Increased waist circumference and prevalence of type 2 diabetes and hypertension in Chinese adults: two population-based cross-sectional surveys in Shanghai, China

Increased waist circumference and prevalence of type 2 diabetes and hypertension in Chinese adults: two population-based cross-sectional surveys in Shanghai, China


Objective To evaluate the changes in body mass index (BMI) and waist circumference (WC) and their associations with the prevalence of hypertension and type 2 diabetes mellitus (T2DM) in Chinese adults.

Design 2 consecutive population-based cross-sectional surveys.

Setting A total of 12 districts and seven counties in Shanghai, China.

Participants 12 329 randomly selected participants of the survey in 2002–2003, and 7423 randomly selected participants of the survey in 2009. All participants were residents of Shanghai aged 35–74 years.

Outcome measures Measured BMI and WC. Previously diagnosed and newly identified hypertension and T2DM by measured blood pressure, fasting and postload glucose.

Results While the participants of the two surveys were comparable in BMI in each age group, the participants of the 2009 survey had significantly larger WC than those of the 2002–2003 survey, with an annual percentage change being higher among participants aged 45–49 years in men and women. The increase in prevalence of T2DM was observed in all age groups and also appeared more evident in participants aged 45–49 years. The prevalence of hypertension was observed to increase more rapidly in elderly men and middle-aged women. Obesity, both overt and central, was associated with the risk of the two diseases, but BMI was more strongly linked to hypertension while WC appeared more evidently related with T2DM.

Conclusions The prevalence of central obesity and related chronic diseases has been increasing in Shanghai, China. Our findings provide useful information for the projection of the growing burden of T2DM and hypertension in Chinese adults.

Size-fractionated particle number concentrations and daily mortality in a chinese city.

Size-fractionated particle number concentrations and daily mortality in a chinese city.

Background: Associations between airborne particles and health outcomes have been documented worldwide; however, there is limited information regarding health effects associated with different particle sizes.Objectives: We explored the association between size-fractionated particle number concentrations (PNCs) and daily mortality in Shenyang, China.Methods: We collected daily data on cause-specific mortality and PNCs for particles measuring 0.25-10 μm in diameter between 1 December 2006 and 30 November 2008. We used quasi-Poisson regression generalized additive models to estimate associations between PNCs and mortality, and we used natural spline smoothing functions to adjust for time-varying covariates and long-term and seasonal trends.Results: Mean numbers of daily deaths were 67, 32, and 7 for all natural causes, cardiovascular diseases, and respiratory diseases, respectively. Interquartile range (IQR) increases in PNCs for particles measuring 0.25-0.50 μm were significantly associated with total and cardiovascular mortality, but not respiratory mortality. Effect estimates were larger for PNCs during the warm season than the cool season, and increased with decreasing particle size. IQR increases in PNCs of 0.25-0.28 μm, 0.35-0.40 μm, and 0.45-0.50 μm particles were associated with 2.41% (95% CI: 1.23, 3.58%), 1.31% (95% CI: 0.52, 2.09%), and 0.45% (95% CI: 0.04, 0.87%) higher total mortality, respectively. Associations were generally stable after adjustment for mass concentrations of ambient particles and gaseous pollutants.Conclusions: Our findings suggest that particles < 0.5 μm in diameter may be most responsible for adverse health effects of particulate air pollution and that adverse health effects may increase with decreasing particle size

The biodiversity hypothesis and allergic disease: world allergy organization position statement.

The biodiversity hypothesis and allergic disease: world allergy organization position statement.

Biodiversity loss and climate change secondary to human activities are now being associated with various adverse health effects. However, less attention is being paid to the effects of biodiversity loss on environmental and commensal (indigenous) microbiotas. Metagenomic and other studies of healthy and diseased individuals reveal that reduced biodiversity and alterations in the composition of the gut and skin microbiota are associated with various inflammatory conditions, including asthma, allergic and inflammatory bowel diseases (IBD), type1 diabetes, and obesity. Altered indigenous microbiota and the general microbial deprivation characterizing the lifestyle of urban people in affluent countries appear to be risk factors for immune dysregulation and impaired tolerance. The risk is further enhanced by physical inactivity and a western diet poor in fresh fruit and vegetables, which may act in synergy with dysbiosis of the gut flora. Studies of immigrants moving from non-affluent to affluent regions indicate that tolerance mechanisms can rapidly become impaired in microbe-poor environments. The data on microbial deprivation and immune dysfunction as they relate to biodiversity loss are evaluated in this Statement of World Allergy Organization (WAO). We propose that biodiversity, the variability among living organisms from all sources are closely related, at both the macro- and micro-levels. Loss of the macrodiversity is associated with shrinking of the microdiversity, which is associated with alterations of the indigenous microbiota. Data on behavioural means to induce tolerance are outlined and a proposal made for a Global Allergy Plan to prevent and reduce the global allergy burden for affected individuals and the societies in which they live.

Climate Change and Our Environment: The Effect on Respiratory and Allergic Disease.

Climate Change and Our Environment: The Effect on Respiratory and Allergic Disease.

J Allergy Clin Immunol Pract. 2013 Mar;1(2):137-141.

Climate Change and Our Environment: The Effect on Respiratory and Allergic Disease.


Section of Allergy/Asthma/Immunology, Children’s Mercy Hospitals and Clinics, Kansas City.


Climate change is a constant and ongoing process. It is postulated that human activities have reached a point at which we are producing global climate change. This article provides suggestions to help the allergist/environmental physician integrate recommendations about improvements in outdoor and indoor air quality and the likely response to predicted alterations in the earth’s environment into their patient’s treatment plan. Many changes that affect respiratory disease are anticipated. Examples of responses to climate change include energy reduction retrofits in homes that could potentially affect exposure to allergens and irritants, more hot sunny days that increase ozone-related difficulties, and rises in sea level or altered rainfall patterns that increase exposure to damp indoor environments. Climate changes can also affect ecosystems, manifested as the appearance of stinging and biting arthropods in new areas. Higher ambient carbon dioxide concentrations, warmer temperatures, and changes in floristic zones could potentially increase exposure to ragweed and other outdoor allergens, whereas green practices such as composting can increase allergen and irritant exposure. Finally, increased energy costs may result in urban crowding and human source pollution, leading to changes in patterns of infectious respiratory illnesses. Improved governmental controls on airborne pollutants could lead to cleaner air and reduced respiratory diseases but will meet strong opposition because of their effect on business productivity. The allergy community must therefore adapt, as physician and research scientists always have, by anticipating the needs of patients and by adopting practices and research methods to meet changing environmental conditions.