中华流行病学杂志最新文献

Objective: To explore the association between smoking status and the risk of depressive symptoms among the elderly in Shandong Province. Methods: Using the multi-stage stratified cluster random sampling method, 2 111 elderly individuals aged 60 and above were selected from 4 cities (Yantai, Linyi, Dezhou, and Binzhou) in Shandong,2024. Relevant information was collected through a questionnaire survey, and depressive symptoms were assessed using the Center for Epidemiological Studies Short Depression Scale. Binary logistic regression models were employed to examine the association between smoking status and the risk of depressive symptoms. Results: The smoking rate among the elderly was 13.9%, the smoking cessation rate was 15.4%. A total of 478 older adults (22.6%) scored 10 points or higher on the enter for Epidemiological Studies Short Depression Scale. After adjusting for relevant confounding factors, multivariate logistic regression analysis showed that, compared to never smokers, smoking cessation was a protective factor against depressive symptoms (OR=0.558, 95%CI: 0.386-0.806), while current smoking showed no significant association with depressive symptoms (OR=0.761, 95%CI: 0.520-1.114). Conclusion: Targeted measures should be implemented to help elderly smokers quit smoking early and improve mental health outcomes in this population.

Non-neonatal tetanus is an acute, specific and toxic disease characterized by persistent tonic contraction and paroxysmal spasms of skeletal muscles caused by Clostridium tetani invading the human body through skin or mucosal breaks, reproducing in an anaerobic environment and producing tetanospasmin. After tetanus exposure, debridement, active immunization and passive immunization are mainly used for prevention, but there were still cases of incidence after prevention. With the development of passive immune agents, new research evidence has emerged. On the basis of debridement and active immunization, rational use of passive immune agents may further reduce the risk of disease and the occurrence of adverse reactions. Based on the Standard for Diagnosis and Treatment of Non-neonatal Tetanus (2024 edition) issued by National Health Commission of the People's Republic of China, experts in the field were organized by Animal Injury Treatment Branch of China Medical Rescue Association, and Animal Injury and Acute Infectious Disease Prevention Branch of Beijing Society of Integrative Medicine. This consensus was developed by referring to the guidelines and consensus, combined with the clinical experience of experts.

Food addiction (FA) is a behavior akin to substance addiction, characterized by an individual's prolonged difficulty in controlling the intake of ultra-processed foods, and it has become a significant risk factor for issues such as obesity, type 2 diabetes, and eating disorders. College students are at the stage termed as emerging adulthood, marked by increasing psychological challenges, during which FA poses a threat to their physical and mental health; however, research on FA among college students is relatively limited, especially in developing effective intervention measures, which urgently need to be strengthened through research and practice. This review examines the factors influencing FA in college students at various levels, including personal, interpersonal, and societal, and summarizes existing intervention methods, aiming to provide a reference for subsequent related studies.

Objective: To describe the characteristics of sleep quality in the baseline population of the South China Cohort, and identify potential factors influencing sleep quality and sleep behaviors. Methods: A face-to-face survey and physical examination were conducted to collect information on demographic characteristics, medical history, medication use, lifestyles, and sleep conditions. After excluding individuals with missing sleep-related data and covariates, including physical activity and dietary information, a total of 72 666 participants aged 25 to 89 were included. Sleep quality was assessed by constructing a healthy sleep score comprising five sleep behaviors, a score of ≤2 was defined as poor sleep quality. Logistic regression analysis was used to examine the distribution of poor sleep quality, and log-binomial regression was used to analyze the associations of sleep quality and sleep behaviors with demographic characteristics, socioeconomic factors, lifestyle factors (including smoking, alcohol consumption, physical activity level, and dietary diversity), and chronic diseases conditions (including obesity, diabetes, coronary heart disease, hypertension, gout, and pulmonary diseases). Results: The proportion of poor sleep quality in the population of South China was 7.49%. We found that the proportion of poor sleep quality was higher among individuals aged 60-74 years, those with poor socioeconomic status, individuals with an education level below university, households with an annual income less than 30 000 Yuan, individuals engaged in manual labor, as well as those who were overweight/obese, smoked, drank alcohol, had low levels of physical activity, and exhibited low dietary diversity. Age, gender, socioeconomic status, lifestyle factors, and chronic diseases were found to be statistically associated with sleep quality and sleep behaviors in the South China population. Conclusions: Sleep quality varies across different population groups in South China, with age, gender, socioeconomic status, lifestyle, and chronic diseases serving as key determinants. Therefore, public attention to sleep health and the promotion of healthy lifestyles are crucial to improving sleep quality and reducing the risk of chronic diseases.

Objective: To investigate the relation of serum resistin levels among pregnant women with the occurrence of large for gestational age (LGA) and its mediation by gestational diabetes mellitus (GDM). Methods: Pregnant women with 15-20⁺⁶ gestational weeks were recruited and followed until pregnancy termination. After trend tests for resistin levels and GDM and LGA incidence, restricted cubic spline (RCS) models were used to fit the risk curves for resistin levels concerning GDM and LGA. Log-binomial regression models weighted by the Copy's method were then applied to examine the relationship between high resistin exposure and both GDM and LGA, yielding adjusted RR and 95%CI after controlling for covariates. Finally, a causal mediation model was used to quantify the proportion of the association between high resistin exposure and LGA mediated by GDM via four-way effect decomposition. Results: A total of 1 481 pregnant women were included, with 270 cases of GDM (18.2%) and 241 cases of LGA (16.3%). Compared with the Q₁ group, the Q₃ and Q₄ groups had significantly higher risks of GDM, with adjusted RRs (95%CI) of 2.04 (1.74-2.39) and 3.61 (3.05-4.25), respectively. Similarly, the Q₂, Q₃, and Q₄ groups exhibited increased risks of LGA, with adjusted RRs (95%CI) of 1.29 (1.10-1.51), 1.46 (1.25-1.71), and 2.35 (2.00-2.76), respectively.Using receiver operating characteristic curve, the high-resistance cutoff was identified as 10.36 ng/ml. Pregnant women exposed to high resistin levels had 2.80 times (RR=2.80, 95%CI: 2.10-3.73) higher risk of developing GDM and 1.64 times (RR=1.64, 95%CI: 1.23-2.18) higher risk of developing LGA. Mediation analysis showed that GDM explained approximately 47.8% of the association between high resistin and LGA (mediation proportion: 13.4%; interaction proportion: 46.1%). Conclusions: High maternal serum resistin levels in mid-pregnancy are associated with an elevated risk of LGA, with nearly half of this risk mediated through GDM-related pathways. Serum resistin may serve as a biomarker for screening and intervening in GDM and LGA.

Early/delayed pubertal timing has become a significant global public health concern due to its profound effects on growth patterns and mental health of children and adolescents. Heavy metal exposure is one of the important environmental factors influencing the pubertal timing. Heavy metals can enter the human body in various ways, affecting the secretory function of the hypothalamic-pituitary-gonadal axis, inducing oxidative stress response, and increasing the expression of estrogen receptor-α, thereby disrupting the normal growth and development process. Fetus period and childhood are the key window periods for children's growth and development, during which organs and systems are in the stage of gradual development and maturation. During these periods, the body's ability to metabolize environmental heavy metals is relatively limited, rendering the impact of heavy metal exposure on puberty development more pronounced. This paper aims to explore the association of heavy metal exposure during fetus period and childhood with early/delayed pubertal timing, and clarify the biological mechanism to provide a reference for the early/delayed pubertal timing prevention and intervention in children, and further promote public attention to environmental heavy metal exposure and children's health.

Objective: To investigate the parent-of-origin effects (POE), interactions between imprinted and non-imprinted genes, and POE-environment interactions of candidate genes in the FGF/FGFR signaling pathway on the risk of non-syndromic cleft lip with or without cleft palate (NSCL/P). Methods: A case-parent trio design was adopted, including 806 NSCL/P trios (2 418 individuals). Single-locus POE was estimated using log-linear models; interactions between imprinted and non-imprinted genes were analyzed using the Cordell method; and POE-environment interactions were assessed via the Wald test. Bonferroni correction was applied for multiple testing. A total of 379 single-nucleotide polymorphisms (SNPs) located on two imprinted genes (FGF12 and FGF14) and 17 non-imprinted genes within the FGF/FGFR signaling pathway were included in the NSCL/P trio analysis. Results: Single-locus POE analysis identified 23 SNPs in FGF12, FGF14, FGFR2, FGF1, and FGFR1 with potential POE (all P<0.05). However, none remained statistically significant after Bonferroni correction (all P>1.32×10^-⁴). Interaction analysis of the 23 SNPs with potential POE revealed positive signals between 9 SNP pairs from the imprinted gene FGF14 and the non-imprinted gene FGFR2, and 1 SNP pair from FGF14 and FGF1 (all P<0.05). The interaction between FGF14 rs9518631 and FGFR2 rs10510097 remained statistically significant after Bonferroni correction (P=1.97×10^-³). POE-environment interaction analysis indicated that the POE of 5 SNPs located on FGF14, FGFR2, and FGFR1 were influenced by maternal passive smoking during pregnancy, and the POE of FGFR2 rs10510097 was influenced by maternal multivitamin supplementation during pregnancy (all P<0.05). However, none of these findings remained statistically significant after Bonferroni correction (all P>2.17×10^-³). Conclusion: The FGF/FGFR signaling pathway may influence the risk of NSCL/P through interactions between the imprinted gene FGF14 and the non-imprinted gene FGFR2.

Objective: To analyze the incidence characteristics of respiratory syncytial virus (RSV) infection in children aged ≤5 years in Pudong New Area of Shanghai during 2013-2023. Methods: The study was conducted on children aged ≤5 years who met the definition of acute respiratory infection cases (ARI) from January 2013 to December 2023 were enrolled, and nasopharyngeal swab were collected from them for virus detection by real-time PCR, and clinical information of the cases were collected, and χ² test or Fisher exact probability method was used to compare the differences between groups. Results: A total of 2 718 children were included in the surveillance for ARI, including 197 RSV-positive children, the overall positive rate was 7.25% (197/2 718). In the RSV positive children, 86 (43.65%) were type A infection cases and 111 (56.35%) were type B infection cases. From 2013 to 2023, the positive rate of RSV in children increased first and then decreased, and the positive rate was higher in autumn and winter and lower in spring and summer. RSV infection rate gradually decreased with age, the highest positive rate was in children under 1 year old, with the positive cases accounting for 16.33% (80/490) in RSV-positive children. The main symptom of RSV infection was cough (93.91%, 185/197). Conclusions: From 2013 to 2023, RSV infection was more prone to occur in children under 1 year old in Pudong. The common symptom was coughing, the infection mainly occurred in winter. Active monitoring of RSV should be strengthened, especially for children under 1 year old and infected individuals with common symptoms of cough, to reduce the risk of RSV single or mixed infection with human coronavirus.

As China's population ages at an increasingly rapid rate, osteoporosis, a disease closely associated with aging, has emerged as a significant threat to healthy aging. Developing an accurate prediction model for the risk of osteoporosis onset remains crucial for the early identification of individuals at high risk. Our research team aims to establish the West China Bone Health Cohort in both hospital and community settings. We plan to collect phenotypic and omics data through questionnaires, carry out physical examinations and clinical imaging, collect biological samples, and perform laboratory tests. Our goal is to map bone mass change trajectories, identify risk factors influencing osteoporosis, and uncover key molecular biomarkers through a multi-omics approach. We anticipate that our work will enable the early detection, prevention, and intervention for osteoporosis. In this paper, we aimed to provide an overview of the research background, objectives, methods, quality control measures, and progress for our cohort, which is currently under construction.

Objective: To explore the epidemiological characteristics and influencing factors of mortality among HIV-infected patients in Zhejiang Province, China, and to provide evidence for optimizing regional prevention strategies to reduce deaths among HIV-infected patients. Methods: The data were obtained from Chinese Disease Prevention and Control Information System and Zhejiang Chronic Disease Information Management System. A retrospective cohort study was established, inclusion criteria for study subjects were HIV-infected patientss whose current address was in Zhejiang and whose diagnosis time was from January 1, 2003 to December 31, 2022. Mortality density (per 100 person-years) and mortality proportion were calculated. Chi-square tests were used to compare mortality differences across subgroups, and Cox proportional hazards regression models identified mortality-associated influencing factors, with hazard ratios (HR) and 95%CI reported. Results: Among 43 975 reported HIV-infected patients,there were 5 179 deaths including 1 918 AIDS-related deaths, 2 474 non-AIDS-related deaths and 787 unclassified deaths. The mortality densities for all-cause, AIDS-related, non-AIDS-related, and unclassified deaths were 1.86, 0.69, 0.89, and 0.28 per 100 person-years, respectively. The proportion of all-cause mortality showed a declining trend (from 1.67% in 2003 to 1.19% in 2022,Z=32.92,P<0.001). AIDS-related deaths decreased over time, while non-AIDS-related deaths exhibited a continuous upward trend. The results of the Cox proportional hazards regression model analysis showed that risk factors for HIV-infected patients' mortality included those who received antiviral therapy (ART) with 3-5 months, 6-11 months, ≥12 month of diagnosis and no ART (aHR were 1.26, 1.42, 1.17, and 9.39, respectively), the age at the time of diagnosis were 50- and ≥65 years old (aHR were 2.03 and 3.63, respectively). Protective factors included being female (aHR=0.65), later diagnosis period (2016-2022) (aHR=0.87). Married with a spouse (aHR=0.85). Educational levels were junior high school (aHR=0.88), high school/vocational school (aHR=0.66), college and above (aHR=0.46), Baseline CD4⁺T lymphocyte counts were 200-349 cells /μl (aHR=0.46), 350-499 cells/μl (aHR=0.36), and ≥500 cells/μl (aHR=0.34). Conclusions: From 2003 to 2022, the number of HIV-infected patients' deaths in Zhejiang Province showed an overall increasing trend, but the mortality proportion declined. Greater attention should be paid to non-AIDS-related deaths, with efforts focused on establishing chronic disease management pathways for elderly HIV-infected patients and strengthening multidisciplinary care for non-AIDS-related conditions.