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High risk of metabolic syndrome after delivery in pregnancies complicated by gestational diabetes.
Shen, Y, Li, W, Leng, J, Zhang, S, Liu, H, Li, W, Wang, L, Tian, H, Chen, J, Qi, L, et al
Diabetes research and clinical practice. 2019;:219-226
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Abstract
AIMS: To investigate the risk of postpartum metabolic syndrome in women with GDM compared with those without GDM in a Chinese population. METHODS Tianjin GDM observational study included 1263 women with a history of GDM and 705 women without GDM. Multivariate logistic regression was used to assess risks of postpartum metabolic syndrome between women with and without GDM. Postpartum metabolic syndrome was diagnosed by two commonly used criteria. RESULTS During a mean 3.53 years of follow up, 256 cases of metabolic syndrome were identified by using the NCEP ATPIII criteria and 244 cases by using the IDF criteria. Multivariable-adjusted odds ratios of metabolic syndrome in women with GDM compared with those without GDM were 3.66 (95% confidence interval [CI] 2.02-6.63) for NCEP ATPIII criteria and 3.90 (95% CI 2.13-7.14) for IDF criteria. Women with GDM had higher multivariable-adjusted odds ratios of central obesity, hypertriglyceridemia, and high blood pressure than women without GDM. The multivariable-adjusted odds ratios of low HDL cholesterol and hyperglycemia were not significant between women with and without GDM, however, the multivariable-adjusted odds ratio of hyperglycemia became significant when we used the modified criteria. CONCLUSIONS The present study indicated that women with prior GDM had significantly higher risks for postpartum metabolic syndrome, as well as its individual components.
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Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults.
Bennett, DA, Du, H, Bragg, F, Guo, Y, Wright, N, Yang, L, Bian, Z, Chen, Y, Yu, C, Wang, S, et al
BMJ open diabetes research & care. 2019;(1):e000835
Abstract
OBJECTIVE Aim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated by adiposity. RESEARCH DESIGN AND METHODS The prospective China Kadoorie Biobank recruited ~512 000 adults from 10 diverse areas across China. Self-reported PA was estimated based on type, frequency and duration of specific types of PA, covering four domains (occupation, leisure, household and commuting). SLT was defined as hours per day spent watching television, reading or playing card games. Stratified Cox proportional hazards models were used to estimate adjusted HRs (aHRs) for PA and SLT associated with incident diabetes. Analyses were stratified by age-at-risk (5-year intervals), sex and region and adjusted for household income, education, alcohol consumption, smoking, fresh fruit intake, self-reported general health status, family history of diabetes and body mass index (BMI) status. Analyses of total PA, occupational and non-occupational PA and SLT were mutually adjusted for each other, as appropriate. RESULTS After ~9 years of follow-up, there were 14 940 incident diabetes cases among 460 736 participants without prior diabetes or cardiovascular diseases at baseline. The mean (SD) age at baseline was 51 (10.6) years, 59% were women and 43% resided in urban areas. Overall, the mean BMI was 23.5 (3.3) kg/m2, which differed by ~0.5 kg/m2 among individuals in the highest compared with the lowest PA and SLT groups. PA was inversely associated the risk of diabetes 16% (aHR: 0.84, 95% CI 0.81 to 0.88) lower in top than bottom fifth. After further adjustment for BMI this was attenuated to 0.99 (95% CI 0.98 to 1.00). SLT was positively associated with diabetes and each 1 hour per day higher usual level was associated with aHR of 1.13 (95% CI 1.09 to 1.17) for diabetes, attenuated to 1.05 (95% CI 1.01 to 1.09) after further adjustment for BMI. CONCLUSIONS Among Chinese adults, higher levels of PA and lower levels of SLT were associated with lower risks of diabetes with no evidence of effect modification by each other. These associations appeared to arise mainly through adiposity.
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[Efficacy difference between warming acupuncture and other acupuncture methods for primary obesity: a Meta-analysis].
Xu, L, Ding, C, Chen, J, Tan, R, Chen, D, Xu, S, Zhou, X
Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2018;(9):1019-26
Abstract
OBJECTIVE To systematically evaluate the efficacy difference between warming acupuncture and other acupuncture methods in the treatment of primary obesity. METHODS A computer-based retrieval was conducted at PubMed, EMBASE, CENTRAL, CINAHL, Alt HealthWatch, CNKI, CBM, WANFANG database and VIP database. Retrieval time was from the establishment date of database to October 4, 2017. Randomized controlled trial (RCT) of warming acupuncture comparing with other acupuncture methods for the treatment of primary obesity were included. The relative risk (RR) and weighted mean difference (WMD ) were used as combined effects for categorical variables and continuous variables, respectively. RESULTS Totally 13 RCTs were included involving 878 patients. The Meta-analysis indicated compared with other acupuncture methods, warming acupuncture could more reduce weight (WMD: -1.49 kg, 95% CI: -2.53 to -0.45, P=0.005), improve the total effective rate (RR=1.16, 95% CI: 1.09 to 1.24, P<0.000 01), reduce BMI (WMD: -1.24 kg/m, 95% CI: -2.34 to -0.14, P=0.03), reduce waist circumference (WMD: -1.65 cm, 95% CI: -2.53 to -0.76, P=0.02) and reduce hip circumference (WMD: -2.86 cm, 95% CI: -4.37 to -1.35, P=0.000 2), but had no significant influence on total cholesterol (WMD: -0.05 mmol/L, 95% CI:-0.98 to 0.88, P=0.91). CONCLUSION The warming acupuncture has better efficacy on primary obesity than other acupuncture methods, but less effects on lipid indicators.