中华流行病学杂志最新文献

Objective: To analyze the association between metabolic dysfunction- associated steatotic liver disease (MASLD) and the risk for cardiovascular events in adults in Shanghai communities. Methods: A community-based prospective cohort study was conducted, based on the Shanghai Suburban Natural Population Cohort and Biobank, in 34 783 adults who were free of cardiovascular events at baseline in Shanghai. Multivariate Cox proportional hazards regression model was used to analyze the association between MASLD and the risk of cardiovascular events. The Fine-gray competing risks model was used to handle the influence of competing risk events in the Cox proportional hazards regression model. Subgroup analyses were performed according to factors that may affect the relationship between MASLD and cardiovascular events, with multiplicative interaction effects examined. Results: A total of 34 783 participants were included in the cohort, with a follow-up time of M (Q₁, Q₃) of 6.90 (6.62, 7.45) years. During follow-up, 2 067 new incident cardiovascular event cases were observed among the 13 837 patients with MASLD, with a cumulative incidence of 5.94%. Multivariate Cox proportional hazards regression analysis showed that MASLD increased the overall risk of cardiovascular events (HR=1.17, 95%CI: 1.06-1.29). Subgroup analysis results showed that significant interaction effects were observed for age, hyperlipidemia, and overweight/obesity on the association between MASLD and cardiovascular events (all P for interaction <0.05). Conclusions: The prevalence of MASLD is relatively high in the adult community population in Shanghai. MASLD is associated with an increased risk of cardiovascular events.

Objective: To investigate the relationship between muscle mass index (MMI) and triglyceride-glucose (TyG) index in adults in Xi'an. Methods: Data were derived from the baseline survey of Xi'an urban population cohort, part of the natural population study conducted during 2018-2019 in northwestern China. The TyG index and MMI adjusted by weight (W-MMI) and MMI adjusted by BMI (BMI-MMI) were calculated to investigate their relationship by using logistic regression model. Restricted cubic spline was used to analyze the dose-response relationship between W-MMI or BMI-MMI and TyG index. Sensitivity analysis and subgroup analysis were performed to evaluate the robustness of the results. Results: A total of 3 152 study participants (average age 37.8 years) were included in the analysis. After adjusting for covariates, the participants in the Q₄ group of W-MMI had a 65.7% (OR=0.343, 95%CI:0.227-0.517) lower risk for high TyG compared with those in the Q₁ group. In terms of BMI-MMI, the Q₄ group had a 68.5% (OR=0.315, 95%CI: 0.208-0.478) lower risk for high TyG compared with the Q₁ group. The restricted cubic spline model revealed a significant linear dose-response relationship between muscle mass and TyG. The sensitivity and subgroup analyses showed robust results. Conclusion: In the adult population of Xi'an, MMI was negatively correlated with the TyG index, suggesting that enhancing physical exercise to increase or strengthen muscle mass might help reduce the risk of insulin resistance.

This paper synthesizes domestic and international literature as well as disciplinary development practices to propose a theoretical framework for field epidemiology, establishing its legitimacy as a distinct branch of epidemiology. Field epidemiology focuses on the rapid investigation, risk communication, and emergency intervention of public health emergencies, incorporating multidisciplinary theories and methods from epidemiology, management, public health laboratory techniques, communication studies, law, and information technology. Its interdisciplinary nature underscores its integration with the humanities and social sciences, emphasizing the bidirectional interaction between field epidemiologists and the public. Characterized by timeliness, complexity, social relevance, legal considerations, decision-making approaches, and collaborative efforts, field epidemiology not only extends the scope of traditional epidemiology but also enhances the scientific rigor of public health emergency management. Greater involvement of higher education institutions in advancing field epidemiology as a discipline could bridge the gap between theoretical research and public health practice while accelerating the field's overall progress and development in China.

Objective: To investigate the co-infection status of HIV, Treponema pallidum (TP), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and HCV in female sex workers (FSWs) in Yunnan Province in 2023, and provide evidence for the development of the prevention and intervention strategies for sexually transmitted diseases (STD). Methods: A cross-sectional study was conducted in FSWs in Yunnan from April to June 2023 in the form of face-to-face questionnaire survey, and biological samples were collected from the FSWs. Apriori algorithm was used for the association analysis rule on the co-infection patterns of HIV, TP, CT, NG, and HCV in the FSWs. Results: A total of 3 040 FSWs aged 16-65 years were surveyed, in whom 1 546 (50.85%) were married, 2 608 (85.79%) were local residents, 1 980 (65.13%) were in Han ethnic group, and 2 140 (70.40%) had education level of junior high school or below. The detection rates of HIV, TP, CT, NG, and HCV infections were 0.23% (7/3 040), 2.29% (69/3 040), 11.51% (350/3 040), 3.49% (106/3 040) and 0.39% (12/3 040), respectively. Analysis on the co-infection patterns revealed that the most common dual co-infection was CT+NG (1.51%).The most common triple co-infection was TP+CT+NG (0.16%). The only observed quadruple co-infection was TP+CT+NG+HCV (0.03%). The association rule analysis showed that the highest support was for CT+NG (1.51%). Confidence varied significantly depending on antecedent and consequent rules. Lift values indicated strong positive correlations among the most STD (all >1.00 except CT→HCV and HCV→CT, where lift <1.00). In the dual co-infections, NG and HIV had the strongest association (lift=8.19). As the number of co-infections increased, the likelihood of additional infections increased, reflecting stronger disease correlations. Conclusions: The co-incidence patterns of STDs in FSWs in Yunnan are complex, with CT, NG, and TP causing the most common co-infections. It is necessary to take an integrated measure of joint health education, testing, prevention, and treatment for multi diseases in the future.

Schizophrenia is a severe mental disorder and one of the top ten causes of disability worldwide. Its pathogenesis remains incompletely understood, making early prevention challenging. With the development of systematic epidemiological methods, multidimensional data integration and analysis have increasingly contributed to exploring the mechanisms of complex diseases and population health. Meanwhile, the progress in genomics, transcriptomics, and proteomics have provided more precise tools for schizophrenia research. This paper summarizes the application of multi-omics technologies in the assessment of the risk for schizophrenia, introduces their significance and practical value in this field, and discusses the future application.

Objective: To analyze the distribution and trends of obesity, overweight, and body mass index (BMI) in residents aged 18-69 years in Shandong Province from 2004 to 2023, and provide data support for obesity prevention and control. Methods: The data were from seven cross-sectional surveys of the China Chronic Disease and Risk Factor Surveillance from 2004 to 2023. Complex weighted sampling was used to analyze BMI and the prevalence of overweight and obesity in men and women and in urban or rural adults in Shandong from 2004 to 2023. The average annual percentage change (AAPC) was used to describe the trends. Results: From 2004 to 2023, the average BMI of adults aged 18-69 years in Shandong increased from 23.79 (95%CI:23.50- 24.08) kg/m² to 25.78 (95%CI:25.64-25.91) kg/m², with an AAPC of 0.47% (95%CI:0.38%-0.65%) (P<0.001). The average BMI increased in urban and rural adults as well as in both men and women. In 2004, the average BMI was 23.55 (95%CI:23.15-23.96) kg/m² in men and 24.03 (95%CI:23.60-24.46) kg/m² in women. In 2023, the average BMI was 25.81 (95%CI:25.62-25.99) kg/m² in men and 25.75 (95%CI:25.54-25.95) kg/m² in women. The average BMI in urban adults increased from 24.41 (95%CI:24.06-24.75) kg/m² to 25.97 (95%CI:25.77-26.17) kg/m². The average BMI in rural adults increased from 22.68 (95%CI:22.20-23.17) kg/m² to 25.58 (95%CI:25.39-25.77) kg/m². The AAPC of BMI was higher in rural adults (0.50%, 95%CI:0.40%-0.69%) than in urban adults (0.41%, 95%CI:0.25%-0.57%), with both P<0.001. In 2023, the prevalence of overweight was 39.39% (95%CI:37.78%-41.00%) and the prevalence of obesity was 26.20% (95%CI:24.77%- 27.64%), which increased by 30.34% and 109.27% respectively compared with 2004. The AAPCs of overweight and obesity prevalence were 1.62% (95%CI:1.14%-2.28%) and 4.66% (95%CI:4.01%- 5.99%), respectively, with both P<0.001. Conclusions: The prevalence of overweight and obesity in urban and rural adults aged 18-69 years increased in Shandong from 2004 to 2023. It is urgent to take effective measures to strengthen the prevention and control of obesity.

Objective: To analyze the age-period-cohort characteristics of the global burden of psoriasis from 1992 to 2021 and predict its future trends. Methods: Based on the Global Burden of Disease 2021 study, we employed the Joinpoint regression model to analyze trends in the incidence, prevalence, and disability-adjusted life years (DALY) of psoriasis. An age-period-cohort model was constructed to assess its impact on psoriasis incidence trends. The Bayesian age-period-cohort (BAPC) model was applied to predict the disease burden from 2022 to 2034. Results: Between 1992 and 2021, the age-standardized incidence rate and age-standardized DALY rate all exhibited an increasing trend globally in both men and women. The DALY of medium Social-demographic index (SDI) countries was the highest [1 144 223 (829 568-1 527 294)], followed by high SDI countries [975 397 (714 215-1 297 563)], medium high SDI countries [750 441 (546 290-999 446)], medium low SDI countries [599 948 (432 684-806 758)], and low SDI countries [216 728 (157 310-292 188)]. The age-period-cohort model revealed that the risk for psoriasis increased with age before peaking and then declined: the peak age for males was 55-59 years, while for females, it was delayed to 65-69 years. The incidence risk increased over time and showed a rising trend across successive birth cohorts. The BAPC model predicted a continuous increase in psoriasis incidence, with the incidence rate showing a sustained and gradual upward trend, projecting the number of new cases to exceed 5 943 801 by 2034. Conclusions: Since 1992, the burden of psoriasis has significantly increased, exhibiting regional and gender heterogeneity. The future incidence risk is expected to continue rising.

Objective: To refine the indicator weights of performance evaluation tool for vaccination service and comprehensively evaluate the service performance of vaccination units in some provinces of China. Methods: A total of 156 vaccination units from six provinces of China were selected. A combined weighting method based on the game theory was applied to assign weights to the evaluation indicators of the performance of vaccination service. The Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank the vaccination service performance of each vaccination unit. Results: The results of the combined weighting showed that the subjective weighting ratio α₁ was 44.20% and the objective weighting ratio α₂ was 55.80%. Among the first-level indicators, the highest combined weighting was given to the operational performance (42.73), followed by the configuration performance (40.60). Among the secondary indicators, the three indicators of vaccination service, financial guarantee and human resource had the highest weights, which were 18.66, 16.88 and 11.68, respectively. TOPSIS analysis indicated that the relative closeness index of each province ranged from 0.45 to 0.51, and the vaccination units of Zhejiang Province showed the best immunization service perfprmance, followed by Shaanxi Province. Conclusions: The combined weighting method based on game theory integrating subjective and objective weights could make the final weight results more representative and scientific. The gap inthe levels of vaccination service performance of indirect vaccination units among the provinces have been narrowed, but the unbalanced regional development still persist. It is recommended that each region optimize the allocation of resources to vaccination units, innovate the service mode, and actively learn from the advanced experience of each region to improve their own service performance according to the contextual needs.

Aortic aneurysm (AA), a degenerative vascular condition with subclinical nature, demonstrates relatively low incidence rate but substantial risk for rupture related mortality.Given its insidious onset, absence of pathognomonic early symptoms, coupled with high case-fatality rate and low screening rate, AA frequently has missed or delayed diagnoses. Currently, there is a lack of drugs that can effectively prevent or reverse the progression of AA. The investigation of AA epidemiology and risk factors can facilitate not only the identification of populations at high-risk and timely screening, but also improve outcome through targeted risk factor modification. This paper synthesizes current evidence on AA epidemiological patterns and associated risk determinants to provide a theoretical framework to improvve the early prevention strategies and transform clinical therapy from reactive treatment to active prevention.

Objective: To explore the correlation between temporal distribution of influenza cluster epidemic and influenza epidemic period indicated by sentinel surveillance data in Beijing in surveillance during 2014-2020 and 2022-2024, and provide scientific evidence for the early warning of influenza epidemic period. Methods: The incidence data of influenza cluster epidemic and sentinel surveillance data of influenza in Beijing from 2014-2020 and 2022-2024 were collected for a descriptive analysis on their epidemiological characteristics and temporal distributions, and assess their temporal correlation by using Spearman correlation analysis. Results: The onset time of influenza case cluster occurred 3.13 weeks earlier averagely (SD=2.64) than the epidemic period indicated by sentinel surveillance data, with peak occurring 2.38 weeks earlier averagely (SD=1.19), and the end time was delayed on average by 0.25 weeks (SD=2.38). Both the incidence time (r=0.997, P<0.001) and the peak time (r=0.997, P<0.001) showed significant positive correlations. Conclusion: The temporal distributions of influenza case cluster in surveillance during 2014-2020 and 2022-2024 can be used for the early warning of influenza epidemics in Beijing, the timely improvement of prevention and control measures and the allocation of medical resources.