The association between economic development, lifestyle differentiation, and C-reactive protein concentration within rural communities in Hainan Island, China.

OBJECTIVE: Earlier fieldwork in rural areas of Hainan Island, China, demonstrated that during the course of economic development increasing differences had emerged in lifestyles within communities. It is possible that these variations might have stratified residents into subpopulations with different health attributes. This study examined the association between C-reactive protein (CRP) concentration, a biomarker of future cardiovascular events, and personal lifestyle parameters and the degree of community-level economic development among rural communities. METHODS: A cross-sectional field survey was undertaken in 19 rural communities in Hainan. Convenience sampling was used to recruit 1,744 participants. Dried blood spot samples were collected to measure high-sensitivity CRP concentration. Sex-stratified multilevel regression analyses were conducted to identify factors associated with CRP concentration among the participants. RESULTS: While CRP concentration was negatively associated with being married and (more) education among men, for women CRP concentration was associated with the frequency of poultry consumption (P = 0.014) and the experience of migratory work in the previous year (P = 0.009). In addition, for females, living in communities with a greater degree of inequality, as indexed by the Gini coefficient, was also associated with increased CRP concentration (P = 0.003). CONCLUSION: Given that CRP concentration is a marker of future CVD risk, this study suggests that within these previously homogenous rural communities, economic development might have stratified people into population subgroups with a different CVD risk.

Urinary concentrations of toxic and essential trace elements among rural residents in Hainan Island, China.

BACKGROUND: Toxic element exposure and essential trace element consumption may have changed after the Chinese economy transformed to a market-oriented system. The objectives of this study were to measure urinary concentrations of toxic (arsenic, cadmium, lead) and essential trace (selenium, zinc, copper) elements among rural residents in Hainan, China and to examine if variations in economic development are linked to differences in toxic and trace element exposure. METHODS: We conducted a questionnaire-based survey and undertook anthropometric measurements of residents aged ≥20 years (n = 599). Urinary samples were collected and analyzed using inductively coupled plasma mass spectrometry. RESULTS: The median (µg/g creatinine) element concentrations were: arsenic, 73.2; cadmium, 1.8; lead, 3.1; selenium, 36.5; zinc, 371; and copper, 11.0. Intra-community variation in element concentrations was explained by age (arsenic, cadmium, zinc and copper), sex (arsenic, cadmium and selenium: higher in females; zinc: higher in males), body mass index (cadmium) and individual involvement in the market economy as indexed by agrochemical use (lead and selenium). The degree of community-level economic development, which was determined by the proportion of people living in better housing among the study communities, was positively associated with cadmium concentration. CONCLUSIONS: The degree of community-level economic development was positively associated with urinary cadmium concentration while individual involvement in the market economy was positively associated with lead and selenium.

Epstein-Barr virus antibody titer and its association with the domain scores from the World Health Organization's Quality of Life questionnaire: Findings from Rural Hainan Province, China.

OBJECTIVE: Epstein-Barr virus (EBV) antibody titer has recently been used as a biomarker of psychological stress. This is the first study to investigate the association between EBV antibody titer and perceived quality of life (QOL) in Hainan Island, China. METHODS: Participants from two regions of Hainan Island, recruited into a larger study investigating the health impact of rapid economic development among rural residents, were stratified by age, sex, and region; 15 people were randomly selected from each of the 16 subgroups, to give a total sample size of 240. EBV antibody titer in dried blood spot samples was measured by enzyme-linked immunosorbent assay. The abbreviated version of the World Health Organization's Quality of Life questionnaire was used to gather information on six categories of QOL. Multiple linear regression analysis was used to examine the relationship between EBV antibody titer and QOL. RESULTS: After adjusting for the effects of age, sex, region and C-reactive protein concentration, EBV antibody titer was negatively associated with the physical (P = 0.044) and psychological QOL domains (P = 0.039). CONCLUSION: This study suggests that among individuals living in an environment in the initial stages of economic development EBV antibody titer, a biomarker of psychological stress, is not only associated with the psychological aspects of QOL but is also linked to physical problems.