled by 16S rRNA sequencing. A guild-based method was adopted to cluster operational taxonomic units (OTU) into co-abundance groups (CAG) as functional units. PICRUSt2 were used to predict metagenome functions. The aging trend were assessed by linear regression. A random forest model incorporating significant CAGs with chronological age was developed to fit microbial age in the healthy and subsequently applied to those with NCDs. Results The age of all participants ranged from 51.4 to 89.3 years (mean of 70.2). A decline in Chao1 index and an increase in Pielou evenness with aging were observed among healthy women but not men. The microbial drift based on Bray-Curtis distance appeared driven by age and differed significantly by sex. Eleven CAGs were identified as potential aging markers in men, and twelve in women; wherein only CAG_6 (Bifidobacterium sp. dominated) and CAG_118 (Veillonella dispar dominated) were positively related with age in both genders. The 1,4-dihydroxy-2-naphthoate biosynthesis served as the core metabolic pathway that increased with age in both men and women. Subjects with metabolic diseases had an older microbial age than the healthy, particularly among men. Conclusions This study indicates the importance of gut microbiota in healthy aging among Chinese men and women. The aging related sex-specific patterns of gut microbiota can be modified by prevalent NCDs. Key messages • The aging patterns of gut microbiota guild were different in middle-aged and elderly Chinese men and women. • The microbial age was older in subjects with metabolic diseases than those without.

Non-linear dose-response relationship between body mass index and stroke risk in middle-aged and elderly Chinese men: a nationwide Longitudinal Cohort Study from CHARLS.

Body mass index (BMI) and stroke risk have been linked, but these findings are still debated. This study investigated the relationship between BMI and stroke risk in a middle-aged and elderly Chinese population. This study used four waves of CHARLS data (2011, 2013, 2015, and 2018), including 12,161 participants. The CHARLS sample was obtained by multi-stage probability sampling and all participants were assessed by one-to-one interviews using a standardized questionnaire. We used a Cox proportional-hazards regression model to examine the relationship between BMI and stroke risk. We used Cox proportional hazards regression with cubic spline functions and smooth curve fitting to identify the non-linear relationship between them. A series of sensitivity analyses were also conducted. The multivariate Cox proportional hazards regression model identified a positive association between BMI and stroke risk (HR=1.025, 95% CI: 1.010-1.040). We also found a non-linear relationship between BMI and stroke incidence, with an inflection point at 26.63 kg/m2 for BMI. Each 1 kg/m2 increase in BMI to the left of the inflection point was related to a 4.4% increase in stroke risk (HR=1.044, 95% CI: 1.019-1.069). We stratified individuals by gender to further investigate their association and found a particular non-linear relationship and saturation effect between BMI and stroke risk in men, with the inflection point at 25.94 kg/m2. Each 1 kg/m2 increase in BMI to the left of the inflection point was related to a 7.6% increase in stroke risk (HR=1.076, 95% CI 1.034-1.119). The association was linear in women, with each 1 kg/m2 increase in BMI associated with a 2.1% increase in stroke risk (HR=1.021, 95% CI 1.002, 1.040). In men, there was a specific non-linear association and saturation effect of BMI with stroke (inflection point of 25.94 kg/m2), while in women, there was none. When males had a BMI below 25.94 kg/m2, the risk of stroke was significantly and positively associated with BMI. By controlling BMI below 25.94 kg/m2 in men, a further decrease in BMI may promote a significant reduction in stroke risk.

Differences in spine volumetric bone mineral density between grade 1 vertebral fracture and non-fractured participants in the China action on spine and hip status study

This study evaluated the prevalence of vertebral fractures (VF) in middle-aged and elderly Chinese men and women and explored the differences in lumbar spine volumetric bone mineral density (vBMD) derived from quantitative CT (QCT) between those with a grade 1 vertebral fracture and non-fractured individuals. 3,457 participants were enrolled in the China Action on Spine and Hip Status (CASH) study and had upper abdominal CT examinations. Vertebral fractures were identified by Genant's semi-quantitative method from lateral CT scout views or CT sagittal views. L1-3 vBMD was measured by Mindways QCT Pro v5.0 software. The characteristics of different fracture severity groups were compared using one-way ANOVA, independent-samples t-tests, and Kruskal-Wallis H-tests. 1267 males (aged 62.77 ± 9.20 years) and 2170 females (aged 61.41 ± 9.01 years) were included in the analysis. In men, the prevalence of VF increased from 14.7% at age&lt;50 years to 23.2% at age ≥70 years, and in women from 5.1% at age&lt;50 years to 33.0% at age ≥70 years. Differences in mean age and vBMD were found between the different fracture grade groups. After age stratification, vBMD differences in men aged &lt; 50 years old disappeared (p = 0.162) but remained in the older age bands. There was no significant difference in mean vBMD between those with multiple mild fractures and those with a single mild fracture. In women, the prevalence of VF increased rapidly after age 50, while it grew more slowly in men. In general, with the exception of men &lt;50 years old, participants with a grade 1 VF had lower vBMD than non-fractured individuals. The majority of women younger than 50 with a grade 1 VF had normal bone mass. We recommend that a vertebral height reduction ratio of &lt;25% be diagnosed as a deformity rather than a fracture in people under the age of 50. The presence of multiple mild fractured vertebrae does not imply lower BMD.

Triglyceride Glucose-Body Mass Index Is a Reliable Indicator of Bone Mineral Density and Risk of Osteoporotic Fracture in Middle-Aged and Elderly Nondiabetic Chinese Individuals.

(1) Background: This study aimed to investigate the relationship of triglyceride glucose–body mass index (TyG-BMI) with bone mineral density (BMD), femoral neck geometry, and risk of fracture in middle-aged and elderly Chinese individuals. (2) Methods: A total of 832 nondiabetic individuals were selected from the prospective population-based HOPE cohort. All individuals underwent DXA for assessment of BMD at the lumbar spine, femoral neck, and total hip, as well as femoral neck geometry. The 10-year probabilities of both major osteoporotic (MOFs) and hip fractures (HFs) were calculated. (3) Results: Cortical thickness, compression strength index, cross-sectional moment of inertia, cross-sectional area, section modulus, and 25(OH)D levels were significantly lower in women (all p < 0.001). The presence of osteoporosis was related to age, BMI, BMD and femoral neck geometry, TyG-BMI, MOF, and HF. TyG-BMI was positively correlated with BMD. In men, TyG-BMI showed significant negative correlation with HF but not with MOF, the correlation exists only after adjusting for other variables in women. Femoral neck geometries were significantly impaired in individuals with low TyG-BMI. (4) Conclusion: TyG-BMI is positively associated with BMD and geometry, and negatively associated with risk of fracture in nondiabetic middle-aged and elderly Chinese men and women.

Increasing obstructive sleep apnea risk is associated with hearing impairment in middle-aged Chinese men-A cross-sectional study.

ObjectiveMidlife males with obstructive sleep apnea (OSA) bear a high risk for cardiovascular diseases. However, the association of OSA and hearing impairment is controversial. Our objective was to observe the incidence of hearing loss in middle-aged males with different risks for OSA.Methods794 men aged 40–65 who participated in health examination and pure tone hearing screening between January and June 2021 were recruited in the study. Medical history was collected. Height, weight and blood pressure were tested, and biochemical test including blood lipids and blood glucose was performed. According to the STOP-BANG score, the observed subjects were divided into low, intermediate and high groups for OSA risk. Hearing impairment was defined as failure in responding to any pure tone of 25 dB HL in any ear at the frequencies: 4 kHz for high frequency range and 0.5k, 1k, 2 kHz for low/medium frequency range. The incidence of hearing loss in those groups was compared after adjusting the cardiovascular risk factors.ResultsThe incidence of hearing impairment in the groups of intermediate, high, and intermediate/high risk for OSA (46.9%, 45.2%, 46.3%, respectively) were higher than that in the group of low risk for OSA (33.3%, P<0.001). After adjusting cardiovascular risk factors, the risk of hearing impairment in the group of high risk for OSA is 1.64 times of the group of low risk for OSA (95%CI: 1.02–2.69, P<0.05). The risk of hearing impairment at high frequency(4kHz) in the group of intermediate/high risk for OSA is 1.43 times of the group of low-risk for OSA (95%CI: 1.00–2.06, P<0.05).ConclusionThe risk of hearing impairment in midlife men with high, intermediate/high risk for OSA is significantly increased, especially at high frequency of 4 kHz.

Prevalence and Reasons for the Absence of Vaginal Intercourse in Chinese Middle-Aged and Elderly Men.

IntroductionAs the global population ages, research on the health of middle-aged and elderly men has intensified.AimTo report a paucity of data on the prevalence, etiology, and risk factors associated with lack of vaginal intercourse in middle-aged and elderly Chinese men.MethodsBetween January, 2018, and May, 2020, 6,096 men aged 40-90 years old who reside in mainland China were included in the community-based study. Validated scales related to erectile dysfunction (EHS and IIEF-5) and late-onset hypogonadism (ADAM and AMS), and in-person interview method were used to collect data. Multivariable analysis was performed to examine the risk factors associated with the absence of intercourse.OutcomesPrevalence estimate of no current vaginal intercourse and its associations with basic factors and medical comorbidities. Reasons for no current vaginal intercourse.ResultsThe prevalence of intercourse absence was 19.8% (95% CI; 18.8–20.8%) in middle-aged and elderly Chinese males, and this proportion was significantly higher in older age groups (8.6%, 11.5%, 24.1%, and 34.2% for men aged 40–49, 50–59, 60–69, and 70–90, respectively; P < .05). Among the men who attributed the lack of intercourse to themselves, 168 (21.4%, 95% CI; 18.7–24.4%) had erectile problems and were apprehensive about erectile failure during intercourse. Strained spousal relationships (35 men, 8.4%, 95% CI; 6.1–11.4%), marital issues (163 men, 39%, 95% CI; 34.4–-43.8%), and poor health of the partner (179 men, 42.8%, 95% CI; 38.2–47.6%) were described as reasons for lack of intercourse with spouses. Same risk factors were also found in the multivariate analysis.Clinical implicationsModifiable factors that are related to lack of intercourse may be beneficial to Chinese middle-aged and elderly men.Strength & limitationsThe main strength of the study is that it involved real-world settings. The limitations are as follows. Firstly, psychological data, data on sexual frequency and data regarding types of sex other than vaginal intercourse were not recorded. Secondly, this is a cross-sectional study, from which definite or causative conclusions can't be drawn. Thirdly, the spouses of the participants were not included in the study, and hence the data represent the perceptions of males only. Finally, objective data are required.ConclusionModifiable factors related to both the patients and their partners were associated with an increased rate of no intercourse in Chinese middle-aged and elderly men. Guidance for sexual life may benefit men with an absence of intercourse. Future studies are warranted to reexamine our findings.Lu Y, Zhang J, Ma C, et al. Prevalence and Reasons for the Absence of Vaginal Intercourse in Chinese Middle-Aged and Elderly Men. Sex Med 2022;10:100511.

Celia, Misoka, I by Xue Yiwei

Reviewed by: Celia, Misoka, I by Xue Yiwei Xu Gang Xue Yiwei Celia, Misoka, I Trans. Stephen Nashef. Toronto. Rare Machines. 2022. 286 pages. THE AWARD-WINNING Chinese Canadian author Xue Yiwei’s novel Celia, Misoka, I tells a story of immigrants in this great, globalized age. In a most unusual winter in Montreal, the death of his wife and the moving out of his daughter throws the first-person narrator, a middle-aged Chinese man who has been living in Montreal for fifteen years, into an unprecedented spiritual crisis: “I was aware that something had changed between the world and me. I was no longer a husband, no longer even a father, no longer the owner of a business, maybe no longer even really a man.” Engulfed by despair and disillusionment, the narrator’s world is gray, full of sadness, loneliness, and a kind of “powerful coldness.” Fortunately, on Montreal’s Mount Royal, two mysterious women enter his collapsing world at the same time: one is Celia, “the healthy sufferer”; the other is Misoka, who is sitting in a wheelchair and busy writing by the frozen Beaver Lake. “Just like that, they entered my life, Celia and Misoka, two mysterious women with completely different energies, appearing before me like some irresolvable contradiction.” The contradiction in these two peculiar beings arouses in the narrator an intense curiosity about life itself. Isn’t it human nature to be curious about others? This intense curiosity not only gives the narrator a sense of longing and anxiety for the future but also a sense of fullness he has never felt before. Quite unexpectedly, it also gives him a new understanding of the past. The novel is about the wonders of life that befall the lonely strangers whose lives are thrown into the infinite void. “Three insignificant grains of sand” were brought to Mount Royal by the winds of this globalized age. In this moment of wonder, “it was as though the rose of time had come into bloom,” and the three trajectories of fate constantly crisscross and mirror one another like three movements of a sonata. The value and meaning of being as well as the outlook of the bigger picture of life also appear in this sonata of fate. In Xue Yiwei’s literary works, history and reality are always looking for an opportunity in the character’s inner world to collide and produce some far-reaching and profound sparks of humanity. The multiple foci of his narrative serve to connect the obscure past of the characters: once the abyss of memory and imagination is open, one can see the heart-stirring power of the characters’ inner storm. Celia, Misoka, I shows the plight of modern men and women in the era of globalization through the suspenseful life stories of the three characters. Xue skillfully employs a narrative structure similar to that of a detective novel, in which the characters take turns to reveal the darkest memories of the enigmatic women. The greatest suspense of the story is why the women had become what they were. The author uses the rhythm and emotional flow of the story to draw the readers into the mood of melancholy and disillusionment. As the greatest wonder in frigid Montreal, Celia and Misoka eventually save the narrator from despair. However, their experiences seem to overlap with the narrator’s, so that when we examine them retrospectively, we realize that they appear so suddenly and disappear so quickly, as if they never existed. Perhaps they are just a supplement to the relationship between the narrator and his dead wife, or a fantasy of the bigger picture of life out of the narrator’s desperate state of mind. In this sense, both Celia and Misoka may be in fact different personas of the narrator. At the end of the novel, the narrator reveals his true thoughts about humanity through the words of Hermit Wang: “Once an immigrant, always an immigrant. For someone who has emigrated, returning home is simply a second emigration. You can never go home! You will forever and everywhere be a stranger!” This is true for Misoka, whose suffering came from the emotional trauma caused by...

The Role of Sex Hormones on Bone Mineral Density, Marrow Adiposity, and Muscle Adiposity in Middle-Aged and Older Men.

PurposeThe etiology of age-related bone loss is less clear in men. This study is aimed to observe the variations of endogenous sex hormone concentrations with increasing of age in men, and investigate their relations to bone mass, marrow adiposity, and muscle adiposity.MethodsA total of 199 community-dwelling Chinese men (aged 41 to 82 years) were included and measured of serum total estradiol, total testosterone, and follicle-stimulating hormone (FSH) concentrations by enzyme-linked immunosorbent assay (ELISA). Vertebral trabecular volumetric bone mineral density (vBMD) was measured by quantitative computed tomography for all participants, and vertebral marrow fat content and erector muscle fat content were quantified by Chemistry-shift-encoding magnetic resonance imaging in 62 participants.ResultsIn this population, FSH concentration increased (p < 0.001) gradually with aging. Lower vBMD was independently associated with higher FSH concentration (β = -0.216, p < 0.001), but not with total estradiol or total testosterone. For each standard deviation increase in FSH there was a 50% higher risk of an individual having osteopenia or osteoporosis (vBMD < 120 mg/cm3). Marrow fat content and erector muscle fat content were greater in osteopenic and osteoporotic men, but there were no associations with sex hormones concentrations.ConclusionIn summary, FSH but not total estradiol or total testosterone is related to vertebral trabecular vBMD in middle-aged and older Chinese men. Neither marrow adiposity nor muscle adiposity is associated with sex hormones.

Isolated systolic hypertension and insulin resistance assessment tools in young and middle-aged Chinese men with normal fasting glucose: a cross-sectional study

The vital role of insulin resistance (IR) in the pathogenesis of isolated systolic hypertension (ISH) has been expounded at the theoretical level. However, research on the correlation between some specific IR indicators and ISH is still rare, especially at different glycemic statuses. We conducted this study to explore the association between three IR indicators and ISH among young and middle-aged adults with normal fasting plasma glucose (NFG). This large cross-sectional study included 8246 young and middle-aged men with NFG and diastolic blood pressure < 90 mmHg. The homeostasis model assessment for IR (HOMA-IR) index, triglyceride glucose (TyG) index, and the metabolic score for IR (METS-IR) were calculated with the corresponding formula. The proportions of ISH among young and middle-aged men were 6.7% and 4.4%, respectively. After fully adjusting, only HOMA-IR rather than TyG and METS-IR was significantly associated with ISH. Moreover, fully adjusted smooth curve fitting showed that the association between HOMA-IR and ISH were approximately linear in both two age groups (P for non-linearity were 0.047 and 0.430 in young and middle-aged men, respectively). Among young and middle-aged men with NFG, using HOMA-IR instead of noninsulin-dependent IR indicators may have advantages in the hierarchical management of ISH. Further longitudinal research may be needed to determine their potential causal relationship.

Dose-response relationship between fat distribution and liver cancer incidence: A prospective cohort study in Chinese men

BackgroundBased on a prospective cohort study in middle-aged Chinese men, the current study characterized the dose-response relationships between fat distribution measurements and the incidence of primary liver cancer. MethodsHazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox regression models for the association between waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI) with liver cancer incidence. Dose-response curves were characterized using a restricted cubic spline function. ResultsAfter a mean follow-up time of 11.9 (SD = 2.4) years, 440 liver cancer cases were identified from 60,625 participants. WC, WHtR, ABSI, and BRI were found to be associated with an increased risk of liver cancer at a given level of body mass index (BMI), with multivariable-adjusted HRs of 1.19 (95% CI: 1.01–1.41), 1.26 (95% CI: 1.02–1.50), 1.12 (95% CI: 1.05–1.23) and 1.28 (95% CI: 1.08–1.53) for per SD increment, respectively. Dose-response curves suggested that the risk increased rapidly above the median levels of WC, WHtR, and BRI. For ABSI, the risk decreased from the minimum level to about the 35th percentile and increased slowly thereafter. ConclusionsThe current study suggested an association between abdominal obesity in middle age and increased risk of primary liver cancer at a given level of BMI. WHtR and BRI were better predictors of liver cancer risk compared with WC and ABSI.

Skeletal muscle loss is associated with diabetes in middle-aged and older Chinese men without non-alcoholic fatty liver disease.

BACKGROUNDSkeletal muscle, a key insulin target organ, has been reported to be associated with diabetes mellitus (DM). Compared to non-diabetic patients, diabetic patients have decreased muscle mass and a higher prevalence of sarcopenia, and patients with sarcopenia may be at increased risk of developing diabetes. In individuals with nonalcoholic fatty liver disease (NAFLD), sarcopenia is associated with the severity of fibrosis and steatosis. Previous studies have demonstrated that NAFLD is strongly associated with DM and sarcopenia.AIMTo determine the relationship between skeletal muscle mass and DM in Chinese middle-aged and elderly men, and whether the association is affected by NAFLD. METHODSSkeletal muscle mass was calculated as appendicular skeletal muscle mass (ASM) in kg/body weight × 100%. Liver fat content (LFC) was measured using a quantitative ultrasound method. RESULTSAs the ASM decreased, fasting blood glucose (FBG), 2-h postprandial blood glucose (2hBG), and LFC increased in both genders, as did the prevalence of DM and NAFLD. Spearman analysis showed that the ASM was negatively correlated with the FBG, 2hBG, and LFC. Stepwise logistic regression analysis showed that after adjustments, the ASM quartile was negatively associated with the presence of DM in males, but not in females. Subgroup analysis showed that the ASM quartiles remained negatively correlated with the presence of DM in the non-NAFLD population (including males and females), but no correlation was found between ASM quartiles and the presence of DM in the NAFLD population. When stratified by LFC quartiles, ASM was negatively correlated with the presence of DM in the first and second LFC quartiles in males.CONCLUSIONSkeletal muscle mass loss was shown to be associated with the presence of DM in males, but not in females; NAFLD weakens this association. The results suggested that the stratified management of diabetes mellitus should be considered according to skeletal muscle mass and NAFLD.

Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in middle-aged and older Chinese individuals: Results from the China Health and Retirement Longitudinal Study

ObjectivesMale lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is common and may increase the risk of depressive symptoms. This study aimed to investigate the associated factors of LUTS/BPH and its association with depressive symptoms in middle-aged and older Chinese men. MethodsThis study used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A total number of 8,586 men aged ≥45 years were included in this study. Participants answered positively to whether they have ever been diagnosed with a prostate illness (excluding prostatic cancer) were defined as LUTS/BPH individuals. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Multivariate logistic analyses were applied to explore the associated factors of LUTS/BPH, association between LUTS/BPH and depressive symptoms, and risk factors of depressive symptoms according to LUTS/BPH status. ResultsThe weighted overall prevalence of LUTS/BPH was 13.1% in Chinese men aged ≥45 years. The prevalence of depressive symptoms was 29.1% in LUTS/BPH individuals and 22.9% in non-LUTS/BPH individuals. Depressive symptoms and LUTS/BPH shared some same risk factors, which were education, living regions, annual household consumption, sleep duration and multimorbidity. The results from logistic models showed that education, sleep duration and multimorbidity were significantly and independently associated with depression of LUTS/BPH individuals (P<0.001). ConclusionsPrevalence of depressive symptoms in LUTS/BPH population was higher than in non-LUTS/BPH population. Education, sleep duration and multimorbidity were associated with the onset of depressive symptoms in LUTS/BPH individuals (P<0.001).

Body Mass Index Changes in Relation to Male Reproductive Hormones: Longitudinal Results From a Community-Based Cohort Study.

The objective of the current study was to explore the relationship between longitudinal change in body mass index (BMI) and reproductive hormones in middle-aged and elderly Chinese men. A cohort study was conducted in a rural area of China. Local male residents aged 40–80 years were recruited at baseline in 2012 and were followed up in 2016. Information about weight, height, waist circumference, sex hormones, smoking status, and medical history were obtained. The change in BMI reported no significant relationship with the change in total testosterone (TT), calculated free testosterone (cFT), and bioavailable testosterone (BioT) in Pearson correlation analyses. When the change in BMI was divided into three groups—“great loss,” “normal fluctuation,” and “great gain”—TT, cFT and BioT had the highest increase (or the lowest decrease) in men with “normal fluctuation” in BMI compared with the other two groups. The advantage of maintaining a stable BMI was more evident for those who were overweight, non-smoking, and disease-free. There was a tendency of a continuous increase in cFT and BioT with BMI increase in smoking and diseased populations. Maintaining a stable BMI is associated with maintaining normal levels of reproductive hormones, especially in overweight, non-smoking, and healthy men aged over 40 years.

Quality Diet Index and Risk of Pancreatic Cancer: Findings from the Singapore Chinese Health Study.

Limited research has been conducted on the effect of quality diet index (QDI), which represents a comprehensive assessment of healthy diet quality and quantity, on pancreatic cancer risk in Asian populations. Using data from the Singapore Chinese Health Study, a prospective cohort of 63,257 middle-aged or older Chinese men and women, four QDI scores: the Alternative Health Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED), the Dietary Approaches to Stop Hypertension (DASH), and the Heathy Diet Indicator (HDI), at baseline were calculated. After 25 years of follow-up, 311 cohort participants developed pancreatic cancer. Cox proportional hazard regression method was used to estimate HR and 95% confidence interval (CI) for pancreatic cancer associated with higher QDI scores. Higher scores of AHEI-2010, aMED, and DASH were significantly associated with lower pancreatic cancer risk (all P trend < 0.05). Compared with the lowest quartile, HRs (95% CIs) of pancreatic cancer for the highest quartiles of AHEI-2010, aMED, and DASH scores were 0.65 (0.46-0.90), 0.57 (0.38-0.85), and 0.66 (0.46-0.95), respectively. These associations were more apparent among men. Overall, there was no statistically significant difference in the QDI-pancreatic cancer risk association between subgroups stratified by levels of body mass index, history of diabetes, and smoking status. Higher QDI scores were significantly associated with reduced risk of pancreatic cancer. The consistent results across multiple QDIs shows that adherence to a healthy diet may lower pancreatic cancer risk, suggesting that dietary modification may be a promising approach for primary prevention of pancreatic cancer.

How Do Middle-Aged Chinese Men and Women Balance Caregiving and Employment Income?

Unpaid family caregivers might suffer losses in income as a result of care provision. Here we used data from the baseline survey of the China Health and Retirement Longitudinal Study to assess the relationship between hours of weekly caregiving provided to grandchildren/parents/parents-in-law and individual’s monthly employment income. Our study sample comprised 3718 middle-aged Chinese adults who were of working age (45–60 years). For women and men separately, we used a likelihood-based method to determine a caregiving threshold in a two-stage Heckman selection procedure. Instrumental variables were used to rule out the endogeneity of caregiving hours. Our analysis revealed a negative association between caregiving and income for women that depended on a caregiving threshold of 63 h per week. There was an absence of caregiving-income relationship among men. These results offer new insights into the opportunity costs of unpaid caregiving and support tailored policies to protect the financial well-being of female caregivers.

Patterns of heavy drinking behaviour over age and birth cohorts among Chinese men: a Markov model

ObjectivesTo estimate the age patterns and cohort trends in heavy drinking among Chinese men from 1993 to 2011 and to project the future burden of heavy drinking through 2027.DesignWe constructed...

Association of hypogonadism symptoms and serum hormones in aging males.

The association between hypogonadism symptoms and the levels of serum hormones are still in debate. To investigate the relationship between hypogonadism symptoms and serum hormones in middle-aged and elderly Chinese men, this community-based cross-sectional study was conducted based on a total of 965 ageing men. The ageing males' symptom (AMS) scale, International Index of Erectile Function-5 (IIEF-5), International Prostate Symptom Score (IPSS) questionnaires and related variables were assessed. Blood tests for total testosterone (TT), sex hormone-binding globulin (SHBG) and luteinising hormone (LH) were performed. Serum level of free testosterone (FT) and bioavailable testosterone (Bio-T) was calculated. The mean age was 56.34±8.85years. Total AMS score was significantly associated with all five serum hormones (LH: p<0.001; SHBG: p<0.001; TT: p=.043; FT: p=0.007; Bio-T: p<0.001). We identified sexual and somatic symptoms were obviously related to five serum hormones, while psychological symptoms seemed to have no association with serum hormones. After adjusting for age and BMI, multiple linear regression analysis indicated that LH had positive correlations with total AMS score, somatic and sexual symptom score (p<0.05). In conclusion, LH and SHBG had the strongest correlation hypogonadism and might be used as early predictors for symptomatic hypogonadism in the near future.

Retirement pathways and pension inequality in China: a grounded theory study

PurposeExisting research focuses on the pension systems and reforms in China from a macro-level and financial perspective. The expectations of mid-life Chinese people regarding their retirement and pensions have been ignored to date, and this research set out to address this lacuna.Design/methodology/approachThe application of qualitative research methods is relatively novel in Chinese social science. As a grounded theory (GT) study, the research reported here deployed semi-structured interviews to investigate middle-aged Chinese women's and men's perceptions of their pensions and retirement. In total, 36 interviews were conducted, following the constructivist GT method.FindingsThe data point to disparities between the choices and perceptions of individuals on the one hand and the official assumptions underlying the current pension regime on the other hand. Research participants had varying interpretations of the inequality in retirement incomes in China, the main division being between enterprise workers and public-sector employees.Originality/valueAlthough there are in principle rigidly fixed retirement ages for men and women in contemporary China, the phenomena of early retirement and working post-retirement are increasing. There are trade-offs between work/retirement and family needs, which influence the choices of middle-aged citizens. Retirement pathways are increasingly individualised, reflecting broader patterns of individualisation and inequality in China.