Risk Factors In Chinese Patients Research Articles

Financial toxicity assessment and associated factors analysis of patients with cancer in China.

Cancer-related expenditures present a lasting economic burden on patients and their families and may exert long-term adverse effects on the patients' life and quality of life. In this study, the comprehensive score for financial toxicity (COST) was used to investigate the financial toxicity (FT) levels and related risk factors in Chinese patients with cancer. Quantitative data were collected through a questionnaire covering three aspects: sociodemographic information, economic and behavioral cost-coping strategies, and the COST scale. Univariate and multivariate analyses were performed to identify factors associated with FT. According to 594 completed questionnaires, the COST score ranged 0-41, with a median of 18 (mean±SD, 17.98±7.978). Over 80% of patients with cancer reported at least moderate FT (COST score <26). A multivariate model showed that urban residents, coverage by other health insurance policies, and higher household income and consumption expenditures were significantly associated with higher COST scores, indicative of lower FT. The middle-aged (45-59 years old), higher out-of-pocket (OOP) medication expenditures and hospitalizations, borrowed money, and forgone treatment were all significantly associated with lower COST scores, indicating higher FT. Severe FT was associated with sociodemographic factors among Chinese patients with cancer, family financial factors, and economic and behavioral cost-coping strategies. Government should identify and manage the patients with high-risk characteristics of FT and work out better health policies for them.

Sex differences in subjective cognitive impairment and clinical correlates in Chinese patients with subthreshold depression

ObjectiveSubthreshold depression (SD) is a global mental health problem given its high prevalence, comorbidity, functional impairment, and its association with increased service utilization. However, currently little is known about sex differences of SD in cognitive impairment with clinical correlates. This study aims to explore sex differences in subjective cognitive impairment and clinically associated risk factors in Chinese patients with subthreshold depression (SD).MethodsA total of 126 patients with SD, 40 males and 86 females, aged 18–45 years, were included in this cross-sectional observational study. Their general information, psychological assessments, and psychiatric symptom assessments were collected online. The Patient Health Questionnaire depression-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Deficits Questionnaire-Depression (PDQ-D), and Toronto Alexithymia Scale (TAS-20) with 3 subdomains were used. The obtained scores were analyzed with partial correlation and multiple linear regression analysis models.ResultsOur results showed that females had significantly higher PDQ-D-20 total score than males. However, the differences in TAS-20 and subdomain score according to sex were not significant. Notably, TAS-20 and DDF (difficulty describing feelings) subdomain contributed to cognitive impairment in males, whereas both PHQ-9 total score and TAS-20 or DDF subdomain contributed to cognitive impairment in females.ConclusionThese findings revealed significant sex differences in cognitive impairment and clinical correlates in SD, which should be further followed-up in the future.

Clinical features and independent predictors of Behçet's disease associated with myelodysplastic syndrome.

To investigate the correlation of Behçet's disease (BD) with myelodysplastic syndrome (MDS) and identify the predictive risk factors in Chinese patients. A retrospective study of BD associated with MDS (BD-MDS) patients from the First Affiliated Hospital of Zhengzhou University was conducted. Among 15 BD-MDS patients, 10 were females and 5 males. While 13 (86.7%) patients had abnormal karyotype, 11 patients with trisomy 8. 10 (66.7%) had gastrointestinal (GI) involvement. Compared with 60 general BD patients without MDS, the BD-MDS patients were significantly older. In addition, fever and GI involvement were more common in BD-MDS patients, whereas these patients had lower levels of leukocyte count, haemoglobin, and platelet count (p<0.05). Logistic regression analysis showed that GI involvement, low haemoglobin, and high ESR level were independently associated with the development of MDS in BD patients. BD-MDS patients with GI involvement (IBD-MDS) were usually much older and have more fever than IBD patients without MDS, as well as lower leukocyte count, haemoglobin level, platelet count, and higher erythrocyte sedimentation rate (ESR) and C-reactive protein levels (p<0.05). By comparison with 60 primary MDS patients without BD, the BD-MDS patients had more abnormal karyotypes and more trisomy 8 (p<0.05), while the distribution of 2016 WHO subtypes of MDS and IPSS-R categories were similar. Our findings suggest that cytogenetic abnormalities, especially trisomy 8, may play a role in the association of GI involvement, BD, and MDS. GI involvement, low haemoglobin, and high ESR level were independent predictors for MDS development in BD patients.

A retrospective cohort study in Chinese patients with adult polymyositis and dermatomyositis: risk of comorbidities and subclassification using machine learning.

To identify the risk factors in Chinese patients with adult polymyositis and dermatomyositis for their comorbidities and explore a subclassification system. Clinical records of 397 patients with idiopathic inflammatory myopathies were retrospectively reviewed. Logistic regression was used to identify potential risk factors for interstitial lung disease (ILD), other rheumatic diseases, and malignancy after bivariate analysis. Hierarchical clustering and decisional tree were utilised to identify subgroups and explore a subclassification system. A total of 119 polymyositis and 191 dermatomyositis patients were included. Anti-PM/Scl, anti-Ro52, anti-aminoacyl-tRNA synthetase and anti-MDA5 (adjusted odds ratios (AOR)=4.779, 1.917, 5.092 and 7.714 respectively) antibodies were risks (p<0.05), whereas overlapping malignancy was protective (AOR=0.107; p=0.002) for ILD across polymyositis, dermatomyositis and the total group. In subgroup models, Raynaud's phenomenon, arthralgia and semi-quantitative anti-nuclear antibody (AOR=51.233, 4.261, 3.047 respectively) were risks for other overlapping rheumatic diseases (p<0.05). For overlapping malignancy, male and anti-TIF1γ antibodies (AOR=2.533, 16.949) were risks (p<0.05), whereas disease duration and combination of ILD (AOR=0.954, 0.106) were protective in the total group (p<0.05); while anti-NXP2 antibodies were identified as risk factors (AOR=73.152; p=0.038) in polymyositis. Hierarchical clustering suggested a subclassification with 6 subgroups: malignancy overlapping dermatomyositis, classical dermatomyositis, polymyositis with severe muscle involvement, dermatomyositis with ILD, polymyositis with ILD, and overlapping of myositis with other rheumatic diseases. Accompanying ILD, other rheumatic diseases and malignancy are strongly associated with clinical manifestation and myositis-specific or myositis-associated autoantibodies among Chinese polymyositis and dermatomyositis patients. The subclassification system proposed a more precise phenotype defining toward stratified treatments.

Prevalence of cardiovascular disease risk factors in Chinese patients with type 2 diabetes mellitus, 2013–2018

Objective Coronary heart disease (CHD) is the most common cause of death in patients with type 2 diabetes (T2DM). We aim to estimate the prevalence of CHD and cardiovascular risk factors in Chinese patients with T2DM. Methods A total of 66,536 inpatients with diabetes treated from 2013 to 2018 were investigated, and demographic and clinical data were collected from 30,693 patients with T2DM. Age-standardized prevalence of CHD was calculated on the basis of data from the Chinese population census in 2010. Logistic regression analysis was used to analyze the risk factors. Results The crude prevalence of CHD was estimated to be 23.5% and a standardized prevalence was 13.9% (16.0% in men and 11.9% in women). More than half of patients with CHD have four or more of the five traditional risk factors, much higher than the 38.96% of patients without CHD (p < .01). Multivariate regression analysis showed that diabetes duration, hypertension, smoking, underweight, overweight, obesity and hypoglycaemia were significantly associated with increased risk of CHD (all p < .05). The odds ratio of CHD in patients with three, four or five defined CHD risk factors (i.e. diabetes, hypertension, dyslipidaemia, overweight or obese, and smoking) were 2.35 (95% CI 1.81–3.04), 2.96 (95% CI 2.28–3.85) or 5.29 (95% CI 4.04–6.93), compared with diabetes patients without any other risk factors. Conclusions The prevalence of CHD was rather high in Chinese T2DM inpatients, and the aggregation of CHD risk factors was severe. Thus, hierarchical CHD prevention strategies based on risk factors are necessary.

Tumor grade and symptoms at presentation are survival risk factors in Chinese patients with primary retroperitoneal sarcoma

No cohort studies have been performed on Chinese primary retroperitoneal sarcoma (RPS) patients. Data derived from western cohort studies may not be directly superimposable on Asian counterparts. Furthermore, the risk factors for survival of RPS are currently unknown for Chinese patients. The objectives were therefore to (1) gain insight into RPS incidence and patient demographics and clinical details; (2) determine the risk factors for overall survival (OS) and disease-free survival (DFS); and (3) critically appraise the Asian cohort data in relation to information obtained in western cohort studies. In this retrospective cohort study, the health records of patients that had been diagnosed with primary localized RPS with curative intent between 2009 and 2020 were analyzed. Cox proportional hazards analysis was conducted to evaluate the risk factors for OS and DFS. A total of 261 patients met the inclusion criteria. Ninety-six (36.8%) patients had been diagnosed with well-differentiated liposarcoma, 63 patients (24.1%) with dedifferentiated liposarcoma, 41 patients (15.7%) with leiomyosarcoma (LMS), 22 patients (8.4%) with solitary fibroma, 7 patients (2.7%) with malignant peripheral nerve sheath tumor (MPNST), and 32 patients (12.3%) with another type of RPS. The study further revealed that (1) the 5-y OS and DFS in RPS patients was 67.8% and 51.3%, respectively, with the highest OS and DFS observed in MPNST (100% and 100%, respectively) and the lowest 5-y OS and DFS attributed to LMS (42.6% and 28.9%, respectively); (2) symptoms at presentation, Federal National Cancer Center (FNCLCC) grade, and number of combined resections are independent risk factors in OS; (3) symptoms at presentation, FNCLCC grade, chemotherapy, and hospital length of stay are independent risk factors for DFS; and (4) patients at high risk (symptoms at presentation and high-grade tumors) have less than half the chance of survival at 5 y post-diagnosis than patients with a low-risk profile. Symptoms at presentation constitute a risk factor for OS and DFS. When combined with tumor grade - another risk factor for both OS and DFS - patients can be classified into a high-risk and low-risk category to gauge a patient's prognosis and, accordingly, frame an optimal clinical trajectory. Moreover, the clinicopathology and overall prognosis of RPS in Asian and Western populations are comparable and hence superimposable. The present study identifies the risk factors of survival in RPS and suggests symptoms at presentation should be considered in the preoperative consultation and added in prognostic grouping.

UGT1A1 rs4148323 A Allele is Associated With Increased 2-Hydroxy Atorvastatin Formation and Higher Death Risk in Chinese Patients With Coronary Artery Disease.

It is widely accepted that genetic polymorphisms impact atorvastatin (ATV) metabolism, clinical efficacy, and adverse events. The objectives of this study were to identify novel genetic variants influencing ATV metabolism and outcomes in Chinese patients with coronary artery disease (CAD). A total of 1079 CAD patients were enrolled and followed for 5 years. DNA from the blood and human liver tissue samples were genotyped using either Global Screening Array-24 v1.0 BeadChip or HumanOmniZhongHua-8 BeadChip. Concentrations of ATV and its metabolites in plasma and liver samples were determined using a verified ultra-performance liquid chromatography mass spectrometry (UPLC-MS/MS) method. The patients carrying A allele for the rs4148323 polymorphism (UGT1A1) showed an increase in 2-hydroxy ATV/ATV ratio (p = 1.69E−07, false discovery rate [FDR] = 8.66E−03) relative to the value in individuals without the variant allele. The result was further validated by an independent cohort comprising an additional 222 CAD patients (p = 1.08E−07). Moreover, the rs4148323 A allele was associated with an increased risk of death (hazard ratio [HR] 1.774; 95% confidence interval [CI], 1.031–3.052; p = 0.0198). In conclusion, our results suggested that the UGT1A1 rs4148323 A allele was associated with increased 2-hydroxy ATV formation and was a significant death risk factor in Chinese patients with CAD.

Utilization of apnea-hypopnea index as a novel predictive factor for difficult mask ventilation in the Chinese population under general anesthesia

PurposeDifficult mask ventilation (DMV) is a potentially life-threatening situation that can arise during anesthesia. However, most clinical predictors of DMV are based on European and US populations. On the other hand, most predictive models consist of multiple factors and complicated assessments. Since obstructive sleep apnea (OSA) is among the most important risk factors associated with DMV, the apnea-hypopnea index (AHI) may play an important role in determining patient risk.The purpose of this study was to investigate the relationship between DMV and AHI, and to determine preoperative risk factors for DMV in Chinese patients.MethodsA prospective cohort trial enrolled patients scheduled for elective surgery. After obtaining informed consent, patient demographic information was collected, and patients were tested with pre-operative polysomnography. The anesthesiologist who managed the airway graded the mask ventilation. The difficult mask ventilation was defined as the mask ventilation provided by an unassisted anesthesiologist without oral airway or other adjuvant. A logistic regression model was used to analyze the association between AHI and DMV.ResultsA total of 159 patients were analyzed. For both primary and secondary outcomes, the unadjusted and adjusted odds ratio for DMV showed significant increases by 5 AHI units. AHI, age, and the Mallampati classification were found to be independent predictive factors for DMV.ConclusionsAHI is associated with DMV as a novel independent risk factor in Chinese patients. Along with age and Mallampati classification, AHI should be included in establishing a superior predictive strategy for DMV screening.Trial registrationChinese Clinical Trial Registry ChiCTR-DDD-17013076

Association of -344C/T polymorphism in the aldosterone synthase (CYP11B2) gene with cardiac and cerebrovascular events in Chinese patients with hypertension.

ObjectiveSeveral recent studies have shown that the aldosterone synthase gene (CYP11B2) −344C/T polymorphism is related to cardiovascular diseases. However, whether the −344C allele influences the incidence of cardiovascular diseases in Chinese patients with hypertension is unclear.MethodsChinese patients with essential hypertension were genotyped for the −344C/T polymorphism in CYP11B2 (n = 755; CC, n = 112; CT, n = 361; TT, n = 282) and followed for 11 years for major adverse cardiovascular events (MACEs), including stroke, onset of coronary artery disease (CAD), and CAD-related death. Established cardiovascular risk factors were used to adjust the multivariate Cox analysis.ResultsAfter a mean follow-up period of 7.60 ± 1.12 years, a significantly higher incidence of MACEs was seen in patients with the CC genotype than in those with the CT and TT genotypes. The CC variant was significantly and independently predictive of MACEs (hazard ratio = 2.049), CAD (hazard ratio = 1.754), and stroke (hazard ratio = 2.588), but not CAD-related stroke or death.ConclusionThe CYP11B2 −344 CC genotype is a risk factor for CAD and stroke, independent of other established cardiovascular risk factors in Chinese patients with hypertension.

The prevalence, risk factors, and clinical characteristics of insulin resistance in Chinese patients with schizophrenia

BackgroundStudies have shown that patients with schizophrenia are at a high risk of developing insulin resistance (IR). We investigated the prevalence of IR and its clinical correlates in hospitalized Chinese patients with schizophrenia. MethodsA total of 193 patients with schizophrenia (113 males and 80 females) were recruited for the study. We collected their demographic and clinical data, including data on their plasma glucose and lipid levels. All patients were rated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to assess cognitive function, while Positive and Negative Syndrome Scale (PANSS) was used to assess psychopathology. The cut-off value for the homeostasis model assessment of insulin resistance (HOMA-IR) was set at 1.7. ResultsThe prevalence of IR was 37.82% (73/193). The IR patients had significantly higher waist-to-hip ratio and body mass index (BMI), and higher fasting plasma glucose (FPG), triglyceride (TG), and low density lipoprotein (LDL) levels compared to non-IR patients (all p<.05). Binary logistic regression analysis showed that smoking, BMI, and TG and LDL levels are significant predictors of IR. In addition, correlation analysis showed that IR was significantly correlated with the waist-to-hip ratio, BMI, and LDL level (Bonferroni corrected p<.05). The multivariable linear regression analysis indicated that the BMI and FPG are associated with the IR index. There was no significant difference in IR index between patients who were taking different antipsychotics. ConclusionWe found a high prevalence of IR and its risk factors in Chinese patients with schizophrenia. Active weight control to reduce the BMI and waist circumference and reducing the number of cigarettes consumed, may be essential to decrease the incidence of IR in patients with schizophrenia.

Diabetic Optic Neuropathy and Its Risk Factors in Chinese Patients With Diabetic Retinopathy.

To investigate diabetic optic neuropathy (DON) prevalence and risk factors in Chinese diabetic retinopathy (DR) patients. This retrospective study included 1067 eyes (550 patients) that underwent ocular imaging. The diabetes duration, systolic blood pressure (SBP), hemoglobin A1c (HbA1c), and high-density lipoprotein (HDL) were also recorded simultaneously. A total of 410 eyes with DON and 657 eyes without DON were included (38.4% DON prevalence). DON eyes were classified as having diabetic papillopathy (DP), optic disc neovascularization (NVD), anterior ischemic optic neuropathy (AION), or optic atrophy (OA). Proliferative DR eyes had a higher DON prevalence than nonproliferative DR eyes (P < 0.001). Diabetes duration, SBP, and HbA1c were higher in DON patients than in non-DON patients (all P < 0.001). Additionally, HDL was lower in patients with DON (0.74 ± 0.13 mM) than in those without DON (1.00 ± 0.24 mM, P < 0.001). HbA1c levels were greater in AION patients (10.00 ± 1.53% [85.76 ± 16.71 mmol/mol]) than in DP patients (8.78 ± 1.97% [72.45 ± 21.55 mmol/mol], P = 0.017); central foveal thickness (CFT) significantly varied among groups (P < 0.001). Increased age, diabetes duration, SBP, CFT, and DR severity were risk factors for DON; and increased HbA1c was a risk factor for NVD, AION, and OA (all P < 0.05). Our study results strengthen the argument that increased age, diabetes duration, SBP, CFT, DR severity, and HbA1c are all risk factors for DON in patients with DR.

Tea Consumption and Cardiovascular Risk Factors Among Chinese Patients with Type II Diabetes (P06-129-19)

ObjectivesWe aimed to investigate the associations between tea consumption and CVD risk factors in Chinese patients with T2D. MethodsIn a community-based cross-sectional study, 7866 subjects aged 31 to 89 years were recruited between 2011 and 2013 in Suzhou, China. Among these, 1061 subjects with T2D (492 men and 569 women; defined according to the criteria of the American Diabetes Association) who were free of major CVD were included in the present study. Data on dietary habits including tea consumption were collected using a food frequency questionnaire. Multivariate logistic regression model was used to illustrate the associations between tea consumption and CVD risk factors. ResultsAfter the adjustment for potential confounders, participants with higher frequency of tea drinking (≥2 times/d), as compared with those who never or hardly drank tea, had significantly higher risk of dyslipidemia (OR = 1.826, 95% CI: 1.084–3.076) and non-alcoholic fatty liver disease (OR = 1.971, 95% CI: 1.051–3.700). No significant association was found between the frequency of tea consumption and obesity, hypertension, metabolic syndrome or hyperuricemia. ConclusionsFrequent consumption of tea is associated with altered CVD risk factors including dyslipidemia and increased risk of NAFLD among Chinese T2D patients. Further prospective studies are needed to confirm the associations. Funding SourcesThis work was supported by the National Key R&D Program of China and the National Natural Science Foundation of China. This study was also supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD). Supporting Tables, Images and/or Graphs▪

Correlation between the distribution of intracranial and extracranial aterial lesions and risk factors in Chinese patients with ischemic stroke: a multicenter registry study

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke. Methods In this multi-center study, 2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to May 2016 were enrolled. Carotid ultrasonography and transcranial color-coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion. According to the distribution of lesions, the subjects were divided into 2 groups: the simple intracranial artery stenosis group and the simple extracranial artery stenosis group. The difference of risk factors between the two groups was compared. Results Of the 2 310 patients with ischemic stroke, 1 516 (65.6%) had simple intracranial artery stenosis and 794 (34.4%) had simple extracranial artery stenosis. The incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group (68.1% vs 48.7%, P<0.001). Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group (36.4% vs 22.1%, 14.9% vs 9.8%; all P<0.001). Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension, diabetes, obesity, and family history of stroke, and their systolic blood pressure, diastolic blood pressure, body mass index (BMI), fasting blood-glucose, glycosylated hemoglobin, triacylglycerol, total cholesterol, and low-density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group (all P<0.05). The proportion of elderly (≥65 years old), male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group (all P<0.05). Multivariate logistic regression analysis showed that elderly (≥65 years old), male, and smoking history were independent risk factors for extracranial arterial stenosis (OR=2.012, 1.637, 1.325, respectively; all P<0.05). While hypertension, diabetes, less physical activity, and high BMI levels were independent risk factors for simple intracranial arterial disease (OR=1.301, 1.252, 1.248, 1.030, respectively; all P<0.05). Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China. Key words: Ultrasonography; Ischemic stroke; Atherosclerosis; Distribution; Risk factor

TCTAP A-012 Effect of Fibrinogen on Percutaneous Coronary Intervention in Chinese Patients: A Large Single-center Study

This large cohort study aimed to investigate the association between fibrinogen levels and 2-year all-cause mortality, and its predictive value in addition to a basic model including traditional risk factors in Chinese patients receiving the contemporary percutaneous coronary intervention (PCI). A

Perceptions of Perioperative Stroke Among Chinese Anesthesiologists: Starting a Long March to Eliminate This Underappreciated Complication.

Perceptions of Perioperative Stroke Among Chinese Anesthesiologists: Starting a Long March to Eliminate This Underappreciated Complication.

Prevalence and risk factors for vascular calcification in Chinese patients receiving dialysis: baseline results from a prospective cohort study

Objective: With limited data available on calcification prevalence in chronic kidney disease (CKD) patients on dialysis, the China Dialysis Calcification Study (CDCS) determined the prevalence of vascular/valvular calcification (VC) and association of risk factors in Chinese patients with prevalent hemodialysis (HD) or peritoneal dialysis (PD).Methods: CKD patients undergoing HD/PD for ≥6 months were enrolled. Prevalence data for calcification and medical history were documented at baseline. Coronary artery calcification (CAC) was assessed by electron beam or multi-slice computed tomography (EBCT/MSCT), abdominal aortic calcification (AAC) by lateral lumbar radiography, and cardiac valvular calcification (ValvC) by echocardiography. Serum phosphorus, calcium, intact parathyroid hormone (iPTH), and 25-hydroxyvitamin D and FGF-23 were evaluated. A logistic regression model was used to evaluate the association between risk factors and VC.Results: Of 1,497 patients, 1,493 (78.3% HD, 21.7% PD) had ≥1 baseline calcification image (final analysis cohort, FAC) and 1,423 (78.8% HD, 21.2% PD) had baseline calcification data complete (BCDC). Prevalence of VC was 77.4% in FAC (80.8% HD, 65.1% PD, p < .001) and 77.5% in BCDC (80.7% HD, 65.8% PD). The proportion of BCDC patients with single-site calcification were 20% for CAC, 4.3% for AAC, and 4.3% for cardiac valvular calcification (ValvC), respectively. Double site calcifications were 23.4% for CAC and AAC, 6.5% for CAC and ValvC, and 1.1% for AAC and ValvC, respectively. In total, 17.9% patients had calcification at all three sites.Conclusions: High prevalence of total VC in Chinese CKD patients will supplement current knowledge, which is mostly limited, contributing in creating awareness and optimizing VC management.

Association of long-term glycaemic control on tear break-up times and dry eye symptoms in Chinese patients with type 2 diabetes.

Diabetes mellitus is known to be associated with dry eye syndrome (DES), but the effects of long-term glycaemic control on tear film metrics and dry eye symptoms are not known in the Chinese population. To evaluate tear film stability and dry eye symptoms and their associations with systemic risk factors in Chinese patients with type 2 diabetes mellitus (T2DM). Cross-sectional study set at the Lo Fong Siu Po Eye Centre (Grantham Hospital), Hong Kong. A total of 80 Chinese participants, aged 18 or above, with T2DM recruited from the specialist outpatient setting were included. The Oculus Keratograph 5M (Oculus Inc., Wetzlar, Germany) was used to measure the non-invasive tear break-up time (NITBUT). Ocular symptoms were evaluated using the Ocular Surface Disease Index (OSDI). The association between OSDI, NITBUT and metabolic parameters relating to diabetes were evaluated using multiple linear regression. The associations between long-term glycaemic control and NITBUT and OSDI scores. Stepwise multiple linear regression analysis revealed glycated haemoglobin to be the only significant independent variable for NITBUT (R2 = 0.099, P = 0.014) and OSDI (R2 = 0.062, P = 0.044) after controlling for potential confounders. The age-adjusted prevalence of DES was 20% (95% confidence interval: 11-30%) in the Chinese T2DM population. The odds of DES for increasing percentage of glycated haemoglobin was 1.49 (95% confidence interval: 1.03-2.17, P = 0.04). Our findings highlight the importance of good glycaemic control as a modifiable risk factor for both dry eye symptoms and tear film instability in patients with T2DM.

Fractional esterification rate of cholesterol in high-density lipoprotein associates with risk of coronary heart disease

BackgroundFractional esterification rate of cholesterol in high-density lipoprotein (FERHDL) has been found to be closely correlated with atherosclerotic dyslipidemia, especially lipoprotein distributions, and is a potentially useful predictor for coronary heart disease (CHD). The associations of FERHDL, measured by the simple and precise HPLC method, with angiographically defined CHD and its related risk factors in Chinese patients were evaluated.MethodsTwo hundred and fifty eight Chinese patients who had indications for angiography were enrolled in this study. Coronary angiograms were obtained by the standard techniques. FERHDL was determined by the HPLC method. Cholesterol levels in serum HDL, LDL and subfractions were measured by ultracentrifugation/HPLC method. Associations between FERHDL and CHD and CHD risk factors were analyzed.ResultsFERHDL was correlated with almost all the CHD risk factors. Compared with the non-CHD group, the CHD patients had higher values of FERHDL (20.9 ± 7.9%/h vs 17.7 ± 7.1%/h, p = 0.001). FERHDL was found to be independently and positively correlated with log TG (β = 0.386, P < 0.001) and log (LDLb-C) (β = 0.165, P = 0.020), respectively, and negatively correlated with log (HDL2-C)(β = −0.351, P < 0.001). Logistic regression analysis demonstrated that age, diabetes mellitus, smoking and FERHDL (OR = 1.056–1.080, p < 0.05) were independent risk factors for CHD.ConclusionFERHDL significantly correlated with both HDL2-C and LDLb-C, and therefore, is the predictor of lipoprotein distributions. In addition, after correcting for the presence of classic risk factors, FERHDL was independently associated with the presence of angiographically defined CHD.

Relationship between healthy lifestyle behaviors and cardiovascular risk factors in Chinese patients with type 2 diabetes mellitus: a subanalysis of the CCMR-3B STUDY.

This subanalysis of a cross-sectional, nationwide study was undertaken to assess the relationship between healthy lifestyle behaviors and multiple cardiovascular risk factors among people with type 2 diabetes mellitus (T2DM). Data collected from 25,454 participants, including demographics, lifestyle behaviors and cardiovascular risk profiles, were analyzed. Blood pressure control as well as blood glucose and blood lipid (3Bs) levels were measured as multi-risk factors for cardiovascular disease. Healthy lifestyle behaviors included regular exercise, nonsmoking status and no alcohol consumption. The relationship between the healthy lifestyle behavior(s) and control of 3B(s) was calculated. Of the 25,454 eligible participants, 4171 (16.4%) were current smokers, 2011 (7.9%) currently consumed alcohol, and 11,174 (43.9%) did not exercise. In total, 654 (2.6%) reported all three unhealthy lifestyle behaviors. Most participants (71.1%) had received at least a high school education and were more likely to smoke and drink as compared to those with lower education. Unhealthy lifestyle behaviors were commonly found in participants with low atherosclerosis risk, such as non-elderly people and those with an above-college education level. Unhealthy lifestyle is associated with poor 3B control and worse medication adherence. Unhealthy lifestyles are common in Chinese people with T2DM, especially in people who are non-elderly and above-college educated. Interventions aimed at changing risky lifestyle behaviors are required for improved outcomes for Chinese patients with T2DM.

Age-related coronary risk factors in Chinese patients with acute myocardial infarction

Objective: To determine the age-related coronary risk factors in Chinese patients with acute myocardial infarction (AMI). Methods: Among 31 provinces, municipalities or autonomous districts in China, from January 1st 2013 to September 30th 2014, 24 394 consecutive AMI patients who were admitted to 107 hospitals were divided into five groups according to age. Cardiovascular risk factors of groupⅠ (<45 years, n=2 307), group Ⅱ (45-54 years, n=4 448), group Ⅲ (55-64 years, n=7 029), group Ⅳ (65-74 years, n=6 147) and group Ⅴ (≥75 years, n=4 463) patients were compared. Results: Among 24 394 AMI patients [with a mean age of (62.2±13.8) years, 18 162 males], 24.7% patients had three and more conventional modifiable cardiovascular risk factors. ST-elevation myocardial infarction (STEMI) was diagnosed in 18 209 (74.6%) patients. The ratios of female, hypertension and diabetes tended to increase with the increase of age. Young AMI patients were predisposed to smoking, overweight/obesity and hyperglycemia. Nearly 90% patients in group Ⅰ and group Ⅱ were male. The ratio of male patients (92.3% to 58.0%), overweight/obesity (63.9% to 37.4%), current smoking (68.7% to 19.8%), dyslipidemia (9.1% to 4.5%), family history of premature coronary artery disease (CAD) (6.2% to 1.2%) and eating greasy food (86.1% to 66.2%) decreased markedly from group Ⅰ to Ⅴ patients. Proportion of hypertension gradually increased from 34.3% in group Ⅰ patients to 57.9% in group Ⅴ patients. Diabetes was most common to group Ⅳ (65-74 years) patients. Conclusion: There were different risk factors for AMI patients in different age groups, and young AMI patients were predisposed to live an unhealthy lifestyle.