Middle-aged Chinese Women Research Articles

Revolutionary narratives of self-compassion among older women in post-Mao Beijing

Drawing upon interviews and participant observation conducted with hundreds of middle-aged and elderly Chinese women in rural and urban neighborhoods in Beijing Municipality between 1993 and 2012, this paper explores the emergence of revolutionary new narratives of self-compassion among older women in reform-era Beijing. Taught before 1949 that they should first and foremost serve their families and after 1949 that they should put their own individual needs aside and serve the party and the masses, many older Chinese women in Beijing – after the seeds of market reform were sown in the late 1970s – slowly began to focus more attention than before on themselves, their past and present experiences, sources of and solutions to past and present distress, and their own personal enjoyment of everyday life. The analysis shows how western theories of both gero-transcendence and individualization as modernization are insufficient to account for the complex cultural formations of self-care that have developed among older women in the first decades of post-Mao China.

Sleep disturbance and correlates in menopausal women in Shanghai

ObjectiveThe aim of this study was to investigate the sleep disturbance and its correlates in Chinese middle-aged women. MethodsA total of 2046 Chinese women 40–60years of age were recruited in this cross-sectional descriptive study. The subjects were surveyed using the Pittsburgh Sleep Quality Index (PSQI), the modified Kupperman Index (KI), and a general questionnaire to obtain sociodemographic data. Data were analyzed using SPSS 20.0 software. ResultsIn this study, the mean (standard deviation) age of the participants was 51.69 (6.54) years and the mean PSQI score was 6.88 (3.20). The prevalence of sleep disturbance was 33.2% (a PSQI global score ≥8). The prevalence of sleep disturbance was higher in women with a menopausal status (from 34.8% in premenopausal women to 40.9% in postmenopausal women, P<.001) and in women with an increased age (from 21.7% in women 40–44years of age to 41.8% in women 55–60years of age, P<.001). Vasomotor symptoms (classical menopausal symptoms, VMS) were associated with sleep disturbance. An increase in the severity of menopausal symptoms (higher total KI scores) was observed in women who experienced sleep disturbance. A logistic regression analysis revealed that menopausal status, vasomotor symptoms, modified KI scores, a history of disease, and older age (≥50years) were significant risk factors for sleep disturbance. ConclusionsSleep disturbance was highly prevalent in this large sample of middle-aged Chinese women. Therefore, clinicians should pay more attention to sleep problems in middle-aged Chinese women and measures should be taken to improve the quality of sleep in these women.

Relationship between thyroid-stimulating hormone and blood pressure in the middle-aged and elderly population

Hypothyroidism and subclinical hypothyroidism may be associated with hypertension and metabolic syndrome. The aim of this study was to investigate the relationship between thyroid-stimulating hormone (TSH) and blood pressure, as well as the relationship between thyroid function and insulin resistance in middle-aged and elderly Chinese. This was a cross-sectional, community-based study. Serum TSH, fasting glucose and insulin were measured in 2,988 subjects aged 35-80 years. Logistic regression analysis was used to identify the risk factors for hypertension. Analysis of variance and multiple linear regression analysis were performed to characterise the relationship among TSH, insulin resistance and blood pressure. Higher serum TSH concentration was found to be an independent risk factor for hypertension in females (odds ratio 1.4, 95% confidence interval 1.02-1.93; p-value = 0.039). The female group with subclinical hypothyroidism and high normal TSH (2.5-4.8 mIU/L) were more susceptible to high blood pressure than those with low normal TSH (0.3-2.5 mIU/L) (p-value < 0.05). After adjustment for waist-hip ratio and body mass index, neither the correlation between blood pressure and homeostasis model assessment of insulin resistance (HOMA-IR) nor the correlation between TSH and HOMA-IR were found to be significant in this study. This study provides evidence that both subclinical hypothyroidism and high normal TSH are independent risk factors for hypertension in middle-aged and elderly Chinese women.

A preliminary investigation of the impact of oily skin on quality of life and concordance of self‐perceived skin oiliness and skin surface lipids (sebum)

This preliminary study investigated both the impact of oily skin on quality of life (QoL) and the agreement between subjective oily skin self-assessment and objective skin surface sebum measurement in young to middle-aged Chinese women in Beijing. A 18-item Chinese version of the Oily Skin Self-Image Questionnaire (OSSIQ) was used to assess the impact of oily skin on QoL in 300 healthy female subjects (age groups: 20-25; 26-30; 31-35,). The subjects were divided equally into the oily skin group and the non-oily skin group based on their self-perception of skin oiliness. The level of skin surface lipids (SSL) was measured on the middle of the forehead, and both cheeks using the Sebumeter(®). In order to assess the agreement between self-perceived skin oiliness and measured SSL, we tentatively used the SSL median value as a dividing point to regroup all subjects. The results indicate that the Chinese version of the OSSIQ distinguished the oily skin group from the non-oily skin group. Subjects in the oily skin group had significant higher emotional status score and behavior score when compared with subjects in the non-oily skin group. Subjects in the oily skin group had higher SSL when compared with subjects in the non-oily skin group, especially in younger age groups. The agreement between self-perceived skin oiliness and measured SSL was moderately strong in younger age groups, and declined with age. These results strongly suggest that having oily skin can cause a significant negative impact on QoL among Chinese women. The Chinese version of the OSSIQ is a reliable and valid tool for assessing the impact of oily skin on QoL. The accuracy of oily skin self-assessment declines with age.

Association between history of abortion and metabolic syndrome in middle-aged and elderly Chinese women

Epidemiologic studies have suggested that abortion may cause long term health consequences such as cardiovascular disease. Until recently, studies focusing on the association between history of abortion and metabolic diseases were limited. In the present study, we aimed to investigate the association between history of abortion and metabolic syndrome (MetS) in middle-aged and elderly Chinese women. A cross-sectional survey was performed in 6302 women (age ≥ 40 years) in Shanghai. Standardized questionnaire was used to obtain the information about reproductive histories. Overall, we observed a positive association between history of induced abortion and the prevalence of MetS, independent of potential confounding factors. A multivariable-adjusted logistic regression analysis revealed that compared to those without a history of induced abortion, women with a history of induced abortion remained at 1.25 times more likely to have MetS (OR = 1.25, 95% CI = 1.06-1.47, P < 0.05), and the association was number-dependent. However, no significant association between history of spontaneous abortion and the prevalence of MetS was observed. Compared to those without a history of spontaneous abortion, the multivariate-adjusted odds ratio associated with a history of spontaneous abortion for MetS was 0.88 (95% CI = 0.65-1.19, P > 0.05).

Association between history of abortion and nonalcoholic fatty liver disease in middle-aged and elderly Chinese women

PurposeTo evaluate the possible relationship between self-reported history of abortion and nonalcoholic fatty liver disease (NAFLD) in middle-aged and elderly Chinese women. MethodsA cross-sectional study was performed in 5911 women aged 40 years or older in Jiading District, Shanghai, China. Reproductive histories, including miscarriage and induced abortion, were collected using a validated questionnaire by trained physicians. Abdominal B-mode ultrasound evaluation and serum liver enzymes levels were used in the diagnosis of NAFLD. ResultsThe percentage reporting history of abortion in women with NAFLD was higher than in those without NAFLD (72.4% vs. 69.3%, age-adjusted P = .001). Compared with women without a history of abortion, the fully adjusted odds ratio (OR) for NAFLD in those with a history of abortion was increased by 28% (OR, 1.28 and 95% confidence interval [CI], 1.06–1.55). Histories of miscarriage and induced abortion were also associated with increased risk of prevalent NAFLD in fully adjusted models (OR, 1.84 and 95% CI, 1.24–2.72; OR, 1.23 and 95% CI, 1.02–1.50, respectively). ConclusionsBoth miscarriage and induced abortion are associated with prevalent NAFLD in middle-aged and elderly Chinese women.

All-cause and cause-specific mortality after hip fracture among Chinese women and men

All-cause mortality risk persisted for 5 years after hip fractures in both men and women. There may be gender-specific differences in effect and duration of excess risk for cause-specific mortality after hip fracture. To determine all-cause and cause-specific mortality risk in the first 5 years after hip fracture in an Asian Chinese population. The Singapore Chinese Health Study is a population-based cohort of 63,257 middle-aged and elderly Chinese men and women in Singapore recruited between 1993 and 1998. This cohort was followed up for hip fracture and death via linkage with nationwide hospital discharge database and death registry. As of 31 December 2008, we identified 1,166 hip fracture cases and matched five non-fracture cohort subjects by age and gender for each fracture case. Cox proportional hazards and competing risks regression models with hip fracture as a time-dependent covariate were used to determine all-cause and cause-specific mortality risk, respectively. Increase in all-cause mortality risk persisted till 5 years after hip fracture (adjusted hazard ratio, aHR = 1.58 [95 % CI, 1.35-1.86] for females and aHR = 1.64 [95 % CI, 1.30-2.06] for males). Men had higher mortality risk after hip fracture than women for deaths from stroke and cancer up to 1 year post-fracture but women with hip fracture had higher coronary artery mortality risk than men for 5 years post-fracture. Men had higher risk of death from pneumonia while women had increased risk of death from urinary tract infections. There was no difference in mortality risk by types of hip fracture surgery. All-cause mortality risk persisted for 5 years after hip fractures in men and women. There are gender-specific differences in effect size and duration of excess mortality risk from hip fractures between specific causes of death.

Prospective cohort study of tea consumption and risk of digestive system cancers: results from the Shanghai Women's Health Study

Data from in vitro and animal studies support a protective role for tea in the etiology of digestive system cancers; however, results from prospective cohort studies have been inconsistent. In addition, to our knowledge, no study has investigated the association of tea consumption with the incidence of all digestive system cancers in Chinese women. We investigated the association of regular tea intake (≥3 times/wk for >6 mo) with risk of digestive system cancers. We used the Shanghai Women's Health Study, a population-based prospective cohort study of middle-aged and older Chinese women who were recruited in 1996-2000. Adjusted HRs and associated 95% CIs were derived from Cox regression models. After a mean follow-up of 11 y, 1255 digestive system cancers occurred (stomach, esophagus, colorectal, liver, pancreas, and gallbladder/bile duct cancers) in 69,310 nonsmoking and non-alcohol-drinking women. In comparison with women who never drank tea, regular tea intake (mostly green tea) was associated with reduced risk of all digestive system cancers combined (HR: 0.86; 95% CI: 0.74, 0.98), and the reduction in risk increased as the amount and years of tea consumption increased (P-trend = 0.01 and P-trend < 0.01, respectively). For example, women who consumed ≥150 g tea/mo (∼2-3 cups/d) had a 21% reduced risk of digestive system cancers combined (HR: 0.79; 95% CI: 0.63, 0.99). The inverse association was found primarily for colorectal and stomach/esophageal cancers. In this large prospective cohort study, tea consumption was associated with reduced risk of colorectal and stomach/esophageal cancers in Chinese women.

Factors associated with the age of natural menopause and menopausal symptoms in Chinese women

ObjectiveTo investigate the factors associated with the age of natural menopause and menopausal symptoms in a large population of Chinese middle-aged women. Study designIn this cross-sectional study, a total of 20,275 women (40–65 years) attending health screening in Jiangsu Province of China were enrolled. A structured questionnaire was used to collect data of demographics, menopausal status, chronic diseases, reproductive history, etc. Also we evaluated the severity of menopausal symptoms by Kupperman menopause index (KMI). Main outcome measureMenopausal age and scorings of Kupperman menopause index. ResultsThe overall median age at natural menopause was 50 years. Lower educational level, poor economic status, lower body mass index (BMI), age at menarche less than 14 years, nulliparity and smoking were associated with earlier onset of natural menopause (P<0.05). The most frequently symptoms in postmenopausal women were sexual problems (57.05%), muscle/joint pain (53.29%) and insomnia (51.02%), while fatigue, insomnia and muscle/joint pain were predominant symptoms in pre- and peri-menopausal women. After adjusting for confounding factors, logistic regression analysis revealed that women with poor educational background, low income, divorce, higher BMI, higher parity, smoking and chronic diseases presented higher KMI scores (P<0.05). ConclusionThe study provided an estimate of median age at natural menopause in Chinese women. The main factors contributing to earlier onset of menopause and severity of menopausal symptoms were lower educational level, poor economic status, and smoking. Thus, this study provides important insights for physicians to prevent and treat menopause related symptoms.

Sleep duration and its correlates in middle-aged and elderly Chinese women: The Shanghai Women’s Health Study

Abnormal sleep duration, either long or short, is associated with disease risk and mortality. Little information is available on sleep duration and its correlates among Chinese women. Using information collected from 68,832 women who participated in the Shanghai Women's Health Study (SWHS), we evaluated sleep duration and its correlations with sociodemographic and lifestyle factors, health status, and anthropometric measurements and their indexes using polynomial logistic regression. The mean age of the study population was 59.6 years (SD=9.0; range: 44.6-79.9 years) at time of sleep duration assessment. Approximately 80% of women reported sleeping 6-8 h/day, 11.5% slept 5h or less, and 8.7% slept 9h or more. As expected, age was the strongest predictor for sleep duration and was negatively correlated with sleep duration. In general, sleep duration was positively associated with energy intake, intakes of total meat and fruits, body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) after adjustment for age and other factors. Both short and long sleep duration were negatively associated with education level, family income, and leisure-time physical activity and positively associated with number of live births, history of night shift work, and certain chronic diseases, compared to sleep duration around 7 h/day (6.5-7.4h/day). Short sleep duration was related to tea consumption and passive smoking. Long sleep duration was related to menopausal status and marital status. In this large, population-based study, we found that sleep duration among middle-aged and elderly Chinese women was associated with several sociodemographic and lifestyle factors and with disease status. The main limitation of the study is the cross-sectional design that does not allow us to draw any causal inference. However, this study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce sleep problems in middle-aged and elderly Chinese women. It also provides important information on potential confounders for investigation of sleep duration on health outcomes in this population.

Circulation: Clinical Summaries

<i>Circulation:</i> Clinical Summaries

Soy Food Intake and Circulating Levels of Inflammatory Markers in Chinese Women

BackgroundSoy and some of its constituents, such as isoflavones, have been shown to affect the inflammatory process in animal studies. The association between soy food intake and inflammatory markers has not been evaluated adequately in humans. ObjectiveOur aim was to evaluate whether higher intake of soy foods was inversely associated with inflammatory markers in 1,005 middle-aged Chinese women. DesignIn this cross-sectional study, dietary intake of soy foods was assessed by a validated food frequency questionnaire and by a 24-hour recall when biospecimens were procured. A general linear model was used to estimate the geometric means of selected inflammatory markers, including interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNFα), soluble IL-6 receptor, soluble GP130, soluble TNF receptors 1 and 2, and C-reactive protein, across categories of soy food intake after adjusting for age, lifestyle and dietary factors, and history of infectious or inflammation-related diseases. ResultsWe found that multivariable-adjusted geometric mean concentrations of IL-6 and TNFα were inversely associated with quintiles of soy food intake, with a difference between the highest and lowest quintiles of 25.5% for IL-6 (P for trend=0.008) and 14% for TNFα (P for trend=0.04). Similar inverse associations were found for TNFα (P for trend=0.003), soluble TNF receptor 1 (P for trend=0.01), soluble TNF receptor 2 (P for trend=0.02), IL-1β (P for trend=0.05), and IL-6 (P for trend=0.04) when soy food consumption was assessed by the frequency of consumption in the preceding 24 hours. No significant associations were found for other markers studied. ConclusionsThis study suggests that soy food consumption is related to lower circulating levels of IL-6, TNFα, and soluble TNF receptors 1 and 2 in Chinese women.

Associations between Ionomic Profile and Metabolic Abnormalities in Human Population

BackgroundFew studies assessed effects of individual and multiple ions simultaneously on metabolic outcomes, due to methodological limitation.Methodology/Principal FindingsBy combining advanced ionomics and mutual information, a quantifying measurement for mutual dependence between two random variables, we investigated associations of ion modules/networks with overweight/obesity, metabolic syndrome (MetS) and type 2 diabetes (T2DM) in 976 middle-aged Chinese men and women. Fasting plasma ions were measured by inductively coupled plasma mass spectroscopy. Significant ion modules were selected by mutual information to construct disease related ion networks. Plasma copper and phosphorus always ranked the first two among three specific ion networks associated with overweight/obesity, MetS and T2DM. Comparing the ranking of ion individually and in networks, three patterns were observed (1) “Individual ion,” such as potassium and chrome, which tends to work alone; (2) “Module ion,” such as iron in T2DM, which tends to act in modules/network; and (3) “Module-individual ion,” such as copper in overweight/obesity, which seems to work equivalently in either way.ConclusionsIn conclusion, by using the novel approach of the ionomics strategy and the information theory, we observed potential associations of ions individually or as modules/networks with metabolic disorders. Certainly, these findings need to be confirmed in future biological studies.

Construction of a traditional Chinese medicine syndrome-specific outcome measure: the Kidney Deficiency Syndrome questionnaire (KDSQ)

BackgroundDevelopment of Traditional Chinese Medicine (TCM) syndrome-specific outcome measures is needed for the evaluation of TCM syndrome-specific therapies. We constructed a Kidney Deficiency Syndrome Questionnaire (KDSQ) for the evaluation of the common TCM syndromes Kidney-Yin Deficiency Syndrome (KDS-Yin) and Kidney-Yang Deficiency Syndrome (KDS-Yang) in middle-aged women with menopausal symptoms.MethodsKDS-Yin and KDS-Yang were traditionally defined by expert opinion were validated by exploratory factor analysis (EFA) and structural equation modeling (SEM). Content validity was tested by EFA on a sample of 236 women from a seminar and SEM on another sample of 321 women from a postal survey. Other psychometric properties were tested on 292 women from the seminar at baseline and two systematically selected sub-samples: 54 who reported no changes in discomforts 11–12 days after the baseline and 31 who reported changes in discomforts 67–74 days after the baseline. All participants completed the KDSQ, the Greene Climacteric Scale and the standard 12-item Short Form Health Survey.ResultsThe EFA and SEM established the measurement models of KDS-Yin and KDS-Yang supporting content validity of the KDSQ. Internal consistency was good (Cronbach’s Alpha >0.70). Construct validity was supported by theoretically-derived levels of correlation with the established external measures. Test–retest reliability was strong (ICCagreement: KDS-Yin, 0.94; KDS-Yang, 0.93). The KDSQ was responsive to changes over time as tested by effect size and longitudinal validity.ConclusionsThe KDSQ was a valid and reliable measure for KDS-Yin and KDS-Yang in Hong Kong Chinese middle-aged women with menopausal symptoms.

Abstract 632: Effect of body mass index on the association between smoking and risk of gastric cancer in the Singapore Chinese Health Study

Abstract Background: Tobacco smoking is an established risk factor for gastric cancer. Recently, reports have suggested high body mass index (BMI) as a significant risk factor for esophageal adenocarcinoma whereas the relationship with gastric cancer remains inconsistent. The aim of the current study is to evaluate two potentially modifiable factors, tobacco smoking and increased body mass index, as risk factors for gastric cancer among Singapore Chinese. Methods: We prospectively examined the association between smoking and BMI at baseline, and the risk of developing gastric cancer in the Singapore Chinese Health Study, a cohort of 63,257 middle-aged and older Chinese men and women enrolled between 1993 and 1998. Information on body weight, height, cigarette smoking and other lifestyle factors and diet was obtained through in-person interview at enrollment. BMI was calculated using weight in kg divided by height in meter squared (kg/m2). Incidence of cancer and death among cohort participants was obtained via linkage with nationwide registries. Results: As of 31 December 2009, 568 cohort participants who were free of cancer at baseline had developed gastric cancer. Compared to never smokers, current smokers had a 38% increase in risk of gastric cancer (95% confidence interval: 1.12-1.70), with a positive dose-response association between number of cigarettes per day (P for trend=0.002) and number of years of smoking (P for trend=0.005), and gastric cancer risk. After adjustment for cigarette smoking and other potential confounders, hazard ratios (95% confidence interval) of gastric cancer for subjects with BMI 20-&amp;lt;24, 24-&amp;lt;28 and 28+ kg/m2 were 1.30 (1.00-1.68), 1.19 (0.88-1.60), and 1.65 (1.14-2.40), respectively, relative to those with &amp;lt;20 kg/m2 (P for trend=0.063). This dose-response association between increasing BMI and cancer risk was stronger for cardia cancer (P for trend =0.021) than for noncardia cancer (P for trend=0.19). In separate analyses in groups defined by BMI, hazard ratios (95% confidence interval) of gastric cancer for current smokers with BMI of β28, 24-&amp;lt;28, 20-&amp;lt;24, and &amp;lt;20 kg/m2 were 1.11 (0.51-2.45), 1.08 (0.67-1.75), 1.52 (1.16-1.99), and 1.90 (1.05-3.43), respectively, as compared with nonsmokers. The positive dose-response associations between dose and duration of smoking, and gastric cancer risk were limited to lean subjects with BMI&amp;lt;24 kg/m2 and not observed in the more obese subjects. Conclusion: Smokers with relatively low level of BMI had enhanced risk of gastric cancer compared to smokers with higher BMI. Our findings corroborate the hypothesis that lean smokers have increased oxidative DNA damage relative to their non-lean counterparts, which may in turn explain their heightened susceptibility to tobacco carcinogens-induced DNA damage in gastric carcinogenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 632. doi:1538-7445.AM2012-632

Age at menarche, the leg length to sitting height ratio, and risk of diabetes in middle-aged and elderly Chinese men and women.

AimsTo evaluate the associations of age at menarche and the leg length-to-sitting-height ratio, markers of adolescent growth, with risk of diabetes in later life.Materials and MethodsInformation from 69,385 women and 55,311 men, aged 40–74 years from the Shanghai Women's Health Study and Shanghai Men's Health Study, were included in the current analyses. Diabetes status was ascertained through biennial in person follow-up. Cox models, with age as the time scale, were used.ResultsThere were 2369 cases of diabetes (1831 women; 538 men) during an average of 7.3 and 3.6 years of follow-up of the women and men, respectively. In females, menarche age was inversely associated with diabetes risk after adjustment for birth cohort, education, and income (HR = 0.95, 0.92–0.98). In both genders, leg length-to-sitting-height ratio was inversely related to diabetes (HR = 0.88, 0.80–0.97 for men; HR = 0.91, 0.86–0.96 for women) after adjustment for birth cohort, education, and income. Further adjustment for adult BMI at study enrollment completely eliminated the associations of age at menarche (HR = 0.99, 0.96–1.02) and the leg length-to-sitting-height ratio (HR = 1.00, 0.91–1.10 for men; HR = 1.01, 0.96–1.07 for women) with diabetes risk.ConclusionsOur study suggests that markers of an early age at peak height velocity, i.e. early menarche age and low leg-length-to-sitting height ratio, may be associated with diabetes risk later in life and this association is likely to be mediated through obesity.

Sources of variability in epidemiological studies of sleep using repeated nights of in-home polysomnography: SWAN Sleep Study.

To quantify sources of night-to-night variability. This project was conducted in 285 middle-aged African American, Caucasian, and Chinese women from the Study of Women's Health Across the Nation (SWAN) Sleep Study living in Chicago, the Detroit area, Oakland, and Pittsburgh. The study used 3 repeated nights of in-home polysomnography (PSG) measures. Night 1 data included assessment of sleep staging, sleep apnea, and periodic limb movements, while Nights 2 and 3 focused on sleep staging. Mean total sleep time (TST) increased substantially from 365 minutes on Night 1 to 391 minutes and 380 minutes, respectively, on Nights 2 and 3. Mean percent sleep efficiency (SE%) for the 3 nights were 83%, 85%, and 85%, respectively. Night 1 sleep values were significantly different than Nights 2 and 3 measures except for S2 (%), S1 (min), and Delta (S3+4)%. Nights 2 and 3 differences in variability were negligible. Obesity, past smoking, and financial strain measures were associated with greater Night 1 vs. Night 2 or Night 3 differences. We concluded that there was significant Night 1 vs. Nights 2 and 3 variability and, though relatively modest, it was sufficient to bias estimates of association. Additionally, personal characteristics including smoking, obesity, and financial strain increased night-to-night variability. This reports adds new information about between and within person sources of variation with in-home PSG and identifies elements that are essential in the design and planning of future sleep studies of multi-ethnic groups in social and physiological transition states such as the menopause.

Multifocal Osteolytic Lesions Within Lumbar Spine in a Middle-Aged Chinese Woman

Case report. To describe a case presented as osteolytic lesions involving 2 inconsecutive lumbar, which was pathologically proved to be of smooth muscular origin. Smooth muscle tumor of uncertain malignant potential (STUMP) could be diagnosed when the neoplasm showed some malignant behavior, whereas its histologic image revealed very low malignance. A 47-year-old woman presented with low back pain and numbness of the left lower extremity attributable to osteolytic lesions in the second and fourth lumbar vertebral bodies, which was subsequently diagnosed as STUMP. A benign metastasizing leiomyoma was highly suspected. Clinical, pathologic, and radiologic characters of the patient with STUMP confined within the lumbar spine were retrospectively reviewed. A mini review was also conducted. We describe the first spine-confined case of STUMP. Significant new information in the growing literature of this rare and newly identified diagnosis has addressed the need for orthopedists to consider the STUMP diagnosis.

Dietary inclusion of salmon, herring and pompano as oily fish reduces CVD risk markers in dyslipidaemic middle-aged and elderly Chinese women

Dietary intervention studies to assess the cardioprotective effects of oily fish are scarce in China. The present study aimed to examine the effects of the oily fish, Norwegian salmon, herring and local farmed pompano (Trachinotus ovatus) on CVD risk markers when included in the Chinese diet. In this 8-week, parallel-arm, randomised intervention study, 126 Chinese women with hypertriacylglycerolaemia, aged 35-70 years, were assigned to four groups to consume an experimental lunch containing 80 g fillets of either one of three oily fish or a mix of commonly eaten meats (pork/chicken/beef/lean fish) for 5 d/week. The results showed that inclusion of the three oily fish significantly increased the intake of n-3 long-chain PUFA (LC-PUFA) while decreasing the dietary n-6:n-3 PUFA ratio. Compared to the control group, significant increases of DHA, EPA+DHA and total n-3 PUFA in plasma choline phosphoglyceride were observed in the three oily fish groups. Plasma TAG levels were significantly reduced only in the salmon and herring groups. When compared to the baseline level, the three oily fish diets significantly decreased serum concentrations of TAG, apoB, apoCII and apoCIII, but only the salmon and herring diets significantly lowered TNF-α and raised adiponectin levels in serum. The salmon diet additionally decreased the serum concentration of IL-6. To conclude, dietary inclusion of salmon, herring and pompano as oily fish can effectively increase serum n-3 LC-PUFA content and are associated with favourable biochemical changes in dyslipidaemic middle-aged and elderly Chinese women, and these beneficial effects are mainly associated with n-3 LC-PUFA contents.

Fish, shellfish, and long-chain n−3 fatty acid consumption and risk of incident type 2 diabetes in middle-aged Chinese men and women

Long-chain polyunsaturated n-3 (omega-3) fatty acids, found mainly in fish, have been postulated to reduce type 2 diabetes (T2D) risk. However, the role of long-chain n-3 fatty acids and fish intake in the development of T2D remains unresolved. We examined associations between fish, shellfish, and long-chain n-3 fatty acids and the risk of T2D in a middle-aged Chinese population. This was a prospective population-based cohort study in 51,963 men and 64,193 women free of T2D, cardiovascular disease, and cancer at baseline with valid dietary information. Dietary intake, physical activity, and anthropometric measurements were collected. A Cox regression model was used to evaluate the association of fish, shellfish, and long-chain n-3 fatty acid (in g/d) with risk of T2D. Fish, shellfish, and long-chain n-3 fatty acid intakes were inversely associated with T2D in women. The relative risks [RRs (95% CI)] for quintiles of fish intake were 1.00, 0.96 (0.86, 1.06), 0.84 (0.75, 0.94), 0.80 (0.71, 0.90), and 0.89 (0.78, 1.01) (P for trend = 0.003) and for shellfish were 1.00, 0.91 (0.82, 1.01), 0.79 (0.71, 0.89), 0.80 (0.71, 0.91), and 0.86 (0.76, 0.99) (P for trend = 0.006). In men, only the association between shellfish intake and T2D was significant. The RRs (95% CI) for quintiles of fish intake were 1.00, 0.92 (0.75, 1.13), 0.80 (0.65, 1.00), 0.89 (0.72, 1.11), and 0.94 (0.74, 1.17) (P for trend = 0.50) and for shellfish intake were 1.00, 0.93 (0.76, 1.12), 0.70 (0.56, 086), 0.66 (0.53, 0.82), and 0.82 (0.65, 1.02) (P for trend = 0.003). An inverse association between fish and shellfish intake and T2D in women was found. No evidence of a detrimental effect of fish intake in this population was observed.