Insufficient individual outdoor activity is common among older adults, yet research on the association between individual outdoor activity frequency and all-cause mortality among older adults remains limited. Therefore, we aimed to explore the association between individual outdoor activity frequency and all-cause mortality among older Chinese adults. We conducted a prospective cohort study using data from 8117 participants aged 65 years or above from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Accelerated failure time (AFT) models were used to assess the longitudinal association between individual outdoor activity frequency and all-cause mortality by using time ratios (TRs) and 95% confidence intervals (CIs). Subgroup analyses of the association were conducted by age, sex and residence. In addition, sensitivity analyses were performed to assess the robustness of main results. During a median follow-up period of 5.11 years, a total of 3893 (47.96%) participants died. Compared with participants who never engaged in individual outdoor activity, those who engaged rarely or sometimes (TR: 1.24, 95% CI: 1.10-1.40) and those who engaged regularly or almost every day (TR: 1.59, 95% CI: 1.48-1.70) had a statistically significant longer survival time in the fully adjusted model. Subgroup analyses showed consistent associations in nearly all strata. Sensitivity analyses confirmed the robustness of main results. Frequent participation in individual outdoor activity was significantly associated with longer survival time among older Chinese adults. Our findings support encouraging older adults to engage in regular individual outdoor activity for longevity benefits.

OBJECTIVE:To evaluate the longitudinal association between the Metabolic Score for Insulin Resistance (METS-IR) and the risk of diabetes mellitus in rural Chinese adults. METHODS:This retrospective cohort study included 53,120 participants aged ≥18 years from 2018 to 2023. Participants were stratified by quartiles of the METS-IR metrics. Cox proportional hazards models assessed the association between METS-IR and incident diabetes. Restricted cubic spline (RCS) models examined nonlinear trends. Subgroup analysis, interaction tests, and multiple sensitivity analyses were performed. Predictive ability was evaluated using time-dependent receiver operating characteristic (ROC) curves. RESULTS:During 176,413.4 person-years of follow-up (median 3.83 years), 14,397 participants developed diabetes. After multifactorial adjustment, METS-IR was significantly and positively associated with diabetes onset (hazard ratio (HR)=1.094,95% confidence interval (CI): 1.076-1.112, P < 0.001); those in the highest quartile group had a 1.435-fold higher risk compared to the lowest. RCS analysis revealed a nonlinear dose-response relationship. Kaplan-Meier curves confirmed increasing cumulative risk with higher METS-IR. Results remained robust across subgroups and sensitivity analyses. The area under the curve (AUC) for METS-IR predicting diabetes was 0.601 (1 year), 0.586 (3 years), and 0.599 (5 years). CONCLUSION:METS-IR is significantly correlated with the onset of diabetes, and the relationship is nonlinear. While it demonstrates limited discriminatory performance as a standalone screening tool, it remains suitable for initial risk stratification in primary health care institutions with limited resources.

OBJECTIVES:We aimed to explore the impact of lifestyle factors (LFs) on the transition from no cardiometabolic disease (CMD) to first CMD, subsequently to cardiometabolic multimorbidity (CMM), and then to death. STUDY DESIGN:Retrospective cohort study. METHODS:The data from the annual health checkup database for residents of the Electronic Health Management Center in Xinzheng, China. A total of 100,231 participants aged ≥40 years who were free of type 2 diabetes mellitus (T2DM), ischemic heart disease (IHD), and stroke at baseline were enrolled. CMM was defined as ≥2 diseases of T2DM, IHD, and stroke. We used multi-state models to explore the impact of LFs (smoking, drinking, dietary habits, physical activity, and body size) in different stages of CMD progression. RESULTS:During a mean follow-up of 4.19 years, 47272 participants developed at least one CMD, 10734 developed CMM, and 13378 died afterward. The hazard ratios (95 % confidence intervals) for each additional high-risk lifestyle factor for transitions from no CMD to first CMD and from first CMD to CMM were 1.44 (1.43-1.46) and 1.14 (1.12,1.17), while those for the risk of death for transitions from no CMD, first CMD, and CMM were 1.16 (0.92,1.46), 1.12 (1.06,1.17) and 1.25 (1.20,1.30). When first CMDs were further subdivided into T2DM, IHD, and stroke, we found that even at the same transition stage, the five high-risk LFs had different impacts on disease-specific transitions. CONCLUSIONS:Our findings emphasize the importance of incorporating comprehensive lifestyle interventions into the management of CMD in middle-aged and older adults.

BACKGROUND:The atherogenic index of plasma (AIP) has been shown to be positively correlated with cardiovascular disease in previous studies. However, it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease (CHD). Therefore, the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people. METHODS:19,194 participants aged ≥ 60 years who had three AIP measurements between 2018 and 2020 were included in this study. AIP was defined as log10 (triglyceride/high-density lipoprotein cholesterol). The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020. Cox proportional hazards models were used to estimate the hazard ratio (HR) with 95% CI of CHD events between different trajectory groups from 2020 to 2023. RESULTS:Three different trajectory patterns were identified through group-based trajectory model: the low-level group (n = 7410, mean AIP: -0.25 to -0.17), the medium-level group (n = 9981, mean AIP: 0.02-0.08), and the high-level group (n = 1803, mean AIP: 0.38-0.42). During a mean follow-up of 2.65 years, a total of 1391 participants developed CHD. After adjusting for potential confounders, compared with the participants in the low-level group, the HR with 95% CI of the medium-level group and the high-level group were estimated to be 1.24 (1.10-1.40) and 1.43 (1.19-1.73), respectively. These findings remained consistent in subgroup analyses and sensitivity analyses. CONCLUSIONS:There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly. This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.

The Chinese visceral adiposity index (CVAI), a favorable surrogate index for assessing visceral fat distribution and function, has been proven to be associated with various conditions, including diabetes mellitus, cardiovascular diseases, and strokes. Nevertheless, evidence on the association of CVAI with the risk of incident hypertension among older adults is limited. This study aimed to explore the association between CVAI and the risk of incident hypertension among older adults. Data were collected from the annual health examination dataset in Xinzheng, Henan Province from 2018 to 2023. A total of 10,353 participants aged ≥ 60 years were included. Cox proportional hazard models were used to examine the association between CVAI and the risk of incident hypertension by using hazard ratios (HRs) and 95

Abstract Background: The effect of baseline overweight and obesity status on cardiovascular disease(CVD) morbidity and adverse outcomes remains unclear. The aim of this study was to examine the association between overweight, obesity and CVD morbidity, mortality, and all-cause mortality in Chinese older individuals. Methods:This retrospective cohort study analyzed data from electronic health examination records of 86,049 older individuals aged ≥ 60 years in Xinzheng City, Henan Province, China, from January 2011 to December 2019. Cox proportional risk regression models and competing risk models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD morbidity and mortality, as well as all-cause mortality, in overweight and obese individuals. Restricted cubic splines were employed to evaluate dose-response associations. Results:During a median follow-up of 5.96 years, 35,731 older individuals were diagnosed with CVD. The total number of participant deaths was 17,029, with 7,605 deaths from CVD. The morbidity of CVD was higher in the overweight and obese groups compared to the normal BMI group, with HRs of 1.06(95%CI, 1.02-1.10) and 1.23(95%CI, 1.16-1.30), respectively. Competing risk models controlling for fatal events showed an increased morbidity of CVD in the overweight and obese groups, with HRs of 1.15(95%CI, 1.11-1.18) and 1.31(95%CI, 1.26-1.37), respectively. In contrast, the overweight group had a reduced risk of all-cause mortality and CVD mortality compared to the normal BMI group, with HRs of 0.91(95%CI, 0.88-0.94) and 0.89(95%CI, 0.82-0.97), respectively. The study found that the risk of all-cause mortality was lower in the obese group, with HRs of 0.89(95%CI, 0.82-0.97). Participants had the lowest risk of all-cause mortality and CVD mortality when their BMI was between 26 and 28 kg/m². The restricted cubic spline plots showed a J-shaped association between BMI and CVD morbidity and an inverse J-shaped association with CVD mortality and all-cause mortality. Conclusion:Overweight and obesity are positively correlated with the morbidity of CVD and negatively correlated with all-cause mortality in Chinese older individuals. However, it cannot be assumed that there is a negative correlation between obesity and CVD mortality. Therefore, obese individuals should aim to reduce weight appropriately, and overweight individuals should take appropriate measures to prevent obesity.

Cardiometabolic multimorbidity (CM), defined as the coexistence of two or three cardiometabolic disorders, is one of the most common and deleterious multimorbidities. This study aimed to investigate the association of Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with the prevalence of CM. The data were obtained from the 2021 health checkup database for residents of the Electronic Health Management Center in Xinzheng, Henan Province, China. 81,532 participants aged ≥ 60 years were included in this study. Logistic regression models were used to estimate the odd ratios (ORs) and 95% confidence intervals (CIs) for CUN-BAE, BMI, WC, and WHtR in CM. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory ability of different anthropometric indicators for CM. The multivariable-adjusted ORs (95% CIs) (per 1 SD increase) of CM were 1.799 (1.710–1.893) for CUN-BAE, 1.329 (1.295–1.364) for BMI, 1.343 (1.308–1.378) for WC, and 1.314 (1.280–1.349) for WHtR, respectively. Compared with BMI, WC and WHtR, CUN-BAE had the highest AUC in both males and females (AUC: 0.642; 95% CI 0.630–0.653 for males, AUC: 0.614; 95% CI 0.630–0.653 for females). CUN-BAE may be a better measure of the adverse effect of adiposity on the prevalence of CM than BMI, WC, and WHtR.

The association between fasting plasma glucose (FPG), an important indicator of overall glycemic status, and the risk of cardiovascular mortality has been well investigated. The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. This study aimed to identify long-term FPG trajectories and investigate the association between trajectory groups and cardiovascular and all-cause mortality. A latent class growth mixture modeling (LCGMM) was used to identify FPG trajectories. Cox proportional hazard models were used to estimate associations between FPG trajectories and the risk of all-cause and cardiovascular mortality. A U-shaped relationship between FPG and all-cause and cardiovascular mortality was observed in the restricted cubic spline regression models. Two FPG longitudinal trajectories of low-level (mean FPG = 5.12mmol/L) and high-level (mean FPG = 6.74mmol/L) were identified by LCGMM. After being adjusted for potential confounders, compared with the low-level category, the hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.23(1.16–1.30) and 1.25(1.16–1.35), respectively, for the high-level group. Long-term FPG trajectories are significantly associated with and potentially impact the risk of all-cause and cardiovascular mortality.

BackgroundThe impact of baseline triglyceride-glucose (TyG) index and abnormal low or high-density lipoprotein cholesterol (LDL-C or HDL-C) levels on all-cause and cardiovascular disease (CVD) mortality remains unclear. This study aimed to investigate the relationship between TyG index and LDL-C or HDL-C and all-cause and CVD mortality.MethodsThis retrospective cohort study analyzed data from health examinations of 69,068 older adults aged ≥60 in Xinzheng City, Henan Province, China, between January 2013 and January 2023. Cox proportional risk regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the TyG index and LDL-C or HDL-C about all-cause and CVD mortality. Restricted cubic spline was used to assess the dose-response relationship.ResultsDuring 400,094 person-years of follow-up (median follow-up 5.8 years [interquartile range 3.0-9.12]), 13,664 deaths were recorded, of which 7,045 were due to CVD. Compared with participants in the second quartile of the TyG index, participants in the fourth quartile had a 16% increased risk of all-cause mortality (HR: 1.16, 95% CI: 1.12,1.22), and an 8% increased risk of CVD mortality (HR: 1.08, 95% CI: 1.01,1.16). Similar results were observed in LDL-C and HDL-C, with all-cause and CVD mortality risks for participants in the fourth quartile compared with participants in the third quartile for LDL-C of (HR: 1.07, 95% CI: 1.02,1.12) and (HR: 1.09, 95% CI: 1.01,1.17), respectively. The risk of all-cause and CVD mortality in participants in the fourth quartile group compared with those in the second HDL-C quartile group was (HR: 1.10, 95% CI: 1.05,1.16) and (HR: 1.11, 95% CI: 1.04,1.18), respectively. We found that the TyG index was nonlinearly associated with all-cause and CVD mortality (P non-linear <0.05), and LDL-C was nonlinearly associated with all-cause mortality (P non-linear <0.05) but linearly associated with CVD mortality (P non-linear >0.05). HDL-C, on the other hand, was in contrast to LDL-C, which showed a non-linear association with CVD mortality. We did not observe a significant interaction between TyG index and LDL-C or HDL-C (P >0.05).ConclusionTyG index and LDL-C or HDL-C increased the risk of all-cause and CVD mortality, especially a high TyG index combined with abnormal LDL-C.

Purpose:Previous studies have shown that metabolically healthy obesity (MHO) and changes in its status are connected to an increased incidence of cardiovascular disease (CVD). Yet, fewer studies have been conducted in China, especially for the middle-aged and elderly population, a high-risk group. The purpose of the study was to investigate the association between metabolic health status and CVD events.Patients and Methods:A total of 46,055 participants were categorized into 6 subgroups with different metabolic states according to the existence of metabolic syndrome and body mass index (BMI). The changes in obesity and metabolic health status were defined from baseline to follow-up outcomes with a combination of overweight and obesity. Cox proportional hazards models estimated the association of CVD events and each BMI-metabolic groups.Results:MHO and metabolic abnormality normal weight (MANW) subjects had a higher HR of CVD, 1.62 (95% CI, 1.36-1.92) and 1.24 (95% CI, 1.07-1.44), respectively, than their metabolically healthy normal weight (MHNW) counterparts. Then, more than 50% and 30% of the metabolically healthy overweight or obesity (MHOO) populations maintained their status and converted to a metabolically unhealthy state, respectively. Stable MANW, MHOO and metabolically abnormal obesity (MAO) were associated with a higher risk for CVD, 1.68 (95% CI, 1.37-2.05),1.26 (95% CI, 1.08-1.47) and 1.65 (95% CI, 1.45-1.88), respectively, than stable MHNW.Conclusion:Despite being of normal weight, MANW status is in fact a risk factor for CVD, as well as MHO, especially for the Chinese middle-aged and elderly population. Furthermore, metabolic health is a transient state for partial middle-aged and elderly Chinese individuals, and MAO has the highest risk of CVD, including coronary heart disease (CHD) and stroke.

我国是全世界老年人口规模最大的国家,也是老年人口增加最快的国家[1].2000-2018年,60岁及以上老年人口从1.26亿人增加到2.49亿人,老年人口占总人口的比重从10.2％上升至17.9％[2].伴随人口老龄化的到来,中国老龄事业十二五发展规划提出了探索"医养结合"的新模式,医养结合机构是指兼具医疗卫生资质和养老服务能力的医疗机构或养老机构,主要为入住机构的老年人提供养老、医疗、护理、康复与心理精神支持等服务.

ObjectivesThe body roundness index (BRI) is a novel anthropometric index that is a better indicator for predicting fat distribution than the body mass index (BMI). The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. However, few population-based, longitudinal studies of BRI have been conducted, especially among the Chinese population. The study aimed to investigate the association of BRI and its longitudinal trajectories with all-cause and cardiovascular mortality.MethodsA total of 71,166 participants with four times BRI measurements between January 2010 and December 2019 were included in this longitudinal study, with a median follow-up was 7.93 years, and 11,538 deaths were recorded, of which 5,892 deaths were due to cardiovascular disease (CVD). A latent class growth mixture modeling (LCGMM) was used to identify BRI trajectories. Cox proportional hazard models were used to estimate associations between BRI trajectories and the risk of all-cause and cardiovascular mortality.ResultsIn the restricted cubic spline regression models, a U-shaped relationship between BRI and all-cause and cardiovascular mortality was observed. Three BRI longitudinal trajectories of low-stable (mean BRI = 2.59), moderate-stable (mean BRI = 3.30), and high-stable (mean BRI = 3.65) were identified by LCGMM. After being adjusted for potential confounders, the HRs for all-cause mortality were 1.18 (1.13–1.24) for the moderate-stable group and 1.74 (1.66–1.82) for the high-stable group compared to the low-stable group. The HRs for cardiovascular mortality were 1.12 (1.05–1.18) for the moderate-stable group and 1.64 (1.53–1.75) for the high-stable group compared to the low-stable group.ConclusionA nonlinear association of BRI with all-cause and cardiovascular mortality was observed, and participants in the higher BRI longitudinal trajectory group were significantly associated with an increased risk of all-cause and cardiovascular mortality.

Background: Non-alcoholic fatty liver disease (NAFLD) represents a large and growing public health problem. Insulin resistance (IR) plays a crucial role in the pathogenesis of NAFLD. The aim of this study was to determine the association of triglyceride-glucose (TyG) index, TyG index with body mass index (TyG-BMI), lipid accumulation product (LAP), visceral adiposity index (VAI), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-c) and metabolic score for IR (METS-IR) with NAFLD in older adults and to compare the discriminatory abilities of these six IR surrogates for NAFLD.Methods: This cross-sectional study included 72,225 subjects aged >= 60 years living in Xinzheng, Henan Province, from January 2021 to December 2021. The data were collected from the annual health examination dataset. Logistic regression models were used to examine the relationships between the six indicators and NAFLD risk. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory ability of different IR surrogates for NAFLD under the influence of potential risk factors.Results: After adjusting for multiple covariates, compared with the first quintile, the odds ratios (ORs) and 95% confidence intervals (CIs) of the highest quintiles of TyG-BMI were the most obvious (OR:43.02, 95% CI:38.89-47.72), followed by the METS-IR (OR:34.49, 95% CI:31.41-37.95). Restricted cubic spline analysis reported that there were non-linear positive association and dose-response relationship between 6 IR surrogates and NAFLD risk. Compared with other IR-related indicators (LAP, TyG, TG/HDL-c and VAI), TyG-BMI showed the highest AUC (AUC:0.8059;95% CI:0.8025-0.8094). Additionally, METS-IR also had a high predictive performance for NAFLD, and the AUC was greater than 0.75 (AUC:0.7959;95% CI:0.7923-0.7994). Conclusion: TyG-BMI and METS-IR had pronounced discrimination ability to NAFLD, which are recommended as complementary markers for the assessment of NAFLD risk both in clinic and in future epidemiological studies.

Background The prevalence of obesity, hypertension and diabetes is increasing. Hypertension and diabetes are common complications. Additionally, obesity and hypertension–diabetes comorbidity (HDC) are both closely related to insulin resistance. The aim of this study was to determine the association of obesity indicators with HDC in elderly individuals. Methods This retrospective cohort study included 74,955 subjects aged ≥ 60 years living in Xinzheng, Henan Province, from January 2011 to December 2019. The data were collected from the annual health examination dataset. Cox proportional hazard regression models and competing-risk survival regression models were used to examine the relationships between the three indicators and HDC risk. Results After 346,504 person-years of follow-up, HDC developed in 9,647 subjects. After further adjustments for confounders and death competing risks, compared with a body mass index (BMI) of 18.5–23.9 kg/m 2 , the fully adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of BMI < 18.5, 24–27.9 and ≥ 28 kg/m 2 for HDC morbidity were 0.651(0.538,0.788),1.00,1.396(1.336,1.459) and 1.769(1.666,1.878), respectively. Moreover, participants with abdominal obesity measured via waist circumference (WC) or waist-to-height ratio (WtHR) had a higher risk of HDC (HR:1.513; 95% CI: 1.45,1.578 and HR:1.412;95% CI: 1.353,1.473), respectively, than participants with low WC or with low WtHR. In the joint analyses, the highest risk was observed in participants who were overweight and who had central obesity (HR: 1.721; 95% CI: 1.635, 1.811) compared with the nonoverweight and noncentral obesity groups. Conclusions Increased BMI, WC and WtHR were associated with an increased risk of HDC. There was an additive interaction between general body adiposity (as measured via BMI) and central obesity (as measured via WC and WtHR) for HDC. Therefore, reasonable control of BMI, WC and WtHR may be an effective measure to prevent HDC among elderly individuals.

目的 了解分析2016-2020年河南省三级公立医院床位资源配置状况和利用效率,为改善床位资源利用不均和促进床位资源高效利用提供参考依据.方法 采用描述性统计、床位效率指数和床位利用模型,分析河南省各类别三级公立医院床位配置状况和利用效率.结果 2016-2020年河南省三级公立医院床位数累积增长26％,每千人口床位数增长了0.27张,并且床位周转速度加快,平均住院日有所下降.三级公立医院床位整体处于高效率运行状态,其中综合医院和专科医院床位运行效率较高,中医医院床位运行效率相对较低,不同地市间床位利用效率存在较大差异.结论 科学统筹区域间三级公立医院床位配置,提升床位资源配置的公平性,改善床位利用不均现状;加强中医医院医疗水平建设,促进中医医院床位高效利用.

目的:探讨河南省老年人自我医疗状况及影响因素.方法:采用多阶段整群随机抽样抽取7597名河南省60岁及以上老年人为研究对象,对"两周内是否因为不舒服用药或采取自我医疗措施"进行家庭健康调查,基于传统安德森卫生服务行为模型进行Logistic回归分析.结果:7957人中,有自我医疗行为2606人(32.75％);日常居住地为农村(OR=0.518,95％CI:0.454～0.592)、城乡居民医保(OR=0.514,95％CI:0.443～0.597)的老年人选择自我医疗的倾向性较低;年龄在70～79岁(OR=1.168,95％CI:1.032～1.322)、女性(OR=1.173,95％CI:1.046～1.315)、近1 a没有接受健康体检(OR=1.144,95％CI:1.019～1.284)、从家到最近医疗机构的时间在11～30 min(OR=1.215,95％CI:1.023～1.444)和>30 min(OR=2.237,95％CI:1.094～4.577)、患1种慢性病(OR=10.370,95％CI:8.877～12.115)和患≥2种慢性病(OR=28.167,95％CI:23.673～33.514)的老年人更倾向进行自我医疗.结论:年龄、性别、日常居住地、近1a健康体检情况以及就医便利程度、医保类型、慢性病种数是影响河南省老年人自我医疗行为的主要因素.

Objective To explore the factors of the TCM constitution of hypertension in elders aged ≥60 and to provide a reference basis for preventing and treating hypertension in elders.Methods Retrospective data collection from health records of residents aged ≥60 in Xinzheng,Henan Province,from January to December 2021,including 60 510 study subjects. The χ2 test was used to compare the differences between the two groups. A binary Logistic regression model was established to analyze the TCM constitution factors of hypertension in the elders. Results The univariate analysis showed that gender,age,marital status and qi deficiency,yang deficiency,phlegm-dampness,static-blood,qi-stagnation constitution,and mild constitution were associated with hypertension in the elders,with statistically significant differences（all P＜0.05）. Logistic regression analysis showed that: the prevalence of hypertension in people aged ≥60 was 43.9%（26 579/60 510）. The constitution risk factor for hypertension in males was phlegm-dampness constitution（OR=1.649,95% CI: 1.571-1.731）,and the protective factor for hypertension was mild constitution（OR=0.723,95% CI: 0.677-0.772）,qi deficiency constitution（OR=0.767,95% CI:0.712-0.827） and yang deficiency constitution（OR=0.793,95% CI: 0.732-0.860）; the risk factors for the hypertensive constitution in women were phlegm-dampness constitution（OR=1.539,95% CI:1.470-1.611） and static-blood constitution（OR=1.341,95% CI: 1.209-1.487）; the protective factors for hypertensive constitution were mild constitution（OR=0.714,95% CI: 0.671-0.759）,yang deficiency constitution（OR=0.782,95% CI: 0.727-0.841） and qi deficiency constitution（OR=0.927,95% CI: 0.868-0.990）. Conclusion The TCM constitution influences factors of hypertension in the elders,including the phlegm-dampness constitution,static-blood constitution,yang deficiency constitution,qi deficiency constitution,mild constitution. The prevention and treatment of hypertension in the elders should be varied according to gender.

Objectives: Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) is considered to be a more accurate indicator of body fat estimation. We aimed to investigate the association of CUN-BAE with the risk of type 2 diabetes mellitus (T2DM) and to compare the strength of the association between CUN-BAE, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and T2DM.Methods: The data were obtained from the annual health checkup database of residents in Xinzheng, China. From January 2011 to December 2021, 80,555 subjects aged ≥45 years met the inclusion criteria. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CUN-BAE, BMI, WC, and WHtR in T2DM.Results: During a mean follow-up of 6.26 years, T2DM occurred in 12,967 subjects. The multivariable-adjusted HRs (95% CIs) of T2DM (highest vs. reference group) were 1.994 (1.811–2.196) for CUN-BAE, 1.751 (1.665–1.842) for WC, 1.715 (1.631–1.804) for WHtR, and 1.510 (1.436–1.588) for BMI, respectively. In addition, the risk of T2DM increased with baseline CUN-BAE (HR: 1.374; 95% CI: 1.328, 1.421), WC (HR: 1.236; 95% CI: 1.215, 1.256), WHtR (HR: 1.228; 95% CI: 1.208, 1.248), and BMI (HR: 1.175; 95% CI: 1.156, 1.195).Conclusion: Compared to BMI, WC or WHtR, CUN-BAE may more adequately reflect the adverse effects of adiposity on the risk of T2DM.

目的 分析医保对河南省城乡居民住院情况的影响,为政策制定机构提供相关参考依据.方法 本文基于河南省第六次卫生服务调查数据中的住院情况、医保类型以及相关基线资料,采用单因素分析和二元logistic回归模型进行统计分析.结果 本研究共纳入29 786名河南省城乡居民,结果显示,相对于参比组(参比组为没有医疗保险的居民),有城镇职工基本医疗保险的居民住院的可能性是参比组的1.739倍(P＜0.001,95％CI:1.535～1.971);有城乡居民基本医疗保险的居民住院的可能性是参比组的是1.456倍(P＜0.001,95％CI:1.320～1.625);有新农合的居民住院的可能性是参比组的1.259倍(P＜0.001,95％CI:1.130～1.403).有商业医疗保险的居民住院的可能性则相对更低(OR=0.781,95％CI:0.693～0.881;P＜0.001).结论 医疗保险对城乡居民住院行为影响显著,释放了居民的就医需求,提高了国民健康水平.