Type 2 Diabetes Mellitus (T2DM) is a chronic disease closely related to personal life style. Therefore, achieving effective self-management is one of the most important ways to control it. There is evidence that social support can help to improve the self-management ability of patients with T2DM, but which social support is more effective has been rarely explored. The purpose of this study is to construct an integrated model to analyze which social support has more significant impact on self-management of T2DM, and provide reasonable suggestions to health care providers on how to effectively play the role of social support. We established a social support indicator evaluation system and proposed an integrated model that combines ANP (Analytical Network Process) and CRITIC (CRiteria Importance through Intercriteria Correlation) methods to evaluate the impact of social support on T2DM self-management from both subjective and objective perspectives. The weights calculated by the model will serve as the basis for us to judge the importance of different social support indicators. Informational support (weighting 49.26%) is the most important criteria, followed by tangible support (weighting 39.24%) and emotional support (weighting 11.51%). Among 11 sub-criteria, guidance (weighting 23.05%) and feedback (weighting 14.68%) are two most relevant with T2DM self-management. This result provides ideas and evidence for health care providers on how to offer more effective social support. To our knowledge, this is the first study in which Multi-Criteria Decision Making (MCDM) tools, specifically ANP and CRITIC, are used to evaluate the impact of social support on improving self-management of type 2 diabetes. The study suggests that incorporating two sub-indicators of guidance and feedback into the diabetes care programs may have great potential to improve T2DM self-management and further control patient blood glucose and reduce complications.

Milk composition remains the best estimate of infant requirements. The aims of this study were to quantify carotenoids and tocopherols in human milk from healthy Chinese mothers, and to explore their associations with lactation stage, region, socio-economic and obstetric characteristics, and dietary intake. Human milk was obtained from 509 healthy mothers, and concentrations of carotenoids and tocopherols were analyzed by Ultra High Performance Liquid Chromatography. The mothers’ socio-economic and obstetric characteristics and dietary intake through a single 24-h dietary recall were evaluated. The median concentrations (μg/100 mL) of each component of 0–4 days, 5–11 days, 12–30 days, 31–60 days, 61–120 days, and 121–240 days postpartum were respectively as follows: β-carotene 8.0, 2.8, 2.1, 1.7, 1.9, 1.8; β-cryptoxanthin 6.2, 3.4, 2.4, 1.7, 1.8, 2.1; lutein 5.7, 7.0, 2.2, 2.9, 2.8, 3.7; lycopene 6.3, 2.5, 1.8, 1.4, 1.4, 1.5; zeaxanthin 1.0, 1.4, 0.8, 0.8, 1.0, 1.1; α-tocopherol 645, 382, 239, 206, 212, 211; γ-tocopherol 68, 63, 70, 73, 68, 88. The levels of those components varied significantly among different lactation stages and presented regional differences. Associations of carotenoid contents with maternal education, delivery mode, and present body mass index were found in multivariate analyses. These results suggested that lactation stage, region, and socio-economic and obstetric factors were associated with human milk concentrations of carotenoids and tocopherols in healthy Chinese mothers.

Hypertension is a major risk factor for the global burden of disease, particularly in countries that are not economically developed. This study aimed to evaluate risk factors associated with self-reported hypertension among residents of Inner Mongolia using a cross-sectional study and to explore trends in the rate of self-reported hypertension. Multi-stage stratified cluster sampling was used to survey 13,554 participants aged more than 15 years residing in Inner Mongolia for the 2013 Fifth Health Service Survey. Hypertension was self-reported based on a past diagnosis of hypertension and current use of antihypertensive medication. Adjusted odds risks (ORs) of self-reported hypertension were derived for each independent risk factor including basic socio-demographic and clinical factors using multivariable logistic regression. An optimized risk score model was used to assess the risk and determine the predictive power of risk factors on self-reported hypertension among Inner Mongolia residents. During study period, self-reported hypertension prevalence was 19.0% (2571/13,554). In multivariable analyses, both female and minority groups were estimated to be associated with increased risk of self-reported hypertension, adjusted ORs (95% CI) were 1.22 (1.08, 1.37) and 1.66 (1.29, 2.13) for other minority compared with Han, increased risk of self-reported hypertension prevalence was associated with age, marital status, drinking, BMI, and comorbidity. In the analyses calculated risk score by regression coefficients, old age (≥71) had a score of 12, which was highest among all examined factors. The predicted probability of self-reported hypertension was positively associated with risk score. Of 13,421 participants with complete data, 284 had a risk score greater than 20, which corresponded to a high estimated probability of self-reported hypertension (≥67%). Self-reported hypertension was largely related to multiple clinical and socio-demographic factors. An optimized risk score model can effectively predict self-reported hypertension. Understanding these factors and assessing the risk score model can help to identify the high-risk groups, especially in areas with multi-ethnic populations.

Evidence on the effect of ambient air pollution on vitamin D is limited. This study aimed to examine the association of air pollution exposure with serum levels of 25-hydroxyvitamin D (25OHD) using UK Biobank health datasets. A total of 448,337 subjects were included in this analysis. Land Use Regression was applied to assess individual exposures to particulate matter with diameters ≤2.5 µm (PM_2.5), ≤10 µm (PM₁₀), nitrogen dioxide (NO₂), and nitrogen oxides (NO_x). Linear regression models evaluated the associations between air pollutants and serum vitamin D levels after adjustment of a series of confounders. All analyzed air pollutants were negatively associated with serum vitamin 25OHD levels. After adjusting for potential confounders, a 10 μg/m³ increase in concentrations of PM_2.5, PM₁₀, NO_x, and NO₂ was associated with −9.11 (95%CI: −13.25 to −4.97), −2.47 (95%CI: −4.51 to −0.43), −0.56 (95%CI: −0.82 to −0.30), and −1.64 (95%CI: −2.17 to −1.10) nmol/L decrease in serum vitamin 25OHD levels, respectively. Interaction analyses suggested that the effects of air pollution were more pronounced in females. In conclusion, long-term exposures to ambient PM_2.5, PM₁₀, NO_x, and NO₂ were associated with vitamin D status in a large UK cohort.

Despite the importance of vitamin D in early stages of life, data are lacking on the levels of vitamin D intake and serum 25-hydroxyvitamin D (25-(OH)D) among Chinese school-age children. The aims of this study were to investigate the vitamin D intake and serum 25-(OH)D concentration of children aged 7 to 12 years in China, and to measure the associations between vitamin D status and children’s growth and development parameters. We obtained data on vitamin D intake, serum 25-(OH)D concentration, and anthropometric measurements from a cross-sectional study on school-aged children in China. Multiple linear regression and multivariable logistic regression analyses assessed the associations mentioned above. A total of 563 children (9.5 ± 1.6 years) from six areas of China were included. Among them, 86.1% had a vitamin D intake below the recommended nutrient intake (10 μg/day), and 54.7% had vitamin D deficiency (serum 25-(OH)D <15 ng/mL). We also found that high vitamin D intake was inversely associated with the risk of vitamin D deficiency (OR = 0.836, 95% confidence interval: 0.713, 0.980), and serum 25-(OH)D concentration was positively associated with the intelligence score and body mass index-for-age Z-score (BAZ) (p < 0.05). Insufficient vitamin D intake and serum 25-(OH)D are prevalent among Chinese school-aged children. A negative association was observed between vitamin D intake and the risk of vitamin D deficiency. Moreover, vitamin D status was positively associated with intelligence and BAZ, which await confirmation in future studies.