ObjectivesTo investigate the early determinants of overweight and obesity status at age two years.MethodsA total of 1098 healthy neonates (563 boys and 535 girls) were involved in this community-based prospective study in China. Data on body weight and length were collected at birth, the 3rd and 24th month. A self-administered questionnaire was used to collect data on social demography and feeding patterns of children, etc. Three multivariable logistic regression models were employed to make various comparisons of weight status, i.e., model 1 (obesity vs. non-obesity), model 2 (combined overweight and obesity vs. normal weight, and model 3 (obesity, overweight and normal weight).ResultsPrevalences of overweight/obesity (95th >BMI ≥85th p and BMI ≥95th p, referring to WHO BMI standards) at 2 years of age are 15.8%/11.2% for boys and 12.9%/9.0% for girls, respectively. Being born with macrosomia (OR: 1.80–1.88), relatively greater BMI increment in the first 3 months (OR: 1.15–1.16) and bottle emptying by encouragement at age two (OR: 1.30–1.57) were found in all three models to be significant risk factors for higher BMI status at 2 years. Pre-pregnancy maternal BMI (OR: 1.09–1.12), paternal BMI (OR: 1.06), and mixed breastfeeding (OR: 1.54–1.57) or formula feeding (OR: 1.90–1.93) in the first month were identified as significant in models 2 and 3. Child-initiated bottle emptying at age two was observed to increase the risk of obesity by 1.31 times but only in model 1.ConclusionFetal and early postnatal growth and feeding pattern appear to have significant impacts on early childhood overweight and obesity status independent of parental BMI. Policy-based and multidisciplinary approaches to promote breastfeeding and enhancement of feeding skills of care takers may be promising intervention strategies.
Background Hypertrophic cardiomyopathy (HCM) and hypertension coexist fairly frequently in clinical practice. However, the evidence about the impact of hypertension on the prognosis of HCM is limited. The present study aims to investigate the impact of hypertension on the prognosis of HCM patients. Methods A total of 468 HCM patients were enrolled, and patients were divided into hypertension group (31.8%) and non-hypertension group (68.2%). The primary study endpoint was HCM-related death, consisting of heart failure (HF)-related death, stroke-related death and sudden cardiac death (SCD). Associations between hypertension and HCM-related death were analyzed by Cox regression models with the use of propensity score matching (PSM) as primary analysis. Results There were 55 HCM-related death during a median follow-up time of 4.6 years, and the mortality rate was 2.53 per 100 person years. Kaplan-Meier analysis based on the crude cohort or PSM cohort revealed no significant difference regarding the HCM-related death between the two groups. In the crude cohort, both univariable and multivariable Cox regression analysis indicated that hypertension was not significantly associated with HCM-related death with hazard ratios (HR) at 0.74 (95% CI [0.40–1.36], p value: 0.329) and 0.77 (95% CI [0.35–1.71], p value: 0.521), respectively. Similarly, no strong evidence for an association was observed between hypertension and HCM-related death in the PSM cohort with unadjusted HR at 0.90 (95% CI [0.34–2.41]; p value: 0.838) and adjusted HR at 0.77 (95% CI [0.35–1.71]; p value: 0.521), respectively. Other propensity score methods, including overlap weighting and inverse probability treatment weighting demonstrated similar results. Sensitivity analysis also indicated that the concomitant hypertension did not significantly increase the risk of HF-related death, stroke-related death or SCD in HCM patients. Conclusion HCM-related death did not significantly differ between hypertension and non-hypertension groups, suggesting a negative impact of hypertension on the clinical prognosis of HCM patients.
BackgroundThis study aimed to explore the impact of social activity frequency on mid- and long-term overall survival in older Chinese people.MethodsThe association between social activity frequency and overall survival was analysed in 28 563 subjects from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohorts.ResultsA total of 21 161 (74.1%) subjects died during the follow-up of 132 558.6 person-years. Overall, more frequent social activity was associated with longer overall survival. From baseline to 5 years of follow-up, adjusted time ratios (TRs) for overall survival were 1.42 (95% CI 1.21 to 1.66, p<0.001) in the not monthly but sometimes group, 1.48 (95% CI 1.18 to 1.84, p=0.001) in the not weekly but at least once/month group, 2.10 (95% CI 1.63 to 2.69, p<0.001) in the not daily but at least once/week group, and 1.87 (95% CI 1.44 to 2.42, p<0.001) in the almost everyday group versus never group. From 5 years to the end of follow-up, adjusted TRs for overall survival were 1.05 (95% CI 0.74 to 1.50, p=0.766) in the not monthly but sometimes group, 1.64 (95% CI 1.01 to 2.65, p=0.046) in the not weekly but at least once/month group, 1.23 (95% CI 0.73 to 2.07, p=0.434) in the not daily but at least once/week group, and 3.04 (95% CI 1.69 to 5.47, p<0.001) in the almost everyday group versus the never group. Stratified and sensitivity analysis revealed similar results.ConclusionFrequent participation in social activity was significantly associated with prolonged overall survival in older people. However, only participating in social activity almost every day could significantly prolong long-term survival.
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