中华流行病学杂志最新文献

Global public health is currently undergoing unprecedented and complex changes. The COVID-19 pandemic has exposed vulnerabilities and weaknesses of the global health system, urging nations globally to prioritize pandemic prevention and response strategies. Simultaneously, emerging infectious diseases such as mpox and avian influenza, as well as re-emerging infectious diseases including tuberculosis, AIDS, and viral hepatitis, continue to pose threats to global public health security. Moreover, the prevalence of chronic diseases remains significant, while concerns pertaining to environmental health and the well-being of children and adolescents are growing increasingly prominent. Addressing these challenges requires the formulation of effective public health policies, strengthened international cooperation, enhanced health education, improved public health literacy, and the establishment of a more resilient global public health system.

Objective: To understand the epidemiological characteristics and spatiotemporal distribution of genital herpes in China from 2010 to 2023 and provide evidence for the prevention and control of genital herpes. Methods: The reported data of genital herpes cases in 31 provinces (autonomous regions and municipalities) in China from 2010 to 2023 were collected from the National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. Software Joinpoint 5.2.0 was used to analyze the epidemiological characteristics of genital herpes, software ArcGIS 10.5 was used for spatial autocorrelation analysis, and software SaTScan 10.2.3 was used for spatiotemporal scanning analysis. Results: The reported incidence rate of genital herpes increased from 1.58/100 000 to 2.00/100 000 in China from 2010 to 2023, with an average annual percentage change of 0.90%. The upward trend of reported incidence rate was significant (t=2.35, P=0.037). There was a positive spatial autocorrelation in the reported incidence of genital herpes with the global Moran's I ranging from 0.36 to 0.51 (all P<0.001). Local spatial autocorrelation analysis showed that the number of hotspots increased from 144 in 2010 to 232 in 2023, mainly distributed in provinces Zhejiang, Guangdong, Guangxi, Chongqing and Hunan. The number of hotspots in of Chongqing, Sichuan, Yunnan and Guizhou increased significantly from 7 to 57. A total of 67 spatiotemporal clusters were detected by spatiotemporal scanning analysis, mainly distributed in Guangdong from 2011 to 2015, in Zhejiang and Fujian from 2015 to 2019, and in Chongqing and Guizhou from 2019 to 2023. Conclusions: From 2010 to 2023, the reported incidence of genital herpes in China showed an upward trend, and there was an obvious spatiotemporal clustering of genital herpes. The distribution of hotspots was basically consistent with the distribution of spatiotemporal clustering areas, mainly distributed in the southeastern coastal area and southwestern region, and the spatiotemporal clustering areas gradually changed from the southeast coastal area to the southwest region.

Objective: To evaluate the association between hypertension duration and risk for chronic kidney disease in residents in China. Methods: Participants aged 18-74 years from the sixth round of China Chronic Disease and Risk Factor Surveillance in 2018 were included. The age/date at hypertension diagnosis was reported by them, and hypertension duration was calculated based on the age at diagnosis and the age at survey. The hypertension duration was calculated as 0 year (i.e., normotensive participants), 0.1- year, 5.0- years, 10.0- years, and ≥15.0 years. Serum creatinine, urinary albumin, and urinary creatinine levels were measured, and chronic kidney disease was diagnosed when glomerular filtration rate was <60 ml·min^-1·(1.73 m²)^-1 and/or urine albumin-to-creatinine ratio was ≥30 mg/g. Multivariable logistic regression analysis, which took intra-group correlation into account, was used to evaluate the association of hypertension duration with chronic kidney disease. Results: A total of 140 662 residents were finally included in the analysis. After adjusting the confounders, including blood pressure, the odds ratio of chronic kidney disease was 1.16 (95%CI: 1.09-1.23), 1.33 (95%CI: 1.20-1.48), 1.33 (95%CI: 1.18-1.49), and 1.43 (95%CI: 1.29-1.60) in study subjects with hypertension durations of 0.1-4.9 years, 5.0-9.9 years, 10.0-14.9 years, and ≥15.0 years, respectively, in comparison with normotensive people. This result was further supported by the positive association between hypertension duration and chronic kidney disease in people with previously diagnosed hypertension. The results of restricted cubic spline suggested that the risk for chronic kidney disease showed a steep increase within 0.1- 4.9 years after hypertension diagnosis, then showed neither increase nor decrease. The above association seemed to be stronger in those with hypertension diagnosed age <45 years. Compared with those with hypertension duration of 0.1-4.9 years, the odds ratio was 1.38 (95%CI: 1.04-1.84), 1.22 (95%CI: 0.91-1.65), and 1.47 (95%CI: 1.04-2.07) in those with hypertension durations of 5.0-9.9 years, 10.0-14.9 years, and ≥15.0 year, respectively. In those with hypertension diagnosis at ≥45 years, the corresponding odds ratio was 1.08 (95%CI: 0.98-1.19), 1.08 (95%CI: 0.97-1.21), and 1.16 (95%CI: 1.02-1.32), respectively. Conclusions: Hypertension duration is positively associated with the risk for chronic kidney disease in residents in China, and this association is independent of blood pressure level. Early diagnosis of hypertension and long-term control of blood pressure are effective strategies for secondary prevention of hypertension-related chronic kidney disease.

Objective: To assess the association between possible sarcopenia and the risk for frailty in middle-aged and elderly adults in China. Methods: A prospective cohort study design was used in this study. Data were from the China Health and Retirement Longitudinal Study during 2011-2018 and the baseline data in 2011, the follow up was conducted in 2013, 2015 and 2018, respectively. Frailty index was used to evaluate frailty status, and grip strength and repetitive sitting-up time were measured to detect possible sarcopenia. Cox proportional hazards regression model was used to estimate the association between possible sarcopenia and the risk for frailty in middle-aged and older adults. Results: In a 44 884 person-years follow-up, a total of 586 cases with frailty were recorded, and the incidence density of frailty was 13.06 per 1 000 person-year. The risk for frailty was also higher in those who were aged 60 years and above (HR=2.05, 95%CI: 1.71-2.45), had a primary school education level or below (HR=1.55, 95%CI: 1.29-1.85), had waist-to-height ratio ≥0.5 (HR=1.39, 95%CI: 1.11-1.75) and had depression (HR=1.52, 95%CI: 1.28-1.81). Drinking was associated with reduced risk for frailty (HR=0.76, 95%CI: 0.62-0.94). The risk for frailty increased (HR=1.73, 95%CI: 1.47-2.05) in those who might has possible sarcopenia. Conclusions: In middle-aged and elderly adults, those with possible sarcopenia, lower education level, central obesity and depression might be at high risk for frailty, and early interventions for high-risk population can be taken to slow the progression of frailty.

Objective: To investigate the relationship of several adiposity-related anthropometric parameters, including BMI, waist circumference (WC), waist-to-hip ratio (WHR), body fat percentage (BFP) and indoles in plasma with the incidence of atherosclerotic cardiovascular disease (ASCVD) in adults in China. Methods: In China Kadoorie Biobank (CKB) study, blood samples were collected from 2 183 participants in the first resurvey in 2008 to detect indoles. Participants' body weight, body height, WC, hip circumference, and BFP were measured at baseline survey in 2004 and resurvey in 2008, the BMI and WHR were calculated with standardized methods. The long-term follow-up of all participants started from the completion of the resurvey in 2008 until the occurrence of incident ASCVD, death, loss to follow-up or until December 31, 2018. CKB ascertained outcome status (incident ASCVD) through death and disease registries and national health insurance databases, supplemented by active follow-up. Multivariate linear regression model was used to estimate the associations of anthropometric measurements at baseline survey and the first resurvey, and changes in these measurements with 3 indoles [indole, indole-3-acetic acid (IAA), and indole-3-propionic acid (IPA)]. Cox proportional hazard regression model was used to estimate the associations between indoles and the risk for ASCVD. Results: Anthropometric measurements at baseline survey or the first resurvey were negatively associated with plasma IPA level. The regression coefficient (β) of baseline BMI (per 1.0 kg/m²) with 0.1 standard deviation (SD) IPA was -0.23 (95%CI: -0.36 - -0.10) (false discovery rate=0.004). After adjusting for baseline BMI, the β of baseline WC, WHR and BFP with 0.1 SD IPA were -0.09 (95%CI: -0.18 - -0.01), -0.12 (95%CI: -0.19 - -0.05), and -0.20 (95%CI: -0.32 - -0.08), respectively. The annual change in BMI (difference between BMI in 2008 and 2004 divided by the time interval) was associated with indole and IAA, with β of 1.40 (95%CI: 0.58 - 2.21) and -1.07 (95%CI: -1.91 - -0.23), respectively, at each 0.1 increase of SD. Over a median (Q₁, Q₃) follow-up of 10.46 (10.36, 10.53) years after 2008 resurvey, 236 cases of ASCVD were recorded. IAA and IPA levels were negatively associated with the risk for ASCVD, with hazard ratios for one SD increase of IAA and IPA of 0.87 (95%CI: 0.76 - 0.99) and 0.84 (95%CI: 0.73 - 0.96), respectively. Conclusions: Our results suggested that anthropometric measurements and their changing trends affect the levels of plasma imicrobial tryptophan metabolite levels, decreased levels of IAA and IPA levels are associated with increased risk of ASCVD and indoles in plasma including IPA and IAA might be the mediating factors for adiposity-induced ASCVD.

Objective: To explore the association between pre-diabetes and glomerular hyperfiltration status in residents in China. Methods: The study subjects were the non-diabetes population in China Chronic Disease and Risk Factor Surveillance in 2018. According to the definition of prediabetes, the study subjects were divided into normoglycemic and pre-diabetes groups, and multivariate factorial logistic regression model was used to analyze the association between prediabetes and the risk for glomerular hyperfiltration and glomerular filtration rate decline, respectively. Restricted cubic spline was used to explore the dose-response relationship between different glycemic indexes and the risk for glomerular hyperfiltration. Results: A total of 129 735 eligible study subjects aged 18 to 74 years were included, including 45 336 persons with prediabetes. After adjusting for confounders, the OR for glomerular hyperfiltration in the prediabetes group was 1.26 (95%CI: 1.20-1.32) compared with the normoglycemic group, and prediabetes was not associated with decreased glomerular filtration rate (OR=1.03, 95%CI: 0.96-1.12). Age-stratified results showed a 28% increase of risk for glomerular hyperfiltration in prediabetes group compared with normoglycemic group in those aged 18-59 year (OR=1.28, 95%CI: 1.21-1.35), and a 15% increase of risk in old adults aged 60-74 years (OR=1.15, 95%CI: 1.05-1.25); the risk for glomerular hyperfiltration in women with prediabetes (OR=1.38, 95%CI: 1.29-1.47) was higher than that in men with prediabetes (OR=1.14, 95%CI: 1.06-1.22); and the risk for prediabetes glomerular hyperfiltration was higher in those with insufficient physical activity (OR=1.29, 95%CI: 1.22-1.36) than in those who were physically active (OR=1.16, 95%CI: 1.04-1.29). Restricted cubic spline results showed that fasting plasma glucose, glycosylated hemoglobin and glomerular hyperfiltration risk all showed U-shaped associations, and 2 hours blood glucose glomerular hyperfiltration risk after taking sugar showed an approximate J-shaped association. Conclusions: The risk for glomerular hyperfiltration exists in the prediabetes population, and prediabetes is not associated with the decrease in glomerular filtration rate. Hyperglycemia control at an early and reversible stage is important to prevent glomerular hyperfiltration developing to hypofiltration and renal impairment.

Objective: To understand the prevalence of frailty and the importance of its influencing factors in adult population in Shaanxi Province. Methods: The data were from Shaanxi baseline survey of natural population cohort study in northwest China during 2018-2019. The frailty index (FI) was constructed to evaluate the frailty status of the population, and XGboost model combined with Shapley method was used to analyze the importance of the sociodemographic and life behavior factors affecting the prevalence of frailty by gender and age. Results: A total of 25 079 subjects were included, in whom 964 (3.8%) had frailty, and there was no significant difference in the overall prevalence of frailty between women (3.9%) and men (3.8%) (P=0.629), but there was a gender specific difference in the distribution of FI (P<0.001), and the proportion of the pre-frailty in men was higher than that in women. The prevalence of frailty increased with age (P<0.001), the prevalence of frailty were 1.3%, 2.5% and 7.8% in young, middle-aged and elderly women, respectively, and 1.9%, 2.7% and 5.5% in young, middle-aged and elderly men, respectively. Sociodemographic characteristics and lifestyle patterns were both influencing factors for the prevalence of frailty, but their importance varied with gender and age. The top five contributing factors were education level, staying up late, annual family income level, sedentary time and marital status in young women, and staying up late, smoking, annual family income level, sedentary time and drinking in young men. The top five contributing factors were education level, annual family income level, passive exposure to smoking, staying up late, and sedentary time in middle-aged women, and annual family income level, education level, sedentary time, staying up late and drinking in middle-aged men. The top five contributing factors were annual family income level, passive exposure to smoking, sedentary time, marital status, and smartphone use in elderly women, and education level, annual family income level, smoking, smartphone use and sedentary time in elderly men. Conclusions: There are gender specific differences in the distribution of FI in Shaanxi. The prevalence of frailty increased with age, but young and middle-aged people also have frailty risk. The prevalence of frailty in young men was mainly related to unhealthy life behaviors, such as staying up late, smoking, sedentary behavior and drinking, while the prevalence of frailty in middle-aged and elderly men and women were more affected by sociodemographic factors, such as education level, economic status and marital status.

Objective: To understand the prevalence of chronic kidney disease (CKD) and influencing factors in adults with hypertension in China and provide evidence for the management of CKD in hypertension patients. Methods: The prevalence data of CKD in hypertension patients in China were collected from China Chronic Disease and Risk Factor Surveillance in 2018, the data of 68 829 hypertension patients were analyzed. After complex weighting, the prevalence of CKD in the study population was compared. A multivariate logistic regression model was used to explore the influencing factors of CKD in adults with hypertension. Results: The prevalence of CKD in the hypertension patients was 18.2% (95%CI: 17.4%-19.0%) and increased with age, and the prevalence was 16.4% in men and 20.6% in women (P<0.001). In different age groups, CKD at stage G1 mainly occurred in those aged 18-44 and 45-59 years, with the prevalence of 10.8% and 7.8%, respectively, while CKD at stages G2 and G3a mainly occurred in those aged >60 years, with the prevalence of 9.4% and 9.7%. Multivariate logistic regression results showed that in the hypertension patients, being aged ≥60 years, being women, smoking (including current and ever smoking), physical inactivity, being underweight or obese, and suffering from diabetes, dyslipidemia and hyperuricemia were the potential risk factors for CKD (all P<0.05). Conclusion: The prevalence of CKD was higher in people with hypertension than in general population in China, and age, gender, smoking status, physical activity level, and suffering from diabetes, dyslipidemia, and hyperuricemia or not were significant influencing factors. It is necessary to strengthen health education and kidney function testing in adults with hypertension and develop comprehensive CKD prevention and control measures targeting high-risk population.

The co-infection of HIV and Mycobacterium tuberculosis (MTB) poses a severe challenge for the prevention and control of infectious disease, resulting in poor clinical outcomes of the patients and risk for wide spread. As steady progress in global health, the co-infection of HIV/MTB has been basically controlled, and the new cases are generally declining. However, its incidence remained high in resource-limited areas. The incidence of the co-infection of HIV/MTB is associated with the interaction among individual, social, health service, and natural factors. Comprehensive measures are needed to reduce this disease burden. This paper summarized the epidemiological characteristics of the co-infection of HIV/MTB and influencing factors both at home and abroad to provide evidence for the identifications of high-risk populations and areas and development of targeted prevention measures for the purpose of reduce the incidence of co-infection of HIV/MTB.