BackgroundMetabolic syndrome (MetSyn) increases the incidence of cardiovascular disease. Information on changes in prevalence of MetSyn in developing countries is limited. This study aims to compare MetSyn prevalence and its associated vascular risk over the period between 2002 and 2010 in a population which has had the world’s fastest economic development over the past three decades.MethodsTwo health surveys were conducted by using the multistage cluster random sampling method in a Chinese population of 85 million in southern China. The participants received a full medical check-up, including measurement of blood pressure (BP), obesity indices, fasting lipids and glucose levels. Data describing socio-economic status and lifestyle factors were also collected through interview. Metabolic syndrome was defined in accordance with the International Diabetes Federation criteria.ResultsA total of 3,561 participants from Survey 2010 were included in the data analysis. Women had a significantly higher prevalence of MetSyn than men. Comparison between the two surveys shows that age-standardized prevalence of MetSyn increased fourfold (from 5.4% in 2002 to 21.3% in 2010) in those ≧ 20 years. Among the MetSyn components, prevalence of hyperglycaemia has increased most (from 9.1% to 53.1%). The age-standardized prevalence of central obesity, hypertension, hypertriglyceridaemia and low HDL-cholesterol increased from 13.5% to 25.4%, from 23.6% to 40.8%, from 12.1% to 17.4% and from 32.1% to 71.1%, respectively. Differences between rural and urban residents in the prevalence in MetSyn and its components narrowed in 2010.ConclusionsCardiovascular risk escalated dramatically in this population between 2002 and 2010. The escalation may relate to the rapid economic development, which led to accelerating changes in nutrition, lifestyle, and socio-economic status. Our findings suggest that health transition in rapidly developing second- and third-world countries may be much faster than what has been observed in Western countries.

BackgroundMany studies have investigated heat wave related mortality, but less attention has been given to the health effects of cold spells in the context of global warming. The 2008 cold spell in China provided a unique opportunity to estimate the effects of the 2008 cold spell on mortality in subtropical regions, spatial heterogeneity of the effects, stratification effect and added effects caused by sustained cold days.MethodsThirty-six study communities were selected from 15 provinces in subtropical China. Daily mortality and meteorological data were collected for each community from 2006 to 2010. A distributed lag linear non-linear model (DLNM) with a lag structure of up to 27 days was used to analyze the association between the 2008 cold spell and mortality. Multivariate meta-analyses were used to combine the cold effects across each community.ResultsThe 2008 cold spell increased mortality by 43.8% (95% CI: 34.8% ~ 53.4%) compared to non-cold spell days with the highest effects in southern and central China. The effects were more pronounced for respiratory mortality (RESP) than for cardiovascular (CVD) or cerebrovascular mortality (CBD), for females more than for males, and for the elderly aged ≥75 years old more than for younger people. Overall, 148,279 excess deaths were attributable to the 2008 cold spell. The cold effect was mainly from extreme low temperatures rather than sustained cold days during this 2008 cold spell.ConclusionsThe 2008 cold spell increased mortality in subtropical China, which was mainly attributable to the low temperature rather than the sustained duration of the cold spell. The cold effects were spatially heterogeneous and modified by individual-specific characteristics such as gender and age.

BackgroundIn many parts of the world, including in China, extreme heat events or heat waves are likely to increase in intensity, frequency, and duration in light of climate change in the next decades. Risk perception and adaptation behaviors are two important components in reducing the health impacts of heat waves, but little is known about their relationships in China. This study aimed to examine the associations between risk perception to heat waves, adaptation behaviors, and heatstroke among the public in Guangdong province, China.MethodsA total of 2,183 adult participants were selected using a four-stage sampling method in Guangdong province. From September to November of 2010 each subject was interviewed at home by a well-trained investigator using a structured questionnaire. The information collected included socio-demographic characteristics, risk perception and spontaneous adaptation behaviors during heat wave periods, and heatstroke experience in the last year. Chi-square tests and unconditional logistic regression models were employed to analyze the data.ResultsThis study found that 14.8%, 65.3% and 19.9% of participants perceived heat waves as a low, moderate or high health risk, respectively. About 99.1% participants employed at least one spontaneous adaptation behavior, and 26.2%, 51.2% and 22.6% respondents employed <4, 4–7, and >7 adaptation behaviors during heat waves, respectively. Individuals with moderate (OR=2.93, 95% CI: 1.38-6.22) or high (OR=10.58, 95% CI: 4.74-23.63) risk perception experienced more heatstroke in the past year than others. Drinking more water and wearing light clothes in urban areas, while decreasing activity as well as wearing light clothes in rural areas were negatively associated with heatstroke. Individuals with high risk perception and employing <4 adaptation behaviors during heat waves had the highest risks of heatstroke (OR=47.46, 95% CI: 12.82-175.73).ConclusionsThere is a large room for improving health risk perception and adaptation capacity to heat waves among the public of Guangdong province. People with higher risk perception and fewer adaptation behaviors during heat waves may be more vulnerable to heat waves.

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