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Ye Y, Zhou Q, Dai W, Peng H, Zhou S, Tian H, Shen L, Han H. Gender differences in metabolic syndrome and its components in southern china using a healthy lifestyle index: a cross-sectional study. BMC Public Health 2023; 23:686. [PMID: 37046236 PMCID: PMC10091685 DOI: 10.1186/s12889-023-15584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Lifestyle changes are important for the prevention and management of metabolic syndrome (MetS), but studies that focus on gender differences in the lifestyle risk factors of MetS are limited in China. This research aimed to generate a healthy lifestyle index (HLI) to assess the behavioral risk factors of MetS and its components, and to explore the gender differences in HLI score and other influencing factors of MetS. METHODS A convenience sample of 532 outpatients were recruited from a general hospital in Changsha, China. The general information and HLI scores [including physical activity (PA), diet, smoking, alcohol use, and body mass index (BMI)] of the subjects were collected through questionnaires, and each patient's height, weight, waist circumference, and other physical signs were measured. Logistic regression analysis was used to analyze the risk factors of MetS and its components. RESULTS The prevalence of MetS was 33.3% for the whole sample (46.3% in males and 23.3% in females). The risk of MetS increased with age, smoking, unhealthy diet, and BMI in males and with age and BMI in females. Our logistic regression analysis showed that lower HLI (male: OR = 0.838,95%CI = 0.757-0.929; female: OR = 0.752, 95%CI = 0.645-0.876) and older age (male: OR = 2.899, 95%CI = 1.446-5.812; female: OR = 4.430, 95%CI = 1.640-11.969) were independent risk factors of MetS, for both sexes. CONCLUSION Low levels of HLI and older ages were independent risk factors of MetS in both males and females. The association between aging and MetS risk was stronger in females, while the association between unhealthy lifestyles and MetS risk was stronger in males. Our findings reinforced the expected gender differences in MetS prevalence and its risk factors, which has implications for the future development of gender-specific MetS prevention and intervention programs.
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Affiliation(s)
- Ying Ye
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
- Xiangya School of Nursing, Central South University, Changsha, P.R. China
| | - Qiuhong Zhou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
- Xiangya School of Nursing, Central South University, Changsha, P.R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China
| | - Weiwei Dai
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Hua Peng
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Shi Zhou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Huixia Tian
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Lu Shen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China
| | - Huiwu Han
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Xiangya Road 87#, Changsha, Hunan, P.R. China.
- Xiangya School of Nursing, Central South University, Changsha, P.R. China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China.
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Kuo WC, Ersig AL, Johnson HM, Brown RL, Oakley LD, Hagen EW, Barnet JH, Peppard PE. Association between stressful life events and non-optimal lipid levels among women with hyperlipidaemia. Eur J Cardiovasc Nurs 2023; 22:210-219. [PMID: 35714051 DOI: 10.1093/eurjcn/zvac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 11/14/2022]
Abstract
AIMS Psychological stress has been linked to lipid dysregulation with noticeable gender differences, but it remains unclear whether women are more susceptible to non-optimal lipid levels than men, when experiencing stressful life events. This study aims to examine the association between stressful life events and non-optimal lipid levels among persons with hyperlipidaemia and whether the association differs between men and women. METHODS AND RESULTS A nested case-control study was performed using data from the Wisconsin Sleep Cohort (WSC) Study from 2011 to 2015, including 224 participants with hyperlipidaemia and without a history of myocardial infarction or heart failure. Among them, 63 participants with non-optimal LDL cholesterol or triglyceride levels were identified as cases, and 161 participants with optimal LDL cholesterol and triglyceride levels were identified as controls. Cases and controls were traced back to their self-reported life events collected through the Retirement and Sleep Trajectories study during 2010-11. The association between stressful life events and non-optimal lipid levels was examined using multivariable logistic regression; confounding effects were addressed using propensity score weighting and Mahalanobis distance matching; gender differences were examined using subgroup analysis. Results showed that a higher number of stressful life events during 2010-11 was associated with greater odds of non-optimal lipid levels during 2011-15 (odds ratio = 1.45, P = 0.03) among women with hyperlipidaemia, whereas the association was not significant among men with hyperlipidaemia (P = 0.910). CONCLUSION Future studies are needed to examine the underlying mechanisms that explain gender differences in the association between stressful life events and non-optimal lipid levels. REGISTRATION ClinicalTrials.gov NCT00005557.
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Affiliation(s)
- Wan-Chin Kuo
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Anne L Ersig
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Heather M Johnson
- Christine E. Lynn Women's Health and Wellness Institute, Boca Raton Regional Hospital/Baptist Health South Florida, Florida Atlantic University, Boca Raton, FL, USA
| | - Roger L Brown
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Linda D Oakley
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Erika W Hagen
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jodi H Barnet
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Paul E Peppard
- School of Medicine and Public Health, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Kuo WC, Bratzke LC, Hagen EW, Hale L, Brown RL, Barnet JH, Peppard PE. Metabolic health disparities driven by financial stress: Behavioural adaptation or modification? Stress Health 2022. [PMID: 36413205 DOI: 10.1002/smi.3210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 11/01/2022] [Accepted: 11/11/2022] [Indexed: 11/23/2022]
Abstract
Financial stress has been linked to an increased risk of metabolic syndrome, yet, it remains unclear whether suboptimal sleep duration and physical inactivity are the adaptive responses to financial stress or effect modifiers in the association between financial stress and metabolic syndrome. Hence, this study aims to examine whether physical activity and sleep duration mediate or moderate the bivariate association between financial stress and metabolic syndrome. A prospective secondary analysis was conducted using data from the Wisconsin Sleep Cohort Study (N = 445, mean [SD] age = 64 [7] years). Baseline moderation effect was examined using subgroup analysis with model constraints; prospective mediation model was examined using bias-corrected bootstrap confidence intervals. Results indicate that participants with higher financial stress were less likely to meet physical activity and sleep recommendations. Baseline moderation analysis indicates that meeting current recommendations of sleep duration and physical activity attenuated the association between financial stress and metabolic syndrome. In the prospective mediation analysis, weekly physical activity levels partially mediated the relationship between financial stress and metabolic syndrome, but sleep duration did not mediate this relationship. In conclusion, the joint effect of optimal sleep duration and physical activity disassociates financial stress from the risk of metabolic syndrome. Future interventions addressing metabolic risk might achieve better outcomes if clinicians and researchers factor in the behavioral adaptation of physical inactivity in financially stressed adults (Clinical Trial Registration: NCT00005557).
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Affiliation(s)
- Wan-Chin Kuo
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Lisa C Bratzke
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erika W Hagen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Roger L Brown
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jodi H Barnet
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Paul E Peppard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Abstract
BACKGROUND Although the academic literature has focused on family caregivers' health outcomes, little is known about the social and environmental determinants of health and the extent to which they relate to health disparities among family caregivers caring for older adults. OBJECTIVES The purpose of the study was to describe the prevalence of diseases and the association with social and environmental determinants of health among family caregivers caring for older adults in Finland. METHODS A cross-sectional analysis was conducted. The study participants were interviewed on sociodemographic factors, comorbidity, and the World Health Organization Quality-of-Life questionnaire. Independent-samples t-test, analysis of variance, and chi-square analyses were used to assess the social and environmental factors' association with health outcomes. RESULTS A total of 126 family caregivers participated in this study. The mean age of study participants was 74.4 years, and most were female, married, and from an urban area. Family caregivers' older age and lower financial satisfaction were the main factors associated with the health inequalities. Older age was associated with age-related eye disorders, hearing impairment, coronary heart disease, and comorbidity. Family caregivers' lower financial satisfaction was associated with diabetes, depression, and higher BMI. Other factors linked to health disparities were family caregivers' sex, educational attainment, and the municipality of living. DISCUSSION This study provides evidence about family caregivers' social and environmental determinants of health. To enhance health equity, nurse-led interventions, a life-course approach, and intersectional actions are required.
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