Global, regional and national burdens of occupational injuries, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.

OBJECTIVES: Occupational injuries pose a significant challenge to global health and development. This study aimed to quantify the international and regional burdens of occupational injuries from 1990 to 2019, stratified by specific causes. METHODS: We analysed global trends in deaths, disability-adjusted life years (DALYs), age-standardised mortality rates (ASMR) and age-standardised DALY rates (ASDR) related to occupational injuries. Specific injuries, including animal contact, drowning, mechanical forces, falls, fire, heat, hot substances, foreign bodies, poisoning and road injuries, were evaluated. Age-stratified and regional analyses were also performed. RESULTS: Globally, the number of deaths, DALYs, ASMR and ASDR related to occupational injuries declined from 1990 to 2019. The middle Socio-demographic Index (SDI) region exhibited the highest burden, whereas the high SDI region showed the least burden. China and India had the highest occupational injury-related death rates in 2019. Males, particularly those aged 25-44 years, were found to be more vulnerable. Road injuries were the leading cause of death in all age groups. Compared with 1990, mortality numbers and rates decreased significantly by 2019, with the highest burdens experienced in East Asia, South Asia and Southeast Asia. CONCLUSION: The global decline in occupational injuries is promising; however, certain regions and demographics remain disproportionately affected. Targeted interventions in high-burden areas are crucial to further reduce the impact of occupational injuries.

Trajectory of gestational weight gain is related to birthweight: The TAWS cohort study in China.

Few studies have reported the timing and amount of gestational weight gain (GWG) to prevent large-for-gestational-age (LGA) or small-for-gestational-age (SGA). This study aimed to evaluate the association of GWG velocity in each trimester with LGA or SGA based on data from the Taicang and Wuqiang cohort study (TAWS, n = 2008). We used a linear mixed model to evaluate the association of trimester-specific GWG velocity with birthweight categories and stratified by prepregnancy body mass index category and parity. For normal-weight pregnant women, mothers with LGA births had higher GWG velocities than mothers with appropriate-for-gestational-age (AGA) births in the first trimester (0.108 vs. 0.031 kg/week, p < 0.01), second trimester (0.755 vs. 0.631 kg/week, p < 0.01) and third trimester (0.664 vs. 0.594 kg/week, p < 0.01); in contrast, mothers with SGA births had lower GWG velocities than mothers with AGA births in the second trimester (0.528 vs. 0.631 kg/week, p < 0.01) and third trimester (0.541 vs. 0.594 kg/week, p < 0.01). For normal-weight pregnant women with AGA births, multiparous women had lower GWG velocities than primiparous women in the second (0.602 vs. 0.643 kg/week, p < 0.01) and third trimesters (0.553 vs. 0.606 kg/week, p < 0.01). Therefore, for normal-weight women, LGA prevention would begin in early pregnancy and continue until delivery and the second and third trimesters may be critical periods for preventing SGA; in addition, among normal-weight pregnant women with AGA births, multiparous women tend to have lower weight gain velocities than primiparous women.

[Effect of pre-pregnancy body mass index on first-trimester pregnant women glucose and lipid metabolism].

OBJECTIVE: To examine the association of pre-pregnancy body mass index(BMI) and first-trimester glucose and lipid metabolism. METHODS: A total of 298 pregnant women with high risk factors for gestational diabetes in early pregnancy, with an average age of 32.24 years, 66.11% were primiparous and the average time for blood collection was 12.5 weeks, were collected from August 2021 to April 2022 at the Department of Nutrition, Haidian District Maternal and Child Health Hospital, Beijing. Pregnant women were divided into low weight group(n=15), normal weight group(n=181), overweight/obese group(n=102) according to their pre-pregnancy BMI. Fasting glucose, fasting insulin, lipid quadruple, C-reactive protein, leptin and adiponectin levels were compared among groups. RESULTS: (1)Triglyceride concentrations were significantly higher in women in the overweight/obese group(1.51 mmol/L vs.1.15 mmol/L) than in women in low weight group(P<0.01). HDL cholesterol(HDL-C) levels were lower than in women with low weight(1.64 mmol/L vs.1.95 mmol/L)(P<0.01). (2)Pre-pregnancy low weight women had reduced pancreatic ß-cell function in early pregnancy with the HOMA-ß index of 60.41%, and women in the overweight/obese group had heavier fasting insulin levels(7.86 vs.3.42 µU/mL) and insulin resistance(1.75 vs 0.74) in early pregnancy than low weight women(P<0.01). (3)Pre-pregnancy BMI was positively correlated with triglycerides, fasting insulin, C-reactive protein levels, and degree of insulin resistance in early pregnancy(r=0.30, 0.28, 0.45 and 0.45, P<0.01)and negatively correlated with HDL-C levels in early pregnancy(r=-0.29, P<0.01). CONCLUSION: Among pregnant women with risk factors for gestational diabetes, pre-pregnancy overweight and obesity are associated with glucose and lipid metabolism levels in early pregnancy.

[Effect of different delivery modes on the level of protein, glucose and blood lipids in cord artery and vein blood].

OBJECTIVE: To explore whether there are differences in the levels of protein, glucose and blood lipids in umbilical vein and umbilical artery blood of newborns with different delivery modes, and to evaluate their value as indicators of fetal intrauterine nutrition and nutritional support. METHODS: A total of 89 pairs of mothers and infants who were delivered in Danyang People's Hospital of Jiangsu Province from June to September 2021 were selected as the study subjects, including 38 cases of spontaneous delivery and 51 cases of cesarean section. The basic information of pregnant women, pregnancy information, newborn delivery and physical examination information were extracted from the medical record information system of the hospital. According to the mode of delivery, HITACHI 7600 automatic biochemical analyzer was used to measure the levels of protein, glucose and blood lipids in umbilical vein and umbilical artery blood, including total protein(TP), albumin(ALB), glucose(GLU), total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C). The data were statistically analyzed using IBM SPSS Statistics 26.0 statistical software. RESULTS: The levels of TP, ALB, GLU, TC, TG, HDL-C and LDL-C in the umbilical vein blood of the spontaneous delivery group were(56.40±5.83)g/L, (38.41±3.43)g/L, (4.55±1.53)mmol/L, (1.68±0.42)mmol/L, (0.25±0.11)mmol/L, (0.84±0.17)mmol/L and(0.69±0.23)mmol/L, respectively. The levels of TP, ALB, GLU, TC, TG, HDL-C and LDL-C in umbilical artery blood were(56.49±9.91)g/L, (37.72±4.77)g/L, (4.07±1.52)mmol/L, (1.60±0.42)mmol/L, (0.24±0.10)mmol/L, (0.80±0.18)mmol/L and(0.68±0.24)mmol/L, respectively. The levels of TP, ALB, GLU, TC, TG, HDL-C and LDL-C in umbilical vein blood of cesarean section group were(52.08±4.12)g/L, (36.12±2.13)g/L, (3.45±1.16)mmol/L, (1.61±0.39)mmol/L, (0.19±0.08)mmol/L, (0.82±0.18)mmol/L and(0.61±0.20)mmol/L, respectively. The levels of TP, ALB, GLU, TC, TG, HDL-C and LDL-C in umbilical artery blood were(51.49±7.59)g/L, (35.40±3.60)g/L, (3.09±1.15)mmol/L, (1.48±0.40)mmol/L, (0.19±0.08)mmol/L, (0.78±0.18)mmol/L and(0.60±0.20)mmol/L, respectively. The levels of TP, ALB, Glu and TG in cord vein blood and cord artery blood in spontaneous labor group were significantly higher than those in cesarean section group(P<0.05); The levels of Glu, TC, TG and HDL-C in cord vein blood were significantly higher in spontaneous labor group and cesarean section group than those in cord artery blood(P<0.05). CONCLUSION: The levels of protein, glucose and blood lipids in umbilical vein and umbilical artery blood were different among different delivery modes.

[Effect of different delivery modes on the level of cortical hormones in cord artery and vein blood].

OBJECTIVE: To investigate the difference of cortical hormones in cord artery and vein blood of newborns with different delivery modes. METHODS: A total of 65 pregnant women who delivered in the People's Hospital of Danyang City, Jiangsu Province from June to September 2021 were selected as the study subjects, including 26 cases of spontaneous delivery and 39 cases of cesarean section. The basic information of 65 pregnant women and newborns was collected by questionnaire survey. According to the mode of delivery, the levels of corticosteroids in umbilical vein and umbilical artery blood were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS), including corticosterone, 11-desoxycorticosterone, aldosterone, cortisol, 11-deoxycortisol and cortisone. The data were statistically analyzed using IBM SPSS Statistics 26.0 statistical software. RESULTS: The levels of cortisol, 11-deoxycortisol, aldosterone, cortisol, 11-deoxycortisol and cortisone in the umbilical vein blood of the spontaneous delivery group were(2.44±1.87), (0.64±0.29), (0.49±0.35), (54.95±40.80), (3.20±1.23) and(142.27±57.42)ng/mL, respectively. The levels of corticosterone, 11-deoxycortisol, aldosterone, cortisol, 11-deoxycortisol and cortisone in umbilical artery blood were(4.51±4.47), (0.57±0.28), (0.42±0.29), (60.79±45.53), (2.69±1.25) and(123.10±46.32)ng/mL, respectively. The levels of corticosterone, 11-deoxycortisone, aldosterone, cortisol, 11-deoxycortisone and cortisone in umbilical vein blood of cesarean section group were(0.94±1.09), (0.47±0.14), (0.26±0.14), (22.63±19.82), (2.30±0.90) and(84.51±29.49)ng/mL, respectively. The levels of corticosterone, 11-deoxycortisol, aldosterone, cortisol, 11-deoxycortisol and cortisone in umbilical artery blood were(2.22±2.24), (0.43±0.17), (0.27±0.14), (30.09±25.93), (1.87±0.76) and(75.03±24.90)ng/mL, respectively. The levels of corticosterone, 11-desoxycorticosterone, aldosterone, cortisol, 11-deoxycortisol and cortisone in cord vein blood and cord artery blood in spontaneous labor group were significantly higher than those in cesarean section group(P<0.05). The levels of corticosterone and cortisol in cord vein blood were significantly lower in spontaneous labor group and cesarean section group than those in cord artery blood(P<0.05), the levels of 11-desoxycorticosterone, 11-deoxycortisol and cortisone in cord vein blood were significantly higher in spontaneous labor group and cesarean section group than those in cord artery blood(P<0.05). CONCLUSION: There are differences in the level of cortical hormones in cord artery and vein blood in different delivery modes.

Human milk cholesterol is associated with lactation stage and maternal plasma cholesterol in Chinese populations.

BACKGROUND: Milk cholesterol concentrations throughout lactation were analyzed, and the relationship between maternal plasma cholesterol and milk cholesterol in various Chinese populations was examined. METHODS: A sub-sample of 1138 lactating women was randomly selected from a large cross-sectional study in China (n = 6481). Milk cholesterol concentrations were determined by HPLC, and concentrations of maternal plasma lipids were determined by an automated biochemical analyzer. RESULTS: The mean cholesterol concentrations were 200, 171, and 126 mg/L for colostrum, transitional milk, and mature milk, respectively. Cholesterol concentrations differed significantly between stages of lactation (colostrum vs. transitional milk, colostrum vs. mature milk, transitional milk vs. mature milk, all p < 0.001). Concentrations of maternal plasma total cholesterol (TC) (p = 0.02) and low-density lipoprotein cholesterol (LDL-C) (p = 0.03) were significantly associated with milk cholesterol. Milk cholesterol concentrations varied among different ethnicities (Tibetan vs. Hui: 164 vs. 131 mg/L, p = 0.027) but not among different geographic regions. CONCLUSIONS: The concentration of cholesterol in human milk changes dynamically throughout lactation. Milk cholesterol concentrations are significantly associated with maternal plasma concentrations of TC and LDL-C, and milk cholesterol concentrations vary across ethnicities in China. IMPACT: Concentrations of milk cholesterol were measured in various Chinese populations. Cholesterol concentrations differ significantly between stages of lactation. Maternal plasma total cholesterol and low-density lipoprotein cholesterol are associated with milk cholesterol. Milk cholesterol concentrations vary across ethnicities in China.

Exploration of the optimal range of urinary iodine concentration in Chinese pregnant women in mildly iodine-deficient and -sufficient areas.

PURPOSE: There is some uncertainty about the optimal ranges for urinary iodine concentration (UIC) during pregnancy. This study aimed to explore associations between maternal UIC and thyroid function in iodine sufficient and mildly iodine deficient areas. METHODS: It was a cross-sectional study in which 1461 healthy pregnant women were enrolled to collect their blood and urine samples during their routine antenatal care in Tianjin and Wuqiang, China. Wuqiang was a mildly iodine-deficient region, while Tianjin was iodine sufficient. UIC, free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), serum iodine concentration (SIC) including total serum iodine concentration (tSIC) and non-protein bound serum iodine concentration (nbSIC) were assessed during the routine antenatal care visits. RESULTS: The median UIC in pregnant women was 174 (113, 249) µg/L in Tianjin and 111 (63, 167) µg/L in Wuqiang, respectively. Compared with Tianjin, UIC, FT3 and TSH were lower, and FT4, tSIC, nbSIC, rates of TPOAb and TgAb positivity and the thyroid dysfunction rate (TDR) were higher in Wuqiang (P < 0.001). FT3, FT4, tSIC and nbSIC increased during pregnancy in Tianjin with increasing UIC, while only FT3 and nbSIC increased in Wuqiang (P < 0.05). In Tianjin, the TDR increased with UIC and peaked at UIC ≥ 500 µg/L (P = 0.002), while in Wuqiang, the TDR showed a weak "U-shaped" relationship with UIC and the rate was lowest with UIC 100-149 µg/L. CONCLUSIONS: In iodine-deficient areas, there was a lower TDR in pregnant women with UIC 100-149 µg/L. We suspected that the optimal UIC criteria recommended by WHO may be a little high for pregnant women in mild-to-moderate iodine-deficient countries.

What are the determinants of low exclusive breastfeeding prevalence in China? A cross-sectional study.

Exclusive breastfeeding (EBF) status is far from the national target in China. To identify the modifiable factors associated with EBF of infants aged under 6 months in China. A cross-sectional study was conducted in 12 provinces/municipalities across China in 2017-2018. We used multistage stratified cluster sampling and collected data through face-to-face interviews with mothers using an electronic questionnaire. Totally, 5287 pairs of mother-infant aged <6 months were investigated. The EBF prevalence was 29.2% (1544/5287). Mothers with correct knowledge of colostrum (adjusted odds ratio [AOR]:1.32, 95% confidence interval [CI]: 1.07, 1.62), EBF (AOR: 1.39, 95% CI: 1.06, 1.81) and the highest scores of perceptions for breastfeeding benefits (AOR: 1.36, 95% CI: 1.14, 1.61) were more likely to exclusively breastfeed. However, mothers with more frequent unwillingness of breastfeeding during the first month postpartum were less likely to practice EBF (AOR: 0.68, 95% CI: 0.52, 0.90). Infants having their first breast milk within 24 h of birth increased the odds of EBF (AOR: 2.41, 95% CI: 1.86, 3.13). Infants were less likely to be exclusively breastfed in the families in which the main caregiver was the grandmothers. Mothers without receiving infant formula feeding suggestions via the health facilities, media, or the Internet (AOR: 1.57, 95% CI: 1.33, 1.85) or without the experience of infant formula feeding in public (AOR: 1.45, 95% CI: 1.23, 1.72) might more likely to practice EBF. To acquire comprehensively correct knowledge and keep a positive attitude of breastfeeding for the mothers are crucial for improving the EBF prevalence. Family supports are potential interventions worth focusing on. Infant formula promotion remains a great barrier for EBF in China.

[Concentration of osteopontin in human milk and associated factors in Chinese populations from 2011 to 2013].

OBJECTIVE: To analyze content of human milk osteopontin(OPN) and to explore associated factors in Chinese populations. METHODS: The samples and data were extracted from the database for human milk composition in China between 2011 and 2013. A sub-sample of 459 mothers was randomly selected after stratification according to lactation stage, and human milk OPN concentrations were determined by ultra performance liquid chromatography-tandem mass spectrometer(UPLC/MS). RESULTS: The average OPN concentration(M(P25, P75)) in breast milk was 44.0(30.1-72.0) mg/L within 0-330 days postpartum. OPN concentrations were independent of lactation stage, which were 45.6(31.8, 80.7) mg/L in colostrum, 41.3(29.2, 70.0) mg/L in transitional milk and 46.9(30.2, 71.9) mg/L in mature milk, corresponding to 0.40%、0.42% and 0.65% of the total milk protein content(OPN/protein%). The percentage of OPN to total protein in milk showed an increasing trend with lactation progression(r=0.21, P<0.001). Multivariate analysis showed that sleep quality of mothers within one week prior to milk collection was correlated with the breast milk OPN level(P=0.04). The OPN level in breast milk from mothers with good sleep quality was significantly higher than that from mothers with poor sleep quality(46.5 mg/L vs.34.7 mg/L). The median level of milk OPN concentration in mothers from Yunnan was higher than mothers from Beijing(50.5 mg/L vs.36.1 mg/L, P=0.03). Maternal age, mode of delivery, prepregnancy body mass index, weight gain during pregnancy, passive smoking and outdoor activities 24 hours prior to milk collection were not correlated with milk OPN concentration. OPN concentration in breast milk was not related to preterm birth. Also, milk OPN concentration did not correlate with diarrhoea, respiratory disease, or allergic disease in infants during two weeks before milk collection. CONCLUSION: The concentration of OPN in breast milk of Chinese woman may be similar among different lactation stages. Geographic region and sleep quality of mothers may be related to the milk OPN concentration.

[Meta analysis of the validity of image-based dietary assessment method based on energy and macronutrients].

OBJECTIVE: Meta-analysis was used to study the validity of image-based dietary assessment(IBDA) in evaluating energy and macronutrients intake, and compared with three traditional method: weighed food record(WFR), 24-hour dietary recall(24-HDR) and double-labeled water(DLW). METHODS: Studies were retrieved and collected from various databases including China National Knowledge Infrastructure(CNKI), WanFang Database, VIP Database, PubMed, Web of Science, Cochrane Library and Embase, screened according to the inclusion and exclusion criteria. After extracting the data, all the data were Meta-analyzed through RevMan 5.4. RESULTS: A total of 24 studies were included. Meta-analysis showed that, comparison of IBDA method and traditional method in energy intake assessment[MD=-54.71 kcal/d(95%CI-118.81-9.39), P=0.09], comparison of carbohydrate intake assessment[MD=-2.77 g(95%CI-8.86-3.31), P=0.37], comparison of protein intake assessment[MD=0.00 g(95%CI-2.09-2.09), P>0.05], comparison of fat intake assessment[MD=0.10 g(95%CI-2.06-2.25), P=0.93], these differences were not statistically significant. Subgroup analysis showed that, IBDA method compared with the 24-hour dietary review method in protein intake(P=0.01), the difference was statistically significant. IBDA method overestimated protein intake by about 7.3% on average compared with the 24-hour dietary review method. CONCLUSION: There was no significant difference between IBDA method and traditional method in the assessment of energy and macronutrient intakes.

Optimal gestational weight gain in Chinese pregnant women by Chinese-specific BMI categories: a multicentre prospective cohort study.

OBJECTIVE: To establish optimal gestational weight gain (GWG) in Chinese pregnant women by Chinese-specific BMI categories and compare the new recommendations with the Institute of Medicine (IOM) 2009 guidelines. DESIGN: Multicentre, prospective cohort study. Unconditional logistic regression analysis was used to evaluate the OR, 95 % CI and the predicted probabilities of adverse pregnancy outcomes. The optimal GWG range was defined as the range that did not exceed a 1 % increase from the lowest predicted probability in each pre-pregnancy BMI group. SETTING: From nine cities in mainland China. PARTICIPANTS: A total of 3731 women with singleton pregnancy were recruited from April 2013 to December 2014. RESULTS: The optimal GWG (ranges) by Chinese-specific BMI was 15·0 (12·8-17·1), 14·2 (12·1-16·4) and 12·6 (10·4-14·9) kg for underweight, normal weight and overweight pregnant women, respectively. Inappropriate GWG was associated with several adverse pregnancy outcomes. Compared with women gaining weight within our proposed recommendations, women with excessive GWG had higher risk for macrosomia, large for gestational age and caesarean section, whereas those with inadequate GWG had higher risk for low birth weight, small for gestational age and preterm delivery. The comparison between our proposed recommendations and IOM 2009 guidelines showed that our recommendations were comparable with the IOM 2009 guidelines and could well predict the risk of several adverse pregnancy outcomes. CONCLUSIONS: Inappropriate GWG was associated with higher risk of several adverse pregnancy outcomes. Optimal GWG recommendations proposed in the present study could be applied to Chinese pregnant women.

[Metabolomics study on the newborns of pregnant women with gestational diabetes].

OBJECTIVE: To investigate the metabolic changes of umbilical cord blood in pregnant women with gestational diabetes mellitus(GDM) compared with pregnant women with normal glucose tolerance, and to analyze the effect of GDM on neonatal metabolism. METHODS: Pregnant women in the first trimester were recruited in the cohort study in Taicang District, Jiangsu Province from 2014 to 2016. Oral glucose tolerance test was used to diagnose GDM, at 24-28 weeks of gestation. Pregnant women with GDM were taken as the case group and normal pregnant women as the control group. Five mL of umbilical cord blood was collected from full-term newborns, and non-target metabolites in serum samples were detected by ultra high performance liquid chromatography-tandem mass spectrometry. The t test, principal component analysis and orthogonal partial least square analysis were used to analyze the difference of metabolites in umbilical cord blood between the two groups. The metabolic pathways involved in the markers were analyzed according to P& lt; 0. 05 and variable importance projection(VIP)& gt; 1. 0. The metabolic pathways involved in the markers were analyzed based on the KEGG database. RESULTS: According to the result of GDM diagnosis, 42 pregnant women with GDM and 39 control pregnant women were included. A total of 868 small molecular metabolites were detected in umbilical cord blood samples. The concentrations of 41 metabolites were different between groups(P& lt; 0. 05 and VIP& gt; 1. 0), including 18 kinds of amino acid metabolites, 9 kinds of lipid metabolites, 5 kinds of exogenous compounds, 4 kinds of nucleotide metabolites, 3 kinds of peptides, 1 kind of vitamin(pantothenic acid) and 1 kind of coenzyme(gulonic acid). γ-glutamylalanine in the GDM group was lower than that in the control group(P& lt; 0. 01), and other compounds in the GDM group were higher than those in the control group(P& lt; 0. 05). Combined with pathway analysis, the above metabolites are mainly involved in lysine degradation pathway and aminoacyl tRNA biosynthesis pathway. CONCLUSION: Compared with the newborns of pregnant women with normal blood glucose, the metabolites in cord serum from full-term newborns of pregnant women with GDM are mainly characterized by the increase of some amino acids and lipid metabolites.

[Prevalence and risk factors for anemia of Chinese lactating women in 2013].

OBJECTIVE: To investigate the prevalence of anemia and its risk factors for lactating women in China. METHODS: Data was extracted from Chinese National Nutrition and Health Surveillance-Mothers for children under 2 years of age(2013). Totally, 11 178 mothers of children under 2 years old were selected from 55 counties of 30 provinces in China by using the multi-stage stratified cluster randomization sampling method. Among these women 7129 are lactating. The basic information of lactating women was collected through the questionnaire survey. Hemoglobin concentration was measured by photometric determination of haemiglobincyanide(HiCN) method. Participants without blood sample and basic information were excluded. Finally, 6255 lactating women were included in the analysis. Complex sampling method with weighted analysis was used. RESULTS: Totally, with a complex sampling method with weighted analysis, the prevalence of anemia for lactating women was 9.3%. The mean hemoglobin level was(136.1±0.9) g/L. The mild and moderate anemia accounted for 98.8% of all anemic cases. Compared with those lactating time<6 months, lactating time between 6 to 12 months had a lower risk of anemia(OR=0.74, 95%CI 0.61-0.90). Compared with those living in large cities, the maternal living in poor rural areas had a higher risk of anemia(OR=1.69, 95%CI 1.29-2.20). CONCLUSION: In 2013, the prevalence of anemia was mild for the lactating women in China. Lactating women in poor rural areas, within 6 months after deliveryhad the higher risk for anemia.

[Nutritional status of vitamin B_(12) and its influence factors in Chinese lactating women in 2013].

OBJECTIVE: To examine the vitamin B_(12) status of lactating women in China and to analyze the factors affecting the level of serum vitamin B_(12) in these subjects. METHODS: Participants were from the Chinese National Nutrition and Health Surveillance in 2013. By multi-stage stratified cluster randomly sampling method, 10 331 lactating women were selected from 55 counties of 30 provinces in China. Questionnaire was conducted to collect the basic information of lactating women and the dietary intake of them in the past one month was collected by food frequency questionnaire. A total of 20% of the total number of lactating women(a total of 1976) were randomly selected to analyze serum vitamin B_(12) by electro-chemiluminescence immunoassay method. Serum vitamin B_(12) deficiency was defined as a serum vitamin B_(12) level<200 pg/mL. The distribution of serum vitamin B_(12 )was lognormal, a generalized linear model was used to analyze the factors affecting the serum vitamin B_(12) level after logarithm transformation of it. RESULTS: The median of serum vitamin B_(12)(P25, P75) in lactating women was 469. 0(349. 0, 633. 5)pg/mL, the prevalence of vitaminB_(12) deficiency was 2. 7%(53/1976)and marginal deficiency rate was 12. 8%. With the increase of the education level of the lactating women the rate of vitamin B_(12) deficiency decreased gradually. The rate of vitamin B_(12 )deficiency of the lactating women presented regional differences and varied significantly among different regionals, education levels and the mothers who were breastfeeding or not. The value of serum vitamin B_(12 )was analyzed by generalized linear regression model showed that the levels of serum vitamin B_(12) in general rural counties and medium-sized or small cities were 1. 07 and 1. 13 times higher than those in poor rural areas, respectively. The serum vitamin B_(12) level of non-lactating women was 1. 08 times higher than that of lactating women. The serum vitamin B_(12 )level of the lactating women with junior high school level or below was significantly lower than that of the lactating women with college education and university education level, 88. 3% and 85. 0% of the lactating women with college education and university education, respectively. Serum vitamin B_(12) levels were positively correlated with intake of livestock meat, fish and seafood. CONCLUSION: The status of vitamin B_(12) in lactating women in China is good. Our findings suggest that some regionals, education levels, breastfeeding or not and livestock meat, fish meat and seafood supplement may be associated with serum vitamin B_(12 )in lactating women.

[Relationship between household safe drinking water, hygienic toilet and prevalence of stunting for Chinese children aged 0 to 5 years old in 2013].

OBJECTIVE: To investigate the relationship between household drinking water, toilet status and the prevalence of stunting for Chinese children aged 0 to 5 years old in 2013. METHODS: Data was extracted from the Chinese National Nutrition and Health Surveillance in 2013. A total of 32 861 children aged 0 to 5 years old were selected from 165 townships(streets) of 55 counties(cities/districts) in 30 provinces. Caregivers were face to face interviewed to collect data, including demographic characteristics of children, mothers and household, main source of household drinking water and main type of household toilet. Height/Length of children was measured using a standard procedure. Height(Length) for age Z score(HAZ(LAZ)) was calculated using WHO Anthro Survey Analyser software(online version), and stunting was defined as HAZ(LAZ)<-2. SAS 9. 4 was used to analyze. SURVEYFREQ procedure was used to calculate the coverage rate of safe drinking water, hygienic toilet, and the prevalence of stunting. SURVEYLOGISTIC procedure was used to analyze the relationship between household safe drinking water, hygienic toilet and prevalence of stunting for Chinese children aged 0 to 5 years old in 2013. RESULTS: A total of 32 861 children completed the study. The coverage rate of safe drinking water was 86. 9%. The proportion of water piped into household, a public tab and water from a protected spring or well was 49. 4%, 15. 9% and 15. 6%, respectively. The coverage rate of hygienic toilet was 56. 8%. The proportion of pour-flush toilet and pit latrine were 52. 1% and 4. 7%. The prevalence of stunting for 0 to 5 years old children was 8. 1% in China. The prevalence of stunting were 8. 1% for children aged 0-5 years old with safe household drinking water and 7. 8% for those without safe household drinking water. The difference was not significant(P=0. 882). The prevalence of stunting was 6. 6% for children aged 0-5 years old with hygienic household toilet and 10. 0% for those without hygienic household toilet. The difference was not significant(P=0. 069). There was no significant relationship between household sanitary condition and stunting for children aged 0 to 5 years old. CONCLUSION: Household sanitary conditions, including main source of household drinking water and the main type of household toilet may not be associated with the prevalence of stunting for children aged 0 to 5 years old in this settings.

Effects of fish oil supplementation on glucose control and lipid levels among patients with type 2 diabetes mellitus: a Meta-analysis of randomized controlled trials.

BACKGROUND: Previous studies have yielded inconsistent findings on the role of fish oil in type 2 diabetes mellitus (T2DM). We systematically summarized the available evidence from randomized controlled trials (RCT) and aimed to investigate the effects of fish oil supplementation on glucose control and lipid levels among patients with T2DM. METHODS: A comprehensive literature search was performed in electronic databases (PubMed, ProQuest, Cochrane Library, CNKI, VIP, and Wanfang) to identify all relevant RCTs which were published up to May 31st, 2019. We used Modified Jadad Score system to evaluate the quality of each included RCT. The pooled effects were estimated using random-effects model and presented as standardized mean differences with 95% confidence intervals. RESULTS: A total of 12 RCTs were included in this meta-analysis. There was no significant difference in glucose control outcomes comparing fish oil supplementation to placebo. The effect size of fasting plasma glucose (FPG) was 0.13 (95% CI: - 0.03 to 0.28, p > 0.05). No marked change was observed in fasting insulin (FINS), glycosylated hemoglobin (HbA1c), and HOMA of insulin resistance (HOMA-IR) levels. Fish oil supplementation was associated with a decrease of triglyceride (TG) level by - 0.40 (95%CI: - 0.53 to - 0.28, p < 0.05), and an increase of high density lipoprotein (HDL) cholesterol level by 0.21 (95%CI: 0.05 to 0.37, p < 0.05). In subgroup analysis, HDL cholesterol level was higher among Asian and low-dose(< 2 g/d n-3 PUFA) subgroups compared to their counterparts (p < 0.05). TG level was lower in mid and long duration groups, along with an inconspicuous difference in short duration group. CONCLUSIONS: This meta-analysis shows that among patients with T2DM, fish oil supplementation leads to a favorable blood lipids profile but does not improve glucose control.

[Effect of pregnant serum folate concentration on newborn's birth weight].

OBJECTIVE: To study the effect of pregnant serum folate concentrations on the birth weight. METHODS: This study was a prospective cohort study. Pregnant women aged 18-45 who were examined and delivered in a county in Hebei Province from June 2016 to August 2018 and their newborns were included in the study. A total of 490 women were recruited and collected venous blood before the 20 th week of pregnancy. Basic information of women as well as their use of folic acid supplements was collected at the same time. Newborns' basic information, such as sex and birth weight, had been collected after delivery. The chemiluminescence method was used to determine the serum folate concentrations. Folate concentrations quartile were used as the cut-off point to divide subjects into four groups. The general linear model and multivariate unconditional Logistic regression analysis were used to study the effect of different serum folate concentrations on the infant birthweight. RESULTS: The age of 490 pregnant women was(27. 9±4. 1) years. The serum folate value P50(P25, P75) was 12. 3(9. 0, 14. 5) ng/mL and its' detection time was(13. 7±2. 6) weeks. 49. 3%(242/490) newborns were male. The average gestational age of the newborns was(39. 1±1. 0) weeks and the average birth weight was(3403±425) g. The birth weight of four groups' newborns were(3408±456) g, (3405±450) g, (3427±418) g and(3374±378) g, respectively. General linear model analysis showed that there was no significant difference in the effect of serum folate levels before the 20 th week of gestation on the birth weight(serum folate concentration<9. 0 ng/mL(ß=32. 24, P=0. 55), serum folate concentration 9. 0-12. 2(ß=18. 01, P=0. 74), serum folate concentration 12. 3-14. 4(ß=42. 27, P=0. 43)]. Multivariate unconditional Logistic regression analysis showed that the group with folate concentration above 14. 5 ng/mL can reduce the risk of small for gestational age(SGA) [(P=0. 02, OR=0. 08(95% CI 0. 01-0. 61)]. Comparing with ghe pregnant women whose serum folate concentration was in 9. 0-12. 4 ng/mL. Hovever, there was no significant difference between the pregnant serum folate levels and large for gestational age(LGA). CONCLUSION: There was no significant correlation between serum folate concentrations and the birth weight. But higher folate level may reduce the risk of SGA.

[Relationship between different feeding methods and growth rate of infants within 6 months in a community in Beijing from 2013 to 2015].

OBJECTIVE: To observe the influence of feeding method on early growth rate of infants. METHODS: A retrospective cohort study was conducted with 416 infants born in a community in Beijing from October 2013 to October 2015. Infants fed by breast milk as the sole source of milk food were classed into the breastfeeding group, others were classed into the non-breastfeeding group. The information of physical examination on birth and within 6-month old was collected to analyze the influence of different feeding method on growth rate Z scores of length and body weight within 6-month old infants. RESULTS: When evaluating the effect of feeding patterns on the growth rate at 1 month, there was no significant difference between the two groups at 0-1 months and 0-3 months old body weight and body length growth rate Z score.When evaluating the effect of feeding patterns on the growth rate at 3 month, the results showed, in the 3-6 months old formula powder feeding group(0.60), the weight growth rate Z score of the infant was higher than that of the predominant breastfeeding group(-0.01).The length-growth rate Z score also showed that the formula powder feeding group(0.40) was higher than the predominant breastfeeding group(-0.03).The weight growth rate Z score of 0-6 months old was higher in the formula powder feeding group(0.90) than in the predominant breastfeeding group(0.60).The body length growth rate Z score was higher in the formula powder feeding group(1.00) than in the predominant breastfeeding group(0.70). CONCLUSION: The feeding pattern of infants at 3 months of age will affect their subsequent growth rate. The addition of formula powder may cause the growth rate curve to shift upwards, thereby increasing the risk of overweight and obesity in infants.

[Effects of vitamin D supplementation in early pregnancy on high-risk groups of gestational diabetes mellitus].

OBJECTIVE: To investigate the effect of vitamin D supplementation(VD) in early pregnancy on the serum 25-hydroxyvitamin D(25-OH-D) level and the risk of gestational diabetes mellitus(GDM). METHODS: From October to December 2017, a total of 101 pregnant women with high risk factors for GDM were enrolled in the first pregnancy consultation at the nutrition clinic of Haidian Maternal and Child Health Hospital, and were randomly divided into intervention group and control group. The intervention group was supplemented with 700 U VD and 100 mg of calcium at the beginning of pregnancy, and the control group was supplemented with 100 U VD and 100 mg of calcium at the same time, and the intervention time was until delivery. RESULTS: After intervention, the mean serum 25-OH-D level in the intervention group was(92. 08±29. 69) nmol/L, and that in the control group was(69. 99±25. 10) nmol/L. The serum levels of 25-OH-D in the pregnant women, gestational age and cord blood were higher than those in the control group(P<0. 05). The incidence of GDM in the intervention group was 18. 37%, and the incidence rate in the control group was 28. 85%(P>0. 05). Compared with the control group, the OR value of the risk of GDM in the intervention group was 0. 56(95% CI 0. 22-1. 42)( P<0. 05). CONCLUSION: The supplementation of VD in early pregnancy can significantly improve the VD nutrition level of pregnant women, but does not significantly reduce the incidence of GDM.