Impact of Sociodemographic Characteristics, Lifestyle, and Obesity on Coexistence of Diabetes and Hypertension: A Structural Equation Model Analysis amongst Chinese Adults
Abstract:Background. In general, given the insufficient sample size, considerable literature has been found on single studies of diabetes and hypertension and few studies have been found on the coexistence of diabetes and hypertension (CDH) and its influencing factors with a large range of samples. This study aimed to establish a structural equation model for exploring the direct and indirect relationships amongst sociodemographic characteristics, lifestyle, obesity, and CDH amongst Chinese adults. Methods. A cross-sec… Show more
“…This method is particularly apt for SEM when dealing with categorical and ordinal observed variables. Given the limited interpretative power of the chi-square value in large samples ( 30 ), we relied on three key fit indices to assess the model’s fit: Tucker–Lewis index (TLI ≥ 0.90), Comparative fit index (CFI ≥ 0.90), and root mean square error of approximation (RMSEA ≤ 0.05) ( 31 ). Figure 1 Base structural equation model.…”
Introduction: Given the high prevalence of thyroid nodules and the potential for malignancy, it is imperative to understand the various factors that contribute to their development. This study aimed to explore the relationship between metabolic syndrome, lifestyle, and thyroid nodules in adult men in southern China.
Method: This study enrolled a total of 183, 990 subjects at a medical examination center in a general hospital in southern China between January 1, 2015, and December 31, 2020. Multivariate logistic regression analysis was utilized to evaluate the relationship between metabolic syndrome, lifestyle factors and thyroid nodules. Furthermore, structural equation modeling (SEM) elucidated the intricate relationships among these variables.
Result: The prevalence of thyroid nodules among Chinese adult males was 14.9%. Several factors were identified as risk factors for thyroid nodules, including advanced age, irregular meal time, smoking or quitting smoking, quitting drinking, heavier manual labor, hypertension, diabetes, dyslipidemia and centripetal obesity. And, belonging to ethnic minorities and drinking alcohol were found to be protective factors against thyroid nodules. Structural equation modeling highlighted metabolic syndrome's mediating role amidst lifestyle influences on thyroid nodules.
Conclusion: The prevalence of thyroid nodules in Chinese adult males is relatively moderate to low. The factors identified in this study can help clinicians identify high-risk patients and develop targeted screening strategies for the timely detection of thyroid nodules. However, further mechanistic research and longitudinal studies are necessary to explore the underlying causes and establish causal relationships.
“…This method is particularly apt for SEM when dealing with categorical and ordinal observed variables. Given the limited interpretative power of the chi-square value in large samples ( 30 ), we relied on three key fit indices to assess the model’s fit: Tucker–Lewis index (TLI ≥ 0.90), Comparative fit index (CFI ≥ 0.90), and root mean square error of approximation (RMSEA ≤ 0.05) ( 31 ). Figure 1 Base structural equation model.…”
Introduction: Given the high prevalence of thyroid nodules and the potential for malignancy, it is imperative to understand the various factors that contribute to their development. This study aimed to explore the relationship between metabolic syndrome, lifestyle, and thyroid nodules in adult men in southern China.
Method: This study enrolled a total of 183, 990 subjects at a medical examination center in a general hospital in southern China between January 1, 2015, and December 31, 2020. Multivariate logistic regression analysis was utilized to evaluate the relationship between metabolic syndrome, lifestyle factors and thyroid nodules. Furthermore, structural equation modeling (SEM) elucidated the intricate relationships among these variables.
Result: The prevalence of thyroid nodules among Chinese adult males was 14.9%. Several factors were identified as risk factors for thyroid nodules, including advanced age, irregular meal time, smoking or quitting smoking, quitting drinking, heavier manual labor, hypertension, diabetes, dyslipidemia and centripetal obesity. And, belonging to ethnic minorities and drinking alcohol were found to be protective factors against thyroid nodules. Structural equation modeling highlighted metabolic syndrome's mediating role amidst lifestyle influences on thyroid nodules.
Conclusion: The prevalence of thyroid nodules in Chinese adult males is relatively moderate to low. The factors identified in this study can help clinicians identify high-risk patients and develop targeted screening strategies for the timely detection of thyroid nodules. However, further mechanistic research and longitudinal studies are necessary to explore the underlying causes and establish causal relationships.
“…In the model, the one-way path (X→Y) means that X influences Y, while the two-way path (X ↔ Y) means that X correlates with Y 32. Standardised coefficients for each path are reported, including factor loadings and factor coefficients.…”
ObjectivesWhether the routine delivery of diabetes-related knowledge can change patients’ attitudes and hence influence their self-management activities remains unknown in primary healthcare settings in China. Thus, this study aims to explore the complex transformation process between knowledge, attitude and practice (KAP) among patients with diabetes in a city in China.DesignA cross-sectional study.SettingYuhuan City, Zhejiang Province, China.ParticipantsA total of 803 patients with diabetes were invited to attend a questionnaire survey and 782 patients with type 2 diabetes completed the survey. The average age of participants was 58.47 years old, 48.21% of whom only attended primary school or below.Primary and secondary outcome measuresA questionnaire based on existing scales and expert consultation was applied to assess patients’ socio-demographic information (SI), disease progression risk and diabetes-related KAP. A structural equation model was built to analyse the relationships between patients’ characteristics and KAP.ResultsNo significant association was found between patients’ knowledge and attitude (β=0.01, p=0.43). Better knowledge and attitude were both found to be associated with better diet and physical activities (β=0.58, p<0.001; β=0.46, p=0.01). However, patients with a more positive attitude toward diabetic care showed worse foot care practice (β=−0.13, p=0.02), while better knowledge was associated with better foot care practice (β=0.29, p<0.001). In addition, patients with higher SI (β=0.88, p<0.001) and/or disease progression risk (β=0.42, p<0.001) tended to present higher levels of disease knowledge.ConclusionsWhile successful KAP transformation has been achieved in practice for diet and physical activities, there is a need to improve foot care practice. Health education should also prioritise the prevention, detection and care of diabetic foot. Also, appropriate methods should be adopted to deliver health education to vulnerable patients, such as the elderly, those living in rural areas, those with minimal education, the unemployed and low-income patients.
“…The World Health Organization (WHO) estimates that around 600 million people suffer from high blood pressure, with a global increase of 60% by 2025, in addition to around 7.1 million deaths per year, which causes very high costs for health systems, directly influencing the economy of these countries [3,4] For example, low-and middle-income countries (LMICs) have 93% of the world's disease burden and contribute to around 78% of deaths from cardiovascular disease and 50% of the total disease burden [3]. Several authors show that demographic characteristics such as advanced age, alcohol consumption, smoking and a sedentary lifestyle can increase the risk of hypertension [5]. Also, the Body Mass Index (BMI) has been a determining factor in the diagnosis of obesity [5].…”
Section: Introductionmentioning
confidence: 99%
“…Several authors show that demographic characteristics such as advanced age, alcohol consumption, smoking and a sedentary lifestyle can increase the risk of hypertension [5]. Also, the Body Mass Index (BMI) has been a determining factor in the diagnosis of obesity [5]. Until the 20th century, infectious diseases were the main causes of death in the world population.…”
WHO estimates that around 600 million people suffer from high blood pressure which causes high costs for health systems and influences the economy of these countries. In this study, we investigate the sociodemographic characteristics and risk factors related to hypertension among individuals from Huambo, Angola. This cross-sectional study was conducted with 158 participants consulted in the Cardiology services at Hospital Geral do Huambo, between January and July 2023. A total of 67.1% of the studied patients were hypertensive. The mean age of the hypertensive (55.8±11.3) patients was higher than non-hypertensive (53.1±13.4) patients, although no significance was observed (p=0.199). Patients aged between 30 and 40 (OR=1.19, P=0493), male (OR=1.17, P=660), employees (OR=9.94, P=0935), patients consuming alcohol (OR=1.11, P=0.864), and practising physical activity (OR=1.12, P=0.742) presented a high chance of developing hypertension, while those living in urbanized areas (OR=0.78, P=0.59) and with a low educational level (OR=0.43, P=0.194), had a low chance to develop hypertension. There was no statistical significance between demographic or behavioural characteristics with hypertension (P>0.05). Regarding clinical characteristics, body mass index was statistically related to hypertension (p=0.011). Our findings show that hypertension is a major health problem for the young population of Huambo. There is an urgent need to create strategies to improve the prevention, diagnosis, and treatment of hypertension, not only in Huambo but throughout the country. Further studies to understand determinants related to hypertension should be carried out among the young population in Angola.
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