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Articles by Q. Qiao
Total Records ( 6 ) for Q. Qiao
  W. G. Gao , Q. Qiao , J. Pitkaniemi , S. Wild , D. Magliano , J. Shaw , S. Soderberg , P. Zimmet , P. Chitson , S. Knowlessur , G. Alberti and J. Tuomilehto
  Aims To develope risk prediction models of future diabetes in Mauritian Indians. MethodsThree thousand and ninety-four Mauritian Indians (1141 men, aged 20–65 years) without diabetes in 1987 or 1992 were followed up to 1992 or 1998. Subjects underwent repeated oral glucose tolerance tests and diabetes was diagnosed according to 2006 World Health Organization/International Diabetes Federation criteria. Cox regression models for interval censored data were performed using data from 1544 randomly selected participants. Predicted probabilities for diabetes were calculated and validated in the remaining 1550 subjects. ResultsOver 11 years of follow-up, there were 511 cases of diabetes. Among variables tested, family history of diabetes, obesity (body mass index, waist circumference) and glucose were significant predictors of diabetes. Predicted probabilities derived from a simple model fitted with sex, family history of diabetes and obesity ranged from 0.05 to 0.64 in men and 0.03 to 0.49 in women. To predict the onset of diabetes, area under the receiver operating characteristic (ROC) curve (AROC) of predicted probabilities was 0.62 (95% confidence interval, 0.56–0.68) in men and 0.64 (0.59–0.69) in women. At a cut-off point of 0.12, the sensitivity and specificity were 0.72 (0.71–0.74) and 0.47 (0.45–0.49) in men and 0.77 (0.75–0.78) and 0.50 (0.48–0.52) in women, respectively. Addition of fasting plasma glucose (FPG) to the model improved the prediction slightly [AROC curve 0.70 (0.65–0.76) in men, 0.71 (0.67–0.76) in women]. ConclusionsA diabetes prediction model based on obesity and family history yielded moderate discrimination in Mauritian Indians, which was slightly inferior to the model with the FPG but may be useful in low-income countries to promote identification of people at high risk of diabetes.
  W. G. Gao , Y. H. Dong , Z. C. Pang , H. R. Nan , L. Zhang , S. J. Wang , J. Ren , F. Ning and Q. Qiao
  Aims: To determine the secular trend of prevalence of Type 2 diabetes and pre-diabetes in a Chinese population from 2001 to 2006.
Methods: Two consecutive population-based surveys for diabetes were conducted in a randomly selected population aged 35–74 years and living in Qingdao, China in 2001–2002 (n = 10854) and 2006 (n = 4416). All participants underwent standardized 2-h 75-g oral glucose tolerance tests (OGTTs), along with fasting capillary plasma glucose (FCG) tests in 2006. One urban community underwent OGTTs directly in 2002 (n = 1815), while a two-step screening strategy using FCG as a first-line screening test followed by OGTTs was used in 9039 individuals in 2001. Diabetes and pre-diabetes was defined according to the 2006 World Health Organization/International Diabetes Federation criteria.
Results: Based on the results of direct OGTTs, the age-standardized prevalence of diabetes and pre-diabetes in urban areas was 12.2 and 15.4% in 2002, whereas the prevalences were 18.8 and 28.7% in urban areas and 14.1 and 20.2% in rural areas in 2006 (P < 0.001, in urban areas). Using the two-step screening strategy, the prevalence of diabetes in 2001 was 10.1% in urban and 7.7% in rural areas and 13.8% in urban and 12.2% in rural areas in 2006 (P < 0.001). Based on the data of the 2006 survey, the two-step screening strategy missed 30.2% of diabetes cases when compared with the number defined by the direct OGTT approach.
Conclusions: Qingdao has experienced a marked increase in the prevalence of diabetes and pre-diabetes in the past 5 years. Intervention to prevent a further increase in the prevalence of diabetes is urgently required.
  X. H. Zhou , L. N. Ji , Y. Y. Luo , X. Y. Zhang , X. Y. Han and Q. Qiao
  Aim: To determine the performance of glycated haemoglobin (HbA1c) as a screening tool for detecting newly diagnosed diabetes (NDM) and pre-diabetes.
Methods: A diabetes survey was conducted in Beijing among community dwellers who were willing to participate in the survey. Included in the survey were 903 individuals aged 21–79 years without previously diagnosed diabetes and in whom HbA1c and other required covariates had been measured. NDM and pre-diabetes (impaired glucose tolerance + impaired fasting glucose) were defined according to the World Health Organization 1999 criteria based on 75-g oral glucose tolerance test. Receiver operating characteristic curve (ROC) was plotted to determine the performance of HbA1c.
Results: The prevalence of NDM and pre-diabetes was 11.1% and 22.4%, respectively. At an optimal HbA1c cut-off point of ≥ 6.0%, the test gave a sensitivity of 80.0% and a specificity of 89.8% for diagnosing NDM; at an optimal cut-off point of ≥ 5.7%, the sensitivity was 59.4% and specificity 73.9% for diagnosing pre-diabetes. Individuals with HbA1c≥ 6.0% tended to be more obese than those with HbA1c < 6.0%, but blood pressure and lipid profiles did not differ between the two groups.
Conclusions: HbA1c as a single screening test is adequate to detect newly diagnosed diabetes but is not able to identify pre-diabetes in this obese Chinese population.
  F. Ning , Z. C. Pang , Y. H. Dong , W. G. Gao , H. R. Nan , S. J. Wang , L. Zhang , J. Ren , J. Tuomilehto , N. Hammar , K. Malmberg , S. W. Andersson and Q. Qiao
  Objective  To investigate the major risk factors and their association with the dramatic increase in the prevalence of diabetes from 2001-2002 to 2006 in Qingdao, China.

Methods  Population-based cross-sectional studies on diabetes were performed in 4598 men and 7026 women aged 35-74 years. The 2006 World Health Organization diagnostic criteria for diabetes were used.

Results  The crude prevalence of diabetes was 11.3% in both men and women in urban areas and 5.3% and 8.9% in rural areas in 2001-2002. This increased to 19.2% and 16.1% in urban areas and 14.2% and 13.8% in rural areas in 2006 for men and women, respectively. The increase in diabetes prevalence from 2001-2002 to 2006 was paralleled by an increased body mass index in rural areas but not in urban areas. The major risk factors associated with diabetes were age, family history of diabetes, obesity, hypertension and high triglycerides. The multivariate adjusted odds ratio and 95% confidence interval for diabetes corresponding to a one standard deviation increase in waist circumference was 1.81 (1.47, 2.23) in urban men, 1.64 (1.26, 2.13) in rural men, 1.98 (1.66, 2.37) in urban women and 2.02 (1.63, 2.51) in rural women. Low socio-economic classes had a higher risk for diabetes in urban areas but a lower risk in rural areas, both associated with increased waist circumference.

Conclusion  Established risk factors are of great importance for the prevalence of diabetes in the urban and rural Chinese populations and changes in these factors could explain the recent dramatic increase in diabetes prevalence, particularly in rural areas. Considering the high prevalence of obesity and physical inactivity, intervention is urgently required in China.

  W. G. Gao , Y. H. Dong , Z. C. Pang , H. R. Nan , S. J. Wang , J. Ren , L. Zhang , J. Tuomilehto and Q. Qiao
  Aims  A diabetes risk score for screening undiagnosed diabetes was constructed and validated in Chinese adults.

Methods  Two consecutive population-based diabetes surveys among Chinese adults aged 20-74 years were conducted in 2002 (n = 1986) and 2006 (n = 4336). Demographic and anthropometric measures were collected following similar procedures. Standard 2-h 75-g oral glucose tolerance tests (OGTTs) were performed to diagnose diabetes in both surveys. Fasting capillary plasma glucose (FCG) and glycated haemoglobin (HbA1c) were also measured together with the OGTTs on the same day of the 2006 survey. Beta coefficients estimated using logistic regression analysis derived from data of the 2002 survey were used to develop the risk assessment algorithm. The performance of the algorithm was validated in the study population of the 2006 survey.

Results  Of all the variables tested, waist circumference, age and family history of diabetes were significant predictors of diabetes and were used to construct the risk assessment score. The score, ranging from 3 to 32, performed well when applied to the study population of the 2006 survey. The area under the receiver operating characteristic curve was 67.3% (95% CI, 64.9-69.7%) for the score, while it was 76.3% (73.5-79.0%) for FCG alone and 67.8% (64.9-70.8%) for HbA1c alone. At a cut-off point of 14, the sensitivity and specificity of the risk score were 84.2% (81.0-87.5%) and 39.8% (38.2-41.3%).

Conclusions  The risk score based on age, waist circumference and family history of diabetes is efficient as a layperson-oriented diabetes screening tool for health promotion and for population-based screening programmes.

  L. Y. Qie , J. P. Sun , F. Ning , Z. C. Pang , W. G. Gao , J. Ren , H. R. Nan , L. Zhang and Q. Qiao
 

Aims

To study the cardiovascular disease risk profiles in newly diagnosed diabetes diagnosed by either glucose or/and HbA1c criteria in Chinese adults.

Methods

Two population-based cross-sectional studies were conducted in 2006 and 2009, respectively. Data from 1987 men and 2815 women aged 35-74 years were analysed. Newly diagnosed diabetes was defined according to either glucose (fasting and/or 2-h glucose), HbA1c or both criteria.

Results

Ageing, positive family history of diabetes, elevated levels of waist circumference, systolic blood pressure, total cholesterol, triglycerides and γ-glutamyl transferase were independently associated with newly diagnosed diabetes defined by glucose criterion alone, but not for diabetes defined by HbA1c criterion alone. Only waist circumference, total cholesterol and smoking were significantly associated with the presence of diabetes defined by HbA1c criterion alone.

Conclusions

Cardiovascular disease risk profiles were different in patients with newly diagnosed diabetes defined by the two diagnostic criteria for diabetes. This may have certain clinical implications on diabetes management and research.

 
 
 
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