Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases...Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.展开更多
Purpose To establish and propose a national body mass index (BMI) reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH (Chinese National Survey on Stude...Purpose To establish and propose a national body mass index (BMI) reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH (Chinese National Survey on Students Constitution and Health) data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult's Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China (WGOC) to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.展开更多
Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR wer...Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.展开更多
Foreign body ingestion is a common condition, es-pecially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batter-ies. Most fo...Foreign body ingestion is a common condition, es-pecially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batter-ies. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with mini-mal complications. This review describes a comprehen-sive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experi-ence.展开更多
基金This project is supported by China Roche Pharmaceuticals.
文摘Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.
基金Funded by International Life Sciences Institute, Focal Point in China.
文摘Purpose To establish and propose a national body mass index (BMI) reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH (Chinese National Survey on Students Constitution and Health) data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult's Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China (WGOC) to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.
文摘Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.
文摘Foreign body ingestion is a common condition, es-pecially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batter-ies. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with mini-mal complications. This review describes a comprehen-sive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experi-ence.