Background: Metabolic syndrome (MetS) in non-overweight/obese people is insidiously associated with cardiovascular disease. Novel anthropometric indices can reflect central obesity better than the traditional anthropometric indices. Therefore, we hypothesize that these newly developed anthropometric indices can better identify MetS in non-overweight/obese people than conventional indices.Methods: Cross-sectional data of sociodemographic, biochemical and anthropometric indices were collected from 2916 non-overweight/obese Chinese people. A body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI) and abdominal volume index (AVI) were calculated. Partial correlation analysis was used to clarify the correlation between anthropometric indices and MetS variables. Binary logistic regression analysis was applied to assess the association between anthropometric indices and MetS and its components. Receiver-operating characteristic curve was used to identify the diagnostic ability of anthropometric indices for MetS and its components. The area under curve (AUC) difference between WHtR and each new anthropometric index was compared in pairs.Results: After adjusting for covariates, AVI had the optimal ability of identifying MetS (AUC: 0.743 for male, 0.819 for female) and the strongest correlation with high-density lipoprotein cholesterol (HDL-C) (coe: − 0.227 for male, − 0.207 for female) and the highest odds rations (OR) with low HDL-C group (male: OR = 1.37, female: OR = 1.55). The WHtR was comparable to BRI in assessing MetS (AUC: 0.739 for male, 0.817 for female). WHtR or BRI could also well identify hypertension (AUC: 0.602 for male, 0.688 for female) and dysglycemia (AUC: 0.669 for male, 0.713 for female) and female’s high triglyceride level (AUC 0.712). The recognition ability of the two was equivalent. The ability of ABSI and WWI to identify MetS was weak.Conclusions: AVI is the optimal anthropometric indices to identify MetS in non-overweight/obese Chinese adults. BRI and WHtR can also be considered as discriminators, while ABSI and WWI are weak discriminators. WHtR is easy to measure. So, it is recommended as an early preliminary screening method for the MetS in non-overweight/obese people.

Objective. To develop a “knowledge‐attitude‐practice” questionnaire as an evaluating tool of foreigners’ cognition on TCM treatment, so as to promote the internationalization of TCM. Methods. The questionnaire was based on the “knowledge‐attitude‐practice” model and adjusted by expert consultation using the Delphi method. After conducting a survey among foreigners, Cronbach’s α and exploratory factor analysis were used to test the internal consistency reliability and structural validity of the questionnaire, respectively. Results. A total of 10 experts participated in two rounds of expert consultation. The recovery rates of two rounds of expert consultation form were 100.0%. The coefficient authority in two rounds of expert consultation was 0.87 and 0.88, respectively. The concentration of expert opinions in the knowledge, attitude, and practice dimensions was 3.80 to 4.70 points, 3.70 to 4.50 points, and 3.60 to 4.40 points, respectively, in the first round and 4.30 to 4.80 points, 4.10 to 4.60 points, and 4.00 to 4.50 points, respectively, in the second round. The coefficient of variation in the knowledge, attitude, and practice dimensions was 0.10–0.32, 0.16–0.29, and 0.19–0.35, respectively, in the first round and 0.09–0.19, 0.15–0.25, and 0.16–0.31, respectively, in the second round. The W value and significance test x² in the first round were 0.657 and 218.620 while those in the second round were 0.671 and 181.181(P < 0.001). 8 items were deleted and 1 item was added, and other reserved items were modified according to the statistical analysis results of evaluation items and expert suggestions after the first round and there were no changes after the second round. The revised questionnaire includes three dimensions of knowledge, attitude, and practice, with a total of 30 items. After translating the questionnaire into English, it was conducted in 176 foreigners. Cronbach’s α coefficient of the total questionnaire, knowledge dimension, attitude dimension, and practice dimension was 0.908, 0.781, 0.823, and 0.918, respectively. Exploratory factor analysis extracted 3 factors with a cumulative contribution of 54.090%. After testing reliability and validity, 1 item was deleted, leaving 29 items. Conclusions. After two rounds of expert consultation based on the Delphi method, the results of expert authority, expert coordination, and expert opinions’ concentration were promising, and the expert consultation results were reliable. The “knowledge‐attitude‐practice” questionnaire of foreigners on TCM treatment in English had good reliability and validity and can evaluate foreigners’ cognition on TCM treatment.

Hypertension and diabetes are two common metabolic disorders that often coexist in the same individual. Their concurrence increases the risk of cardiovascular disease, renal dysfunction, and other complications. Cardiovascular disease is the primary cause of morbidity and mortality in individuals with diabetes, and hypertension further aggravates this condition. Interestingly, hypertension and diabetes share several common pathophysiological mechanisms including insulin resistance, vascular inflammation, endothelial dysfunction, obesity, and oxidative stress suggesting a cross-talk between these two conditions that could potentially contribute to the development of other human diseases. Effective management of diabetes should include a multifaceted approach that addresses not only glycemic control but also blood pressure (BP) and lipid control. Treatment plans should be individualized to each patient’s needs and should involve a combination of lifestyle modifications and medications to achieve optimal control. With the availability of newer antidiabetic medications such as SGLT inhibitors and GLP1 receptor agonists, it is crucial to consider their potential to reduce BP, enhance kidney function, and lower the risk of cardiovascular diseases when initiating treatment for glycemic control. A more profound comprehension of the shared underlying mechanisms between these conditions could pave the way for the development of innovative therapeutic approaches to tackle them. Our review offers an in-depth analysis of the literature, providing a holistic view of the mechanisms underlying diabetes-hypertension comorbidity and its implications on heart and kidney diseases. The present article concludes by discussing current approaches for managing hypertensive diabetic patients to create a set of comprehensive individualized recommendations.

The relationship between skeletal muscle and cognitive disorders has drawn increasing attention. This study aims to examine the associations of sarcopenia with cognitive function and dementia risk score. Data on 1978 participants (aged 65 years and older) from the 2011 wave of the China Health and Retirement Longitudinal Study, with four follow-up waves to 2018, were used. Cognitive function was assessed by four dimensions, with a lower score indicating lower cognitive function. Dementia risk was assessed by a risk score using the Rotterdam Study Basic Dementia Risk Model (BDRM), with a higher score indicating a greater risk. Sarcopenia was defined when low muscle mass plus low muscle strength or low physical performance were met. We used generalized estimating equations to examine the associations of sarcopenia. In the fully adjusted models, sarcopenia was significantly associated with lower cognitive function (standardized, β = −0.15; 95% CIs: −0.26, −0.04) and a higher BDRM score (standardized, β = 0.42; 95% CIs: 0.29, 0.55). Our findings may provide a new avenue for alleviating the burden of cognitive disorders by preventing sarcopenia.

Background: Metabolic syndrome and obesity are risk factors for gallstones. However, these two factors often occur together, and few studies have focused on the association between metabolically healthy overweight/obesity (MHOW/MHO) and gallstones. We hypothesized that MHO individuals would be associated with the prevalence of gallstones. Methods: This cross-sectional study included 125,668 participants aged 18–80 years at the Health Promotion Center of Run Run Run Shaw Hospital, Zhejiang University School of Medicine during 2017–2019 years. Each participant underwent a comprehensive health checkup. Gallstones were diagnosed by abdominal ultrasonography. Metabolically health was defined as not meeting the diagnostic criteria for metabolic syndrome (MetS). Obesity was measured by BMI. MetS and weight stratification were combined to classify the metabolism-obesity phenotypes. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% CIs. Results: Among 125,668 participants, 5486 (4.4%) had gallstones. 21407 (17.0%) were MHOW individuals, and 3322 (2.6%) were MHO individuals. MHOW (OR 1.40; 95%CI: 1.29–1.53) and MHO (OR 1.80; 95%CI: 1.53–2.12) participants were at higher risk of gallstones and had larger and more numerous gallstones than metabolically healthy normal weight participants. Obesity, MetS, premenopausal women and advanced age were significantly associated with the prevalence of gallstones. Conclusions: MHOW/MHO individuals exhibited a higher risk of gallstones. In metabolically healthy individuals, the risk of gallstones increased with increasing BMI. Thus, obesity was associated with the prevalence of gallstones, even in relatively metabolically healthy adults.