Whether paternal epigenetic changes resulting from nutrition might be inherited by their offspring remains unknown. This study evaluated the relationship between preconception paternal body weight and their offspring's birth weight in 1,810 Chinese mother-father-baby trios. Information on paternal and maternal preconception body weight and height was collected via a self-reported questionnaire. Birth weight was collected from medical records. Paternal preconception body weight was associated with offspring's birth weight (p trend = .02) after multivariate adjustment. Each standard deviation increment of paternal body mass index was associated with an additional 29.6 g increase of birth weight (95% confident interval: 5.7 g, 53.5 g). The association was more pronounced in male neonates, and neonates with overweight mothers, and with mothers who gained excessive gestational weight, compared to their counterparts (all p interaction < .05). Sensitivity analyses showed similar pattern to that of the main analysis. Paternal preconception body weight was associated with birth weight of their offspring.Impact statement What is already known on this subject? More efforts have previously been put on the maternal contribution to birth weight, however, it is uncertain whether paternal pre-conceptional body weight, an indicator for epigenetic information, might be inherited by their offspring. What do the results of this study add? In the current study that included 1,810 Chinese mother-father-baby trios, a small but significant association was observed between paternal preconception body weight and offspring's birth weight (p trend =.02). What are the implications of these findings for clinical practice and/or further research? Paternal epigenetic information of nutrition could be inherited by their offspring.

Background and objective Patients on parenteral nutrition (PN) are at high risk of both liver and pancreatic injury. More efforts were focused on liver, however, limited data is available to evaluate the effects of PN on pancreas. Thus, we performed a retrospective observational study to evaluate the association between PN and pancreatic injury in Chinese adult patients. Methods Adult patients (18–80 years), who received PN for a week or longer, and with repeated measurements of pancreatic enzymes, were included in the analysis. Pancreatic injury was confirmed by serum level of pancreatic amylase (P-AMYwas 53 U/L or higher) or lipase (LP was 63 U/L or higher), which were evaluated at baseline and following every week during PN duration. Age, sex, body weight, height, diagnosis of diseases, history of diseases, surgery, white blood cell, c-reactive protein, liver and renal function, fasting blood glucose, lipid profile, and daily energy supplied by PN and enteral nutrition were abstracted from medical records. Results A total number of 190 adult patients (125 men, 65 women) were included in the study. The average age and BMI were 61.8 ± 13.0 years and 21.7±3.3 kg/m 2 , while medium serum level of P-AMY and LP were 29.0 U/L (quartile range: 18.0, 47.0) and 33.0 U/L (quartile range: 19.0, 58.0), respectively at baseline. The median duration of PN was 15 days (quartile range: 11.0, 21.0). The prevalence of pancreatic injury was 42.1% (80/190) while it was 28.4% (54/190), 43.3% (77/178), 47.8% (44/92) after one-, two-, and three-week or longer PN adminstration. The proportion of daily energy supplement by PN (OR = 3.77, 95%CI: 1.87, 7.61) and history of infection were positively (OR = 3.00, 95%CI: 1.23, 7.36), while disease history for diabetes mellitus (OR = 0.38, 95%CI: 0.15, 0.98) and cancer (OR = 0.46, 95%CI: 0.23, 0.95), were negetively associated with pancreatic injury. Total bile acids were associated with the increment of P-AMY (beta = 0.98, 95%CI: 0.39, 1.56) and LP (beta = 2.55, 95%CI: 0.98, 4.12) by multi-variate linear regression. Conclusion PN was associated with pancreatic injury, as demonstrated by the increase of both serum P-AMY and LP.

目的 拟探讨老年人体质量指数(body mass index,BMI)与高血压发生风险的关系,为老年人适宜BMI范围制定提供参考.方法 收集上海交通大学医学院附属仁济医院体检中心老年研究对象(≥60岁)共9474例资料,其中男性5337例,女性4137例.所有研究对象均随访5年.基线资料为2014年的身高、体质量,计算体质量指数(body mass index,BMI).根据基线BMI将所有老年研究对象分为5组:BMI<18.5 kg/m2组,BMI 18.5～22.9 kg/m2组,23.0～24.9 kg/m2组,25.0～29.9 kg/m2组和BMI≥30.0 kg/m2组.调查问卷法收集既往慢性疾病史(高血压、糖尿病、脂代谢异常).收集基线收缩压、舒张压、空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白和肾小球滤过率数据.随访期间每年测量收缩压和舒张压.收缩压≥140 mmHg(1 mmHg=0.133 kPa)和(或)舒张压≥90 mmHg认定为高血压.采用Cox比例风险回归模型评估基线BMI与高血压发生风险的关系.结果 随访5年期间新发高血压2138例.调整年龄、性别、糖代谢、脂代谢和肾小球滤过率后发现,以BMI为18.5～22.9 kg/m2的老年人群为对照,BMI<18.5 kg/m2组,23.0～24.9 kg/m2组,25.0～29.9 kg/m2组,≥30.0 kg/m2组高血压发生风险的HR值分别为0.65(95％CI:0.48～0.88),1.23(95％CI:1.10～1.38),1.47(95％CI:1.32～1.63)和1.85(95％CI:1.44～2.38).BMI每增加1.0 kg/m2,高血压发生风险增加7％(HR:1.07;95％CI:1.06～1.09,P<0.001).男女分组的结果与总人群趋势一致.排除60～65岁、糖代谢异常、脂代谢异常的老年人进行敏感性分析得到的结果与主效应分析一致.结论 老年人BMI升高可明显增加高血压发生风险.为降低老年人群发生高血压的风险,建议将体质量控制在正常范围.

Objectives Previous studies reported that overweight older adults had a lower mortality after cardiovascular diseases attack, indicating being thinner might not always be better. However, there is an ongoing debate about what is the optimal range of body mass index (BMI) for the aged population. We aimed to evaluate the value of BMI for the prediction of incident diabetes mellitus (DM) in the Chinese elderly population. Methods A total number of 6,911 Chinese elderly people (4,110 men and 2,801 women, aged 71 ± 6.0 years) were included in this cohort study. BMI was measured at baseline (Jan 1, 2014, to Dec 31, 2014). All the participants were further classified into six groups: <18.5 kg/m2, 18.5 to <22.5 kg/m2, 22.5 to <25.0 kg/m2, 25.0 to <27.5 kg/m2, 27.5 to <30.0 kg/m2, and ≥30.0 kg/m2. Fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) were annually measured during follow-up (Jan 1, 2015-May 31, 2019). DM was confirmed if either FBG ≥ 7.0 mmol/L or HbA1c ≥ 6.5%. We used the Cox proportional hazard regression model to evaluate the association between BMI and the prediction of incident DM. Results Comparing individuals with a BMI range of 18.5 to <22.5 kg/m2 (reference), the hazard ratio for incident DM was 2.13 (95% CI: 1.54~2.95), 2.14 (95% CI: 1.53~3.00), 3.17 (95% CI: 2.19~4.59), 3.15 (95% CI: 1.94~5.09), and 3.14 (95% CI: 1.94~5.09) for the group with a BMI range of 22.5 to <25.0 kg/m2, 25.0 to <27.5 kg/m2, 27.5 to <30.0 kg/m2, and ≥30.0 kg/m2 after adjusting for baseline age, sex, blood pressure, lipid profiles, and eGFR (P trend < 0.001), after adjusting for the abovementioned confounders. The association tended to be closer in men and young participants, compared with their counterparts. Conclusions High BMI was associated with a high risk of developing DM in the Chinese aged population. Thus, it is optimal for the aged population to maintain their body weight within a reasonable range to prevent chronic diseases.

Background and aims: We performed the current study to evaluate the association between dynamic change in estimated glomerular filtration rate (eGFR) and the risk of carotid artery plaque (CAP) in a community-based population. Methods and results: A total number of 37,093 Chinese adults (21,790 men and 15,303 women, aged 42.6 +/- 11.6 years) free of chronic kidney diseases were enrolled. The change in eGFR was calculated based on two measurements in 2013 and 2014 (mean interval: 1.2 y). Participants were further classified into three groups based on the change in eGFR: fast-decrease (>= 3.3%), stable (from-3.3% to 3.3%), and fast-increase (3.3%). CAP was annually assessed by ultrasound B model throughout the study (2013-2018). We have identified 1,624 new cases of CAP (16.0 per 1000 person-year) during follow up. Compared to participants with stable eGFR, participants in both fast-decrease and fast-increase groups were associated with 1.99 folds (HR = 1.99, 95% CI: 1.54, 2.57) and 3.15 folds (HR = 3.15, 95% CI: 2.38, 4.16) higher likelihood of developing CAP. The association between continuous change in eGFR and the risk of CAP demonstrate a "U" shape. Sensitivity analysis generated similar results with main analysis. Conclusions: Both fast decrease and increase in eGFR were associated with the risk of developing CAP in Chinese adults. (C) 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

OBJECTIVE:We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults.DESIGN:Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up.RESULTS:Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis.CONCLUSION:BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.

BACKGROUND:Previous studies reported the controvertible association between red blood cell distribution width (RDW) and diabetes. The aim of this study is to explore whether RDW is associated with incident diabetes.METHODS:We performed this cohort study in 16,971 Chinese adults (9,956 men and 7,015 women, aged 43.3 ± 12.8 years). The level of RDW was measured at baseline (2014). All the participants were further classified into four quartile groups based on baseline RDW. Fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) were measured annually during follow-up (2014-2019). Diabetes was diagnosed if either FBG ≥ 7.0 mmol/L or HbA1c ≥ 6.5%. We used the Cox proportional hazards regression model to evaluate the association between baseline RDW and incident diabetes.RESULTS:We identified 2,703 new cases of diabetes during five-year follow-up. The incidence was 15.9%. Comparing with participants in the lowest quartile group (reference group), the adjusted hazard ratios (HR) for the risk of diabetes were 1.31 (95% CI: 1.16, 1.48) for the highest quartile group (p trend < 0.001), after adjustment for potential confounders. Further adjusting baseline FBG and HbA1c did not materially change the association between RDW and incident diabetes. Each unit increase of RDW was associated with a 16% higher risk of incident diabetes (HR = 1.16, 95% CI: 1.06, 1.26) in a fully adjusted model. Sensitivity analysis generated similar results with prospective analyses after excluding aged participants, participants who are overweight and with obesity, participants with elevated blood pressure, participants with decreased eGFR, and those with anemia at baseline.CONCLUSIONS:High RDW was associated with high risk of developing diabetes in Chinese adults. As RDW is an inexpensive, noninvasive, and convenient indicator, RDW might be considered for inclusion in the risk assessment of high-risk groups of diabetes.

目的 研究体检人群中代谢健康型超重和肥胖检出率及5年随访期间内代谢健康型超重和肥胖的演变情况.方法 以2013-2018年间在上海交通大学医学院附属仁济医院体检中心进行体检的人群作为研究对象.采集身高、体重并计算BMI,测量血压,收集糖代谢指标、脂代谢指标、超敏C反应蛋白、血清尿酸和肝脏B超结果.代谢健康型定义为血压、糖代谢、脂代谢、血清尿酸均正常且无脂肪肝.所有代谢健康型人群进一步根据基线时(2013年)BMI分为体重和代谢均正常、代谢健康型超重和代谢健康型肥胖3组.结果 共64 164人(男性38 134人,女性26 030人)纳入本研究.平均年龄(42.0±12.0)岁,BMI为(23.8±3.2) kg/m2.本组人群中代谢健康型检出率28.7％(18 448人),其中代谢和BMI均正常占78.9％、代谢健康型超重占19.0％,代谢健康型肥胖2.1％.5年随访期间内,代谢健康型的人群中共9 318人转变为代谢不健康型(50.5％).在控制多种混杂因素后,与体重和代谢均正常的人群相比,代谢健康型超重和代谢健康型肥胖的人群转化为代谢不健康型的危险性分别增加11.0％(HR=1.11;95％CI: 1.05～ 1.18)和16.0％ (HR=1.16;95％CI: 1.01～1.33).结论 代谢健康型超重和肥胖的合计检出率为6.1％.与代谢与BMI均正常的人群相比,代谢健康型超重和肥胖转化为不健康的危险性显著增加.

Abstract Background We performed a cohort study to evaluate the association between the CRP trajectory and incident diabetes in Chinese adults. Methods Included were 6439 adults (4111 men and 2249 women; aged 46.6 ± 11.9 years). The concentration of high sensitivity CRP (hs-CRP) was measured in 2013 (baseline), 2014, and 2015. The hs-CRP trajectory was identified based the above three measurements by latent mixture modeling. Incident diabetes cases were diagnosed by fasting blood glucose (≥126 mg/dl) or Hb A1c (≥6.5%) during subsequent 3 years (2016–2018). Results Hs-CRP concentration during 2013–2015 was classified into 3 levels: low (< 1.0 mg/L), moderate (1.0–3.0 mg/L), and high (≥3.0 mg/L) based on a statement by American Heart Association. We named four hs-CRP trajectories as following: “low-stable” (low in 2013 and maintained at low concentration in 2014 and 2015), “moderate-fluctuated” (moderate in 2013, then increased to high concentration in 2014, and decreased to low concentration in 2015), “high-decreased” (high in 2013 but decreased to moderate concentration in 2014 and 2015), and “moderate-increased (moderate in 2013 and increased to high concentration in 2014 and 2015)”. We identified 235 incident diabetes during subsequent 3 years. The adjusted HR for incident diabetes was 1.71 (95% CI: 1.02, 2.87) comparing the moderate-increased and the low-stable group, after adjusting for potential confounders. In the secondary analyses, two single-measured hs-CRP concentration (in 2013 or in 2015) and the average of hs-CRP were associated with high risk of diabetes (P-trend< 0.01 for all). Conclusions The hs-CRP trajectory pattern was associated with altered incident diabetes in Chinese adults.

Whether metabolically healthy obesity (MHO) is associated with longitudinal changes in high-density lipoprotein cholesterol (HDL-C) remains unclear. MHO was defined as participants with overweight and obesity (BMI ≥ 24.0 kg/m2, n = 2921), free of history of metabolic diseases, and without abnormalities of blood pressure, fasting blood glucose, hemoglobin A1c, lipid profile, carotid artery and liver ultrasonographic findings at baseline. Metabolically healthy normal weight (MHN) was defined as participants with normal weight (BMI < 24.0 kg/m2, n = 9578) and without above-mentioned abnormalities. HDL-C, fasting blood glucose, hemoglobin A1c, and blood pressure were assessed annually. Glucose abnormality was considered if either FBG ≥ 5.6 mmol/L or HbA1c ≥ 5.7%; while, high blood pressure (HBP) was considered if either systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg during 5 years of follow-up. Compared with the MHN group, the adjusted mean difference in HDL-C change rate was − 0.005 mmol/L per year [95% confidence interval (CI) − 0.007, − 0.003] for MHO after adjustment for a series of potential confounders. Furthermore, transiting to abnormality of blood glucose, but not high blood pressure, was associated with lower cumulative average of HDL-C in MHN group, compared with those remained in metabolically healthy status. MHO and transiting from metabolically healthy to abnormality of blood glucose were associated with HDL-C in Chinese adults. III, cohort study.

The current review aimed to elucidate the role of diet in every stage of inflammatory bowel diseases, from aspects of prevention, treatment and rehabilitation. Western diet, characterized by overconsumption of refined sugar and saturated fat and low consumption of dietary fiber, may partly be blamed for its pathogenesis. Some immune-modulated nutrients (fibers, monounsaturated fatty acids, n-3 polyunsaturated fatty acids and vitamin D) exert their potential beneficial effects on gut microbiota and immune function, resulting in clinical remission and/or preventing relapse. However, data is limited to conclude optimal micronutrient levels and therapeutic implications. Further, diet itself is complex; therefore, it is reasonable to evaluate diet as a whole rather than a single type of food. Some specific dietary patterns are generated for the management of inflammatory bowel diseases with controversial results. Only exclusive enteral nutrition has been widely recommended for pediatric patients with non-stricturing active Crohn's disease. Self-monitoring, avoidance of certain types of foods, limited intake of alcohol and smoking, supplementation of minerals and vitamins if deficiency is confirmed, and adherence to the diet enriched in vegetables and fruits and low in animal food and un-digested fiber during flares are the most common dietary recommendation. Further clinical trials with a high evidence rank are warranted.

The current review aimed to elucidate the role of diet in every stage of inflammatory bowel diseases, from aspects of prevention, treatment and rehabilitation. Western diet, characterized by overconsumption of refined sugar and saturated fat and low consumption of dietary fiber, may partly be blamed for its pathogenesis. Some immune-modulated nutrients (fibers, monounsaturated fatty acids, n-3 polyunsaturated fatty acids and vitamin D) exert their potential beneficial effects on gut microbiota and immune function, resulting in clinical remission and/or preventing relapse. However, data is limited to conclude optimal micronutrient levels and therapeutic implications. Further, diet itself is complex; therefore, it is reasonable to evaluate diet as a whole rather than a single type of food. Some specific dietary patterns are generated for the management of inflammatory bowel diseases with controversial results. Only exclusive enteral nutrition has been widely recommended for pediatric patients with non-stricturing active Crohn's disease. Self-monitoring, avoidance of certain types of foods, limited intake of alcohol and smoking, supplementation of minerals and vitamins if deficiency is confirmed, and adherence to the diet enriched in vegetables and fruits and low in animal food and un-digested fiber during flares are the most common dietary recommendation. Further clinical trials with a high evidence rank are warranted.

目的:探讨老年人体质量指数(body mass index,BMI)、腰围(waist circumference,WC)与血尿酸水平及高尿酸血症(hyperuricemia,HUA)危险性的关系.方法:以上海市浦东新区曹路镇60周岁以上常住居民为研究对象.测量身高、体重和WC,并计算BMI.其他指标包括年龄、性别、收缩压、舒张压、臀围、空腹血糖、尿素氮、肌酐、总胆固醇、三酰甘油、丙氨酸转氨酶、天冬氨酸转氨酶和估算的肾小球滤过率.血清尿酸检测采用比色法:男性>416μmol/L或女性>357μmol/L诊断为HUA.BMI在24.0～28.0为超重,≥28.0为肥胖;WC男性≥85 cm、女性≥80 cm定义为腹型肥胖.分别采用广义线性回归和Logistic回归研究BMI和WC与血尿酸水平及HUA的关系,并控制混杂因素.结果:共8244名老年人纳入本研究(男性3125名、女性5119名),平均年龄(68.5±6.7)岁.控制混杂因素后,BMI和WC与血尿酸水平均呈正相关,老年女性BMI与尿酸的相关性(β=5.24±0.43)明显高于老年男性(β=4.54±0.62).老年男性WC与尿酸的相关性(β=1.13±0.32)高于老年女性(β=1.12±0.21).Logistic回归分析结果显示WC每增加1.0 cm,发生HUA的风险仅增加3％～4％[男性优势比(odds ratio,OR)=1.04,95％可信区间(confidence interval,CI):1.02～1.06;女性OR=1.03,95％CI:1.01～1.05];而BMI每增长1.0,发生HUA的风险增长11％～12％(男性OR=1.11,95％CI:1.06～1.16;女性OR=1.12,95％CI:1.08～1.16).BMI和WC对HUA的发生存在协同作用.与BMI和WC均正常的老年人相比,两者均升高的老年人发生HUA的危险性最高(OR=1.84,95％CI:1.53～2.22).结论:BMI和WC均与老年人HUA关系密切,但两者相比BMI较WC关联更加紧密.

Background and Purpose- CRP (C-reactive protein) is an inflammatory biomarker which predicts the risk of cardiovascular diseases. However, whether CRP is associated with carotid artery plaque (CAP) remains unclear. Methods- The current retrospective study was performed in 8229 Chinese aged adults (aged 65-99 years; 4677 men and 3552 women). hs-CRP (high-sensitivity CRP) concentrations were measured at baseline (2013), and further classified into 3 groups: low risk (<1.0 mg/L), intermediate risk (1.0-3.0 mg/L), and high risk (≥3.0 mg/L). Ultrasound B-mode imaging was repeatedly performed annually to detect CAP during 5-year follow-up (2013-2018). Potential confounders, including body mass index, blood pressure, fasting blood glucose, alanine transferase, aspartate transferase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin, direct bilirubin, blood urea nitrogen, creatinine, and uric acid, lipid profiles, were also collected at baseline. White blood cell was collected as well. We used a logistic regression model for the cross-sectional relation between CRP concentration and CAP status and proportional hazardous Cox model for prospective analyses. Results- Comparing to the low-risk group, the adjusted odds ratios for CAP was 1.66 (95% CI, 1.43-1.92) in the intermediate-risk group and 1.72 (95% CI, 1.39-2.13) in the high-risk group, after adjustment for potential confounders. We identified 512 incident CAP cases during 5-year follow-up. Each mg/L increase of hs-CRP was associated with a hazard ratio of 1.1 (95% CI, 1.03-1.17) to developing CAP. Sensitivity analysis generated similar results with prospective analyses after excluding participants with overweight and obesity, with elevated fasting blood glucose, LDL (low-density lipoprotein) cholesterol, and white blood cell. The association lost significant when we excluded participants with elevated blood pressure, however, few cases of CAP (n=41) was recruited in participants with normal blood pressure during follow-up. Conclusions- High hs-CRP concentration was associated with the high risk of developing CAP in Chinese aged adults.

Background and Objectives: Parents may play important roles in the regulation of children's weight status and consequently the development of childhood hypertension. Thus, this study aimed to examine parental weight status, as a marker of parents' diet and lifestyle, in relation to risk of hypertension in their children. Methods and Study Design: A total of 1,949 children aged 6 to 12 years (1,012 girls, 52%) and their parents were included. Information on demographics, anthropometrics, lifestyle, diet, and medical history were obtained from the participants and their parents through self-administered questionnaires. Childhood hypertension and elevated blood pressure were defined as SBP and/or DBP >= 95th and >= 90th age- and gender-specific percentile, respectively. Parental overweight was defined as BMI >= 24.0 kg/m(2). Results: The prevalence of childhood hypertension was 8.4%, with no significant gender difference (p=0.36). Parents' weight status, especially maternal, was associated with childhood hypertension. After adjustment for potential confounders, children with two parents being overweight were two times more likely to have hypertension as compared with children who had both parents being of normal weight [multivariable-adjusted odds ratio=2.09; 95% confidence interval: ( 1.26, 3.46)]. After further adjustment for children's body mass index, the observed association was substantially attenuated and became statistically non-significant. Conclusions: Findings from this study suggest that parental weight status is associated with the prevalence of hypertension in children presumably through influencing children's weight. Further studies are needed to establish causal inference. This study highlights the importance of parental lifestyle in children's health.

目的 考察系统性红斑狼疮(SLE)产妇孕期体重增长(GWG)对新生儿出生体重的影响.方法 以上海交通大学医学院附属仁济医院(我院)产科分娩的SLE产妇及其新生儿为研究对象.采集产妇一般情况(年龄、身高、孕前体重、教育程度、GWG、既往疾病史、分娩孕周)、第一次产检指标(收缩压、舒张压、胆固醇、甘油三酯、空腹血糖)、新生儿性别、Apgar评分及出生体重.根据年龄和教育程度1:3匹配健康产妇及其新生儿作为对照.产妇GWG与新生儿出生体重关系采用一般线性回归分析.结果 共纳入SLE产妇45例和健康产妇135例.所有产妇平均年龄(29.0±3.0)岁,新生儿平均出生体重(3198.8±501.8)g.SLE组GWG显著低于对照组,(12.4±5.5)kg vs(15.0±5.1)kg,P=0.004,GWG低于适宜体重增长的比例显著高于对照组(37.8％vs 16.3％,P<0.01).将所有产妇按GWG进行四分位分组,结果显示随着GWG增长,新生儿出生体重明显增加.与GWG处于最低四分位的SLE产妇相比,处于最高四分位的产妇的新生儿出生体重多(246.4±234.1)g,差异无统计学意义.结论 SLE产妇GWG明显低于正常产妇,随着GWG的增加,新生儿出生体重有增加趋势.

Background Diabetes has been reported to be associated with carotid artery plaque (CAP). However, it remains unclear whether hemoglobin A1c (HbA1c) level, a marker for long-term glycemic status, is associated with altered CAP risk in individuals with fasting blood glucose (FBG) concentrations below the current cutoff for diabetes. Methods Included were 16,863 Chinese adults (aged 18 years or more; 9855 men and 7008 women) with fasting blood glucose < 7.0 mmol/L at baseline (2013). Both HbA1c level and CAP (assessed via ultrasound B-mode imaging) were annually assessed during 2014–2018. All the participants were further classified into three groups based on baseline HbA1c level: ≤ 5.6%, 5.7–6.4%, and ≥ 6.5%. We used Cox proportional-hazards model to evaluate the association between HbA1c level and incident CAP, adjusting for a series of potential confounders. Results During 5 years of follow up, 3942 incident CAP cases were identified. Individuals with higher baseline HbA1c had higher future risk of CAP (p-trend < 0.001). In the full-adjusted model, each percent increase of HbA1c was associated with a 56% (HR = 1.56, 95% CI 1.37, 1.78) higher risk of CAP. Excluding participants with chronic inflammation, as assessed by high-sensitivity C-reactive protein and white blood cell, and those with FBG ≥ 5.6 mmol/L at baseline generated similar results. Conclusions Elevated HbA1c level was associated with high risk of developing CAP in Chinese adults without FBG defined diabetes.

We evaluated the association between parental factors (overweight, history of hypertension, and education level) and children’s blood pressure status. Further, we evaluated to what extent the potential association could be interpreted by children’s adiposity indices. The current study included 3316 Chinese school students (1579 girls and 1737 boys, aged 6–14 years) and their parents. Parents reported information on their height, body weight, history of hypertension, and the highest education level. Trained medical staff measured children’s blood pressure, height, body weight, waist circumference (WC), and percentage of body fat (PBF, assessed by bio-impedance method). Z-score of all three indices were calculated and used in the analysis. We used generalized linear model to evaluate the association between parental information and z-score of children’s blood pressure. Meditation analysis was used to evaluate the proportion contributed by z-score of children’s adiposity indices (BMI, WC, and PBF). We found that parental overweight and hypertension, but not parental education level, were significantly associated with children’s systolic and diastolic blood pressure (P < 0.05 for all). Approximately 30.4–92.2% of the association between these two parental factors and children’s systolic blood pressure were mediated by children’s adiposity indices, and 22.3–55.6% for children’s diastolic blood pressure. The strongest meditative factor, among the three obesity indices, was children’s BMI z-score. The association between parental factors and children’s blood pressure was mainly mediated by children’s adiposity indices.

BackgroundParents may play important roles in the regulation of children's weight status and consequently risk of childhood HTN. However, data relating parental dietary/lifestyle characteristics to risk of HTN in their children is sparse.ObjectiveUsing parental weight status as a marker of their dietary and lifestyle habits, we aimed to examine the association between parental weight status and risk of hypertension (HTN) in their children.MethodsA total of 1,949 children aged 6 to 12 years (1,012 girls) and their parents were enrolled. Information on demographics, anthropometrics, lifestyle, diet, and medical history were obtained from the participants and their parents through self‐administered questionnaires. Multivariable‐adjusted odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of prevalent HTN in children in relation to parental weight status are presented.ResultsThe HTN prevalence in children was 8.4%, with no significant gender difference (9.0% in boys vs. 7.8% in girls, P=0.36). After adjusting for potential confounders, parental overweight was significantly associated with risk of HTN in children. Compared with children who had both parents being normal weight, the risk of childhood HTN was increased by 94% (OR=1.94; 95% CI: 1.08, 3.50) for children with only father being overweight and 109% (OR=2.09; 95% CI: 1.26, 3.46) for children with both parents being overweight. The observed association was attenuated after further adjustment for children's body mass index.ConclusionsFindings from this cross‐sectional study suggest that parental BMI levels were associated with higher prevalence of HTN in their children through the mediation of children's BMI. Because parental weight status is a marker of the dietary and lifestyle choices in a family, actions focusing on improving health awareness and changing unhealthy habits among parents may exert critical influence on the risk of childhood HTN.Support or Funding InformationThis work was partially supported by a grant from the NIH (R01ES021735).This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

目的·研究胎盘质量与新生儿出生体质量的相关性.方法·以2015年1月—2017年12月于上海交通大学医学院附属仁济医院产科分娩的4187名新生儿及其母亲为研究对象.将所有纳入研究的新生儿按胎盘质量分为胎盘质量过轻(<P10)、胎盘质量正常(P10～P90)和胎盘质量过重(≥P90)共3组.依据医疗记录,采集新生儿(性别、出生体质量、胎盘质量、出生孕周)和母亲(年龄、孕期体质量增长、第1次产检时血压和血生化指标、产次)的临床数据.采用面对面调查法,收集母亲的身高、教育水平、既往病史及妊娠前体质量指数(6个月内)等相关数据.采用多因素一般线性回归模型(generalized linear model,GLM)研究胎盘质量和新生儿出生体质量的关系.采用Logistic回归模型研究胎盘质量对巨大儿及低体质量儿出生风险的影响.结果·最终纳入2948名新生儿及其母亲,母亲平均年龄为(29.3±4.0)岁,共计分娩男婴1552例(52.6％)和女婴1396例(47.4％);新生儿平均出生体质量为(3334.4±417.9)g,平均分娩孕周为(38.7±1.3)周.胎盘质量过轻组、胎盘质量正常组和胎盘质量过重组的新生儿平均出生体质量分别为(3238.1±481.5)g、(3342.6±395.8)g和(3449.8±423.8)g,组间差异具有统计学意义(P=0.000).多因素GLM结果显示,控制分娩孕周、母亲年龄、妊娠前体质量指数、孕期体质量增长等多种混杂因素后,与胎盘质量正常组的新生儿相比,胎盘质量过轻组新生儿出生体质量减少51.4(95％CI为16.0～86.8)g(P=0.000),胎盘质量过重组新生儿出生体质量则增加80.3(95％CI为34.1～126.6)g(P=0.000).巨大儿和低体质量儿的出生比例分别为4.8％ 和2.3％;Logistic回归分析结果显示,胎盘质量每增长92.0 g,可导致巨大儿出生风险增加36％(OR=1.36,95％CI为1.13～1.63),而低体质量儿的出生风险则降低42％(OR=0.58,95％CI为0.40～0.82).结论·胎盘质量与新生儿出生体质量密切相关.