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1.
BMC Med ; 21(1): 222, 2023 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-37365627

RESUMO

BACKGROUND: Understanding the temporal trends in the burden of overall and type-specific cardiovascular diseases (CVDs) in youths and young adults and its attributable risk factors is important for effective and targeted prevention strategies and measures. We aimed to provide a standardized and comprehensive estimation of the prevalence, incidence, disability-adjusted life years (DALY), and mortality rate of CVDs and its associated risk factors in youths and young adults aged 15-39 years at global, regional, and national levels. METHODS: We applied Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 analytical tools to calculate the age-standardized incidence, prevalence, DALY, and mortality rate of overall and type-specific CVDs (i.e., rheumatic heart disease, ischemic heart disease, stroke, hypertensive heart disease, non-rheumatic valvular heart disease, cardiomyopathy and myocarditis, atrial fibrillation and flutter, aortic aneurysm, and endocarditis) among youths and young adults aged 15-39 years by age, sex, region, sociodemographic index and across 204 countries/territories from 1990 to 2019, and proportional DALY of CVDs attributable to associated risk factors. RESULTS: The global age-standardized DALY (per 100,000 population) for CVDs in youths and young adults significantly decreased from 1257.51 (95% confidence interval 1257.03, 1257.99) in 1990 to 990.64 (990.28, 990.99) in 2019 with an average annual percent change (AAPC) of - 0.81% (- 1.04%, - 0.58%, P < 0.001), and the age-standardized mortality rate also significantly decreased from 19.83 (19.77, 19.89) to 15.12 (15.08, 15.16) with an AAPC of - 0.93% (- 1.21%, - 0.66%, P < 0.001). However, the global age-standardized incidence rate (per 100,000 population) moderately increased from 126.80 (126.65, 126.95) in 1990 to 129.85 (129.72, 129.98) in 2019 with an AAPC of 0.08% (0.00%, 0.16%, P = 0.040), and the age-standardized prevalence rate significantly increased from 1477.54 (1477.03, 1478.06) to 1645.32 (1644.86, 1645.78) with an AAPC of 0.38% (0.35%, 0.40%, P < 0.001). In terms of type-specific CVDs, the age-standardized incidence and prevalence rate in rheumatic heart disease, prevalence rate in ischemic heart disease, and incidence rate in endocarditis increased from 1990 to 2019 (all P < 0.001). When stratified by sociodemographic index (SDI), the countries/territories with low and low-middle SDI had a higher burden of CVDs than the countries/territories with high and high-middle SDI. Women had a higher prevalence rate of CVDs than men, whereas men had a higher DALY and mortality rate than women. High systolic blood pressure, high body mass index, and low-density lipoprotein cholesterol were the main attributable risk factors for DALY of CVDs for all included countries and territories. Household air pollution from solid fuels was an additional attributable risk factor for DALY of CVDs in low and low-middle SDI countries compared with middle, high-middle, and high SDI countries. Compared with women, DALY for CVDs in men was more likely to be affected by almost all risk factors, especially for smoking. CONCLUSIONS: There is a substantial global burden of CVDs in youths and young adults in 2019. The burden of overall and type-specific CVDs varied by age, sex, SDI, region, and country. CVDs in young people are largely preventable, which deserve more attention in the targeted implementation of effective primary prevention strategies and expansion of young-people's responsive healthcare systems.


Assuntos
Doenças Cardiovasculares , Isquemia Miocárdica , Cardiopatia Reumática , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Carga Global da Doença , Anos de Vida Ajustados por Qualidade de Vida , Doenças Cardiovasculares/epidemiologia , Fatores de Risco , Incidência , Saúde Global
2.
JAMA Netw Open ; 4(11): e2132602, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34735014

RESUMO

Importance: Assisted reproductive technology (ART) has been widely used for treatment of infertility and has brought millions of births worldwide. The health of offspring conceived by ART has been of much concern, and adverse cardiovascular health outcomes have been reported by previous studies. Objective: To assess the cardiovascular health of children conceived by ART. Design, Setting, and Participants: This cohort study was conducted among participants recruited from November 2017 to February 2019. Participants were 382 children conceived by ART who were selected from a single reproductive center and 382 children who were naturally conceived, randomly selected from a primary school, and matched by sex, age, and maternal age at the child's birth (2 years older or younger). Data were analyzed from March 2019 through December 2019. Exposures: Conception by ART. Main Outcomes and Measures: Blood pressure was measured, and echocardiography was performed to determine left ventricular structural and functional parameters. Adjusted relative wall thickness (aRWT) was found for age, with high RWT defined as an aRWT of 0.375 or more. Results: Among 764 children aged 6 to 10 years, 382 children were conceived by ART (mean [SD] age, 7.20 [1.21] years; 201 [52.6%] boys) and 382 children were naturally conceived (mean [SD] age, 7.20 [1.21] years; 201 [52.6%] boys). Children conceived by ART had statistically significantly increased mean (SD) height (130.2 [9.5] cm vs 128.5 [8.1] cm; P = .007) and body mass index (17.6 [3.6] vs 17.1 [2.7]; P = .03). Those conceived by ART, compared with children in the matched control group, had statistically significantly increased blood pressure (mean [SD] systolic blood pressure, 105.5 [6.9] mm Hg vs 103.5 [8.4] mm Hg; adjusted P < .001; mean [SD] diastolic blood pressure, 67.2 [5.6] mm Hg vs 62.2 [6.3] mm Hg ; adjusted P < .001), left ventricular systolic dysfunction (mean [SD] left ventricular ejection fraction, 64.61% [3.20%] vs 66.70% [3.89%]; adjusted P < .001), and diastolic dysfunction (mean [SD] early/late mitral/tricuspid diastolic velocities ratio, 1.66 [0.28] vs 2.21 [0.36]; adjusted P < .001). They also had statistically significantly increased parameters of left ventricular structure, including mean (SD) left ventricular mass index (31.97 [5.04] g/m2.7 vs 28.28 [3.54] g/m2.7; adjusted P < .001) and RWT (3.30 [0.41] mm vs 2.98 [0.14] mm; adjusted P < .001). Additionally, children conceived by ART had statistically significantly increased prevalence of left ventricular hypertrophy (9 children [2.4%] vs 2 children [0.5%]; P = .03), high RWT (61 children [16.0%] vs 0 children; P < .001), and left ventricle remodeling patterns, including concentric remodeling (60 children [15.7%] vs 0 children), eccentric hypertrophy (8 children [2.1%] vs 2 children [0.5%]), and concentric hypertrophy (1 child [0.3%] vs 0 children) (P for left ventricle remodeling < .001). Conclusions and Relevance: This study found that children conceived by ART had increased blood pressure and unfavorable changes in left ventricular structure and function compared with children who were naturally conceived. These findings suggest that further studies are needed to investigate the potential mechanisms and long-term outcomes associated with these differences.


Assuntos
Hipertensão/epidemiologia , Hipertensão/etiologia , Técnicas de Reprodução Assistida/estatística & dados numéricos , Disfunção Ventricular Esquerda/epidemiologia , Disfunção Ventricular Esquerda/etiologia , Adulto , Sistema Cardiovascular/diagnóstico por imagem , Sistema Cardiovascular/fisiopatologia , Criança , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Idade Materna , Sobrepeso/epidemiologia , Fatores de Risco , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-33114035

RESUMO

It is unclear whether physical activity and sedentary behavior are associated with economic development in low- and middle-income countries (LMICs). We aimed to assess the association between these two behaviors and country economic development among young adolescents in LMICs. Data came from the Global School-based Student Health Survey (GSHS) conducted between 2009 and 2016 in 68 LMICs. A total of 180,298 adolescents aged 12-15 years were included; 15.3% of young adolescents achieved the recommended level for sufficient physical activity (≥60 min/day of physical activity of any kind per week according to WHO) and 64.6% achieved a low sedentary behavior (≤2 h of sitting activities/day according to some guidelines, not accounting for sitting time at school or for doing homework). However, only 9.1% of young adolescents met the recommended levels of both behaviors. Comparing the lowest to the highest quintiles of a country's purchasing power parity per capita (PPP), mean values of both physical activity (boys: 2.55 to 2.96 days/week; girls: 2.10 to 2.31 days/week) and sedentary behavior(boys: 1.86 to 3.13 h/day; girls: 1.83 to 3.53 h/day) increased. The prevalence of having both recommended behaviors decreased among boys (12.0% to 10.0%) and girls (9.6% to 4.9%) (p < 0.001). Although there might be an ecological fallacy, the findings emphasize the need for interventions to increase physical activity and reduce sedentary behavior among children and young adolescents.


Assuntos
Países em Desenvolvimento , Desenvolvimento Econômico , Exercício Físico , Comportamento Sedentário , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pobreza
6.
ScientificWorldJournal ; 2013: 645201, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23970837

RESUMO

By applying techniques in the theory of convex functions and Schur-geometrically convex functions, the author investigates a conjecture of Satnoianu on an algebraic inequality and generalizes some known results in recent years.


Assuntos
Modelos Teóricos
7.
Mol Biol Rep ; 39(10): 9405-14, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22814767

RESUMO

The vitamin D receptor (VDR) gene polymorphisms have been suggested to be involved in the development of diabetes mellitus, including type 1 diabetes (T1DM) and type 2 diabetes (T2DM). However, the results have been inconsistent. In this study, we performed a meta-analysis to investigate the associations. Literature was retrieved from PubMed, ISI Web of Science and Chinese databases. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated using a random or fixed effect model. 79 studies (FokI: 22 studies; BsmI: 25 studies; ApaI: 17 studies; TaqI: 15 studies) on T1DM and 44 studies (FokI: 10 studies; BsmI: 10 studies; ApaI: 14 studies; TaqI: 10 studies) on T2DM were included. The results indicated that BsmI polymorphism was associated with an increased risk of T1DM (B vs. b: OR 1.31, 95 % CI 1.10-1.55, P = 0.002), especially in East Asians (B vs. b: OR 2.57, 95 % CI: 1.55-4.24, P < 0.001); FokI polymorphism was associated with an increased risk of T2DM (f vs. F: OR 1.30, 95 % CI: 1.17-1.45, P < 0.001), especially in East Asians (f vs. F: OR 1.36, 95 % CI: 1.21-1.54, P < 0.001). However, no significant association was observed between ApaI or TaqI polymorphism and diabetes risk with the exception of significant association between ApaI polymorphism and T1DM risk in East Asians. Thus, the authors found BsmI polymorphism in the VDR gene may increase the risk of T1DM in East Asians and the FokI polymorphism may increase the risk of T2DM in East Asians.


Assuntos
Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 2/genética , Receptores de Calcitriol/genética , Estudos de Casos e Controles , Desoxirribonucleases de Sítio Específico do Tipo II/química , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Funções Verossimilhança , Razão de Chances , Polimorfismo de Fragmento de Restrição , Análise de Regressão
8.
Bioresour Technol ; 116: 441-7, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22522015

RESUMO

A pilot-scale lysis-cryptic growth system was built and operated continuously for excess sludge reduction. Combined ultrasonic/alkaline disintegration and hydrolysis/acidogenesis were integrated into its sludge pretreatment system. Continuous operation showed that the observed biomass yield and the sludge reduction efficiency of the lysis-cryptic growth system were 0.27 kg VSS/kg COD consumed and 56.5%, respectively. The water quality of its effluent was satisfactory. The sludge pretreatment system performed well and its TCOD removal efficiency was 7.9% which contributed a sludge reduction efficiency of 2.1%. The SCOD, VFA, TN, NH(4)(+)-N, TP and pH in the supernatant of pretreated sludge were 1790 mg/L, 1530 mg COD/L, 261.1mg/L, 114.0mg/L, 93.1mg/L and 8.69, respectively. The total operation cost of the lysis-cryptic growth system was $ 0.186/m(3) wastewater, which was 11.4% less than that of conventional activated sludge (CAS) system without excess sludge pretreatment.


Assuntos
Ácidos/farmacologia , Álcalis/farmacologia , Esgotos/microbiologia , Ultrassom , Purificação da Água/métodos , Biodegradação Ambiental/efeitos dos fármacos , Análise da Demanda Biológica de Oxigênio , China , Cidades , Hidrólise/efeitos dos fármacos , Projetos Piloto , Eliminação de Resíduos Líquidos , Purificação da Água/economia , Purificação da Água/instrumentação
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