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CONTEXT: All types of caloric restriction are preventive against cardiovascular risk factors, but the best restriction method and most affected factors have not been identified. OBJECTIVE: The objective of this study was to explore the effects of different caloric restriction methods on various cardiovascular risk factors by horizontally comparing program advantages and disadvantages via network meta-analysis. DATA SOURCES: The PubMed, Web of Science, Cochrane Library, and Embase literature databases were searched (October 2013 to October 2023). DATA EXTRACTION: Eligible randomized controlled trials involving participants who underwent caloric restriction and systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and high-density lipoprotein (HDL) cholesterol level measurements were included. DATA ANALYSIS: Thirty-six of 13 208 records (0.27%) were included. Two researchers reviewed the articles, extracted data, and assessed article quality. RESULTS: Alternate-day fasting (ADF) reduced SBP (4.88 mmHg; CI, 2.06-7.15) and DBP (5.10 mmHg; CI, 2.44-7.76). Time-restricted eating reduced SBP (2.46 mmHg; CI, 0.16-4.76) but not DBP. Continuous energy restriction (CER) significantly reduced BMI (1.11 kg/m2; CI = 0.16, 2.06) and waist circumference (3.28 cm; CI, 0.62-5.94). CONCLUSIONS: This meta-analysis confirmed the preventive effect of CER and ADF on various cardiovascular risk factors. Additionally, CER is more likely to reduce obesity, and ADF is more likely to reduce blood pressure (BP). Based on this meta-analysis, CER is recommended to control obesity only for people who are obese and do not have elevated BP or other abnormal indicators. Additionally, ADF for early control or prevention is recommended for patients who have abnormal BP or other cardiovascular risk factors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42023455889.

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Peripheral nerve injury is a debilitating condition that have a profound impact on the overall quality of an individual's life. The repair of peripheral nerve defects continues to present significant challenges in the field. Iron oxide magnetic nanoparticles (IONPs) have been recognized as potent nanotools for promoting the regeneration of peripheral nerves due to their capability as biological carriers and their ability to template the hydrogel structure under an external magnetic field. This research used a fibrin nanofiber hydrogel loaded with IONPs (IONPs/fibrin) to promote the regeneration of peripheral nerves in rats. In vitro examination of PC12 cells on various concentrations of IONPs/fibrin hydrogels revealed a remarkable increase in NGF and VEGF expression at 2% IONPs concentration. The biocompatibility and degradation of 2% IONPs/fibrin hydrogel were assessed using the in vivo imaging system, demonstrating subcutaneous degradation within a week without immediate inflammation. Bridging a 10-mm sciatic nerve gap in Sprague Dawley rats with 2% IONPs/fibrin hydrogel led to satisfactory morphological recovery of myelinated nerve fibers. And motor functional recovery in the 2% IONPs/fibrin group was comparable to autografts at 6, 9 and 12 weeks postoperatively. Hence, the composite fibrin hydrogel incorporating 2% IONPs exhibits potential for peripheral nerve regeneration.

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Despite the well-established associations between adolescents' internalizing symptoms and career development, it still remains unclear whether adolescents' internalizing symptoms are precursors or consequences of their career adaptability/ambivalence. Subtler nuance inherent within such association also await to be revealed, because internalizing symptoms and career development have been primarily treated as broad constructs, despite the multifaceted nature of both. To narrow such gaps, this study examined the potentially dynamic associations among career adaptability, career ambivalence, and internalizing symptoms using three-wave longitudinal data. The study collected data from 3196 Chinese adolescents (52.72% girls, mean age = 15.56 years, SD = 0.58) at Wave 1, with 2820 (attrition rate = 11.76%) participating in Wave 2 and 2568 (attrition rate = 8.93%) in Wave 3. The measurement invariance suggested that there were no significant differences across both waves and genders. This study approached associations at both broader construct levels and subtler dimension levels. Results of cross-lagged path models at broader construct levels demonstrated a unidirectional association between internalizing symptoms and career adaptability. Results of models at subtler dimension levels indicated a series of transactional links over time between career adaptability dimensions/ambivalence and depressive symptoms in particular. Career adaptability dimensions and career ambivalence predicted later anxiety symptoms rather than the reverse. Group model comparisons showed no difference across waves and genders. These findings shed light on the dynamic nature of the associations during adolescence between career adaptability/ambivalence and internalizing symptoms, particularly at subtler dimensional levels, which should be considered in relevant clinical and educational practices.

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BACKGROUND: The prevalence of diabetes and obesity has been continuously rising worldwide over the last three decades, particularly in China. The prevalence varies widely among different ethnicities. In this study, we investigated the prevalence of diabetes and obesity, as well as the associated factors for diabetes in Kazakh adults in Xinjiang to improve diabetes screening. METHODS: We collected data from the Xinjiang physical examination in 2018, including a total sample of 118,505 Kazakh adults in Altay District. Data on demographic characteristics, medical history, physical examination, fasting plasma glucose (FPG) and serum lipid profiles were collected. The chi-square test was used to examine the differences between multiple variables. Multivariate logistic regression was performed to identify the factors associated with diabetes. RESULTS: The mean age was 43. 66 years (SD 14.14). 49.3% of the population were women and 75.5% were rural residents. The mean FPG was 5.33 mmol/L (SD 1.22). The prevalence of diabetes was 6.3% and 4.1% received a new diagnosis by FPG. 26.6% were diagnosed with impaired fasting glucose (IFG). The mean body mass index (BMI) was 26.29 kg/m2 (SD 14.14) and the mean waist circumference was 87.69 cm (SD 12.74). 33.2% of the population were overweight, and 33.0% were obese. The prevalence of central obesity was 51.4%. Diabetes was mostly positively associated with hypertension (OR = 3.821, P<0.001), hypertriglyceridemia (OR = 2.757, P<0.001), and hyper-LDL-cholesterolemia (OR = 2.331, P<0.001) in the Kazakh population. The ORs for overweight, obesity and central obesity predictive of diabetes were 1.265, 1.453 and 1.222 ( all P<0.001), respectively. CONCLUSIONS: Despite having a high prevalence of obesity and central obesity, the Kazakh population had a considerably low prevalence of diabetes. Obesity was not the most important risk factor for diabetes in Kazakh individuals. The awareness of diabetes was low. When screening for diabetes in Kazakhs, those with hypertension or dyslipidemia should receive more attention.

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OBJECTIVE: To analyse and discuss the association of gender differences with the risk and incidence of poststroke aphasia (PSA) and its types, and to provide evidence-based guidance for the prevention and treatment of poststroke aphasia in clinical practice. DATA SOURCES: Embase, PubMed, Cochrane Library and Web of Science were searched from January 1, 2002, to December 1, 2023. STUDY SELECTION: Including the total number of strokes, aphasia, the number of different sexes or the number of PSA corresponding to different sex. DATA EXTRACTION: Studies with missing data, aphasia caused by nonstroke and noncompliance with the requirements of literature types were excluded. DATA SYNTHESIS: 36 papers were included, from 19 countries. The analysis of 168,259 patients with stroke and 31,058 patients with PSA showed that the risk of PSA was 1.23 times higher in female than in male (OR = 1.23, 95% CI = 1.19-1.29, P < 0.001), with a prevalence of PSA of 31% in men and 36% in women, and an overall prevalence of 34% (P < 0.001). Analysis of the risk of the different types of aphasia in 1,048 patients with PSA showed a high risk in females for global, broca and Wenicke aphasia, and a high risk in males for anomic, conductive and transcortical aphasia, which was not statistically significant by meta-analysis. The incidence of global aphasia (males vs. females, 29% vs. 32%) and broca aphasia (17% vs 19%) were higher in females, and anomic aphasia (19% vs 14%) was higher in males, which was statistically significant (P < 0.05). CONCLUSIONS: There are gender differences in the incidence and types of PSA. The risk of PSA in female is higher than that in male.

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Chinese national music is unique to China, and in the past, the single means of distribution and the audience led to the fact that knowledge of Chinese culture and history was limited to national musicians and a subset of fans. With the rapid development of the internet, the dissemination of Chinese national music is no longer limited to live performances, but is beginning to shift to media platforms. Social media has had a tremendous impact on Chinese music culture; people can search for any information they need about Chinese music. With the advancement of social media, groups of internet celebrities such as wanghong () have formed on the internet. This study systematically reviews platformisation and the social media in Chinese national music. Past literature and current notions on Chinese national music development under platformisation are examined given the essentiality of smart devices in developing music through digital technology. The study posed three research questions: 1.What is the current state of development of Chinese national music? What opportunities does platformisation bring to Chinese national music? 2.What areas are the focus for research on platformisation and social media? What is the impact on the music field? 3.What is the history of the development of the Chinese wanghong phenomenon? What impact has it made on Chinese national music? A general systematic review of scholarly articles was conducted for this study using multiple publications from reputable databases: Scopus, Web of Science and CNKI (China National Knowledge Infrastructure). The articles were categorised based on scholarly works involving platforms, platformisation, Chinese national music, social media, and wanghong to determine past study profiles in this domain and relevant knowledge gaps.

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Background: Breathing exercises improve oxidative stress in healthy young adults and patients with diabetes, hypertension, and chronic obstructive pulmonary disease. Furthermore, the mechanism of respiratory intervention is controversial. Therefore, in this meta-analysis, we aimed to systematically evaluate the effects of breathing exercises on oxidative stress biomarkers in humans and provide evidence for the clinical application of breathing exercises. Methods: The Embase, PubMed, Cochrane Library, Web of Science, CNKI, and WANFANG databases were searched for studies about the effects of breathing exercises on human oxidative stress levels, with no restraints regarding time, race, or language. The experimental group included various breathing exercises, and the outcome index included malondialdehyde, superoxide dismutase, and glutathione, nitric oxide, vitamin C, or total antioxidant capacity levels from a randomized controlled trial. Data were extracted by more than two authors and reviewed by one author. Results: Ten studies were included from five countries. Data from patients with no disease, chronic obstructive pulmonary disease, hypertension, or diabetes were included. Participants who performed breathing exercises had greater changes in the included biomarkers than those who did not, suggesting that these biomarkers can be used to evaluate oxidative stress after respiratory interventions. Conclusion: Breathing exercises increased SOD and GSH activities and decreased MDA content. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337119, identifier CRD42022337119.

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BACKGROUND: The interparental conflict has been associated with an increased adolescents' engagement in risk-taking behaviors. However, few studies have examined the potential mediation of deviant peer affiliation and the potential moderation of school climate. Grounded in the ecological system theory, this study aimed to explore the mediating role of deviant peer affiliation and the moderating role of school climate between the association of interparental conflict and risk-taking behavior. METHODS: This study conducted a longitudinal design (3 time points, 3 months apart) with the sample comprising 550 middle school students in southeastern China (52.91% males; mean age at Time 1 = 15.37). The performed measurements encompassed interparental conflict (T1), deviant peer affiliation (T2), school climate (T3), risk-taking behavior (T1/T2/T3), and demographic information. RESULTS: The moderated mediation model revealed that after controlling for T1/T2 risk-taking behavior, T1 interparental conflict was longitudinally and positively correlated with T3 risk-taking behavior through T2 deviant peer affiliation. Furthermore, moderated mediation analysis demonstrated that a positive school climate ameliorated the adverse impact of deviant peer affiliation on risk-taking behavior, thereby mitigating the indirect effect of interparental conflict on risk-taking behavior among adolescents. CONCLUSIONS: Our findings propose a nuanced explanation of the processing mechanisms between interparental conflict and risk-taking behaviors among Chinese adolescents. The theoretical and practical implications of the findings are discussed.

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Introduction: The multiple Exp-function scheme is employed for searching the multiple soliton solutions for the fractional generalized Calogero-Bogoyavlenskii-Schiff-Bogoyavlensky- Konopelchenko equation. Objectives: Moreover, the Hirota bilinear technique is utilized to detecting the lump and interaction with two stripe soliton solutions. Methods: The multiple Exp-function scheme and also, the semi-inverse variational principle will be used for the considered equation. Results: We have obtained more than twelve sets of solutions including a combination of two positive functions as polynomial and two exponential functions. The graphs for various fractional-order α are designed to contain three dimensional, density, and y-curves plots. Then, the classes of rogue waves-type solutions to the fractional generalized Calogero-Bogoyavlenskii-Schiff-Bogoyavlensky- Konopelchenko equation within the frame of the bilinear equation, is found. Conclusion: Finally, a direct method which is called the semi-inverse variational principle method was used to obtain solitary waves of this considered model. These results can help us better understand interesting physical phenomena and mechanism. The dynamical structures of these gained lump and its interaction soliton solutions are analyzed and indicated in graphs by choosing suitable amounts. The existence conditions are employed to discuss the available got solutions.

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Long noncoding RNA (lncRNA) plays an important role in multiple cancers. So far, the exact function of lncRNAs in papillary thyroid carcinoma (PTC) is unclear. The purposes of this work were to investigate the function and underlying mechanisms of RNF185 antisense RNA 1 (RNF185-AS1) in PTC. The expression of RNF185-AS1 was analyzed by quantitative real-time PCR (qRT-PCR). Colony formation, 5-ethynyl-2'-deoxyuridine, and Cell Counting Kit-8 assays were utilized to determine cell proliferation. Cell migration and invasion were tested using wound healing and transwell assays. A mouse transplantation tumor model was used for tumor growth analyses in vivo. The regulation of RNF185-AS1 on the downstream miR-429/lipoprotein receptor-related protein (LRP4) axis was predicted and identified through bioinformatic analysis, dual-luciferase reporter assay, and RNA immunoprecipitation (RIP) assay. RNF185-AS1 was dramatically overexpressed in PTC tumors and cells. High RNF185-AS1 expression was associated with bigger tumor size, lymph node metastasis, and advanced tumor-node-metastasis stage in PTC patients. Silencing of RNF185-AS1 impeded the proliferation, migration, and invasion in vitro and constrained tumorigenesis in vivo. Mechanistically, RNF185-AS1 could act as a sponge of miR-429 to regulate the expression of LRP4. In addition, downregulation of miR-429 or upregulation of LRP4 could relieve the proliferation, migration, and invasion of IHH-4 and TPC-1 cells that inhibited by RNF185-AS1 knockdown. Downregulation of RNF185-AS1 may suppress PTC progression through functioning as a sponge of miR-429 to hinder the expression of LRP4. The RNF185-AS1/miR-429/LRP4 axis will lay the groundwork for future therapeutic strategies in PTC.

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INTRODUCTION: Although poor parental supervision has been associated with an increased adolescents' propensity for risk-taking behavior, few researchers have investigated nuanced mechanisms of how and for whom from the perspective of "family × school." Inspired by ecological system theory and self-control theory, this study aimed to investigate the mediating role of self-control and the moderating role of school climate between the link between poor parental supervision and risk-taking behavior. METHODS: Four hundred and ninety-one Chinese adolescents (231 females, Mage = 15.39 ± 1.36) were recruited to participate in a three-wave longitudinal study (3 months apart) and complete questionnaires regarding poor parental supervision (W1), school climate (W1), self-control (W2), and risk-taking behavior (W1/W3). RESULTS: After controlling for W1 risk-taking behavior, our moderated mediation model indicated that W1 poor parental supervision was positively related to W3 risk-taking behavior by restraining the development of W2 self-control. Additionally, a high level of school climate as a protective factor buffered the negative impact of poor parental supervision on adolescents' self-control, further reducing risk-taking behavior. CONCLUSION: Our findings shed light on the processing mechanisms between poor parental supervision and risk-taking behavior among Chinese adolescents and underscore the importance of effective preventions and interventions to facilitate adolescents' healthy development.

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OBJECTIVE: In this study we aimed to propose a new computed tomography-based hemodynamic indicator to quantify the functional significance of aortic dissection and predict post intervention luminal remodeling. METHODS: Computational hemodynamics and 3D structural analyses were conducted in 51 patients with type B aortic dissection, at initial presentation and at approximately 1 month, 3 months, and 1 year post intervention. A functional index was proposed on the basis of luminal pressure difference. Statistical relationships between the proposed indicator and longitudinal luminal development were analyzed. RESULTS: The computed luminal pressure difference (true lumen pressure minus false lumen pressure) varied overall from positive to negative along the aorta. The first balance position at which the pressure difference equals 0 was proposed as the functional indicator. A more distally located first balance position indicated better functional status. Implantation of stent graft distally shifted this balance position. Patients with the balance position shifted out of the dissected region (43%) presented the highest functional improvement after intervention; whereas those with the balance position shifted to the abdominal region (25%) showed unsatisfactory results. The magnitude of distal shifting of the first balance position at 3 months post intervention was statistically related to the subsequent true lumen expansion and false lumen reduction. CONCLUSIONS: The first balance position of luminal pressure difference quantified the hemodynamic status of the dissected aorta. The magnitude of distal shifting of the balance position after intervention was associated with functional improvement and might be used predict longitudinal aortic remodeling.

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RATIONALE: Thyroid hormone resistance syndrome (THRS) is an inherited condition characterized by reduced responsiveness of target tissues to thyroid hormone. Due to their nonspecific symptomatic manifestations, these patients can be misdiagnosed. This study reports a pedigree with THRS caused by a mutation in the thyroid hormone receptor ß (THRß) gene. PATIENT CONCERN: The proband, a 36-year-old woman at 19+4 weeks of gestation, was referred to our hospital because of abnormal thyroid function results. She was diagnosed with hyperthyroidism in October 2015, and had been treated with methimazole until her pregnancy. DIAGNOSIS: The proband and 2 of her children were diagnosed with THRS based on genetic analysis. Sequence analysis of the THRß gene showed a heterozygous mutation C>A located at exon 10. The mutation results in a change in proline for threonine at amino acid position 453, P453T. INTERVENTIONS: No treatment will fully and specifically correct the defect. All 3 patients were in normal metabolic status, and thus treatment was not required. OUTCOMES: During a 2-year follow-up period, none of them had any complaints. The 20-year-old son (167 cm in height) and the 18-year-old daughter (150 cm in height) both had low academic performance. LESSONS: Elevated serum thyroid hormone (TH) levels associated with nonsuppressed thyroid-stimulating hormone (TSH) levels usually leads to the diagnosis of THRS. Genetic analysis provides a short cut to diagnosis and the treatment should be based on the patient's clinical manifestations.

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BACKGROUND: The outbreak of the coronavirus disease-19 (COVID-19) has caused enormous stress among the public in China. Intellectual input from various aspects is needed to fight against COVID-19, including understanding of the public's emotion and behaviour and their antecedents from the psychological perspectives. Drawing upon the cognitive appraisal theory, this study examined three cognitive appraisals (i.e., perceived severity, perceived controllability, and knowledge of COVID-19) and their associations with a wide range of emotional and behavioural outcomes among the Chinese public. METHODS: Participants were 4607 citizens (age range: 17-90 years, Mage = 23.71 years) from 31 provinces in China and they took part in a cross-sectional survey online. RESULTS: The results showed that the public's emotional and behavioural reactions were slightly affected by the outbreak of COVID-19. Moreover, the public had limited participation in the events regarding COVID-19 but actively engaged in precautionary behaviour. In addition, results of structural equation model with latent variables revealed that the three appraisals were differentially related to the outcome variables (i.e., negative emotion, positive emotion, sleep problems, aggression, substance use, mobile phone use, social participation, and precautionary behaviour). CONCLUSIONS: The findings highlight the utility of cognitive appraisal, as a core process of coping stress, in explaining the public's emotion and behaviour in the encounter of public health concern. Practically, the findings facilitate the government and practitioners to design and deliver targeted intervention programs to the public.

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Antibiotics can cause severe ecological problems for aquatic ecosystems due to their wide use and incomplete removal. Microcystis aeruginosa was exposed to different levels of erythromycin (ERY) and sulfamethoxazole (SMX) separately to assess their cytotoxic effects on harmful cyanobacteria. The production and release of the toxin MC-LR was measured, and several endpoints were investigated using flow cytometry (FCM) for 7 d. ERY resulted in cell membrane hyperpolarization and a hormesis effect on growth rate and chlorophyll a fluorescence at environmentally relevant concentrations (0.5 and 5 µg/L). Microcystis exhibited elevated photosynthesis and hyperpolarization at 50 and 125 µg/L of SMX. An increase of metabolically non-active cells was observed in either ERY or SMX cultures while stimulation of esterase activity was also found at 7 d. ERY and SMX caused damage of membrane integrity due to the overproduction of ROS, which led to increased release of MC-LR. MC-LR production apparently was induced by ERY (0.5-500 µg/L) and SMX (50 and 125 µg/L). In conclusion, ERY and SMX can disrupt the physiological status of Microcystis cells and stimulate the production and release of MC-LR, which can exacerbate potential risks to water systems.

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OBJECTIVES: Compared with unaffected individuals, patients with type 2 diabetes (T2DM) have higher risk of hypertension, and diabetes combined with hypertension can lead to server cardiovascular disease. Therefore, the purpose of this study was to establish a simple nomogram model to identify the determinants of hypertension in patients with T2DM and to quickly calculate the probability of hypertension in individuals with T2DM. MATERIALS AND METHODS: A total of 643,439 subjects participating in the national physical examination has been recruited in this cross-sectional study. After excluding unqualified subjects, 30,507 adults with T2DM were included in the final analysis. 21,355 and 9,152 subjects were randomly assigned to the model developing group and validation group, respectively, with a ratio of 7:3. The potential risk factors used in this study to assess hypertension in patients with T2DM included questionnaire investigation and physical measurement variables. We used the least absolute shrinkage and selection operator models to optimize feature selection, and the multivariable logistic regression analysis was for predicting model. Discrimination and calibration were assessed using the receiver operating curve (ROC) and calibration curve. RESULTS: The results showed that the major determinants of hypertension in patients with T2DM were age, gender, drinking, exercise, smoking, obesity and atherosclerotic vascular disease. The area under ROC curve of developing group and validation group are both 0.814, indicating that the prediction model owns high disease recognition ability. The p values of the two calibration curves are 0.625 and 0.445, suggesting that the nomogram gives good calibration. CONCLUSION: The individualized nomogram model can facilitate improved screening and early identification of patients with hypertension in T2DM. This procedure will be useful in developing regions with high epidemiological risk and poor socioeconomic status just like Urumqi, in Northern China.

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CuCo2O4 decoration carbon nanofibers (CNFs) as an enzyme-free glucose sensor were fabricated via electrospinning technology and carbonization treatment. The CNFs with advantages of abundant nitrogen amounts, porosity, large surface area, and superior electrical conductivity were used as an ideal matrix for CuCo2O4 decoration. The resultant CuCo2O4-CNF hybrids possessed favorable properties of unique three-dimensional architecture and good crystallinity, accompanied by the CuCo2O4 nanoparticles uniformly growing on the CNF skeleton. To further enhance the selective molecular recognition capacity of the developed sensor, a conductive film was synthesized through the electropolymerization of thiophene and thiophene-3-boronic acid (TBA). Based on the synergistic effects of the performances of CNFs, CuCo2O4 nanoparticles, and boronic acid-decorated polythiophene layer, the obtained poly(thiophene-3-boronic acid) (PTBA)/CuCo2O4-CNF-modified electrodes (PTBA/CuCo2O4-CNFs/glassy carbon electrode (GCE)) displayed prominent electrocatalytic activity toward electro-oxidation of glucose. The fabricated sensor presented an outstanding performance in the two linear ranges of 0.01-0.5 mM and 0.5-1.5 mM, with high selectivity of 2932 and 708 µA·mM-1·cm-2, respectively. The composite nanofibers also possessed good stability, repeatability, and excellent anti-interference selectivity toward the common interferences. All these results demonstrate that the proposed composite nanofibers hold great potential in the application of constructing an enzyme-free glucose sensing platform.

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Our study is major to establish and validate a simple type||diabetes mellitus (T2DM) screening model for identifying high-risk individuals among Chinese adults. A total of 643,439 subjects who participated in the national health examination had been enrolled in this cross-sectional study. After excluding subjects with missing data or previous medical history, 345,718 adults was included in the final analysis. We used the least absolute shrinkage and selection operator models to optimize feature selection, and used multivariable logistic regression analysis to build a predicting model. The results showed that the major risk factors of T2DM were age, gender, no drinking or drinking/time > 25 g, no exercise, smoking, waist-to-height ratio, heart rate, systolic blood pressure, fatty liver and gallbladder disease. The area under ROC was 0.811 for development group and 0.814 for validation group, and the p values of the two calibration curves were 0.053 and 0.438, the improvement of net reclassification and integrated discrimination are significant in our model. Our results give a clue that the screening models we conducted may be useful for identifying Chinses adults at high risk for diabetes. Further studies are needed to evaluate the utility and feasibility of this model in various settings.

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We sought to determine whether adjusting the indices used to assess beta cell function by anthropometric markers of obesity improves their clinical value in a diabetic population. We conducted a cross-sectional survey of 3732 diabetic patients who underwent a 100 g carbohydrate meal test. Insulin secretion was estimated using HOMA-B of steady state as well as △C0-30 /△G0-30 , △AUCc30-120 /△AUCG30-120 and CPIn for dynamic state. Body weight index, waist circumference, waist-hip ratio and body surface area were recorded. The final analysis included 2873 T2DM patients. Correlation analyses showed that there was a poor correlation between diabetic duration and CPI30 (r = -.040, P < .05), and there were no remarkable changes in the correlation coefficient after CPI30 was divided by BMI, WC, WHR, or body surface area, respectively. The same was found for the correlation between HbA1c and CPI120 with these measures. The main determinants of diabetic duration were age (ß = 0.388, P < .001), log HOMA-IR (ß = -0.328, P < .001), CPI30 (ß = -0.045, P = .011). There were no remarkable changes in ß weights between diabetic duration and CPI30 when it was corrected with anthropometric markers in the multiple stepwise linear regression analyses. The same was found between HbA1c and CPI120 . CPI30 and CPI120 are more practical indexes. Correcting the indices used to estimate the beta cell function by anthropometric markers of obesity may not improve their correlations with diabetic duration or HbA1c in a diabetic population.

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BACKGROUND: Despite a rapid popular of early onset type 2 diabetes (defined as diagnosis at <40 years old) recently, there is a lack of studies on this population in economically undeveloped area. We aimed to investigate the risk factors of macrovascular complications in the early onset T2DM patients in Xinjiang, China. METHODS: A cross-sectional survey of 1736 consecutive patients with T2DM was conducted. Macrovascular complications and risk factors were documented. Another nondiabetic population matched with age and sex was as a control group. Logistic regression analysis was performed to obtain odds ratios (OR) for macrovascular complications in early and late onset T2DM, respectively. RESULTS: The final analysis consisted of 1036 late onset and 219 early onset T2DM patients. The mean HbA1c in the early onset group was higher than that in the late onset group (9.1 ± 2.4% versus 8.3 ± 2.2%, P=0.039) despite a higher proportion of patients in the early onset group receiving insulin treatment (73.1% versus 58.7%, P < 0.001). Compared to the control, early onset patients had higher blood pressure and worse lipid profiles (all P < 0.01). More than half of the early onset T2DM patients already had macro- and microvascular complications, despite of their young age (39.5 ± 10.8) and short DM duration (6.6 ± 8.0). In the early onset group, women had a ~3-fold hazard of atherosclerotic plaques compared with men (OR 3.22, 95% CI 1.53-6.78). CONCLUSIONS: Patients with early onset T2DM have worse glycemic control and higher burden of atherogenic risk factors. The prevalence of macro- and microvascular complications is astonishingly high in these young adults with T2DM. Moreover, young women with T2DM are more susceptible to cardiovascular complications than their male counterpart.

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