中华流行病学杂志最新文献

Objectives: To construct and analyze the social network of men who have sex with men (MSM) in Guangzhou on a geosocial networking platform, aiming to reveal its topological characteristics, connection patterns, and group stratification. The study aims to identify structural bottlenecks and key nodes in information dissemination, thereby supporting targeted public health interventions. Methods: User data were collected via web scraping from a major MSM-oriented social platform. A directed network was constructed with users as nodes and follow relationships as edges. Network topology was assessed using metrics such as degree distribution, clustering coefficient, reciprocity, assortativity, centrality, and community structure. Stratified comparisons and homophily analyses were conducted based on age, sexual role, and number of sexual partners to explore how user attributes relate to structural positioning and interaction patterns. Results: The network included 72 535 users and exhibited a highly sparse (density <0.001), low reciprocity (0.076), weakly clustered (transitivity=0.004), and strongly assortative (0.925) structure, reflecting decentralization and stratification. Younger users (<29 years) showed the highest age-based assortativity (0.369), while users with multiple sexual partners had the strongest behavioral clustering (0.220). The community structure was highly fragmented-70.9% of communities consisted of only two nodes-but overall connectivity was maintained by 12 089 boundary nodes, primarily composed of middle-aged, top-identified, and multi-partner users, who contributed 39.2% of cross-community links. Conclusions: The MSM online network is characterized by structural heterogeneity and hierarchy. High assortativity, low reciprocity, and fragmented communities can hinder the flow of health information and access to support. Future interventions should target high-centrality nodes, improve the visibility of peripheral users, and bridge fragmented clusters. Targeted dissemination based on network structure and strengthening cross-community bridging pathways may help optimize information flow, reduce structural visibility gaps, and build a fairer, more inclusive, and structurally friendly digital intervention environment.

Objective: To explore protein molecular markers and therapeutic targets for gestational diabetes mellitus (GDM). Methods: Based on transcriptomic, proteomic, and genomic data, we performed Mendelian randomization and colocalization analyses to preliminarily identify candidate proteins whose expression levels are associated with GDM risk and to evaluate whether the same causal variants drive protein levels and GDM. Protein-protein interaction (PPI) network analysis was then applied to elucidate interactions among these proteins, and gene ontology (GO) enrichment analysis was conducted to summarize their features in terms of biological processes, cellular components, and molecular functions. Finally, integrating our findings with existing evidence, we graded proteins significantly associated with GDM risk at the expression level according to established criteria for prioritizing potential protein targets. Results: GCKR (OR=3.55, 95%CI: 2.60-4.84) was classified as first-tier evidence. Proteins with second-tier evidence included PARP1 (OR=0.53, 95%CI: 0.39-0.81), NUDT2 (OR=1.13, 95%CI: 1.07-1.20), and NRBP1 (OR=0.18, 95%CI: 0.10-0.31). Third-tier evidence encompassed SV2A (OR=1.30, 95%CI: 1.12-1.52), PINLYP (OR=0.92, 95%CI: 0.89-0.94), PILRA (OR=0.96, 95%CI: 0.95-0.98), LYPLAL1 (OR=1.68, 95%CI: 1.33-2.13), BOLA1 (OR=1.56, 95%CI: 1.18-2.07), TYRO3 (OR=1.08, 95%CI: 1.04-1.11) and SF3B4 (OR=2.89, 95%CI: 1.51-5.51). PPI network analysis revealed an interaction between GCKR and LYPLAL1, and GO enrichment analysis indicated that the 11 proteins were involved in pathways such as the regulation of small-molecule metabolic processes and responses to fructose. Conclusions: Through the development of a multi-omics integrative genetic framework, we identified 11 proteins whose circulating levels are significantly associated with the risk of GDM. These findings offer multidimensional molecular insights into the pathogenesis of GDM, providing multidimensional molecular mechanism evidence for the exploration of potential biomarkers and targeted therapeutic research in GDM.

Objective: To investigate the prevalence and influencing factors of clinical obesity and preclinical obesity in rural adults according to the diagnostic principles of clinical obesity proposed by the Lancet Diabetes & Endocrinology Commission. Methods: Data were obtained from the Henan rural cohort. Clinical obesity and preclinical obesity were diagnosed through questionnaires, physical examination, and laboratory tests. Descriptive analyses were performed using the t-test and χ² test, and influencing factors were analyzed using a multivariate logistic regression model. Results: A total of 28 104 participants were included. The crude prevalence rates of clinical obesity and preclinical obesity were 49.03% and 19.44%, and the age-standardized prevalence rates were 36.88% and 20.33% respectively. Among them, the crude prevalence rates of men (46.41% and 13.27%) were lower than those of women (50.59% and 23.13%). With increasing age, the age-standardized prevalence of clinical obesity in the total population showed an upward trend (trend for P<0.001), and the age-standardized prevalence of preclinical obesity was highest at the age of 40-49 years, then showing a downward trend (trend for P=0.017). Multivariate analysis showed that gender, age, educational level, marital status, smoking status, drinking status, high-fat diet, and physical activity were the influencing factors of clinical obesity and preclinical obesity. Conclusions: The prevalence of clinical obesity among rural adults was relatively high and higher than that of preclinical obesity. Measures should be taken to address modifiable factors to reduce the risk of clinical obesity.

Lung cancer is one of the malignancies with the highest incidence and mortality rates worldwide. Early detection and accurate diagnosis are critical for improving patient prognosis. In recent years, lung cancer risk prediction models have demonstrated increasing value in optimizing screening strategies for lung cancer. This review summarizes the current research progress in lung cancer risk prediction models, with a particular focus on recent advances in variable selection, model construction, and performance validation based on traditional statistical models and machine learning approaches. In addition, the key trends in model development are discussed, and the prospects and challenges of clinical application are analyzed, providing a reference for constructing more efficient and widely applicable lung cancer screening tools.

Objective: To explore the shared genetic basis and potential causal relationships between polyunsaturated fatty acids (PUFAs)-including n-3 PUFAs, docosahexaenoic acid (DHA), n-6 PUFAs, and linoleic acid (LA) and knee osteoarthritis (KOA). Methods: Based on genome-wide association studies for PUFAs (n=136 016) and KOA (n=396 054), we conducted genetic correlation, cross-trait association, and Mendelian randomization (MR) analyses, controlling for potential confounders such as BMI and bone mineral density. Results: Five region-specific signals were identified between PUFAs and KOA at the genomic level. Cross-trait analyses revealed 70 pleiotropic loci, of which five were novel and all related to n-6 PUFAs. MR analyses demonstrated that higher genetically predicted levels of n-6 PUFAs (OR=0.93, 95%CI:0.88-0.98, P=7.11×10⁻³) and LA (OR=0.92, 95%CI:0.87-0.97, P=2.60×10⁻³) were significantly associated with reduced risk of KOA. These protective effects remained robust in multivariable MR. Conclusion: n-6 PUFAs and their subtype LA exert protective effects against the development and progression of KOA.

Objective: To explore the effect of prenatal barium exposure on the advancement of the adiposity rebound phase in children. Methods: We included 2 718 mother-child pairs from the Ma'anshan Birth Cohort in this study. Peripheral venous blood from pregnant women during pregnancy and umbilical cord blood from newborns were collected and tested for serum barium concentrations in mother-child pairs. Length/height and weight were measured, and body mass index (BMI) was calculated at 42 days, 3 months, 6 months, 9 months, 1 year, 1.5 years, 2 years, 2.5 years, 3 years, 3.5 years, 4 years, 4.5 years, 5 years, 5.5 years, 6 years, and 7 years of age. A fractional polynomial mixed-effects model was used to fit the children's BMI trajectories and to determine the timing of adiposity rebound. Binary logistic regression models were used to assess the association between prenatal barium exposure and the advancement of the adiposity rebound phase. The multiplicative model was applied to analyze the effect of the interaction between prenatal barium exposure and child sex on the advancement of the adiposity rebound phase in children. Results: The detection rates of adiposity rebound phase advancement were 87.42%, 86.58%, and 88.30% for all children, boys, and girls, respectively. After adjusting for confounders, binary logistic regression revealed that barium exposure in the first trimester was statistically associated with the advancement of adiposity rebound in all children (OR=1.20, 95%CI: 1.03-1.40) and boys (OR=1.30, 95%CI: 1.06-1.58), respectively. However, no similar associations were found in girls. The multiplicative interaction results showed that the interaction between barium exposure during pregnancy and child sex did not have a significant effect on the advancement of the adiposity rebound phase. Conclusions: Barium exposure in the first trimester may lead to an increased risk of adiposity rebound phase advancement in children, and this effect was more pronounced in boys. However, interaction analyses did not reveal a statistically significant association, so sex-specific differences in children need to be interpreted with caution.

Objective: To analyze the epidemic characteristics and changing trends of local dengue fever among the elderly population in Guangdong Province from 2015 to 2023, in order to provide a scientific basis for improving the prevention and control strategies and measures of dengue fever. Methods: The surveillance data of dengue fever in Guangdong Province from 2015 to 2023 were collected through the China Disease Prevention and Control Information System. The Joinpoint 4.9.1.0, SaTScan 9.6, and ArcGIS 10.7 software were used to analyze the temporal, spatial, and population characteristics of local dengue fever cases among the elderly population. Results: From 2015 to 2023, a total of 3 092 local cases of dengue fever among the elderly population were reported in Guangdong Province. The annual incidence rate was 2.28 per 100 000, which was higher than the 1.37 per 100 000 for the entire population. The incidence of dengue fever among the elderly population exhibited a fluctuating trend, initially decreasing before increasing overall. The circular distribution results indicated that the incidence of dengue fever among the elderly population from 2015 to 2023 was strongly seasonal, with the concentration trend's γ value ranging from 0.81 to 0.95 (γ=0.88,P<0.001), and the peak days of the epidemic mainly occurred in mid-to late September to the end of October. Elderly cases were mainly concentrated in the Pearl River Delta region (58.76%, 1 817/3 092). Spatial autocorrelation analysis revealed that the incidence of the disease among the elderly exhibited apparent spatial clustering, with the high-high clustering area primarily located in the Pearl River Delta region. The spatial clustering area's spatio-temporal scanning analysis results showed that primary clusters area was mainly in Guangzhou City and Chaozhou City, and the secondary clusters area included Guangzhou City, Foshan City, and Shenzhen City in the Pearl River Delta region, Chaozhou City and Jieyang City in Eastern Guangdong, and Zhanjiang City and Yangjiang City in Western Guangdong. The scope of the clustering area exhibited a gradual expansion trend, and the clustering period was basically consistent with the seasonal distribution. The incidence rate of the elderly population was -7.11% on average, with the incidence rate of males being slightly higher than that of females. Conclusions: From 2015 to 2023, the local dengue fever outbreaks among the elderly population in Guangdong Province showed a fluctuating trend. There was a strong seasonal pattern and obvious spatial clustering. Measures should be taken to strengthen the prevention and control of dengue fever among the elderly in the high-incidence and clustered areas.

Objective: To understand the regional differences in the indirect economic burden of cancer in populations in China. Methods: The indirect economic burden of cancer in 31 provinces was measured using disability-adjusted life year data and a human capital approach. Data were sourced from open databases, including literature, the Global Burden of Disease Study 2021, the International Labour Organization, the National Census, and the China Statistical Yearbook. The main analysis utilized the annual per capita wage income of residents in urban and rural areas of China in 2020, as well as in each province, for monetization purposes. The coefficient of variation (CV) was applied to assess the regional disparities. Sensitivity analyses were conducted for key economic parameters. Results: The total indirect economic burden of cancer in China in 2020 was approximately 747.40 billion Yuan, accounting for 0.74% of the local gross domestic product (GDP) for the same year, of which 503.53 billion Yuan (67.37%) was higher for men than 243.87 billion Yuan (32.63%) for women. The top five cancer types by economic burden were lung cancer (221.71 billion Yuan), liver cancer (118.90 billion Yuan), stomach cancer (76.01 billion Yuan), colorectal cancer (58.05 billion Yuan), and esophageal cancer (41.71 billion Yuan). The indirect economic burden of cancer across 31 provinces varied from 0.82 billion Yuan to 78.45 billion Yuan, with a CV of 0.89 (ranging from 0.42% to 1.05% of the corresponding gross regional product); when the national per capita GDP was used for monetization, the provincial estimates increased to (5.01-250.43) billion Yuan, with a CV of 0.73. Conclusions: The indirect economic burden of cancer in populations in China is substantial and should not be overlooked. Regional disparities in this burden are largely influenced by local economic conditions and the specific methodologies applied.

Objective: To understand the burden of acute gastroenteritis in Tianjin and provide a reference basis for formulating prevention policies for foodborne diseases. Methods: A cross-sectional study design and a multi-stage stratified random sampling method were adopted. The survey subjects were the permanent residents of Tianjin who had resided for at least 6 months. From April 2024 to March 2025, household surveys were conducted in 16 districts of Tianjin. The estimated sample size was 13 824 people. Information on the occurrence, treatment, and suspected causes of acute gastroenteritis in the past 3 months of the survey subjects was collected. The survey subjects were weighted adjusted based on the results of the seventh population census in Tianjin. Logistic regression models were used to analyze the related factors of acute gastroenteritis in Tianjin. Statistical analysis was performed using SPSS 26.0 software. Results: A total of 13 823 people were surveyed,among which 468 cases of acute gastroenteritis occurred 742 times. The average incidence rate per quarter 5.37% (742/13 823), and the weighted quarterly incidence rate was 10.79%; the annual incidence rate was 0.219 times per person-year, and the weighted annual incidence rate was 0.454 times per person-year. The rate of hospital visits by cases was 17.95% (84/468). The rate of sample collection from feces was 15.48% (13/84). Additionally, 73.08% (342/468) of the participants used drug treatment, and 31.58% (108/342) used antibiotic treatment. The proportion of those who believed they had consumed contaminated food was 68.80% (322/468). The results of the multivariate logistic regression model analysis showed that the positive factors associated with the incidence of acute gastroenteritis among residents included the second quarter (April to June), age 15-24 years old, students in school, leaving Tianjin for business or tourism in the past three months, annual per capita household income ≤4 000 yuan and 4 001-20 000 yuan; the negative factor was those with educational attainment at middle school and below. Conclusions: In 2024-2025, the annual incidence rate of acute gastroenteritis in Tianjin was relatively high, with high proportion of food-borne acute gastroenteritis and heavy disease burden. Moreover, the hospital visit rate and fecal sample collection rate were relatively low. Therefore, special attention should be paid to and efforts should be intensified in the prevention and control of foodborne diseases.