Objective Vitamin D deficiency has recently evolved as a major public health issue worldwide. But the relationship between vitamin D and cardiovascular health in children remains unclear. Accordingly, we aimed to examine the associations between 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors, and to assess the possible effect modification of obesity on the associations in a Chinese pediatric population. Research design and methods A cross-sectional sample of 6091 children aged 6–18 years was obtained using a cluster sampling method. The 25(OH)D concentrations, and metabolic risk factors, including waist to height ratio, blood pressure, blood lipids, fasting blood glucose (FBG), and insulin were measured. Adjusted ORs and multiplicative or additive interaction were calculated to assess the associations and effect modification, respectively. Results Triglycerides, FBG, insulin, and homeostasis model assessment of insulin resistance were inversely associated with 25(OH)D concentrations (p<0.05) in both sexes. The OR of hyperglycemia among individuals with insufficient vitamin D was higher than those with adequate vitamin D after adjusting for covariates (OR: 1.47; 95% CI 1.26 to 1.70). Moreover, girls with insufficient vitamin D had significantly higher odds for hypertension and high total cholesterol than those with adequate vitamin D, which was not observed in boys. Thirty-two percent (95% CI 14% to 51%) of the increased odds of hyperglycemia can be explained by the interaction between insufficient vitamin D and obesity. Conclusions Vitamin D insufficiency is associated with increased odds of various cardiometabolic risk factors in Chinese children and has a synergistic effect on hyperglycemia with obesity.
Several methods have been established in recent decades that allow use of spot urine to estimate dietary sodium intake. However, their accuracies have been controversial in children.To validate the performance of three commonly used methods-the Kawasaki, Tanaka, and International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) methods. Additionally, this study explored the accuracies of the Tanaka and INTERSALT methods by using spot urine samples taken at four separate times.Forty-one adolescents aged 14 to 16 years completed two non-consecutive 24-hour urine collections and their mean values were used as reference data. The second-morning urine was used for assessment with the Kawasaki method; a casual spot urine and spot urine samples taken at four separate times (morning, afternoon, evening, and overnight) were used for assessment with the Tanaka and INTERSALT methods.The mean differences were 1801 mg, 542 mg, 47 mg, and -31 mg for the Kawasaki, Tanaka, INTERSALT1 (with potassium), and INTERSALT2 (without potassium) methods with their required spot urine, respectively. The proportions of relative difference levels within ± 10% were 4.9% for the Kawasaki method, 19.5% for the Tanaka method, 36.6% for the INTERSALT1 method, and 36.6% for the INTERSALT2 method.The INTERSALT method seemed to provide minimally biased estimations of mean population sodium intake with casual spot urine. However, there is a need to be cautious regarding inconsistencies in estimation among different levels of sodium intake. The methods assessed in this study were unable to accurately estimate sodium intake at the individual level.
ABSTRACT Importance Extensive population‐based studies have explored the prevalence of primary hypertension (HTN) in children and adolescents. However, there is little published data on the characteristics of different types of pediatric HTN and the causes of secondary HTN. Objective To investigate the characteristics of different types of pediatric HTN and the causes of secondary HTN in a hospital setting. Methods The study cohort comprised pediatric inpatients (<18 years of age) discharged with a diagnosis of HTN from Beijing Children’s Hospital during 2015–2020. Pediatric patients with HTN were allocated to secondary and primary HTN groups on the basis of comprehensive analyses of their diagnoses, family history of HTN, and findings on physical examination, as documented in their medical records. The Mann–Whitney U test, χ 2 and Fisher’s exact test were used to assess differences in characteristics of patients with different HTN types and causes of secondary HTN. Results Data of 1470 inpatients with HTN from 18 clinical departments were included in the analysis. Among them, 458 (31.2%) had primary HTN, and 1012 (68.8%) had secondary HTN. Compared with patients had primary HTN, children with secondary HTN were younger and had lower body mass indexes and longer lengths of stay. Moreover, children with primary HTN had mostly been managed by the Endocrinology and Cardiology Departments, 75.8% of them having obesity‐related comorbidities. In contrast, most patients with secondary HTN had been managed by the Nephrology Department, renal diseases being the leading cause of their HTN (46.3%). Interpretation Secondary HTN is more common than primary HTN in pediatric clinical settings, renal diseases being the leading cause of secondary HTN.
To quantify the prevalence of dyslipidemia among children and adolescents in China.Chinese Biomedical Database (CBM), Wanfang Databases, China National Knowledge Infrastructrue (CNKI) and PubMed were comprehensively searched. Original reports were selected if data on prevalence estimates of dyslipdemia among children and adolescents in China, was provided under cross-sectional epidemiological studies. Quality of the literature was evaluated through the STROBE statement. The prevalence through Meta was estimated using the Strata 11.0 software. Subgroup analysis was undertaken on gender, age, regions and secular trends issues. Sensitivity analysis was performed to evaluate the impact of quality or standard of diagnosis.A total of 24 papers were included in this Meta-analysis, with the whole sample size as 129 426. The overall pooled-prevalence of total dsylipidemia was estimated at 25.3% (95% CI: 12.7%-37.8%). Prevalence rates of high TC, LDL-C, TG, low HDL-C and hyperlipemia were 4.1% (95% CI:3.4%-4.9%), 5.3% (95% CI:3.9%-6.7%), 8.5% (95% CI:6.3%-10.7%), 6.8% (95% CI: 3.7%-9.9%), 4.8% (95%CI:0.6%-9.1%), respectively. Girls (3.4%) had lower prevalence of high TG than boys (5.6%), but having higher prevalence of other different types dyslipidemia. Children aged 7-18 years had higher overall prevalence of dyslipidemia (31.6%) when compared to children aged 2-6 years (9.0%). There were no statistically significant differences for subgroups of age, region and period regarding the prevalence rates of high TG, TC and low HDL-C(P > 0.05).Prevalence of dyslipidemia was high and with increasing trend among children and adolescents in China. Early screening and prevention programs on abnormal serum lipids should be emphasized and promoted.
The carbon emission flow of the power system, as a new direction for carbon emission reduction in the power system, provides new ideas for the measurement of carbon emissions in the power system and other issues. This paper aims to propose a method for calculating the carbon emission flow of the power system that takes into account the carbon reduction contribution of new energy, based on the carbon emission flow of the power system, and conducts an empirical analysis in Pingliang City, China. The specific approach is as follows: First, based on the actual network of Pingliang City, the system's power flow distribution is re-determined without considering network losses. Secondly, the carbon emission flow of the network is calculated according to the power flow distribution. Finally, an empirical analysis is conducted through examples, and the results show that the basic method proposed in this paper, which takes into account the output of clean energy in the power system's carbon emission flow, can estimate the carbon reduction contribution of new energy, providing new ideas for the low-carbon development of the power system.
ABSTRACT Importance Childhood and adolescence are critical periods for lifelong bone mineral accrual, but few studies have determined the impact of childhood adiposity on adult bone density. Objective To determine the long‐term impact of childhood adiposity on adult areal bone mineral density (aBMD) and the effect of adult adiposity on this relationship. Methods We conducted a longitudinal study of 1156 adults (56.3% men), for whom skinfold thickness (SFT) had been measured during childhood (6–18 years) and fat mass percentage (FMP) and aBMD were measured during adulthood (29–43 years). Adult aBMD in the lumbar spine (LS), femoral neck (FN), arms, and legs was measured using dual‐energy X‐ray absorptiometry. The direct effect of childhood SFT and its indirect effect through adult FMP on adult aBMD were estimated using general linear regression and a causal steps approach. Results Significant positive associations between childhood SFT and adult aBMD were found in the LS in men ( β = 0.089, P = 0.044) and in all the skeletal sites in women. With respect to the adult fat–bone relationship, high adult FMP was associated with low aBMD in most of the sites in men, but with high FN aBMD in women ( β = 0.144, P = 0.002). Moreover, suppressive effects of adult FMP on the associations between childhood SFT and adult aBMD in the LS (−34.8%) and legs (−67.1%) of men, and a positive effect on the FN aBMD in women (17.0%) were identified. Interpretation Childhood adiposity appears to have a positive long‐term effect on adult aBMD, which may be reduced by adiposity in adult men but reinforced by adiposity in adult women.
Comparing body fat and the effect of body fat on metabolic abnormalities in Chinese and USA teenagers may provide clues for the early prevention and control of cardiovascular disease (CVD). We aimed to compare the prevalence of glucose and lipid metabolism abnormalities, body fat amount and distribution, and the effect of body fat on glucose and lipid metabolism in Chinese and US teenagers.We included 5424 Chinese teenagers (48.5% male) from the China Child and Adolescent Cardiovascular Health (CCACH) study and 8704 USA teenagers (55.6% male) from the USA National Health and Nutrition Examination Survey (NHANES). Blood lipid, blood glucose, and body fat indicators were obtained using the same standardised measurements.The prevalence of dyslipidaemia in Chinese teenagers was of those in the USA (hypercholesterolaemia = 3.5% vs 7.4%; high low-density lipoprotein cholesterol (LDL-C) = 3.6% vs 5.0%; low high-density lipoprotein cholesterol (HDL-C) = 9.9% vs 14.3%; hypertriglyceridaemia = 3.7% vs 10.1%) (P < 0.05). However, with the increase in body mass index (BMI), the prevalence of high LDL-C increased more in Chinese than in US teenagers, even exceeding them in the obese group (2.7% in non-overweight to 9.7% in overweight group in China, P < 0.05; 3.5% in non-overweight to 6.5% in the obese group in the USA, P < 0.05). The prevalence of impaired fasting glucose was higher in China than in the USA (28.0% vs 17.5%, P < 0.05). Besides, Chinese adolescents are more likely to accumulate fat in the abdomen, and the per-unit fat increase would bring a higher risk of dyslipidaemia in Chinese boys than in USA boys.Dyslipidaemia was more prevalent in US teenagers than in Chinese teenagers, but with the increase in BMI, the prevalence of high LDL-C increased more in Chinese than in US teenagers. Impaired fasting glucose (IFG) was significantly more prevalent in China than in the USA. The unfavoured body fat and higher risk of body fat on metabolic disorders in Chinese teenagers suggest that Chinese teenagers should pay more attention to the adverse effect of body fat on metabolic abnormalities.
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