中华疾病控制杂志

A cohort study of air pollutant exposure with the risk of pulmonary nodules progression in Suzhou City

ZHANG Xinyue, CHEN Jie, SHI Yiqiu, LIU Bo, XU Ruining, LIU Kefu, WANG Lina

2024, 28(2): 125-130. doi: 10.16462/j.cnki.zhjbkz.2024.02.001

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Objective This study aimed to investigate the impact of exposure to common air pollutants on the risk of pulmonary nodule progression. Methods A cohort was constructed including individuals identified with pulmonary nodules from a medical examination at a hospital in Suzhou. The average daily exposure concentrations of air pollutants in the year prior to baseline were estimated using the data from environmental monitoring stations. The nodule progression and outcomes were diagnosed by the guidelines for the management of pulmonary nodules proposed by the Fleischner Society. The log-rank test was used to compare the differences in progression rates, and the Cox proportional hazards model was used to estimate the risk of pulmonary nodule progression. Results A total of 785 individuals identified with pulmonary nodules at baseline were included, and among them, 354 cases were observed with progression of pulmonary nodules during a median follow-up of 23.50 months. The individuals exposed to higher concentrations of NO₂, PM_2.5, and PM₁₀ had higher progression rates. Subjects with the highest exposure group (Q4) for PM_2.5 (HR=1.48, 95% CI: 1.06-2.06, P < 0.01) and PM₁₀ (HR=1.56, 95% CI: 1.08-2.25, P=0.02) had significantly higher risks of pulmonary nodules progression compared to that of the lowest exposure group (Q1), and there was a positive dose-response relationship between pulmonary nodules progression risks and highest level of PM₁₀ exposure. Conclusions With the increased levels of air pollutants, the risk of pulmonary nodule progression is increased. It is necessary to strengthen the follow-up management of individuals with pulmonary nodules who are expose to the high levels of air pollutants.

Epidemiological characteristics and spatial aggregation of pulmonary tuberculosis in the elderly aged 65 and over in Shandong Province, 2013-2022

DAI Bingqin, ZHANG Yixin, SUN Xiaoying, ZHANG Jiyu, WU Guangjian, CAO Jie, SUN Chengxi, MA Jixiang

2024, 28(2): 131-137. doi: 10.16462/j.cnki.zhjbkz.2024.02.002

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Objective To analyze the epidemiological characteristics and spatial clustering of pulmonary tuberculosis (PTB) in the elderly aged 65 and over in Shandong Province, so as to provide a reference for the development of precise prevention and control measures. Methods Case data were obtained from the Chinese Disease Control and Prevention Information System. The epidemiological characteristics and spatial aggregation of PTB among the elderly were analyzed by descriptive analysis, Joinpoint regression analysis, and spatial autocorrelation analysis. Results A total of 76 176 elderly patients with PTB were reported in Shandong Province from 2013 to 2022.The average annual incidence was 59.09/100 000. The incidence peaked in January to March each year, and cases were predominantly among male farmers. Joinpoint regression analysis showed that the incidence of elderly PTB had an decreasing trend from 2013 to 2022, with an annual percentage changes (APC) value of -8.92%(95% CI: -10.32%--7.51%, P < 0.05). The results of global spatial autocorrelation showed that the Moran′s I index of the reported incidence of PTB in the elderly ranged from 0.135 to 0.481 (all P < 0.05), suggesting the existence of spatial clustering. Local spatial autocorrelation results showed that the "High-High" clustering areas concentrated in the west of Shandong such as Liaocheng, and the north of Shandong such as Dezhou and Binzhou. Conclusions In Shandong Province, the incidence of PTB among the elderly from 2013 to 2022 is on a downward trend, with male farmers as the main population, the "High-High" aggregation areas in the west and north of Shandong Province need to be emphasized for prevention and control.

Analysis of TRAF1/C5 and TNF-α gene polymorphisms with susceptibility to tuberculosis

WU Shanke, LUO Jiaze, LIAO Yinqian, ZHANG Kaixuan, HU Kuan, ZOU Pinang, WANG Baoguo, ZENG Zhuanping

2024, 28(2): 138-145. doi: 10.16462/j.cnki.zhjbkz.2024.02.003

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Objective To analyze the effects of tumor necrosis factor receptor-associated factor 1 (TRAF1)/complement component 5 (C5) rs10818488 and tumor necrosis factor-alpha TNF-α rs1800629 gene polymorphisms, environmental factors, and their interactions on susceptibility to tuberculosis (TB). Methods The TB-confirmed patients in TB-prone families were selected as the case (TB) group. And the healthy volunteers who had medical checkups in the local community during the same period of time were selected as the healthy controls (HC) group. Besides and those who were related to the TB group and lived together were selected as the healthy household contacts (HHC) group. The association of genotype and environmental factors with TB was analyzed by a logistic regression analysis model, and the interaction between genes and environment was analyzed by crossover analysis combined with a logistic regression analysis model. Results Age above 45 years (χ² =7.90, OR=2.28, 95%CI: 1.28-4.04, P=0.005), smoking (χ² =15.27, OR=4.70, 95%CI: 2.16-10.22, P < 0.001) increased the risk of TB prevalence in the HHC group. Smoking (χ² =13.94, OR=3.58, 95%CI: 1.83-7.01, P < 0.001), living in rural areas (χ² =25.05, OR=3.81, 95%CI: 2.26-6.42, P < 0.001), and poor living room sanitation (χ² =15.31, OR=3.20, 95%CI: 1.79-5.73, P < 0.001) increased the risk of TB prevalence in the HC group. Carriage of TRAF1/C5 rs10818488 AG genotype (co-dominant and hyper-dominant models), GG genotype (co-dominant model), and AG-GG genotype (dominant model) increased the risk of developing TB in the HHC and HC groups. No association between the TNF-α rs1800629 locus and TB susceptibility was found for the time being. Analyzing gene-environment interactions, there was a synergistic effect of the AG-GG genotype at the TRAF1/C5 rs10818488 locus with smoking between the TB and HHC groups, whereas there was a synergistic effect of the AG-GG genotype at the rs10818488 locus with smoking and poor living room sanitation, and a multiplicative interaction with the place of residence between the TB and HC groups, both of which increased the risk of TB prevelance. Conclusions Gene polymorphisms at the TRAF1/C5 rs10818488 locus may be associated with the risk of TB and interact with smoking, place of residence, and indoor sanitation to jointly influence susceptibility to TB.

Spatiotemporal and epidemiological characteristics of mumps in Anhui Province, 2010-2021

LIU Lisha, ZHANG Ning, LI Xuan, DUAN Chunyuan, JIA Xinjing, ZHANG Wenyi, JIA Ruizhong, GUO Jinpeng, WANG Binbing, WANG Yong

2024, 28(2): 146-151. doi: 10.16462/j.cnki.zhjbkz.2024.02.004

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Objective This study aimed to analyze the temporal, spatial, and population distribution and spatiotemporal clustering characteristics of mumps in Anhui Province from 2010 to 2021, understand its epidemiological pattern, and to provide a basis for the development of prevention and control strategies. Methods The reported cases of mumps in Anhui Province from 2010 to 2021 were collected from the Anhui Provincial Center for Disease Control and Prevention. ArcGIS 10.8, Geoda 1.20, and SaTScan 10.1.2 were used to conduct descriptive epidemiological, spatial auto-correlation, and spatiotemporal scanning analyses of mumps in Anhui Province. Results The annual average incidence of mumps was 23.08/100 000 in Anhui Province during 2010-2021, with two peak epidemic periods. The chi-square trend test for incidence showed a downward trend with the years (χ² =10 287.75, P < 0.001). The sex ratio of males to females was 1.67∶1. The highest proportions of cases were aged 5- < 15 years (68.91%) and students (67.89%). Additionally, the two seasonal peaks of mumps occurred from weeks 14 to 28 and from week 46 to week 4 of the following year. The spatial auto-correlation analysis results showed that except for 2012, 2014, and 2015, the Moran′s I indexes indicated positive spatial correlations (P < 0.05). The spatiotemporal scan analysis identified a total of ten clusters, of which the first clustering area was distributed in 26 districts and counties of Anhui Province, with a clustering period of 2011―2013, a radius of 144 km and a log likelihood ratio (LLR) value of 7 803.80. Conclusions Based on the findings, there is a cyclical pattern and declining trend of mumps in Anhui Province. In the future, disease surveillance and early warnings for susceptible populations and hotspots should continue to be strengthened to prevent and control the prevalence of mumps.

Analysis of the effects of different temperature levels in Changsha on human adenovirus infection

LUO Piaoyi, KUANG Wentao, NI Han, FU Liuyi, LYU Yuan, ZHA Wenting, YI Shanghui, ZHANG Siyu

2024, 28(2): 152-160. doi: 10.16462/j.cnki.zhjbkz.2024.02.005

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Objective The objective of this study was to examine the impact and lag effects of varying temperature levels on human adenovirus (HAdV) infection. Methods We collected information on HAdV infection in 2020 and meteorological data for the same period from three sentinel hospitals in Changsha. Spearman rank correlation was employed to analyze the relationship between meteorological factors and the number of HAdV infection cases. Different temperature levels, including daily average, daily maximum, and daily minimum, were categorized using thresholds below P_2.5 and above P_97.5 to define extremely low and high temperatures. The distributed lag nonlinear model (DLNM) was utilized to investigate the impact and lag effect of different temperature levels on HAdV infection. Results In 2020, a total of 41 624 specimens were examined in Changsha, with 1 693 yielding positive results for HAdV, resulting in a prevalence rate of 4.07%. Of these cases, infants and children aged 0-4 years comprised 67.04%. Spearman rank correlation analysis indicated that weak associations (all P < 0.05) between HAdV infection and daily average temperature (r_s=-0.121), daily maximum temperature (r_s=-0.110), and daily minimum temperature (r_s=-0.119). The distributed lag nonlinear model (DLNM) showed that both three-dimensional plot (3-D plot) and contour plots revealed a noticeable short-term effect of high temperature on the risk of HAdV infection. Specifically, under extremely high temperature conditions, both daily average and daily minimum temperatures were found to exhibit a lagged impact on the risk of HAdV infection for a single day. Moreover, the cumulative effects of daily average and daily maximum temperatures displayed a gradual increase with longer lag periods. At a lag of 21 days, the relative risks rose to 15.79 (95% CI: 2.69-92.79) and 11.81 (95% CI: 2.26-61.68), respectively. Additionally, the cumulative effect of daily minimum temperature reached its peak at a lag of 4 days (RR=6.78, 95%CI: 1.05-43.83). Conclusions Infants and young children are particularly vulnerable to HAdV infection. The study findings reveal significant correlations between different temperature levels and the occurrence of HAdV infection. Moreover, the study highlights the significant immediate and cumulative lag effects of extreme temperatures on HAdV infection risk in Changsha.

Dietary patterns and cardiovascular disease among adults in Guizhou Province: a cohort study

ZHANG Ji, ZHOU Jie, YU Lisha, WANG Yiying, WU Yanli, LI Xuejiao, LIU Tao

2024, 28(2): 161-170. doi: 10.16462/j.cnki.zhjbkz.2024.02.006

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Objective To explore the relationship between dietary patterns and cardiovascular disease (CVD), so as to provide evidence for the prevention of CVD. Methods Based on the natural population cohort established in November 2010, a total of 9 280 permanent residents over 18 years old in 12 counties and districts of Guizhou Province were selected by the method of stratified cluster sampling for baseline investigation, those participants received followed up from December 19th 2016 to June 1th 2020. Ultimately, 7 897 individual were eligible by successfully followed-up with complete information at baseline and follow-up for the analysis. Dietary information was obtained by the semi-quantitative food frequency method and dietary patterns were sorted with exploratory factor analysis. Cox proportional risk regression model was conducted to analyze the relationship between dietary patterns and CVD, then the hazard ratio (HR) and corresponding 95% confidence interval were calculated. Results The average age of the subjects was (44.46±15.14) years old, during a median duration of 6.58 years (55 698.80 person-years) of follow-up, 221 new case of CVD were found, the incidence rate of CVD was 3.97/1 000 person-years. Five main dietary patterns determined via factor analysis, named oil and salt pattern, protein pattern, sweet pattern, grain-vegetable pattern, aquatic product pattern, respectively. In the Cox proportional risk regression model, after adjusting other factors, the high level of oil and salt pattern was significantly associated with increasing the risk of CVD (HR=1.44, 95%CI: 1.02-2.02, P < 0.05), medium (HR=1.47, 95% CI: 1.04-2.06, P < 0.05) and high level (HR=1.66, 95%CI: 1.17-2.36, P < 0.05) of sweet pattern statistically argument occurrence of CVD compared with the low level of such patterns. Conclusions Oil and salt pattern and sweet pattern can increase the risk of CVD, reducing the intake of fat, salt and sugary foods can prevent and control the occurrence of CVD.

Combined effect of adult neck circumference and waist circumference on diabetes mellitus

XIN Peng, JIANG Guohong, LI Jing, LI Changkun, FAN Lili, ZHENG Wenlong

2024, 28(2): 171-175. doi: 10.16462/j.cnki.zhjbkz.2024.02.007

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Objective To explore the current situation of neck circumference (NC) and its relationship with diabetes among adults, and to analyze the combined effect of NC and waist circumference (WC) on risk of diabetes. Methods According to the Chinese adult chronic disease and nutrition surveillance program, a total of 4 136 inhabitants aged 18 and above were enrolled from Hexi, Nankai, Hongqiao, Wuqing, Jinnan, Baodi and Jizhou district of Tianjin. Except for measuring NC and WC, venous blood was collected to detect fasting blood glucose, glycosylated hemoglobin and blood glucose after taking sugar for 2 h. Those whose male adult NC < 37 cm or female adult NC < 33 cm were divided into NC1 group and the rest were NC2 group. Investigate the distribution of NC and the prevalence of diabetes in different NC groups. Divide the surveyed population into three groups with WC: normal, pre-central obesity and central obesity, on this basis, analyze the combined effect with NC on the prevalence rate and diabetes risk. Results The average NC of the investigated population in Tianjin was 36.3 cm, which was higher in males than in females, and was positively correlated with age(β=0.271, t=3.452, P=0.001). The prevalence rate of diabetes in NC2 group was 27.7%, which was significantly higher than that in NC1 group (17.9%). In WC normal group and central obesity group, the prevalence rate of diabetes in NC2 group was significantly higher than that in NC1 group. The multivariate logistic regression showed that compared with normal WC + NC1 group, the risk of diabetes increased with the increase of WC and NC, and the central obesity + NC2 group had the highest risk of diabetes (OR=2.939, 95%CI: 2.227-3.880, P < 0.001). Conclusions The prevalence rate of diabetes is high among higher NC people (large neck circumference) in Tianjin adults, and the combined effect of WC and NC on the risk of diabetes is strong. In the future, it is necessary to further study the biological mechanism of NC and diabetes, so that it can be applied to large population screening to achieve the effect of early detection and control of diabetes.

Association between different metabolic types of obesity and glycemic control among community type 2 diabetes patients in Nanjing

WANG Chenchen, XU Hao, CHEN Yijia, ZHOU Hairong, SUN Qiannan, HONG Xin, ZHOU Nan

2024, 28(2): 176-182. doi: 10.16462/j.cnki.zhjbkz.2024.02.008

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Objective To investigate the distribution characteristics and glycemic control of type 2 diabetes patients with different metabolic types and obesity in community in Nanjing. Methods From April to June 2021, multi-stage stratified cluster random sampling method was adopted to recruit type 2 diabetes patients in 12 districts of Nanjing, questionnaire responses, physical examinations and clinical indicators were gathered. According to their metabolic and BMI, the population was divided into metabolically healthy and normal weight (MHNW), metabolically unhealthy but normal weight (MUHNW), metabolically healthy obese (MHO), and metabolically abnormal obese (MAO). Logistic regression was used for multivariate analysis. Results A total of 1 389 subjects were included, with an average age of (65.14±7.71) years old, 598 males (43.05%), among which MHNW, MUHNW, MHO, MAO were 21.31%, 22.97%, 7.85% and 47.87%. The older the age, the higher the incidence of MUHNW and MAO; The proportion of MUHNW in women and patients with diabetes course ≥5 years was higher. The control up to standard rates of fasting blood glucose(FPG) and hemoglobinA1c(HbA1c) among the subjects were 44.92% and 48.88%, respectively. The results of multivariate analysis showed that the incidence of FPG control failure in MAO patients was 1.525 times higher than that in MHNW (OR=1.525, 95% CI: 1.148-2.025, P=0.004); The incidence of HbA1c control failure in MAO patients was 1.516 times higher than that in MHNW patients (OR=1.516, 95%CI: 1.140-2.016, P=0.004), with statistically significant (P < 0.05). Conclusions There are more type 2 diabetes patients with MUHNW and MAO in Nanjing, and the type 2 diabetes patients with MAO have poor glycemic control. Early identification and classified intervention should be carried out for type 2 diabetes patients with different obesity subgroups to effectively control blood glucose, and to prevent and control complications of diabetes.

The prevalence of abnormal glucose metabolism and its associated factors in children aged 6-12 years in Guangzhou

PU Yingqi, GUI Zhaohuan, HUANG Shan, ZHANG Yushan, CHEN Yajun

2024, 28(2): 183-190. doi: 10.16462/j.cnki.zhjbkz.2024.02.009

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Objective To investigate the prevalence of abnormal glucose metabolism and its associated risk factors in children aged 6-12 years in Guangzhou, China. Methods We adopted the method of stratified cluster random sampling to recruit a total of 4 690 children aged 6-12 from 5 primary schools in Guangzhou. All participants completed the questionnaire survey, physical examination, and fasting plasma glucose (FPG) detection. Children were screened for diabetes mellitus (DM) (FPG≥7.0 mmol/L), impaired fasting glucose (IFG) (6.1 mmol/L≤FPG < 7.0 mmol/L), and abnormal glucose metabolism (FPG≥6.1 mmol/L) based on FPG. Multiple linear regression and multiple logistic regression were used to analyze the risk factors of FPG and abnormal glucose metabolism. Results The average FPG of children was (5.16±0.34) mmol/L. The prevalence of abnormal glucose metabolism, IFG, and DM were 0.79%, 0.64%, and 0.15%, respectively. Boys (β=0.161, 95%CI: 0.089-0.135, P < 0.001), 9-12 years children (9- < 11 years old: β=0.071, 95%CI: 0.025-0.075, P < 0.001; 11-12 years old: β=0.090, 95%CI: 0.056-0.126, P < 0.001), and children with abdominal obesity (β=0.042, 95%CI: 0.009-0.078, P=0.013) had higher FPG levels. Children with abdominal obesity (β=1.576, OR=4.838, 95%CI: 2.200-10.638, P < 0.001) and children who did not eat breakfast every day (β=1.158, OR=3.184, 95%CI: 1.069-9.484, P=0.038) had a higher risk of abnormal glucose metabolism. Conclusions The prevalence of abnormal glucose metabolism in children aged 6-12 years in Guangzhou is low. Abdominal obesity and not eating breakfast every day are risk factors of abnormal glucose metabolism in children.

Analysis and judgment of age of physiological aging inflection point of Jiangxi community residents

ZHANG Langlang, XIONG Junxi, LIU Yong, YANG Shanlan, TU Jiaxin, HUANG Helang, WU Lei

2024, 28(2): 191-197. doi: 10.16462/j.cnki.zhjbkz.2024.02.010

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Objective To explore the dynamic changes and inflection points of physiological aging in residents of different ages, and to provide reference for the study of anti-aging/anti-aging measures in different age groups. Methods A multi-stage stratified cluster sampling method was used to select 5 106 community residents aged over 20 years in some communities in Jiangxi Province. The physiological aging degree score of the sample population was measured by physiological-psychological-social three dimensional human aging scale, and the physiological aging curve of the sample population was fitted by locally weighted scatterplot smoothing curve method. According to the results of physiological aging score, the residents were divided into aging group and non-aging group, and the receiver operator characteristic curve was drawn to determine the cut-off value of the inflection point of physiological aging, and a series of indicators such as area under curve value were used to evaluate its predictive value. The binary logistic regression model adjustment of the confounding factors affecting the inflection point was carried out, and the predictive value of the age of the inflection point on aging degree was verified by the C index. Results The physiological aging degree of residents of different ages increased with age; There were four inflection point ages at different stages of life, namely 38.2 years(AUC=0.586, P < 0.01), 49.4 years(AUC=0.555, P < 0.01), 68.9 years(AUC=0.545, P < 0.01), 76.9 years(AUC=0.546, P < 0.01); The logistic regression results showed that after controlling for the mixed effects, the inflection point age had predictive value on the change of physiological aging, and the C index of young people was 0.694 (P=0.03), that of middle-aged people was 0.601 (P < 0.01), that of young and elderly people was 0.658 (P < 0.01), and that of the elderly was 0.627 (P < 0.01). Conclusions The process of physiological aging in human body is not uniform, and physiological aging of people of different ages has inflection points, and inflection points are significant after model verification.

Cell-of-origin subtype classification and prognosis of diffuse large B-cell lymphoma based on variable importance analysis

HAO Ting, GAO Qian, XI Yanfeng, GUAN Hongwei, WANG Tong

2024, 28(2): 198-202. doi: 10.16462/j.cnki.zhjbkz.2024.02.011

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Objective Gene expression profiling (GEP) is the gold standard for cell-of-origin COO classification of diffuse large B-cell lymphoma (DLBCL). The aim of this study was to establish a GEP-based parsimony model to accurately predict the COO subtypes of DLBCL and provide a reference for its clinical application. Methods Genetic and clinical data from 6 DLBCL datasets in the GEO database were collected, and one dataset was used as the training set and the remaining five as the validation set. A variable importance analysis strategy based on penalized regression analysis was constructed to identify the optimal subset of variables, and a logistic regression analysis was performed to determine the six-gene model that was ultimately used for COO classification. Survival analysis was used to assess the relationship between the two COO subtypes predicted by the training and validation sets and clinical prognosis. Results The six-gene model predicted better in the training set [AUC(95% CI): 0.999 (0.997~1.000), discriminant slope and its 95% CI were 0.944 (0.920~0. 966)], and also showed better results in the validation set [AUC and its 95% CI fluctuated from 0.910 (0.820~0.999) to 1.000, and the discriminant slope and its 95% CI fluctuated from 0.506 (0.350~0. 966) to 0.927 (0.841~0.987)]. The prognostic modeling showed that the six genetically predicted subtypes were risk predictors in both the training and validation sets (all P < 0.05). Conclusions The six genes in the six-gene model have important clinical applications for the classification and prognosis of DLBCL. The gene ordering based on variable importance provides a reference basis for further-research on gene function and targeted drug research.

Epidemiological feature and scientific prevention and control of SARS-CoV-2 Omicron subvariant XBB

DENG Jie, LIU Min, LIU Jue

2024, 28(2): 203-208. doi: 10.16462/j.cnki.zhjbkz.2024.02.012

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COVID-19 is still in the state of global pandemic currently. The Omicron variant is still the dominant strain worldwide, and many new subvariants have evolved and emerged continually during the pandemic. XBB is a recombinant of Omicron variants BA.2.10.1 and BA.2.75 sublineages, which was first identified in India in August 2022. Since then, it has rapidly spread to become the main epidemic variant in Singapore, Malaysia, as well as some European and American countries, and evolved some sublineages such as XBB.1, XBB.1.5, etc. XBB has a significantly increased immune escape ability compared with other circulating Omicron subvariants. But there is no evidence that the severity of XBB infection differs from other Omicron subvariants. It is recommended to strengthen the monitoring of virus mutation, carry out vaccination with booster doses in key populations, accelerate the research and development of vaccines and drugs, carry out multi-source monitoring to assess the risk dynamically, and timely take corresponding scientific prevention and control measures to reduce the threat of XBB strain.

Dietary inflammatory index and the risk of cognitive impairment in middle-aged and elderly people: a meta-analysis

WANG Lili, ZHAO Haifeng

2024, 28(2): 209-214. doi: 10.16462/j.cnki.zhjbkz.2024.02.013

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Objective To evaluate the relationship between dietary inflammatory index (DII) and the risk of cognitive impairment in middle-aged and elderly people. Methods We systematically searched CNKI, Cqvip, Wanfang Data, SinoMed, PubMed, Science Direct, Springer, Cochrane Library and Embase databases from inception to June 20, 2022, screened studies based on the inclusion and exclusion criteria. The quality of the studies included was assessed by the Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality methodology checklist. Revman 5.4 and Stata 15.1 software were used for meta-analysis. The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using random-effects model. Results A total of 7 articles with 15 428 participants were included. In the present meta-analysis, the DII was associated with the risk of cognitive impairment (OR=1.62, 95% CI: 1.27-2.05, P < 0.01), especially in studies that used food frequency questionnaire (FFQ) (OR=1.46, 95% CI: 1.21-1.77, P=0.17) and adjusted energy intake (OR=1.71, 95% CI: 1.26-2.33, P=0.07). Conclusions Compared with the low DII diet, the high DII diet is associated with an increased risk of cognitive impairment. Due to limited number and quality of included studies, the above-mentioned conclusion still needs to be verified by more high-quality studies.

Correlation between TLR2 gene polymorphism and tuberculosis susceptibility in Qinghai Province

ZHANG Changming, WANG Yuqing, HUANG Qiuli, WANG Xingbin, YAN Xiaoping, WANG Ling, LIU Kuangyi, LI Bin, SU Xiaodong, ZHANG Yaxin, YANG Dejie, WANG Zhaofen

2024, 28(2): 215-220. doi: 10.16462/j.cnki.zhjbkz.2024.02.014

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Objective To study the relationship between rs3804099 and rs3804100 polymorphisms of Toll-like receptors-2(TLR2) gene and tuberculosis in Qinghai Province. Methods 219 tuberculosis patients from a hospital in Qinghai Province were collected as the case group, and 236 physical examinees at the same time as the control group. The rs3804099 and rs3804100 loci were amplified by polymerase chain reaction (PCR) and genotypes were determined by sequencing. Results rs3804099 (χ² =4.37, P=0.037) and rs3804100 (χ² =4.73, P=0.030) polymorphisms in TLR2 were associated with tuberculosis. The model analysis showed, rs3804099(χ² =5.23, P=0.022) and rs3804100(χ² =7.70, P=0.006) loci were statistically different in the heterozygote model between two groups; while only rs3804100 loci was significantly different in the invisible model (χ² =4.92, P=0.027). The rs3804099(χ² =4.24, P=0.040) and rs3804100(χ² =5.19, P=0.023) polymorphisms of TLR2 gene were correlated with tuberculosis susceptibility in Tibetan population; ), but no correlation was found in Han population. Conclusions The rs3804099 and rs3804100 polymorphisms of TLR2 gene are associated with occurence of tuberculosis in Tibetan in Qinghai, and CC genotype may be a risk factor for causing tuberculosis.

Characteristics and influencing factors of related persistent symptoms in recovered COVID-19 patients caused by Omicron variant in Wuxi City

ZHAN Xingya, LIU Juan, JI Bin, SHEN Yuan

2024, 28(2): 221-227. doi: 10.16462/j.cnki.zhjbkz.2024.02.015

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Objective To explore the characteristics and determinants of persistent symptoms in individuals 3-4 months post-recovery from the Omicron variant-induced COVID-19 infection. The insights gained serve to inform the development of follow-up plans, with the goal of mitigating post-infection symptoms. Methods Surveys were conducted utilizing self-developed somatic and neuropsychiatric symptom scales, the patient health questionnaire-9 (PHQ-9), the Chinese perceived stress scale (CPSS), the generalised anxiety disorder-7 (GAD-7) scale, and the novel disease stigmatization scale. Data analyses were performed using Mann-Whitney U tests, Kruskal-Wallis H tests, chi-square tests, and binary logistic regression models. Results 50.7% of participants reported persistent related symptoms three to four months post-recovery, with 47 types of somatic and neuropsychiatric symptoms identified. Fatigue emerged as the most prevalent somatic symptom (50.5%), while insomnia was the most frequently reported neuropsychiatric symptom (24.3%). Both depression and anxiety were observed to commonly co-occur with these somatic or neuropsychiatric symptoms. Risk factors associated with the persistence of symptoms 3-4 months after discharge from COVID-19 infection included being female (β=0.70, OR=2.01, 95% CI: 1.04-3.86, P=0.037), presentation of clinical symptoms during the quarantine (β=0.78, OR=2.17, 95% CI: 1.13-4.20, P=0.021), moderate to high stress levels (β=1.68, OR=5.35, 95% CI: 2.14-13.38, P < 0.001), and severe stigmatization (β=1.03, OR=2.79, 95% CI: 1.33-5.83, P=0.006). Conclusions A subset of individuals recovering from COVID-19 continue to experience related symptoms three to four months post-recovery. Attention should be focused on high-risk groups who may present with persistent symptoms, ensuring they receive comprehensive support in terms of healthcare and mental health services.

Self-efficacy as a moderator in relationship between medication adherence and quality of life among patients with type 2 diabetes

YU Yebo, HUANG Zhen, WU Yibo, SUN Xinying

2024, 28(2): 228-232. doi: 10.16462/j.cnki.zhjbkz.2024.02.016

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Objective To explore the association between medication adherence and quality of life among patients with type 2 diabetes and the moderating role of self-efficacy on the relationship above. Methods A total of 728 eligible patients with type 2 diabetes were included and data were collected based on the 8-item Morisky medication adherence scale (MMAS-8), diabetes specific quality of life scale (DSQL), and the self-administered diabetes self-efficacy scale. Multiple linear regression models were established to analyze the associations between medication adherence and quality of life and further explored the moderating effect of self-efficacy. Results Among them, 125 patients (17.2%) had good medication adherence. Compared with baseline, scores of DSQL social dimension increased significantly after 9 months of follow-up (t=-3.668, P=0.001). Medication adherence was negatively associated with baseline total DSQL score (β=-0.161, P < 0.001) and month 9 total DSQL score (β=-0.148, P=0.002). Higher self-efficacy enhanced the relationship between medication adherence and DSQL cure dimension (β=0.150, P=0.010) and overall DSQL (β=0.110, P=0.044) at month 9. Conclusions Medication adherence is significantly associated with short-term future quality of life of patients with type 2 diabetes. Improving self-efficacy enhances the positive effect of medication adherence on quality of life, especially on the cure dimension of life quality.

Study on the status and correlation factors of multiple chronic conditions among health examination participants aged ≥45 years in a community in Taizhou City

LIANG Xinyue, CHEN Xiaoxiao, WANG Liangyou, WANG Tingting, WANG Shanling, XIE Yali, LIN Haijiang, HE Na

2024, 28(2): 233-240. doi: 10.16462/j.cnki.zhjbkz.2024.02.017

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Abstract:
Objective To investigate the distribution characteristics and risk factors of common chronic health conditions and multiple chronic conditions(MCCs) among the physical examination population aged ≥45 years in Taizhou City. Methods Based on a cross-sectional study, the health records of people aged ≥45 years who participated in routine health examination at a community health service center in a District of Taizhou city from January to December 2021 were collected. Chi-square test, t test and variance analysis were used to analyze the distribution of chronic health conditions and related health risk factors. Ordered logistic regression was used to analyze the co-existing factors of MCCs. Results A total of 13 020 subjects were included in the study. The overall detection rate of chronic health conditions was 93.07%, with the following rates: hypertension (58.22%), fatty liver (41.31%), abnormal renal function (34.55%), abnormal electrocardiogram (31.80%), dyslipidemia (23.47%), abnormal liver function (20.60%), diabetes (13.45%), and anemia (10.43%). The study identified five chronic disease-related risk factors among the subjects, including lack of exercise (77.26%), unbalanced diet (71.27%), central obesity (55.98%), smoking (32.84%) and alcohol consumption (32.28%). 71.87% of the subjects had MCCs, with hypertension, fatty liver, abnormal renal function, and dyslipidemia being the main components. The results of ordered logistic regression indicated that for each year of age increase (aOR=1.010, 95% CI: 1.006-1.014, P < 0.001), females (aOR=1.396, 95% CI: 1.291-1.510, P < 0.001) and the presence of 2 (aOR=1.169, 95% CI: 1.054-1.295, P=0.003), 3 (aOR=1.561, 95% CI: 1.409-1.730, P < 0.001) and 4 or more (aOR=1.887, 95% CI: 1.668-2.134, P < 0.001) health risk factors were associated with an increased risk of MCCs. Conclusions The aggregation of health risk factors is common in the physical examination population aged ≥45 years in Taizhou City, and the prevalence of multiple chronic conditions is notably high. Advanced age, female gender, and the presence of multiple risk health factors may significantly increase the risk of experiencing multiple chronic conditions, necessitating the enhancement of relevant policies.

Evaluation of the control effect for measured confounders between propensity score matching and disease risk score matching

LU Zhenzhen, ZHAO Enhui, HUANG Lihong

2024, 28(2): 241-248. doi: 10.16462/j.cnki.zhjbkz.2024.02.018

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Abstract:
Objective To compare propensity score (PS) matching and disease risk score (DRS) matching in the scenarios of good PS overlap and poor PS overlap, and to investigate the optimal caliper width for DRS matching. Methods According to the different proportions of the test group and events as well as the different PS overlap situations, 6 scenarios were simulated to compare the balance of covariables and the bias before and after PS matching or DRS matching, followed by analysis of an actual case. Results In the scenarios with good PS overlap, the DRS overlap was also good, and PS matching was more accurate than DRS matching. The optimal caliper width was found to be 10%-20% of the PS standard deviation (SD) for PS matching, and the relative optimal caliper width was 0.5% of the DRS SD for DRS matching. In the scenarios with poor PS overlap, the DRS overlap was also poor, but the DRS matching was more accurate than PS matching. The optimal caliper width was found to be 15%-20% of the DRS SD. In addition, the improvement on the balance of covariates was consistent with the estimation bias of treatment effect. Conclusions When the overlap of PS is good, PS matching is preferred; when the overlap of PS is poor, DRS matching can be selected, and the optimal caliper width is 15%-20% of the DRS SD. In practical application, the control effect for measured a confounder can be evaluated according to the improvement on the covariable balance between groups.

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2024 Vol. 28, No. 2

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

Assistant editor