Background: Evidence on the interrelations between cigarette smoking and a cluster of lifestyle behaviors is scarce for the Chinese youth population. This study is conducted to identify the associations between cigarette smoking and multiple health-related behaviors in a Chinese sample of...

Objectives: This study aimed to investigate the relationship between the triglyceride–glucose (TyG) index, its combination with the body roundness index (BRI), and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM) based on a cross-sectional analysis conducted in Eastern China. Methods: The research originates from a cross-sectional study performed in Zhejiang Province, Eastern China, between March and November 2018. The TyG-BRI index was calculated based on triglyceride, fasting blood glucose, and the BRI. The correlation between the TyG-BRI index and the risk of CKD was assessed using a restricted cubic spline model. A multivariate logistic regression model was used to investigate the association between the TyG-BRI index and the risk of CKD. Receiver operating characteristic (ROC) analyses was used to evaluate the optimal cut-off and value of the TyG-BRI index for predicting CKD. Results: A total of 1756 T2DM participants were enrolled in this study. The TyG-BRI index was significantly higher in participants with CKD than in those without CKD. In the fully adjusted model, the odds ratios for CKD in the second, third, and fourth TyG-BRI quartiles were 0.93 (95% CI: 0.65–1.33), 1.33 (95% CI: 0.94–1.88), and 1.57 (95% CI: 1.10–2.25), respectively, compared to the first quartile. RCS analysis confirmed a linear dose–response relationship between the TyG-BRI index and CKD risk (all p for nonlinearity > 0.05). ROC curve analysis revealed that the TyG-BRI index had moderate predictive value for CKD, with an area under the curve of 0.626 (95% CI: 0.597–0.656, p < 0.001). The optimal cut-off value for the TyG-BRI index was 42.46, with a sensitivity of 68.2% and specificity of 52.2%. Conclusions: The TyG-BRI index was positively associated with the risk of CKD in a T2DM population, demonstrating a dose–response relationship and moderate predictive value. It may serve as a valuable tool for identifying high-risk individuals and informing targeted interventions to prevent or delay CKD progression in this population.

In China, a major source of sodium is salt added during cooking. In this context, use of a salt-restriction spoon (SRS) has been promoted in public health campaigns and by health care providers. To describe use of and factors associated with SRS use, knowledge of correct use, and actual correct use. This study is a population-based, representative survey of 7512 residents, aged 18 to 69 years, of China’s Zhejiang Province. The survey, which was conducted in 2017 using a multistage random sampling strategy, collected demographic information, SRS use, and physical measurements; a 24-h urine collection was obtained from 1,496 of the participants. The mean age of the participants was 44.8 years, 50.1% were females, and over 1/3 (35.3%) were classified as hypertensive. Mean 24-h urinary sodium and potassium excretions were 167.3(72.2) mmol/24 h and 38.2(18.2) mmol/24 h, respectively. Only 12.0% (899/7512) of participants once used or were currently using SRS; of the 899 users, 73.4% knew how to use the SRS correctly, and just 46.5% actually used it correctly. SRS use was more commonly associated with behavioral factors rather than socio-demographic factors. Initiation of SRS use by health care providers was associated with correct technical knowledge of SRS. Lower sodium-to-potassium ratio was associated with SRS use, while SRS use was not associated with urinary sodium and potassium excretion. Use of SRS was uncommon in Zhejiang Province of China. Given that a common source of sodium in China is salt added during cooking, use of SRS is an appealing strategy, ideally as part of a multi-component campaign.

Objective: This study describes the association between taste preference for salt and actual salt intake, thus guiding and refining personal and public health campaigns designed to lower salt intake in China. Methods: A cross-sectional survey of 1489 residents aged 18 to 69 years was conducted in 2017 in China. A multistage random sampling strategy was used, and a combination of questionnaires and physical and laboratory measurements were conducted to collect baseline characteristics and knowledge, attitudes, and behavior (KAB) related to salt. A 24 h urine collection was obtained for sodium and potassium excretion analysis. Participants were divided into two groups, light taste preference and salty taste preference, according to their answer to the question “Compared to others, how do you think your taste preference is for salt?”. Results: The mean age of the 1489 participants was 46.26 years, 48.9% were males, over 1/3 (35.7%) were identified as hypertensive, and 317 (21.3%) self-reported a salty taste preference. The mean of 24 h urinary sodium excretion was 167.32 mmol/24 h, corresponding to 9.79 g salt/d intake, and the sodium-to-potassium ratio (Na/K) was 4.90. The 24 h urinary sodium excretion of salty taste preference (177.06 mmol/24 h) was significantly higher than that of light taste preference (164.69 mmol/24 h). The multiple logistic regression analysis showed that the salty taste preference group had significantly higher 24 h urinary sodium (ORa(95%CI) = 1.004(1.002–1.006)), diastolic blood pressure (DBP), proportion of greasy food preference, and drinking levels, but lower potassium excretion, response levels to most KAB questions, and regular physical activity compared to the light taste preference group. Conclusion: Self-reported taste preference for salt predicted actual salt intake, which was verified by 24 h urinary sodium monitoring. Taste preference for salt could be used as a proxy for intake in terms of targeted salt intake, nutrition, and health education.

Background: Addressing high-salt diets in China through interventions can significantly reduce blood pressure (BP) and the associated health risks. Objective: This study aims to evaluate the effectiveness of a comprehensive salt reduction intervention implemented across counties in Zhejiang Province, focusing on system establishment, extensive publicity, and targeted population interventions. Methods: The Salt Reduction and Hypertension Prevention Project was initiated in Zhejiang Province. Cross-sectional surveys were conducted before the intervention and after. The research commenced in 2017 with a baseline survey involving 7512 participants from five counties. Four counties were randomly selected for the intervention, implementing a multifaceted salt reduction strategy, while one county served as a reference without any intervention. The primary outcomes measured were changes in BP and 24 h urinary sodium and potassium excretion. Results: Following the intervention, 24 h urinary potassium excretion experienced a significant increase, rising from 1441.3 (SD 681.9) to 1676.9 (SD 931.4) mg per day, p < 0.001. Utilizing a linear mixed-effects model, the adjusted net difference in urinary sodium changes was calculated to be 394.1 mg per day (95% CI, 133.2 to 655.0) (p = 0.003). There was a notable reduction in systolic blood pressure (SBP) from 131.2 (SD 19.2) to 129.8 mmHg (SD 18.0), and diastolic blood pressure (DBP) also decreased from 80.8 (SD 10.8) to 78.9 mmHg (SD 10.2), p < 0.001. The adjusted net differences for SBP and DBP between the intervention and reference groups were 1.3 (95%CI, 0.5 to 2.1) and 1.4 mmHg (95%CI, 0.9 to 2.0), respectively, p < 0.001. Conclusions: The findings indicate that a multi-sectoral approach, combined with extensive public awareness initiatives and precisely targeted interventions, can significantly increase urinary potassium excretion and reduce sodium and blood pressure.

Background: Although B vitamins are implicated in cardiovascular regulation, the associations between serum thiamine (vitamin B1) and blood pressure (BP) remain unclear, particularly among women who are at high risk for hypertension-related complications. This study aimed to investigate relationships between serum thiamine levels and BP outcomes among middle-aged and elderly women in eastern China. Methods: A community-based cross-sectional study was conducted among 2015 women aged 45–69 years in Zhejiang Province, China. Serum thiamine levels were quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS). Hypertension was defined as measured BP ≥ 140/90 mmHg, or current use of antihypertensive medications. Multivariate logistic and linear regression models were used to assess associations of thiamine with hypertension prevalence and BP levels, respectively. Dose–response relationships were evaluated using restricted cubic splines (RCSs). Results: Higher thiamine levels were significantly associated with reduced hypertension prevalence (adjusted OR per SD increase: 0.87; 95%CI: 0.77, 0.97), with RCSs confirming linear dose–response (p-overall < 0.05, p-nonlinearity > 0.05). Compared with the lowest tertile, participants in the highest thiamine tertile had a 25% lower hypertension risk. Thiamine levels also showed negative associations with systolic BP (adjusted coef: −1.51 mmHg per SD; 95% CI: −2.33, −0.68), with the participants in the highest tertile showing a 3.94 mmHg reduction (95%CI: −5.97, −1.92). No significant relationship was found for diastolic BP. Conclusions: Serum thiamine is inversely associated with both hypertension prevalence and systolic BP in middle-aged and elderly women. This study supports the potential of serum thiamine as a modifiable biomarker in hypertension prevention strategies, particularly among aging women.