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CN 34-1304/R ISSN 1674-3679

2023 Vol. 27, No. 1

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Literature Review
Study on population and subpopulation precision nutrition
LING Wen-hua
2023, 27(1): 1-3. doi: 10.16462/j.cnki.zhjbkz.2023.01.001
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Precision nutrition is a "tailored" dietary measure based on genetics, physiological metabolism, living characteristics, environmental exposure and other factors. Precision nutrition does not favor that each person or patient will be treated dietary measures differently from every other individual. The mission of precision nutrition should also emphasize to develop dietary measures from the group and subgroup dimensions to promote health and reduce the risk of chronic diseases.
Original Articles
Analysis and prediction of the trends of esophageal cancer mortality attributable to low fruit intake in China from 1990 to 2019
ZHANG Yan-ran, YU Chuan-hua, HU Di, WEI Qiao-qiao, HU Ying
2023, 27(1): 4-10. doi: 10.16462/j.cnki.zhjbkz.2023.01.002
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  Objective  To analyze the long-term trends in esophageal cancer attributable to low fruit intake in China from 1990 to 2019, and to predict the changes from 2020 to 2034, so as to provide scientific suggestions for esophageal cancer prevention and control in China.  Methods  Data on mortality burden of esophageal cancer attributable to low fruit intake in China from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 (GBD2019). Joinpoint regression model was used to analyze the trend of esophageal cancer mortality. Age, period, birth cohort effects were evaluated using age-period-cohort (APC) models. Deaths from 2020 to 2034 were predicted using the R software Nordpred package.  Results  The age-standardized mortality rates showed an overall downward trend for esophageal cancer attributable to low fruit intake from 1990 to 2019 in China, decreased from 3.86/105 to 1.02/105 in total population, from 5.27/105 to 1.72/105 in male, and from 2.61/105 to 0.44/105 in female, with the average annual percentage change (AAPC) of both -4.54%, male -3.83%, female -5.94%, respectively. The analysis of APC model showed that the longitudinal mortality rates of esophageal cancer attributable to low fruit intake showed an upward trend first and then a downward trend with age, and the overall trend was upward, the mortality increased from 0.20/105 to 3.54/105 in total population, from 0.26/105 to 6.40/105 in male, and from 0.37/105 to 1.36/105 in female. Risk of death decreased over time. The RR decreased from 1.28 to 0.19 in total population, from 1.24 to 0.22 in male, from 1.52 to 0.11 in female. Cohorts born later had lower mortality risk. The RR decreased from12.31 to 0.04 in total population, from 8.96 to 0.05 in male, and from 26.04 to 0.01 in female. From 2020 to 2034, the number of deaths will fall to 73 897 and mortality rate to 0.52/105.  Conclusions  The corresponding prevention and control strategies are effective for esophageal cancer attributable to low fruit intake in China from 1990 to 2019. At the same time, it is necessary to strengthen the related disease and physical examination of men over the age of 50 and scientifically guide the fruit intake of residents.
Analysis of death trend and life loss of liver cancer in Yunnan Province, 2015-2019
FENG Cheng-cheng, YU Qiu-li, LIANG Xue-meng, SUN Hao, CHEN Yang, CHANG Wei
2023, 27(1): 11-16. doi: 10.16462/j.cnki.zhjbkz.2023.01.003
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  Objective  To understand the level of death, changing trends and life expectancy loss of liver cancer among Yunnan residents from 2015 to 2019, and to provide a basis for the development of local scientific prevention and control measures.  Methods  The cause of death surveillance data of liver cancer in Yunnan Province from 2015 to 2019 were obtained through the Population Death Information Registration Management System. The epidemiological description of the level of death and life expectancy loss of liver cancer in Yunnan Province was performed by Stata16 and Excel 2019 software to calculate the indicators related to liver cancer death and life expectancy loss. And the trend of liver cancer death and life expectancy loss was analyzed by Joinpoint software.  Results  From 2015 to 2019, 30 912 cumulative liver cancer deaths were reported in Yunnan Province, with an average age of death of (61.76 ± 13.81) years. And the standardized mortality rate increased from 12.40/100 000 in 2015 to 14.10/100 000 in 2019, with both male mortality rates were higher than female, and rural mortality rates were higher than urban. The mortality rate of liver cancer in Yunnan Province increased with age, and the trend of death begins to increase rapidly around the age of 35 for male. The potential years of life lost due to death from liver cancer from 2015 to 2019 was 256 380 person-years, with a potential life loss rate of 1.08 per 1 000. The standardized potential years of life lost was 266 962 person-years, with a standardized potential life loss rate of 1.12 per 1 000, with higher life loss in male than in female and higher life loss in rural than in urban areas.  Conclusions  The crude mortality rate and life expectancy loss of liver cancer in Yunnan Province from 2015 to 2019 are on the rise. And male and rural residents are the high-risk groups, so we need to strengthen early medical checkups for male in the future, and invest more medical resources in rural areas to advocate healthy lifestyles such as reasonable diet and physical exercise to the whole society for early prevention of liver cancer.
A cohort study on the association between metabolically unhealthy obesity and hypertension
CHEN Chang-ying, YANG Song, ZHUANG Qian, SUN Jun-xiang, WEI Peng-fei, ZHAO Xiang-hai, CHEN Yan-chun, SHEN Chong
2023, 27(1): 17-22. doi: 10.16462/j.cnki.zhjbkz.2023.01.004
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  Objective  To explore the association between metabolically unhealthy obesity and hypertension, so as to provide theoretical basis for prevention and control of hypertension.  Methods  A prospective cohort study design was used to investigate the epidemiological baseline of 4 128 adults in Guanlin and Xushe towns of Yixing City, Jiangsu Province in 2009. A total of 2012 hypertensive cases were excluded at baseline and 2116 non-hypertensive subjects were followed up until July 2020. According to the weight and metabolic status, all subjects were grouped into four groups, metabolically healthy and normal weight (MHNW), metabolically healthy overweight/obesity (MHO), metabolically unhealthy and normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUO). Cox proportional risk regression model was used for correlation analysis between metabolic obesity and hypertension. Stratified analysis, heterogeneity test, additive and multiplicative interaction analysis were further carried out. We also conducted sensitivity analyses for the population with developing hypertension in the first year of follow-up and the thin individuals excluded.  Results  637 participants developed hypertension during followed-up. The population attributable risk (PAR) and its percentage (PAR%) of obesity and metabolically unhealthy were 17.4% and 57.93%, respectively. Compared with MHNW, the MHO, MUNW and MUO groups had significantly increased risk of hypertension, and the adjusted HR(95% CI) were 1.29 (1.08-1.56), 1.48 (1.09-2.01) and 1.70 (1.37-2.11), respectively, with increasing trends (P < 0.001). The results of stratified analysis and heterogeneity test showed that the risk of hypertension in women (adjusted HR: 2.14) was higher than that in men (adjusted HR: 1.22), and P for heterogeneity test was 0.017. There was a multiplicative interaction between gender and metabolic status, and the adjusted HR(95% CI) was 1.53 (1.06-2.22), P=0.024. No significant change was detected for the association in the sensitivity analysis.  Conclusions  The metabolically unhealthy obesity significantly increased the risk of hypertension and particularly in women. Therefore, the initiative health intervention for the population with overweight, obesity and metabolic disorders may effectively reduce the risk of hypertension.
Association between dietary diversity and obesity metabolic phenotypes in obese adults in Xi'an
TENG Yu-xin, JING Hui, Samuel Steven Chacha, WANG Zi-ping, SHI Guo-shuai, LI Shan-shan, LIU Dan-meng, YAN Hong, DANG Shao-nong
2023, 27(1): 23-28. doi: 10.16462/j.cnki.zhjbkz.2023.01.005
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  Objective  To investigate the association between dietary diversity and metabolic phenotypes of obesity in obese adults in Xi'an.  Methods  Data were from the baseline survey of Xi'an urban population in the northwest natural population cohort. A total of 1 069 obese participants assessed by BMI≥ 28 kg/m2 with blood samples were selected for analysis. Metabolic phenotypes of obesity were defined based on the metabolic syndrome by Joint Interim Statement criteria. By referring to the evaluation rules of dietary diversity score and the Chinese dietary guidelines the index for dietary diversity was establish. Logistic regression model was used to explore the association between dietary diversity and metabolic phenotypes of obesity.  Results  There were gender differences in dietary diversity. The total dietary diversity score of obesity participants with different metabolic phenotypes was significantly different. Compared with metabolically healthy obesity, the total dietary diversity score of participants with metabolically unhealthy obesity was lower [(4.20±1.88)vs.(4.51±1.97), P=0.010], mainly reflecting lower intake of meat, poultry, fish, eggs and dairy. After controlling for confounding factors, the participants with the highest score had a 38% lower risk of metabolic abnormalities compared to those with the lowest dietary diversity score (OR=0.62, 95% CI: 0.40-0.96). For each unit increase in dietary diversity score, the risk of metabolic abnormalities in obese people decreased by 10% (OR=0.90, 95% CI: 0.82-0.99), and this association was more obvious in women and strong metabolite equivalents obese people.  Conclusions  Increased dietary diversity may be associated with reduced risk of metabolic abnormalities in obese adults. Adopting diversified diet may be an important nutritional intervention to prevent and control metabolic abnormalities in obese people.
Association between blood lipids-related dietary patterns derived by reduced rank regression and diabetes
QIAO Ting-ting, ZHANG Huan-wen, LUO Tao, ZHAO Hui, ZHANG Guo-zhen, DAI Jiang-hong
2023, 27(1): 29-35. doi: 10.16462/j.cnki.zhjbkz.2023.01.006
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  Objective  To explore the association between lipid-related dietary patterns and diabetes, thus providing a scientific basis for dietary intervention in diabetes.  Methods  A total of 4 759 rural residents from Huocheng County in Yili were selected as the study subjects, and relevant data were collected through questionnaires, physical examinations and laboratory tests. Lipid-related dietary patterns were extracted by reduced-rank regression. The correlations between lipid-related dietary pattern scores and intake of each food group and lipid were assessed by Pearson correlation analysis. The relationship between lipid-related dietary pattern and diabetes risk was analyzed by logistic regression model.  Results  Lipid-related dietary pattern was characterized by higher intakes of wheat, meat and fried pasta, and lower intake of mixed grains, vegetables and fruits. Lipid-related dietary pattern was positively correlated with total cholesterol (r=0.296, P < 0.001), low density lipoprotein cholesterol (r=0.225, P < 0.001) and triglyceride (r=0.332, P < 0.001), and negatively correlated with high density lipoprotein cholesterol (r=-0.237, P < 0.001). Logistic regression analysis showed that after adjusting for confounding factors, the risk of diabetes increased by 99% (OR=1.99; 95% CI: 1.47-2.68; P < 0.001) in the lipid-related dietary pattern score Q4 group compared with Q1 group. And there was a linear trend of significantly higher risk of diabetes with increasing dietary pattern scores (Ptrend < 0.001).  Conclusions  Lipid-related dietary pattern scores are positively associated with diabetes risk, and optimizing lipid levels through diet may contribute to early prevention of diabetes.
Dose-response relationship between smoking and hypertension among middle-aged and elderly people in Ma'anshan City, Anhui Province
HU Wen-lei, HE Jia-liu, HU Ming-jun, LI Guo-ao, QIN Qi-rong, ZHU Zhen-yu, HUANG Fen
2023, 27(1): 36-40. doi: 10.16462/j.cnki.zhjbkz.2023.01.007
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  Objective  To explore the relationship between smoking and hypertension among middle-aged and elderly residents in Ma'anshan city, Anhui Province, and provide theoretical basis of hypertension prevention and treatment.  Methods  According to the multi-stage sampling method, 12 132 residents were selected from August to November 2020 in three districts of Ma'anshan city, and participated in questionnaire survey and physical measurement. Binary logistic regression was used to analyze the association between smoking and hypertension, and the dose-response relationship for smoking and hypertension was analyzed using the restricted cubic spline (RCS) model and the generalize linear model.  Results  There were 11 457 subjects in this study, including 6 067 patients with hypertension(52.95%). Taking non-smokers as the reference, the OR value of the risk of hypertension in former smokers was 1.37(95% CI: 1.20-1.56), 1.25(95% CI: 1.07-1.46) and 1.18(95% CI: 1.00-1.39) in Model 1, Model 2 and Model 3, respectively. The RCS curve of smoking and hypertension presents an approximate "J" shape. When the smoking index was greater than 25 pack-years, the risk of hypertension increased monotonically with the increase of smoking index, and the subgroup analysis showed the same results. Pnon-linear was greater than 0.05 and Ptotal was less than 0.001, indicating a linear dose-response relationship between smoking and hypertension. The results of the generalize linear model showed that for every 1-pack-year increased in the smoking index, the risk of hypertension increased 1.004-fold.  Conclusion  There is a significant dose-response relationship between smoking and hypertension in middle-aged and elderly people.
Impacts of ambient particles of differential sizes and sourceson arrhythmias in adults
XU Hong-bing, LIU Ling-yan, WANG Yang, HE Xing-hou, YI Tie-ci, ZHU Yu-tong, LIU Sheng-cong, CHEN Jie, GUAN Xin-peng, WANG Tong, ZHANG Yi, WU Rong-shan, ZHAO Qian, SONG Xiao-ming, LI Jian-ping, HUANG Wei
2023, 27(1): 41-46. doi: 10.16462/j.cnki.zhjbkz.2023.01.008
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  Objective  To assess the impacts of ambient particles of differential sizes and sources on arrhythmias in adults.  Methods  A total of 73 healthy adults underwent 4 repeated clinical visits between November 2014 and January 2016. At each visit, 24h-ambulatory electrocardiograms were performed to record hourly arrhythmia episodes; And serum inflammatory biomarkers, including soluble IL-1 receptor antagonist and macrophage inflammatory protein-1β were also measured. Concentrations of ambient fine particles and particles in size fractions of 5.6-560.0 nm were monitored throughout the study period. Generalized estimating equation models were conducted to evaluate the impacts of ambient particles on arrhythmias.  Results  Episodes of premature ventricular contraction, ventricular couplets, supraventricular premature beat, and ventricular tachycardia were positively associated with interquartile range increases in ultrafine particles at prior 1-day moving average of exposure (P < 0.05), with relative risks of 1.89 (95% CI: 1.27-2.51), 2.23 (95% CI: 1.45-3.00), 1.44 (95% CI: 1.12-1.77), and 2.63 (95% CI: 1.42-3.83), respectively. Particles originated from secondary aerosols and aged vehicle emissions were also associated with arrhythmia episodes. Stratified analyses showed stronger associations in participants with higher levels of soluble IL-1 receptor antagonist and macrophage inflammatory protein-1β.  Conclusions  Ambient particles, especially particles from traffic emission were capable of increasing risks of arrhythmia episodes in adults, and participants with higher levels of systemic inflammation were prone to the proarrhythmic effects of particles.
The association of sleep duration with non-alcoholic fatty liver disease
OU Xia-xian, LI Min-tao, LYU Jun, SUN Dian-jian-yi, MA yuan, MAN Sai-li-mai, YIN Jian-chun, WANG Bo, YU Can-qing, LI Li-ming
2023, 27(1): 47-52. doi: 10.16462/j.cnki.zhjbkz.2023.01.009
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  Objective  To explore the association of sleep duration with non-alcoholic fatty liver disease (NAFLD) among a health checkup population aged 18 years or older in urban District of Beijing from 2008 to 2018.  Methods  A cross-sectional study was designed based on the health checkup data from 2008 to 2018 at Beijing MJ Health Screening Center. Multinomial logistic regression was used to explore the association of sleep duration with NAFLD, and further to assess the associations across different subgroups according to related covariates.  Results  Among 77 697 participants, the average age was (40.7±11.7) years. Of 12.7% reported a sleep duration of fewer than six hours, and 7.0% reported eight hours and more, respectively. The detection rate of NAFLD by ultrasound scan was 37.6%. After adjusting for the potential confounders, the odds ratio (95% CI) for NAFLD for short sleep duration and long sleep duration compared to the reference(normal sleep duration) were 1.08 (95% CI: 1.03-1.14, P=0.003) and 0.88 (95% CI: 0.82-0.95, P < 0.001), respectively. The association of short sleep duration with NAFLD was more substantial in males (Pinteraction < 0.05) and individuals aged 18 to 29 and 30 to 39 years old (Pinteraction < 0.001). However, the association was no longer significant (P > 0.05) when further adjusting BMI.  Conclusions  Sleep duration is associated with the risk of NAFLD, especially in males and young adults. Meanwhile, BMI played a vital role in the association between sleep duration and NAFLD.
Relationship between advanced sleep phase syndrome and type 2 diabetes mellitus based on the propensity score method
GAO Rong-rong, GAO Qian, WANG Tong
2023, 27(1): 53-59. doi: 10.16462/j.cnki.zhjbkz.2023.01.010
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  Objective  This study aimed to analyze the correlation between advanced sleep phase syndrome (ASPS) and type 2 diabetes mellitus (T2DM), to better understand the health effects of sleep and provide a theoretical basis for prevention and intervention of T2DM.  Methods  The data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) (2017-2018) database. ASPS was defined by bedtime and morning rise time on weekdays. T2DM was defined as taking antidiabetic drugs. Associations between ASPS and T2DM were analyzed using the propensity score-based inverse probability treatment weights (IPTW) and overlap weights (OW) to control for potential confounding variables as much as possible.  Results  A total of 6 048 participants were included in the study, of whom 759 had T2DM and 411 were diagnosed with ASPS, accounting for 12.5% and 6.8%, respectively. The prevalence of T2DM was higher in the ASPS group than in the non-ASPS group (20.0% vs. 12.0%, t=21.295, P < 0.001). After controlling for potential confounding by IPTW, the analysis showed that the ASPS group had a 1.540-fold higher risk of developing T2DM than the non-ASPS group (OR=1.540, 95% CI: 1.184-2.002, P=0.001). After further fully balancing the covariates, OW analysis showed the significance of the two still existed (OR=1.362, 95% CI: 1.078-1.722, P=0.001).  Conclusions  ASPS is an independent risk factor for T2DM, suggesting that the management of sleep problems is of great significance in the prevention and treatment of T2DM.
Relationship between hemoglobin level in early pregnancy and gestational diabetes mellitus: a birth cohort study
YAN Ming-xin, ZHAO Dou-dou, WAN Hui-ling, ZHAO Huan, SHAN Li, PEI Lei-lei, MI Yang, QU Peng-fei
2023, 27(1): 60-64. doi: 10.16462/j.cnki.zhjbkz.2023.01.011
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  Objective  To investigate the relationship between hemoglobin levels in early pregnancy and gestational diabetes mellitus (GDM) in pregnant women in northwest China.  Methods  In Northwest Women's and Children's Hospital from July 2018 to July 2019, women in early pregnancy were recruited to birth cohort. A questionnaire was used to collect their basic demographic characteristics and lifestyle behaviors, and to follow up the hemoglobin levels and oral glucose tolerance test (OGTT) in early pregnancy. The association of hemoglobin levels in early pregnancy with GDM was first explored using a logistic regression model, and the nonlinear relationship between hemoglobin levels and GDM was further investigated by restricted cubic splines.  Results  After adjusting for confounders, high hemoglobin levels (Hb ≥135 g/L) in early pregnancy increased the risk of GDM (OR=1.44, 95% CI: 1.13-1.83). For every 10g/L increase in hemoglobin levels in early pregnancy, FPG, OGTT 1h glucose, and OGTT 2h glucose levels increased by 0.03 mmol/L (95% CI: 0.01-0.05), 0.14 mmol/L (95% CI: 0.07-0.21), and 0.13 mmol/L (95% CI: 0.08-0.19), respectively. The results of the restricted cubic strip showed that the risk of GDM progressively increased with increasing hemoglobin levels in early pregnancy.  Conclusions  Elevated hemoglobin levels in early pregnancy will increase the risk of GDM. Women hemoglobin levels in early pregnancy should be actively monitored to promote maternal and infant health.
The associations of anxiety and depression symptoms with pregnancy history among 9 516 early pregnant women
ZOU Peng, HUANG Qiao, CHEN Qing, ZHOU Ni-ya, YANG Huan, ZHOU Wen-zheng, CHEN Hong-yan, HE Yang, LIU Jin-yi, CAO Jia, AO Lin, QI Hong-bo
2023, 27(1): 65-69. doi: 10.16462/j.cnki.zhjbkz.2023.01.012
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  Objective  To investigate the effect of pregnancy history on the incidence of depression and anxiety symptoms among early pregnant women.  Methods  A total of 9 516 early pregnant women were recruited from Obstetric Clinic of the Chongqing Maternal and Child Health Hospital during February 2020 to October 2020. Anxiety and depression symptoms were evaluated by Generalized Anxiety Disorder-7 items (GAD-7) and Patient Health Questionaire-9 items (PHQ-9), respectively. Univariate analyses were used to detect the influencing factors of anxiety and depression symptoms, and logistic analyses were used to evaluate the effect of pregnancy history on the incidence of depression and anxiety symptoms.  Results  The rates of anxiety and depression symptoms were 18.9% and 47.5% among early pregnant women, respectively. Results of univariate analyses indicated that age, BMI (before pregnancy), smoking history, alcohol drinking history, allergies, parity, and abortion number were related to anxiety and depression symptoms. After adjusting for confounders, logistic analyses showed that primipara had higher risk of anxiety symptoms than multipara (OR=1.16, 95% CI: 1.01-1.33, P=0.031). Abortion was associated with increased odds for anxiety (OR=1.26, 95% CI: 1.13-1.41, P < 0.001) and depression (OR=1.19, 95% CI: 1.09-1.29, P < 0.001) symptoms, respectively.  Conclusion  Our study suggested that primipara and abortion were important risk factors for depression and anxiety symptoms in early pregnant women.
The prevalence and risk factors of gestational diabetes mellitus among 23 896 pregnant women in Chongqing
ZENG Xiao-ling, HE Zi-yi, ZHOU Ni-ya, HUANG Qiao, CHEN Qing, CAO Jia, PI Jing-bo
2023, 27(1): 70-76. doi: 10.16462/j.cnki.zhjbkz.2023.01.013
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  Objective  To analyze the changes in the morbidity gestational diabetes mellitus (GDM) and related risk factors in Chongqing from 2018 to 2021, and provide evidence for prevention and control of gestational diabetes mellitus.  Methods  Clinical data of pregnant women who attended prenatal care in Women and Children's Hospital of Chongqing Medical University from January 2018 to June 2021 were collected, and 6269 pregnant women were diagnosed with GDM. The incidence of GDM and risk factors were investigated. The multivariate logistic regression was used for statistical analysis.  Results  A total of 23 896 subjects were included in this study. There were 6 269 pregnant women with GDM, with a ratio of 26.2%, and the incidence rates of GDM in pregnant women from 2018 to 2021 were 27.3%, 25.0%, 26.4%, and 26.4%, respectively. Multivariate logistic regression analysis showed that age (OR=1.47, 95% CI: 1.41-1.54, P < 0.001), BMI (OR=1.74, 95% CI: 1.65-1.83, P < 0.001) and history of endocrine disease (OR=9.32, 95% CI: 8.68-10.01, P < 0.001) were risk factors of GDM.  Conclusions  The incidence of GDM is relatively high in Chongqing, and advanced maternal age and pre-pregnancy overweight or obesity are high risk factors for GDM. Systematic obstetric care should be intensified in Chongqing and more attention should be paid to changes of these risk factors during pregnancy to reduce the occurrence of GDM.
Associations of single nucleotide polymorphisms of HDAC9 and PPP3CA genes with frailty in the Chinese elderly people
YANG Pei, ZHANG Yu-jie, ZHONG Wen-fang, WANG Xiao-meng, LYU Yue-bin, MAO Chen
2023, 27(1): 77-81. doi: 10.16462/j.cnki.zhjbkz.2023.01.014
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  Objective  To explore the associations between the single nucleotide polymorphism (SNP) of histone deacetylase 9 (HDAC9) and calcineurin catalytic subunit A (PPP3CA) and frailty in the Chinese elderly people.  Methods  Our study included 665 participants in the frailty group and 3 388 participants in the control group. Associations between rs2074633 and rs17030795 gene polymorphisms and frailty were evaluated based on genotype frequencies, and five genetic models (co-dominance, additive, dominance, recessive and over-dominance models).  Results  In co-dominance model, individuals carrying HDAC9 rs2074633 TC genotype (OR=1.99, 95% CI: 1.36-2.90) and CC genotype (OR=2.15, 95% CI: 1.48-3.13) were more likely to develop frailty, compared with those carrying TT genotype3. The rs2074633 polymorphisms increased the risk of frailty in both additive model (OR=1.28, 95% CI: 1.11-1.47), dominant model (OR=2.07, 95% CI: 1.44-2.98) and recessive model (OR=1.21, 95% CI: 1.01-1.45). In co-dominance model, individuals carrying PPP3CA rs17030795 AG (OR=1.72, 95% CI: 1.19-2.51) genotype and GG (OR=1.98, 95% CI: 1.37-2.87) genotype were more likely to develop frailty, compared with those carrying AA genotype. The rs17030795 polymorphisms increased the risk of frailty in both additive model (OR=1.28, 95% CI: 1.11-1.48), dominant model (OR=1.85, 95% CI: 1.29-2.66) and recessive model (OR=1.25, 95% CI: 1.04-1.50).   Conclusions  The rs2074633and rs17030795 polymorphisms are associated with the increased risk of frailty.
Study on screening of daily diet and nutrient anti-aging programs for urban residents based on decision tree model
TU Jia-xin, WU Lei, YANG Shan-lan, DENG Li-fang, ZHOU Sheng-ze, ZHU Ruo-ling, HUANG He-lang
2023, 27(1): 82-88. doi: 10.16462/j.cnki.zhjbkz.2023.01.015
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  Objective  The study analyzed and screened the daily diet, nutrient intake type, structure, quantity and other variables of community residents to construct an anti-aging program.  Methods  Four Provinces in North and South were selected as the research field. We applied the physiological-psycho-social three dimensional aging scale (PPSHAS) scale to measure aging and investigated the dietary status of residents. The Decision Tree model was used to construct the program.  Results  There were 660 valid questionnaires retrieved (91.79%), with a male to female ratio of 1∶1.2. Women were generally younger than males (t=2.317, P0.018). A total of 34.85 % of inhabitants were 4.37-12.33 years younger, while 40.00 % were 3.29-10.53 years older. In the younger group, the daily intake of meat vegetables (parts), vegetables, milk, fruits, nuts, water, and so on were significantly higher than in the obviously older group (P < 0.05). And the daily water intake was 625.15 mL higher. The latter consumed more beef, mutton and edible oil than the former (χ2beef, mutton =15.557, χ2edible oil=69.520, P < 0.001). In terms of nutrition, the youthful group consumed considerably more (P < 0.05), but the lipid consumption was the invert (t=26.17, P < 0.001). There are six types of dietary anti-aging programs, with the top three anti-aging contributing factors being water intake (0.47), fish and shrimp (0.10), and nightshade (0.08). Four types of nutrient programs, programs with the top three anti-aging factors were protein (0.48), water (0.28), and dietary fiber (0.08).  Conclusions  With over one-third of urban dwellers are significantly younger. The intake of staple foods, meat vegetables, vegetables, fruits, legumes, and milk were much greater in the youthful group than in the clearly old group, particularly drinking water. Excessive lipid intake is negative to anti-aging. Dietary anti-aging programs are best with No. 1 and No. 2, and nutritional programs are best with No. 1.
Knowledge awareness and its influencing factors of HIV pre-exposure prophylaxis among MSM
KANG Wen-ting, ZHANG Guang, LIU Tong-tong, YANG Xue, GUO Jia-huan, CHENG Li-li, TANG Hou-lin, WANG Jun-jie
2023, 27(1): 89-94. doi: 10.16462/j.cnki.zhjbkz.2023.01.016
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Abstract:
  Objective  To understand the knowledge awareness and its influencing factors of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in different cities and years.  Methods  In 2019 and 2021, an electronic questionnaire was used to collect information including sociodemographic characteristics, PrEP knowledge awareness, and behavior characteristics of MSM in Beijing, Shenzhen, and Kunming. Questionnaires were collected by community organizations. Then the influencing factors of PrEP knowledge awareness were analyzed.  Results  A total of 4 889 questionnaires were collected in the three cities, including 2 399 in 2019 and 2 490 in 2021. The knowledge awareness rates of PrEP in 2019 and 2021 were 6.29% and 25.02% respectively. In 2019, multivariate logistic regression analysis model showed that ages (25- < 34 years old: OR=1.685, 95% CI: 1.007-2.821; ≥ 35 years old: OR=2.01, 95% CI: 1.156-3.497), consulted PrEP (OR=1.731, 95% CI: 1.050-2.855), heard of PEP (Post-exposure prophylaxis) (OR=3.178, 95% CI: 2.079-4.860) were related to the PrEP knowledge awareness. In 2021, multivariate logistic regression analysis showed that education (universities or colleges: OR=3.291, 95% CI: 1.595-6.793; master degree or above: OR=4.507, 95% CI: 2.104-9.652), consulted PrEP (OR=2.591, 95% CI: 1.906-3.521), heard of PEP (OR=5.855, 95% CI: 3.071-11.161), used PEP (OR=1.619, 95% CI: 1.191-2.200), used stimulant (OR=0.623, 95% CI: 0.492-0.789), tested HIV in a year (3-4 times: OR=2.140, 95% CI: 1.265-3.619; ≥5: OR=3.414, 95% CI: 1.987-5.865) were related to the PrEP knowledge awareness.  Conclusions  PrEP knowledge awareness in 2021 has increased significantly compared with 2019 among MSM, but remained low overall. The age, education, HIV testing times, knowledge awareness and uptake of PEP were related to the PrEP knowledge awareness. Comprehensive measures should be continued to strengthen the publicity and education of PrEP to MSM and improve their correct understanding of PrEP.
Short Reports
Analysis of disease burden in Guangzhou, 2010-2020
XI Jun-yan, DONG Hang, LIN Xiao, ZHANG Yan-xia, CHEN Yuan-yuan, QIN Peng-zhe, LIANG Bo-heng, HAO Yuan-tao
2023, 27(1): 95-99. doi: 10.16462/j.cnki.zhjbkz.2023.01.017
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Abstract:
  Objective  To evaluate the trend of disease burden in Guangzhou from 2010 to 2020, and to analyze gender and age differences.  Methods  The disability-adjusted life years (DALY) was calculated using cause-of-death surveillance data and demographic data from 2010 to 2020 in Guangzhou, and the trend of DALY was analyzed using the Joinpoint regression model.  Results  In 2020, the crude death rates of males and females in Guangzhou were 640.87 and 464.49 per 100 000, respectively, mainly due to cardiovascular diseases, neoplasms, and chronic respiratory diseases. From 2010 to 2020, cardiovascular diseases rose to the top cause of the disease burden in males, while the orders of musculoskeletal disorders, skin and subcutaneous diseases, unintentional injuries, and nutritional deficiencies have risen. Cardiovascular diseases remained the first cause of the disease burden in females, while the orders of musculoskeletal disorders, nutritional deficiencies, neurological disorders, unintentional injuries, skin and subcutaneous diseases have risen. The total DALY of males and females was unchanged, but the crude rate and age-standardized rate decreased. The order of disease burden varied among different age groups.  Conclusions  From 2010 to 2020, the disease burden in Guangzhou is dominated by non-communicable diseases, and the disease burden patterns of different genders and age groups have their characteristics. Risk factors should be identified based on main health problems at the urban level, and effective prevention and control strategies should be formulated for the diseases of key populations.
Investigation on the health literacy level of chronic diseases among newly diagnosed diabetic patients and prediabetic population in Jiangsu Province
JI Da-kang, GUO Hai-jian, LIU Yu-xiang, ZHU Xiao-yue, HU Jing-yao, MA Hao-nan, WANG Bei
2023, 27(1): 100-106. doi: 10.16462/j.cnki.zhjbkz.2023.01.018
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Abstract:
  Objective  To estimate the current status and influencing factors of chronic disease health literacy among newly diagnosed diabetic patients and pre-diabetic population among adult residents of Jiangsu Province, and to analyze the relationship between health literacy level and diabetes prevention knowledge, so as to provide a basis for improving the effectiveness of disease prevention and management.  Methods  A multistage stratified random sample was used to investigate the general information, diabetes prevention knowledge, and health literacy level of 1 502 prediabetic and newly diagnosed patients.  Results  The screening test identified 1 502 people with new-onset diabetes and prediabetes, with a mean age of (55.09±7.70) years, including 612 (40.7%) men, whose mean chronic disease health literacy entries scored (3.95±0.62); the lowest mean score (3.65±0.90) was for the communication and interaction ability dimension entries, and 768 (51.1%) of the population had an adequate level of chronic disease health literacy. The results of the multifactor analysis showed that socioeconomic factors such as education level, income level, and retirement status were the main influencing factors. The knowledge score of diabetes prevention and control of the surveyed population was positively correlated with the level of health literacy.  Conclusions  Adult residents with newly diagnosed diabetes and prediabetes in Jiangsu Province have a high level of health literacy, but their level of proactively acquiring health information and solving health problems through communication and interaction is low. The level of health literacy is positively correlated with the score of diabetes prevention knowledge. Low-educated, low-income, and retirees are the targets of health literacy promotion actions.
The use of nutrient supplements during the second trimester of pregnancy: a study in Guangzhou
GUO Xin-yue, LIN li-zi, FANG Hui-ping, TANG Nu, XIE Lu-qin, ZENG Jing-jing, JING Jin, CAI Li
2023, 27(1): 107-111. doi: 10.16462/j.cnki.zhjbkz.2023.01.019
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Abstract:
  Objective  To estimate the use of nutrient supplements among women in the second trimester of pregnancy in Guangzhou City.  Methods  A total of 1 035 pregnant women (20-28 weeks' gestation) were recruited in a hospital in Guangzhou from March 2017 to November 2018. A validated food frequency questionnaire was used to assess nutrient supplement and food intakes in the past month, based on which the daily nutrient intake was calculated. We also calculated the total nutrient intake by summing up the nutrient intake from supplements and food.  Results  Among all the pregnant women, 80.2% used nutrient supplements during the second trimester, and most of them used compound supplements. Among various nutrients, the utilization rates of calcium (76.2%) and folic acid (51.6%) were highest. There were a certain proportion of pregnant women whose nutrient intake from food (except copper) did not reach the estimated average requirement (EAR) and recommended intake (RNI)/adequate intake (AI), especially for vitamin B6, folic acid, and calcium. When nutrient intake from supplement was included, we found that the proportion of total nutrient intake reaching EAR and RNI/AI increased in pregnant women who used supplements, which was significantly higher than that in those who did not (For example, the proportion of total calcium intake reaching RNI was 61.4% in pregnant women who used supplements, but only 8.8% in those who did not).  Conclusions  The utilization rate of nutrient supplements among pregnant women in the second trimester in Guangzhou is relatively high. Nutrient intake from food can't fully meet the needs of most pregnant women. Nutrient supplements should be used appropriately to improve their nutritional status.
Changes and correlation between sleep time and overweight and obesity of children aged 3-6 years in Shenyang in 2010 and 2020
DING Ya-jie, LU Ke, ZHANG Ning-xin, SUN Qi, WEI Wei, WEN De-liang, JIA Li-hong
2023, 27(1): 112-116. doi: 10.16462/j.cnki.zhjbkz.2023.01.020
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Abstract:
  Objective  To describe the changes in overweight and obesity among children aged 3-6 in Shenyang from 2010 to 2020, and exploring the relationship between sleep time and overweight and obesity, to provide a reference for prevention and treatment of childhood obesity in the future.  Methods  The convenience sampling method was adopted to select children aged 3-6 from 6 kindergartens in Shenyang City in 2020. With informed consent, height and weight measurements were taken from all children, and a questionnaire was administered to parents. The data including height, weight and questionaire from children in 10 kindergartens in the same district in 2010 were compared. The changes in children's sleep duration and overweight obesity during the 10 years were statistically analyzed and the effect of sleep duration on the occurrence of overweight obesity in children was explored.  Results  A total of 623 children aged 3-6 years participated in the survey in 2020. In 2010, a total of 574 children aged 3-6 years were investigated. Compared with 2010, there is no statistical difference in age and sex composition of children in 2020 (all P > 0.05). The height, weight, and BMI of children aged 3-6 years in 2020 were higher than those in 2010 (all P < 0.05), and the detection rate of obesity in 2020 (14.9%) was significantly higher than that in 2010 (10.5%, P < 0.05). Multivariate logistic regression showed that the children who slept less than 8h and 8-9h had an increased risk of overweight and obesity. In 2010, the detection rate of overweight and obesity of children who slept less than 8 hours was 2.51 times (95% CI: 1.22-5.19) and 2.78 times (95% CI: 1.17-6.23) than that of normal children, respectively. In 2020, the overweight detection rate of children in the sleep 8-9 h group was 2.71 times (95% CI: 1.34-5.48) and 2.25 times (95% CI: 1.09-4.67) than that of normal children.  Conclusions  Overweight and obesity rates among children aged 3-6 years in Shenyang show a significant increase in the ten years from 2010 to 2020. Children who sleep < 8 h in 2010 and 8-9 h in 2020 are at increased risk of overweight and obesity.
Analysis of death characteristics and potential years of life lost of cervical cancer in Wuhan residents from 2014 to 2019
ZHANG Xiao-xia, TIAN Wei-dong, ZHAO Yuan-yuan, YANG Nian-nian, DAI Juan, JIN Qi-man, YAN Ya-qiong
2023, 27(1): 117-120. doi: 10.16462/j.cnki.zhjbkz.2023.01.021
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Abstract:
  Objective  To investigate the prevalence characteristics and the potential years of life lost (PYLL) of cervical cancer in Wuhan from 2014 to 2019, and to provide a scientific basis for prevention and control.  Methods  The Cervical cancer deaths among Wuhan residents during 2014-2019 were collected from the population-based Mortality Surveillance System. We analyzed the change tendency of crude and standardized mortality rate of cervical cancer in different area and age groups. And PYLL was also calculated to describe the epidemiological characteristics of cervical cancer.  Results  The crude mortalities of cervical cancer was increased from 0.60/105 in 2014 to 2.13/105 in 2019, with APC equal to 32.63% (t=-3.05, P=0.038). The mortality rate of cervical cancer showed an upward trend with the increaseing age groups. The PYLL of cervical cancer increased from 640.00 person-years in 2014 to 2 660.00 person-years in 2019. The average PYLL caused by cervical cancer was 15.26 years, and the standardized PYLL rate was 0.23‰.  Conclusions  The mortality rate of cervical cancer presented an upward trend with the increasing age. Cervical cancer screening should be promoted in younger women. It is necessary to take the corresponding preventive and control measures for reducing the burden of disease.

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