Recent data on prevalence, awareness, treatment, and risk factors of diabetes in China is necessary for interventional efforts.
Objective
To estimate trends in prevalence, awareness, treatment, and risk factors of diabetes in China based on national data.
Design, Setting, and Participants
Cross-sectional nationally representative survey data collected in adults aged 18 years or older in mainland China from 170 287 participants in the 2013-2014 years and 173 642 participants in the 2018-2019 years.
Exposures
Fasting plasma glucose and hemoglobin A1clevels were measured for all participants. A 2-hour oral glucose tolerance test was conducted for all participants without diagnosed diabetes.
Main Outcomes and Measures
Primary outcomes were diabetes and prediabetes defined according to American Diabetes Association criteria. Secondary outcomes were awareness, treatment, and control of diabetes and prevalence of risk factors. A hemoglobin A1clevel of less than 7.0% (53 mmol/mol) among treated patients with diabetes was considered adequate glycemic control.
Results
In 2013, the median age was 55.8 years (IQR, 46.4-65.2 years) and the weighted proportion of women was 50.0%; in 2018, the median age was 51.3 years (IQR, 42.1-61.6 years), and the weighted proportion of women was 49.5%. The estimated prevalence of diabetes increased from 10.9% (95% CI, 10.4%-11.5%) in 2013 to 12.4% (95% CI, 11.8%-13.0%) in 2018 (P < .001). The estimated prevalence of prediabetes was 35.7% (95% CI, 34.2%-37.3%) in 2013 and 38.1% (95% CI, 36.4%-39.7%) in 2018 (P = .07). In 2018, among adults with diabetes, 36.7% (95% CI, 34.7%-38.6%) reported being aware of their condition, and 32.9% (95% CI, 30.9%-34.8%) reported being treated; 50.1% (95% CI, 47.5%-52.6%) of patients receiving treatment were controlled adequately. These rates did not change significantly from 2013. From 2013 to 2018, low physical activity, high intake of red meat, overweight, and obesity significantly increased in prevalence.
Conclusions and Relevance
In this survey study, the estimated diabetes prevalence was high and increased from 2013 to 2018. There was no significant improvement in the estimated prevalence of adequate treatment.
To analyze the disease burden of leukemia in the Chinese population, in 1990 and 2013.Data related to province-specific disease burden in China was used to analyze and compare related parameters as incidence, mortality, the disability-adjusted life years (DALY), years of life lost due to premature mortality (YLL) and years lived with disability (YLD) on leukemia in China in 1990 and 2013. Standardized mortality rates of leukemia in each province in 2013 and the changes since 1990, were described.In 2013, the standardized incidence and mortality rates of leukemia in China were 6.70/100 000 and 4.05/100 000, with reduction of 8.84% and 36.22% when compared with those in 1990, respectively. The standardized DALY rate and YLL rate appeared as 174.58/100 000 and 170.42/100 000 in 2013, with 44.68% and 45.32% reduction, respectively, when compared with the figures in 1990. The standardized YLD rate of leukemia in 2013 was 4.16/100 000, with an 6.94% increase, comparing with that in 1990. Age-specific data showed that the proportion of people who died from leukemia among those who died from all the cancers was more than 10% in people under 35 years old. DALY rate of leukemia was highest among children aged 5 years old and under, which appeared as 317.61/100 000. Compared with those in 1990, the standardized mortality of leukemia appeared decreasing in all the provinces in 2013. The top three provinces with the highest standardized mortality of leukemia in 2013 were Xinjiang (4.72/100 000), Ningxia (4.56/100 000) and Fujian (4.50/100 000).Although the standardized incidence rate, mortality rate, DALY rate and YLL rate due to leukemia decreased, YLD rate due to leukemia increased. Proportions of children and adolescents who died from leukemia remained high. Although the standardized mortalities of leukemia decreased in all the provinces, the differences among them still remained.
A 16-electrode sweeping frequency electrical impedance tomography (SFEIT) system based on the numeric electromagnetism field theory is presented in this paper. Excitation with flexible frequency and intensity is introduced to the SFEIT system, and this improvement can get much more impedance information of the object. The model of the interface impedance between electrode sensor and the object is presented, two experiments done indicate that the interface impedance and parasitic parameter that always causes errors sharply varies with frequency. So comparing with traditional EIT, SFEIT can flexibly choose the intensity and frequency of the excitation according to the characteristic of the object impedance so as to minimize the error and get more accurate information for image reconstruction.
Purpose: COPD prevalence has rapidly increased in China, but the geographical disparities in COPD prevalence remain largely unknown. This study aimed to assess city-level disparities in COPD prevalence and identify the relative importance of COPD related risk factors in mainland China. Patients and Methods: A nationwide cross-sectional study of COPD recruited 66,752 adults across the mainland China between 2014 and 2015. Patients with COPD were ascertained by a post-bronchodilator pulmonary function test. We estimated the city-specific prevalence of COPD by spatial kriging interpolation method. We detected spatial clusters with a significantly higher prevalence of COPD by spatial scan statistics. We determined the relative importance of COPD associated risk factors by a nonparametric and nonlinear classification and regression tree (CART) model. Results: The three spatial clusters with the highest prevalence of COPD were located in parts of Sichuan, Gansu, and Shaanxi, etc. (relative risks (RRs)) ranging from 1.55 (95% CI 1.55– 1.56) to 1.33 (95% CI 1.33– 1.33)). CART showed that advanced age (≥ 60 years) was the most important factor associated with COPD in the overall population, followed by smoking. We estimated that there were about 28.5 million potentially avoidable cases of COPD among people aged 40 or older if they never smoked. PM 2.5 was an important associated risk factor for COPD in the north, northeast, and southwest of China. After adjusting for age and smoking, the spatial cluster with the highest prevalence shifted to most of Sichuan, Gansu, Qinghai, and Ningxia, etc. (RR 1.65 (95% CI 1.63– 1.67)). Conclusion: The spatial clusters of COPD at the city level and regionally varied important risk factors for COPD would help develop tailored interventions for COPD in China. After adjusting for the main risk factors, the spatial clusters of COPD shifted, indicating that there would be other potential risk factors for the remaining clusters which call for further studies. Keywords: COPD, spatial clusters, kriging, classification and regression tree
Background: Breast cancer is the most common malignancy among Chinese females. It's growing urgent to developing model to achieve higher risk prediction accuracy and provide better interpret ability of the risk factors for breast cancer.Methods: We developed an ensemble penalized logistic regression model(EPLR) and a long-term risk prediction model (EPLT) in the Breast Cancer Cohort Study in Chinese Women (BCCS-CW), a large population-based cohort dataset, to predict the risk of individual breast cancer.Findings: During an average follow-up of 6.8 years in the BCCS-CW, 320 cases and 121,738 controls were observed and information of 72 non-experimental predictors was collected for these individuals. The EPLR model obtained AUC values of 0.800 for the internal validation and 0.751 for the external validation set. As for EPLT model, AUC for internal validation and external validation were 0.692 and 0.760, respectively. The Net reclassification Improvement (NRI) index of EPLT relative to the Gail's model and HCBCP model for external validation are 0.193 and 0.233 respectively, indicating that EPLT model enjoys higher classification accuracy.Interpretation: We developed EPLR and EPLT model to screen high-risk population for breast cancer, which serve as useful tools to aid risk-stratified screening and prevention for breast cancer. Funding Information: This study was supported by China Postdoctoral Science Foundation (2021M691911, 2021M701997), the National Key Research and Development Program of China (2016YFC0901301), the Minister-affiliated Hospital Key Project of the Ministry of Health of China (NO:07090122). Declaration of Interests: We declare that they have no competing interests.Ethics Approval Statement: This study was approved by the ethics committees of the Second Hospital of Shandong University and National Center for Chronic and Noncommunicable Disease Control. An informed consent was obtained from all the study subjects.
To understand the epidemiological characteristics of head injuries through data from the Chinese National Injury Surveillance System (NISS).Descriptive analysis was applied to display the overall trend of head injuries in 2013 in NISS and to depict general information, events and clinical characteristics of head injuries with SPSS 19.0 software.In 2013, 195 189 cases of head injuries were collected, males were twice higher than females, with 25.19% of them under 30-44 years of age. The three leading causes responsible for head injuries were falls (42.17%), blunt force injuries (27.46%) and road traffic injury (23.33%). Main locations causing head injuries were in road/street (31.41%), at home (25.02%) and public places (17.17%). Recreation activates (54.22%), driving (19.73%), paid work (12.95%) were the three major activities when injuries took place. Majority of the cases belonged to unintentional (86.79%) with bruise injuries (65.18%). Those mild injuries (78.87%) were treated and discharged (82.02%).In 2013, head injuries were seen more in males than in females, mostly involved in labor force population on head injuries. The leading causes for head injuries were falls, blunt injuries and road traffic.
To evaluate the performance of national injury surveillance in China and provide evidence for the utilization and interpretation of surveillance data and the improvement of injury surveillance.According to the national injury surveillance protocol, a retrospective analysis was conducted on the quality of injury surveillance carried out by the centers for disease control and prevention (CDCs) at all levels in China from 2006 to 2012. And related human resource and budget data in 2012 were collected for analysis.From 2006 to 2012, the injury cases reported to national injury surveillance system increased by 1 time in China. The underreporting rate of injury cases and mis-filling rate of reporting cards decreased in 31 surveillance points (72.1%) and 23 surveillance points (53.5%) respectively. In 2012, the underreporting rates were less than 10% in 33 surveillance points (76.7%) , and the mis-filling rates were less than 10% in 39 surveillance points (90.7%) . Only 19 provincial CDCs (44.2%) and 32 county/district CDCs had full time staff engaged in injury surveillance. Three surveillance points (7.0%) never published their injury surveillance data, while 13 surveillance points shared injury surveillance data with other departments.The quality of injury surveillance was greatly improved in China during 2006-2012, but more efforts are still needed for the further improvement of national injury surveillance, including the increase of human resources and fund investments and more use of surveillance data.
Abstract Background : We performed an updated meta-analysis to clarify the relationship between the CEBPE rs2239633 polymorphism and the CALL susceptibility. Methods: All the case-control studies updated on July 31, 2019 through Web of Science, Pubmed, Cochrane Library, Embase, China Nationa Knowledge Infrastructure (CNKI) electronic database. The heterogeneity in the study was tested by the Q-test and I 2 , and then the random ratio or fixed effect was utilized to merge the odds ratios (OR) and 95% confidence interval (CI). To estimate the impact of individual studies on aggregate estimates, we performed sensitivity analysis. Using funnel plot and Begger’s regression test investigated the publication bias. All data Statistical analyses were performed using Stata 12.0. Results: A total of 23442 participants (7014 patients; 16428 controls) were included in twenty case-control studies selected. There was no association of CEBPE rs2239633 polymorphism with CALL (CC vs CT + TT: OR = 1.08, 95% CI = 0.94 –1.26; CC + CT vs TT: OR = 1.10, 95% CI = 0.94–1.30; C vs T: OR =1.02, 95% CI = 0.92–1.13). In the subgroup analysis by ethnicity, no significant association of this polymorphism and CALL risks among Asia and Caucasian populations for the comparison of CC vs CT + TT, CC + CT vs TT and C vs T genetic models . Conclusion: This meta-analysis did not find the CEBPE rs2239633 polymorphism can increase and decrease the risk of susceptibility to CALL.
Background: Drowning is an important contributor to the burden of death in China. Exposure to open water is a risk factor for drowning, but few studies quantify its impact on drowning. The purpose of this study was to provide an up-to-date analysis of unintentional drowning risk in China, including impact of exposure to open water. Methods: We used Chinese provincial data from the GBD Study 2019 to describe the burden of unintentional drowning in 33 provinces in China and changes from 1990 to 2019. We included provincial outdoor open water resource data into the analysis to explore the relationship between outdoor open water resources and drowning burden using K-median clustering analysis. Findings: There were 2.9 million drowning deaths between 1990 and 2019 in China. Between 1990 and 2019, the unintentional drowning incidence, mortality and DALY rates declined by 31.2%, 68.6% and 74.9% respectively, with differences by age, sex and province. In 2019, the DALY rate for drowning was relatively higher in children under 20 year, the elderly over 80 years and males. Drowning incidence rate among females is higher than that of males. Provincial differences in unintentional drowning burden show a positive relationship to the availability and size of outdoor open water. Interpretation: As expected availability of water increases drowning risk. There is a need to address drowning risk among children and the elderly. Localised water safety plans which consider unique drowning burden and risk factors are needed in China to ensure a sustained decline of unintentional drowning.Funding: Bill & Melinda Gates Foundation.Declaration of Interest: We declare no competing interests.
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