revention and control of noncommunicable diseases is a public health priority worldwide. However, data have shown steady increases in noncommunicable diseases, especially obesity and diabetes, in many countries. [1][2][3][4] Diabetes prevalence in China increased from less than 1% in the 1980s to almost 11% in 2013. [5][6][7][8][9] In 2013, China reported having the largest number of patients with diabetes and spending the second highest amount on diabetes and its complications worldwide. 8,10,11 In addition, the population of patients with prediabetes represents a large reservoir of patients at risk of diabetes. Previous research showed low rates of awareness, treatment, and control of diabetes in China, 6-8 compared with the United States. 12 Previous national surveillance data described the prevalence and treatment of diabetes in China in 2013. 8 Another survey reported estimated diabetes prevalence of 11.2% and prediabetes prevalence of 35.2% in 2015. 13 The prevalence, awareness, and treatment of diabetes varies within populations. 3,7,8,14 Socioeconomic and behavioral factors (eg, diet, smoking) may account for this variation. Behavioral factors are important modifiable factors for diabetes prevention and management. China has launched public health campaigns to promote healthful behaviors, including tobacco control, healthful diet, and physical activity. To our knowledge, no nationally representative studies with consistent study design have comprehensively investigated trends in the prevalence, treatment, and risk factors of diabetes in China. IMPORTANCERecent data on prevalence, awareness, treatment, and risk factors of diabetes in China is necessary for interventional efforts. OBJECTIVE To estimate trends in prevalence, awareness, treatment, and risk factors of diabetes in China based on national data. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional nationally representative survey data collected in adults aged 18 years or older in mainland China from 170 287 participants in the 2013-2014 years and 173 642 participants in the 2018-2019 years.EXPOSURES Fasting plasma glucose and hemoglobin A 1c levels were measured for all participants. A 2-hour oral glucose tolerance test was conducted for all participants without diagnosed diabetes.MAIN OUTCOMES AND MEASURES Primary outcomes were diabetes and prediabetes defined accordingtoAmericanDiabetesAssociationcriteria.Secondaryoutcomeswereawareness,treatment, and control of diabetes and prevalence of risk factors. A hemoglobin A 1c level of less than 7.0% (53 mmol/mol) among treated patients with diabetes was considered adequate glycemic control.

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Israeli adolescents had overall a high rate of poor MD adherence. Jewish middle-school children were at the highest risk. Interventions aimed at increasing physical activity, reducing sedentary time, improving mother's education and promoting reading of food labels are recommended.

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The relationship between subclinical thyroid dysfunction and blood pressure has been controversial and received unsufficient attention. Thus, we performed a cross-sectional study conducted among 6,992 inhabitants from six districts of Jiangsu Province to investigate the association of subclinical thyroid dysfunction with blood pressure in China. The data from 6,583 subjects (4,115 women and 2,468 men) were included and divided into three groups: euthyroidism (n = 5669, 86.11%), subclinical hyperthyroidism (n = 108, 1.65%), and subclinical hypothyroidism (n = 806, 12.24%). In the groups with subclinical hypothyroidism and hyperthyroidism, systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure were not significantly different from those in the groups with euthyroidism after being adjusted for age, sex, BMI, and smoking status (P > 0.05). More extensively, the SBP and DBP in the group of subclinical hypothyroidism with lower level of TSH (TSH 4.51-10.00 mIU/l, SCH(1)) were significantly higher than those of participants with euthyroidism (P < 0.05). Multivariable logistic analysis revealed that subclinical hypothyroidism with lower TSH (TSH 4.51-10.00 mIU/l) was an independent risk factor for increased SBP (OR = 1.28, 95% CI 1.03-1.59, P = 0.028). Similar results could not be found between groups of euthyroid and subclinical hypothyroid with higher level of TSH (TSH > 10 mIU/l, SCH(2)). Further subdivision of the euthyroid group on the basis of a TSH cut-off of 2.5 mIU/l, revealed still no significant difference in blood pressure after adjustment regardless of whether the TSH levels were in the lower reference (TSH 0.40-2.50 mIU/l, n = 4093) or in the upper reference ranges (TSH 2.51-4.50 mIU/l, n = 1576) (P > 0.05). We concluded that subclinical thyroid dysfunction was not associated with blood pressure. Neither subclinical hyperthyroidism nor subclinical hypothyroidism independently predicted increased blood pressure.

BackgroundMyeloid-related protein 8/14 (MRP8/14) is a stable heterodimer formed by two different calcium-binding proteins (MRP8 and MRP14). Studies have identified that MRP8/14 regulates vascular inflammation and serves as a novel marker of acute coronary syndrome. In this study, we evaluated the correlation between serum levels of MRP8/14, hsCRP, endogenous secretory receptor for advanced glycation end-products (esRAGE) and the occurrence of coronary artery disease (CAD), or carotid intima-media thickness (IMT) when CAD was not yet developed in diabetic patients.MethodsSerum levels of MRP8/14, esRAGE and hsCRP were measured in 375 diabetic patients. Then the results of those who had CAD were compared against who had not. Also, we investigated the associations between above-mentioned indicators and IMT of subjects without CAD in both diabetic group and non-diabetic one.ResultsSerum MRP8/14 was significantly higher in CAD than in non-CAD group (9.7 ± 3.6 ug/ml vs. 8.2 ± 3.0 ug/ml, P < 0.001). It was associated with severity of CAD (r = 0.16, P = 0.026). In non-CAD group, MRP8/14 was associated with IMT in patients with (r = 0.30, P < 0.001) or without diabetes (r = 0.26, P = 0.015). The areas under the curves of receiver operating characteristic for CAD were 0.63 (95% CI 0.57-0.68) for MRP8/14, 0.76 (95% CI 0.71-0.81) for hsCRP and 0.62 (95% CI 0.56 -0.67) for esRAGE.ConclusionIn summary, we report that diabetic patients with CAD had elevated plasma MRP8/14 levels which were also positively correlated with the severity of CAD and carotid IMT in patients without clinically overt CAD.

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ObjectivesFollowing its publication in 2008, the Global Nutritional Index (GNI) which captures the triple burden of malnutrition, has been updated to assess the overall nutritional status and nutritional trends of countries, regions and the world, including both under-nutrition and over-nutrition.MethodsThe GNI was modeled on the Human Development Index, using geometric means of three normalized indicators: protein-energy malnutrition (PEM, measured by Disability-Adjusted Life Years (DALYs) from PEM), micronutrient deficiency (MID, measured by DALYs from MID), and penalizing obesity (percent female obesity). GNI (range 0–1) was calculated from 1990–2015 for 186 countries, in seven World Bank income and WHO region groupings.ResultsWorld GNI increased from 0.433 to 0.473 as decreased deficits overcompensated for the rise in obesity. GNI for African low- and middle-income countries (LMIC) (median 0.301 to 0.392) and South-East Asian LMIC (0.456 to 0.564) improved significantly (P<0.001), while for high-income countries (0.657 to 0.611) worsened significantly (P<0.001). GNI for American LMIC (0.459 to 0.457), European LMIC (0.571 to 0.575), Eastern Mediterranean LMIC (0.484 to 0.483) and Western Pacific LMIC (0.433 to 0.494) were unchanged. The disaggregation of the GNI showed that in nearly all the seven country groups there was a significant decrease in both PEM and MID (all P<0.01) (except in HIC where only PEM dropped), and a significant increase in obesity (all P<0.001).ConclusionThese trends are the result of the reciprocal changes between decreased under-nutrition and increased over-nutrition, which has become a major cause of malnutrition worldwide. We suggest, therefore, that future Sustainable Development Goals should include alongside “zero hunger”–“reduce obesity”.