To validate the accuracy of Raycome RBP-1200 used for blood pressure (BP) measurements in Chinese children aged 3-12 years according to the Association for the Advancement of Medical Instrumentation (AAMI)/International Organization for Standardization 81060-2:2013(E) protocol.A prospective observational study was carried out using 'the same arm sequential method' as described in the AAMI protocol. Eighty-seven children participated in this examination and 255 paired-determinations were analyzed.The BP difference between the RBP-1200 and the mercury sphygmomanometer device was -0.9±5.3 mmHg for systolic BP and -1.1±5.0 mmHg for diastolic BP, which were within the range of ±5±8 mmHg as required by criterion 1 of the AAMI protocol. The SD of the averaged difference for each participant was 4.1 mmHg for systolic BP and 3.9 mmHg for diastolic BP, which were also within the requirement of criterion 2 of the AAMI protocol.The Raycome RBP-1200 device fulfills the requirements of the AAMI protocol and it can be recommended for BP measurements in Chinese children aged 3-12 years with low or normal BP values.
Objective: Describe the characteristics of obesity phenotype in Chinese children, and to explore the associations of body fat distributions and distinct obesity phenotype. Design and Method: Children aged 6–18 years were recruited from eight cities in China. Stratified cluster sampling method was used. Height, weight, waist circumference and blood pressure were measured. Fasting plasma glucose, serum high-density lipoprotein cholesterol and triglyceride were examined. Body fat distributions were estimated by whole-body DXA scans (Hologic Discovery-A fan beam densitometer). Obesity was diagnosed based on body mass index by cutoffs recommended by Working Group on Obesity in China (7–18 yrs) and the US 2000 CDC growth charts (6 yrs). Adjusted NCEP III metabolic syndrome criteria was used to estimate metabolic disorder. Combined obese and metabolic status, participants were classified into 4 obesity phenotypes: metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO), metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW). Children were divided into four groups according to visceral fat mass (VFM) and trunk fat mass (TFM) quartiles, separately. Results: 12599 children involved in this study, 8948 of them contained DXA body composition data. The overall prevalence of obesity is 12.5% (male vs. female: 16.7% vs. 8.2%). Rates of prevalence of MHO, MUO, MHNW, MUNW are 7.5%, 5.2%, 64.4%, 8.8% in the whole population. Stratified by age and gender, VFM and TFM are higher in MUO and MUNW groups than MHO and MHNW groups, and those whose VFM and TFM in the highest quartile are more likely to fall into MUO and MUNW groups among elder children (13–18 yrs), especially in boys. Conclusions: Adiposity deposit in viscera and trunk are related to distinct metabolic phenotypes in elder but not younger children. The amount and duration of fat accumulation might contribute to metabolic disorder.
Childhood obesity has become a critical issue in public health area. We searched Wanfang Data and PubMed databases for published studies on health hazards of childhood obesity in China during 2000-2015. From the evidence of the Chinese population studies, we know childhood obesity brings not only cardiovascular, endocrine and respiratory system health hazards, but also other health hazards to liver, moving skeleton, psychological behavior and cognition intelligence, et al. Only to understand the health hazards of childhood obesity, and put the key preventable period of chronic diseases forward to childhood, can pandemic of chronic diseases be controlled from the sources.
Objective: To describe the prevalence of cardiometabolic risk factors in Chinese children and adolescents. Design and Method: Stratified cluster sampling method was used, 12 590 (boys: 6370, 50.6%) children aged 6–18 years were recruited from seven urban cities in 2013–2014. Height, weight, waist circumference (WC) and blood pressure were measured. The levels of fasting plasma glucose, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were examined. General obesity was diagnosed based on body mass index and abdominal obesity based on WC. Hypertension was diagnosed according to blood pressure reference standards for Chinese children. Hyperglycemia was defined as a fast glucose level ≥5.6mmol/L. Dyslipidemia was diagnosed by the recommends of dyslipidemia in Chinese children. Metabolic syndrome (MS) was diagnosed by International Diabetes Federation (IDF) and Chinese standard (CHN), respectively. Results: The standardized overall prevalence of general obesity and abdominal obesity were 11.5% and 21.3%, the prevalence of hypertension was 17.9%, hyperglycemia was 23.7%, elevated TG was 4.7%, elevated TC was 4.1%, elevated LDL-C was 3.1% and low HDL-C was 9.1%. The standardized prevalence of MS appeared 3.2% according to IDF and 5.4% according to CHN. The prevalence of general obesity was negatively correlated with age for both genders. The prevalence rates of general obesity, abdominal obesity, hypertension and hyperglycemia were all higher in boys than in girls. Both the results from IDF and CHN showed that the prevalence of MS as boys >girls, obesity >overweight >normal weight, Northern >Southern. Conclusions: The prevalence rates of multiple cardiometabolic risk factors were high in urban Chinese children. Attention should be paid to identifying and carrying out effective interventions on children, especially in boys.
Background Total bilirubin (TBIL) has antioxidant and anti-inflammatory properties. This study aimed to determine whether elevated TBIL could modify the association between diabetes and stroke. Method Data were obtained from the National Health and Nutrition Examination Survey 2011–2016. TBIL was stratified by median (10.3 µmol/L). The association between diabetes and stroke was quantified using multivariable logistic regression models. The cut-off concentration for the presence of TBIL modification effects was identified by Johnson-Neyman analyses. Mediation analyses were performed to determine the influence of TBIL on mediating factors that mediate the relationship between diabetes and stroke. Results This cross-sectional study included 16 130 participants, with the mean age of 46.8±0.4 years and 48.5% of men. Diabetes was associated with the presence of stroke at TBIL <10.3 µmol/L (OR=2.19, 95% CI 1.58 to 3.05) but not at TBIL ≥10.3 µmol/L (OR=1.27, 95% CI 0.85 to 1.88) after adjustment for confounders. Above associations were significantly different between the two TBIL concentrations ( P for interaction=0.03). Moreover, the modification effect of TBIL specifically occurred in men ( P for interaction=0.02) rather than in women ( P for interaction=0.08). The cut-off concentration for the presence of TBIL modification effects was 17.05 µmol/L. Additionally, the TBIL of ≥10.3 µmol/L inhibited mediating effects of hypersensitive C reactive protein (mediating effect=0.03, 95% CI −0.15 to 0.22, P =0.72) and systemic immune-inflammation index (mediating effect=0.01, 95% CI −0.01 to 0.04, P =0.29) as compared with the TBIL of <10.3 µmol/L. Conclusions Elevated TBIL modified the association between diabetes and stroke through inhibiting mediating effects of inflammatory factors.
Objective: The prevalence of hypertension among Chinese children has increased greatly in recent years. Given blood pressure tracks from childhood into adulthood, screening for hypertension among asymptomatic children plays an important role in reducing blood pressure in childhood and cardiovascular events in adulthood. However, only a few blood pressure measuring devices used in Chinese children were validated by international protocols. Therefore, the aim of this study was to validate the accuracy of Raycome RBP-1200 upper-arm pulse wave device in children aged 3-12 years according to the Association for the Advancement of Medical Instrumentation (AAMI) /International Organization for Standardization (ISO) 81060-2:2013(E) protocol. Design and Method: A prospective observational study was carried out in children aged 3-12 years. Blood pressure was collected using “the same arm sequential method” as described in AAMI protocol. The RBP-1200 innovatively combines a pulse wave detector at the downstream position of the pressurized cuff, which determines systolic blood pressure by detecting changes of the pulse wave and diastolic blood pressure by sensing the real-time changes in the blood flow pulse. Finally, 87 children participated in this test and 255 paired-determinations were analyzed. Results: The difference between the RBP-1200 and gold-standard mercury sphygmomanometer device was − 0.9 ± 5.3 mmHg for systolic blood pressure and − 1.1 ± 5.0 mmHg for diastolic blood pressure, which is less than 5 ± 8 mmHg as requested by criterion 1 of AAMI protocol. The standard deviation of the averaged paired determinations per subject for systolic blood pressure and diastolic blood pressure was 4.1 mmHg and 3.9 mmHg, respectively, which is also within the requirement of criterion 2 of AAMI protocol. Conclusions: The Raycome automated upper-arm pulse wave device RBP-1200 fulfilled the requests of AAMI protocol, which means it can measure blood pressure accurately in children aged 3-12 years.
To evaluate the prevalence of metabolic syndrome (MS) in Chinese children and adolescents to provide scientific basis for early prevention of MS in the related populations.Studies on CNKI, Wanfangdata, VIP and PubMed databases on related prevalence of metabolic syndrome in Chinese children and adolescents between 2004-2014 were searched. Quality of literatures was evaluated according to the cross-sectional study standard in Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Stata 12.0 software was used to estimate the prevalence of MS, as well as on gender, weight and other factors to make subgroup analysis. According to funnel plot and Egger assess publication bias, sensitivity analysis performed by excluding the impact of any article was generated by the combined effect of the value of literature.This study included 19 papers from the literature (5 in English, 14 in Chinese). According to International Diabetes Federation (IDF), National Cholesterol Education Program III (NCEP III) and The definition and prevention recommends of metabolic syndrome in Chinese children and adolescents (CHN2012), the prevalence rates of MS in Chinese children were seen as 1.8%, 2.6% and 2.0%. According to IDF, the prevalence rates of MS appeared 2.9% in boys and 1.8% in girls, 0.2% in children with normal weight, 4.7% in overweight and 17.3% in obesity. Both the results from NCEPIII and CHN2012 showed that the prevalence rates of MS as boys > girls, obesity > overweight > normal weight.Prevalence of MS in Chinese children and adolescents showed a general trend. Data under different standards showed different prevalence rates. Obesity appeared an important risk factor of MS, suggesting that in order to control obesity in children, attention should be paid to identifying and carrying out effective interventions on children under overweight or obesity.
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