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Research Methods and Procedures:A total of 2102 Hong Kong Chinese 12 to 19 years of age were recruited. Participants were considered to have clustering of risk factors if at least three of the following risk factors were present: 1) high-density lipoprotein cholesterol (HDL-C) Յ1.03 mM, 2) low-density lipoprotein cholesterol (LDL-C) Ն2.6 mM, 3) triglyceride (TG) Ն1.24 mM, 4) fasting plasma glucose (FPG) Ն6.1 mM, and 5) age-, sex-, and height-adjusted systolic or diastolic blood pressure (BP) Ն 90th percentile. Receiver operating characteristics (ROC) curves were generated to identify the optimal age-adjusted BMI and WC cut-off values to predict clustering of risk factors in boys and girls separately. These age-adjusted BMI and WC cut-offs were transformed to percentile values. Cole's lambda-mu-sigma (LMS) method was used to obtain smoothed age-specific BMI and WC at these percentile values. Results: The areas under ROC curves for BMI in girls and boys were 0.85 [95% confidence interval (CI), 0.77 to 0.92] and 0.76 (95% CI, 0.66 to 0.85), respectively. The respective areas under ROC curves for WC in girls and boys were 0.82 (95% CI, 0.74 to 0.91) and 0.78 (95% CI, 0.68 to 0.87). The optimal BMI thresholds were at the 78th percentile for girls and the 72nd percentile for boys. The respective values for WC were at the 77th percentile for girls and the 76th percentile for boys. The sensitivities and specificities of these cut-off values ranged from 72% to 80%. Discussion: Age-and sex-specific BMI and WC cut-off values can be used to identify adolescents with clustering of cardiovascular risk factors.

Background Stimulation of immunity by vaccination may elicit adverse events. There is currently inconclusive evidence on the relationship between herpes zoster related hospitalization and COVID-19 vaccination. This study aimed to evaluate the effect of inactivated virus (CoronaVac, Sinovac) and mRNA (BNT162b2, BioNTech/Fosun Pharma) COVID-19 vaccine on the risk of herpes zoster related hospitalization. Methods Self-controlled case series (SCCS) analysis was conducted using the data from the electronic health records in Hospital Authority and COVID-19 vaccination records in the Department of Health in Hong Kong. We conducted the SCCS analysis including patients with a first primary diagnosis of herpes zoster in the hospital inpatient setting between February 23 and July 31, 2021. A confirmatory analysis by nested case-control method was also conducted. Each herpes zoster case was randomly matched with ten controls according to sex, age, Charlson comorbidity index, and date of hospital admission. Conditional Poisson regression and logistic regression models were used to assess the potential excess rates of herpes zoster after vaccination. Findings From February 23 to July 31, 2021, a total of 16 and 27 patients were identified with a first primary hospital diagnosis of herpes zoster within 28 days after CoronaVac and BNT162b2 vaccinations. The incidence of herpes zoster was 7.9 (95% Confidence interval [CI]: 5.2–11.5) for CoronaVac and 7.1 (95% CI: 4.1–11.5) for BNT162b2 per 1,000,000 doses administered. In SCCS analysis, CoronaVac vaccination was associated with significantly higher risk of herpes zoster within 14 days after first dose (adjusted incidence rate ratio [aIRR]=2.67, 95% CI: 1.08–6.59) but not in other periods afterwards compared to the baseline period. Regarding BNT162b2 vaccination, a significantly increased risk of herpes zoster was observed after first dose up to 14 days after second dose (0-13 days after first dose: aIRR=5.23, 95% CI: 1.61–17.03; 14–27 days after first dose: aIRR=5.82, 95% CI: 1.62–20.91; 0-13 days after second dose: aIRR=5.14, 95% CI: 1.29–20.47). Using these relative rates, we estimated that there has been an excess of approximately 5 and 7 cases of hospitalization as a result of herpes zoster after every 1,000,000 doses of CoronaVac and BNT162b2 vaccination, respectively. The findings in the nested case control analysis showed similar results. Interpretation We identified an increased risk of herpes zoster related hospitalization after CoronaVac and BNT162b2 vaccinations. However, the absolute risks of such adverse event after CoronaVac and BNT162b2 vaccinations were very low. In locations where COVID-19 is prevalent, the protective effects on COVID-19 from vaccinations will greatly outweigh the potential side effects of vaccination. Funding The project was funded by Research Grant from the Food and Health Bureau, The Government of the Hong Kong S...

OBJECTIVE -International guidelines recommend optimal control of risk factors in diabetes to prevent cardiovascular events. We examined risk associations between achieving treatment targets for glycemia, blood pressure and lipid control, and other risk factors on subsequent cardiovascular events in Chinese patients with type 2 diabetes. -Between 1995 and 2005, 6,386 Chinese type 2 diabetic patients without a history of coronary heart disease (CHD) or stroke were recruited. They were classified according to the number of treatment targets attained at baseline, and their cardiovascular outcomes were compared. Treatment targets were defined as A1C Ͻ7.0%, blood pressure Ͻ130/80 mmHg, and LDL cholesterol Ͻ2.6 mmol/l. RESEARCH DESIGN AND METHODS RESULTS-After a median follow-up of 5.7 years, cumulative incidence of CHD or stroke (n ϭ 749) increased with decreasing numbers of treatment targets attained at baseline. Attainment of two or more targets at baseline was associated with reduced risk of CHD compared with those with no target achieved (hazard ratio 0.69 [95% CI 0.50 -0.94], P ϭ 0.020). However, the association lost its significance after adjustment for urinary albumin-to-creatinine ratio, estimated glomerular filtration rate, and hemoglobin.CONCLUSIONS -Reaching more treatment targets was associated with reduced risk of new onset of CHD in Chinese patients with type 2 diabetes. Diabetes Care 30:953-959, 2007A ccording to the World Health Organization, 5% of global deaths are directly attributable to diabetes (1). In India and China, 3 million people die from cardiovascular disease every year (2). More than 50% of these cardiovascular deaths were related to chronic diseases such as diabetes. Optimal control of blood glucose, blood pressure, blood lipids, and use of renin angiotensin system blockers such as ACE inhibitors (ACEIs) or angiotensin-II receptor blockers (ARBs) reduce the risk of new onset of cardiovascular complications in type 2 diabetic patients (3-8).Both international and regional guidelines recommend treatment targets for diabetes management. However, national audits reported low rates of adherence to monitoring processes and poor attainment of these targets in diabetic patients (9,10). Apart from this chasm between evidence and practice, the impacts of failure to attain treatment targets on clinical outcomes in a nontrial setting remains uncertain. Against this background, we hypothesize that achieving treatment targets will be associated with a better cardiovascular outcome on long term follow-up.In this observational study, we examined risk associations between attainment of treatment goals and other risk factors, as well as incident cardiovascular events in a consecutive cohort of Chinese type 2 diabetic patients without a history of coronary heart disease (CHD) or stroke at baseline. RESEARCH DESIGN AND METHODS -Since 1995, diabetic patients attending medical clinics at thePrince of Wales Hospital can be referred to the Diabetes Centre for comprehensive assessment based on the European DIAB...