MATERIALS AND METHODS Subjects The data for this cross sectional study were

Materials and methods subjects the data for this

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MATERIALS AND METHODS Subjects The data for this cross-sectional study were derived from a single city center, the Beijing sub-center, which is part of a much larger multi-center research study called the Risk Evaluation of Cancers in Chinese Diabetic Individuals: a lONgitudinal (REACTION) study ( Ning, 2012 ). The REACTION project is a China-wide survey aimed at investigating the influence of metabolic diseases on cancer. The Beijing sub-center included 10 administrative regions, divided into 5 urban areas and 5 suburban areas. A total 10,276 participants aged 40 years or over were enrolled between April and October, 2015. After excluding subjects for any pathology or medical intervention that could alter the neck circumference, including neck malformation, prior neck surgery, thyromegaly, thyroid dysfunction and incomplete information for anthropometric parameters or laboratory examination, 8,971 subjects were finally included in our study. All subjects gave written informed consent in accordance with the Declaration of Helsinki. The protocol was approved by the Committee on Human Research of the Chinese People’s Liberation Army General Hospital. Data Collection A standard questionnaire was completed by an in-person interview (between the survey interviewer and each study participant). Information on demographics, history of disease and corresponding medication use, smoking status and drinking status were collected during this process. Physical examination was performed to obtain information on weight, height, neck circumference, waist circumference and blood pressure. Weight was measured to the nearest 0.5 kg by an electronic weight scale while participants wore light clothing (Beijing Jianmin); height was measured with a vertical height meter to the nearest 0.1 cm. The participants had to remove their shoes, hats, jackets, overcoats, and empty their pockets. Neck circumference was measured with a measuring tape along the inferior margin of the laryngeal prominence and perpendicular to the long axis of the neck, with the subject remaining standing and the head in the horizontal plane position. Waist circumference was measured at the horizontal plane between the inferior costal margin and the iliac crest on the mid-axillary line. All circumferences were recorded to within 0.1 cm. Blood pressure was measured three times at 1-min intervals using a mercury sphygmomanometer after at least a 5-min rest, and the mean value of the three readings was recorded. The blood samples at fasting status were taken to determine fasting plasma glucose and uric acid levels and lipid profile. Participants were then subjected to a glucose load. Participants without a validated history of diabetes underwent a 75-g oral glucose tolerant test (OGTT), and participants with a history of diabetes underwent a 100-g carbohydrate diet test. Two hours after the OGTT or carbohydrate diet test, blood samples were taken again to determine the glucose tolerance of the subjects.
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