Objective Accumulating evidence suggests a close relationship between metabolic disturbance and increased arterial stiffness. However, whether there is an association between pulse pressure (PP) and diabetes and how this association might be impacted by sex is not clear. Methods A total of 209,635 adult Chinese individuals > 20 years old across 32 sites and 11 cities in China (Shanghai, Beijing, Nanjing, Suzhou, Shenzhen, Changzhou, Chengdu, Guangzhou, Hefei, Wuhan, Nantong) were included in the study; participants were free of diabetes at baseline. In the present study, we analyzed the relationship between PP at baseline and incident diabetes using the Cox proportional hazard model. Results During a median follow-up of 2.99 years, a total of 3971 participants (2885 men and 1086 women) developed diabetes, and the incidence was 6.3 per 1000 person-years. With each 10 mmHg increase in PP, the multivariable adjusted hazard ratio (HR) (95% confidence interval) for incident diabetes was 1.117 (1.061, 1.176) in females and 0.981 (0.951, 1.012) in males. Using the lowest quartile of PP as the reference category, the hazard ratio (HR) (95% CI) of the highest quartile of PP for incident diabetes was 1.494 (1.225, 1.822) in females and 0.939 (0.843, 1.045) in males. Smooth plots revealed a significant difference between males and females in the HRs for new-onset diabetes according to PP. Conclusion Higher PP was related to future diabetes development in females but not in males and further research is needed to explore the mechanism.
Background. Preterm infant mothers have always encountered difficulties in human milk production. For this reason, an intervention of breast massage combined with acupoint stimulation was designed to increase the production. Purpose. Through a pilot randomized trial, we assessed the acceptability, feasibility, and effectiveness of breast massage combined with acupoint stimulation and the study procedures. Methods. 40 participants of preterm infants born at less than 34 weeks of gestation were randomly allocated to the CG (control group) or the EG (group with breast massage combined with acupoint stimulation). Data related to the acceptability, feasibility, and effectiveness of the intervention and research procedures were collected and analysed. Results. The daily volume progressively increased each day in the first 7 days in both groups and a significant difference was observed between the groups ( P < 0.001). The initiation time of lactogenesis stage II was 50.06 ± 6.78 (40.00–64.00) hours in the EG and 66.18 ± 14.64 (48.00–96.00) hours in the CG, where a significant difference was detected ( P < 0.05). The mean score of satisfaction with the intervention in the EG was 4.56 ± 0.32 (4.0–5.0), while the retention rates were 82.5% and 85.5% (17/20) in the CG, and 80% (16/20) in the EG. Conclusion. This pilot study was oriented towards the effectiveness of breast massage combined with acupuncture stimulation for the increase of human milk production in the participants. The intervention was accepted well and the study process was reasonable. A large-scale RCT will be able to determine the beneficial effects of this intervention on human milk production.
Purpose Little research exits on the effect of the aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio on the incidence of diabetes mellitus (DM). This study used the large-scale cohort study data of the Chinese population to explore the effect of the AST/ALT ratio on the incidence of DM. Patients and methods The data was downloaded from a computerized database (DATADRYAD, available at www.datadryad.org) including 32 sites and 11 cities in China which were collected between 2010 and 2016 by the Rich Healthcare Group in China. This study was a retrospective cohort study that, included 86,145 participants for the secondary analysis. Multivariable Cox proportional hazards regression and a two-piecewise linear regression model were used to explore the relationship between the AST/ ALT ratio and DM. Results The AST/ALT ratio was negatively correlated with the incidence of DM after adjusting for potential co-variables [HR = 0.44, (95%CI:0.38–0.51), P < 0.001]. By using the two-piecewise linear regression model, the inflection point was 1.3. On the left of the inflection point, the effect size was HR = 0.3 (0.2–0.3, P < 0.001). On the right side of the inflection point, the effect size was HR = 0.9 (0.7 to 1.2; P = 0.561). Conclusion The AST/ALT ratio could be an independent predictor of incident DM and was negatively correlated with DM events.
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