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Objective@#To quantify the effects of short-term walking intervention on body mass index (BMI), waist circumference, and related indicators of working population.@*Methods@#The China Motivational Healthy Walking Program in 2016 recruited 29 224 individuals from 139 demonstration areas for comprehensive prevention and control of chronic and non-communicable diseases at the national level and 70 areas at the provincial level. All subjects volunteered to participate into this program. The intervention lasted 100 days from June to September 2016. The walking behavior, height, weight and waist circumference of subjects were measured using a uniform pedometer, body composition tester, height tester and waist-to-hip caliper before and after the intervention. Daily average steps, daily average effective steps, and the percent of fulfilling continuous walking per day were used as main indicators in this study. Self-administered questionnaires were used to collect demographic characteristics, behaviors and chronic diseases. With the adjustment of potential confounding factors, multilevel regression was used to quantify the effect of walking on BMI and waist circumference, and multilevel logistic regression was used to quantify the effect on overweight or obesity and central obesity.@*Results@#A total of 12 368 subjects completed walking interventions and all measurements included in this study. The mean±SD age of all subjects was (41.19±8.99) years, and 5 155 (59.17%) of them were women. After 100-day intervention, all outcome variables decreased significantly. For every additional 1 000 steps per day, subjects would have extra decrease in BMI of 0.023 kg/m2 [β (95%CI): -0.023 (-0.030, -0.017)], in waist circumference of 0.046 cm [β (95%CI): -0.046 (-0.071, -0.020)], and the likelihood for becoming overweight or obesity was 0.97 times [OR (95%CI): 0.97 (0.95, 0.98)] that of before intervention. With additional 1 000 effective steps per day, the difference between baseline and endpoint increased by 0.028 kg/m2 [β (95%CI): -0.028 (-0.035, -0.020)] in BMI and 0.062 cm [β (95%CI): -0.062 (-0.091, -0.033)] in waist circumference. The likelihood of progressing into overweight or obesity was 0.97 times [OR (95%CI): 0.97(0.95, 0.98)] that of before-intervention, and the likelihood of becoming central obesity was 0.98 times [OR (95%CI): 0.98(0.96, 0.99)] that of before-intervention. Compared to subjects with low level percent of fulfilling continuous walking per day, those with high level would have an extra decrease in BMI by 0.150 kg/m2 [β (95%CI): -0.150 (-0.22, -0.079)], in waist circumference by 0.340 cm [β (95%CI): -0.340 (-0.620, -0.064)], and the likelihood of becoming overweight or obesity decreased to 0.74 times that of the low level group [OR (95%CI): 0.74(0.62, 0.89)] and the likelihood of becoming central obesity decreased to 0.78 times that of the low level group [OR (95%CI): 0.78 (0.68, 0.91)].@*Conclusion@#Strengthening walking exercise in the short term has a positive effect on promoting working population to reduce BMI and waist circumference, and prevent overweight, obesity and central obesity.
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Objective@#To investigate the prevalence of hypercholesterolemia among Chinese adults in different geographic areas, and to analyze the related factors.@*Methods@#China Chronic and Non-Communicable Disease and Risk Factor Surveillance was conducted in 2013, based on 298 counties/districts in 31 provinces of Chinese mainland. The adults aged 18 years old were randomly selected using multi-stage stratified clustering sampling method. Information on chronic disease and risk factors was collected using face-to-face questionnaire interview and physical measurement. Blood samples were collected by local staffs. Serum total cholesterol (TC) was determined using standard method in a central laboratory. After excluding 565 participants missing key variables and 1 558 participants with abnormal TC values, a total of 174 976 participants were included. Weighted prevalence of hypercholesterolemia was calculated. Hypercholesterolemia related individual or geographic determinants were defined using multilevel logistic regression.@*Results@#The prevalence of hypercholesterolemia in Chinese adults age 18 years old and above was 6.9% (95%CI: 6.4%-7.3%), ranged from 3.0% (95%CI: 2.5%-3.4%) in the northwest of China to 14.2% (95%CI: 12.9%-15.5%) in the south (χ2=183.42, P<0.001). The prevalence of hypercholesterolemia was higher in 6 provinces including Tianjin, Liaoning, Fujian, Guangdong, Guangxi, and Hainan (≥9.0%), but lower in 7 provinces including Shanxi, Shannxi, Gansu, Qinghai, Ningxia, Xinjiang, and Tibet (<3.9%). There was a 1.27 fold variation in hypercholesterolemia prevalence by provincial level, and 72.5% of the geographical variation in hypercholesterolemia prevalence was account for by area-level determinants. With multilevel logistic analysis, the individual risk factors associated with hypercholesterolemia included aging, higher education level or annual household income per capita, regular drinking, too much red meal intake, inactivity, overweight or obesity. For geographic factors, residents living at south China, counties/districts with higher urbanization rates, higher education level or lower standardized death rates were more likely to have hypercholesterolemia (all P<0.05).@*Conclusion@#The prevalence of hypercholesterolemia was high in Chinese adults, it was different between regions and related with characteristics of population, individual behaviors and geographical regions.
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Objective@#To investigate the geographical variation of prediabetes in adults in different regions of China, and to analyze the related factors of prediabetes.@*Methods@#Data was obtained from China Chronic Disease and Related Risk Factor Surveillance in 2013. The surveillance adopted multiple-stage stratified cluster random sampling method, which sampled 177 099 residents aged above 18 years old among 298 surveillance points in 31 provinces of Chinese Mainland. Questionnaire interview was used to obtain demographic variables, personal living style, and socio-economical information. Physical examination was conducted and fasting venous blood sample and (oral glucose tolerance test-2 hours, OGTT-2 h) venous blood sample were obtained from the participants. A total of 171 567 residents aged 18 and above were included in the analysis. The prevalence of prediabetes was analyzed by provinces and by China's geographical regions, after complex weighting. Multilevel logistic models were established to explore the related factors of prediabetes on the area level and individual level.@*Results@#The prevalence of prediabetes among residents aged 18 and above was 16.6% (95%CI: 15.6%-17.6%) in China. The prevalence of prediabetes was the highest (18.3%) in the south China and lowest (13.1%) in the northwest area. The difference of the prevalence in different areas were not statistically significant (P=0.510). If categorized the prevalence of prediabetes into 5 groups by quintile, Hainan, Jilin, Shandong, Anhui, Hunan and Chongqing were in the highest group of prevalence of prediabetes (18.6%-22.7%), and Tibet, Qinghai, Gansu, Ningxia, Guizhou, and Jiangxi were in the lowest group (7.6%-12.6%). The variance of prevalence of prediabetes on the county level (MOR: 1.60 (95%CI:1.53-1.67)) was more diverse than the province level (MOR: 1.21(95%CI:1.08-1.29)) and higher than the street level (1.23 (95%CI:1.14-1.30)). Several factors increased risk of pre-diabetes, including smoking, hazardous drinking and harmful drinking, drinking in the past 30 days, overweight, obesity, central obesity, sugary drink intake, hypertension, high total cholesterol, high triglycerides, high blood low-density lipoprotein cholesterol, low blood high-density lipoprotein cholesterol (all P<0.05). After adjusted the above variables, 92.5% of variance of prediabetes prevalence conld be explained on the provincial level.@*Conclusion@#The geographical distribution of prediabetes in adults in China differed by geographic areas, and it significantly varied on the county level. The related variables included demographic variables, personal behavior, and geographic related variables.
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Objective@#To evaluate the provincial representativeness of China Non-communicable and Chronic Disease Risk Factor Surveillance System, 2013.@*Methods@#The Sixth National Population Census data which was collected by National Bureau of Statistics of People's Republic of China was used to calculate proportion of population who aged 65 and above, mortality rate, the proportion of non-agriculture population, the illiteracy rate and urbanization rate in order to evaluate the surveillance system in each province. The Mann-Whitney U test was used to determine the statistically differences between the surveillance system and corresponding general population.@*Results@#Among the 298 disease surveillance points (DSPs) in China Non-communicable and Chronic Disease Risk Factor Surveillance System, there were 111, 85, and 102 DSPs located in the east, middle, and west area of China, which covering 13.90%, 11.48%, and 12.28% of the total population, respectively. The surveillance system covered 169 million of the population of China, accounting for 12.70% of Chinese population. The number of DSPs by provinces ranges from 6 (Hainan, Qinghai, and Ningxia) to 14 (Shandong, Guangdong and Henan). It indicated that mortality rate (DSP: 0.238%; Province: 0.482%) and the illiteracy rate (DSP: 15.54%; Province: 26.22%) among DSPs in Tibet were significantly lower than the provincial level, on the other hand, the proportion of non-agriculture population among DSPs (40.6%) was significantly higher than the provincial level (18.8%). The urbanization rate among Jiangxi DSPs (43.4%) was significantly lower than the provincial level (59.9%). The proportion of non-agriculture population among Shandong DSPs (32.8%) was significantly higher than the provincial level (24.2%), however, the illiteracy rate among Shandong DSPs (3.86%) was significantly lower than the provincial level (5.25%). Other than the provinces mentioned above, there was no statistical differences (P>0.05) among proportions of population who aged 65 and above, mortality rates, the proportions of non-agriculture population, the illiteracy rates and urbanization rate between provincial surveillance system and corresponding area.@*Conclusion@#Other than 3 provinces, in general, China Non-communicable and Chronic Disease Risk Factor Surveillance System had provincial representativeness.
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Objective@#To examine the effects and associated factors of the China Motivational Healthy Walking Program among occupational population.@*Methods@#The 2016 China Motivational Healthy Walking Program recruited 29 224 participants from 139 demonstration areas for comprehensive prevention and control of chronic and non-communicable disease at national level and 70 at provincial level. Intervention on walking was carried out by adopting group and individual motivating measures. Walking steps were recorded by electronic pedometer. We used percent of days achieving 10 000 steps (P10 000), percent of days fulfilling continuous walking (PCW), and proportion of valid walking (PVW) steps to reflect walking quantity, pattern and quality of participants. Motivation intensity was measured by summing up scores of each motivating activity. Questionnaire-based online survey collected information about demographic characteristics, lifestyle risk factors and chronic diseases. This study finally included 12 368 individuals in the analysis. Multilevel logistic regression model was used to assess the effect of group and individual motivating measures on walking activity and corresponding associated factors.@*Results@#Age of the study sample was (41.2±8.99) years, and 58.17% (7 194) of them were female. After 100-day intervention, the P10 000, PCW and PVW of all participants were 93.89%±14.42%,92.01%±15.97% and 81.00%±7.45%, respectively. The mean P10 000 and PCW increased with rising group-motivated scores, self-motivated scores and individual-activity scores (P<0.001 for all). The mean PVW decreased with both higher group-motivated scores and self-motivated scores (both P<0.05), and varied little among groups with different level individual-activity scores (P=0.525). According to the results from the multilevel model, those who had greater group-motivated scores and self-motivated scores tended to have more likelihood of high-level of P10 000 and PCW. Age, sex, smoking status, education attainment and alcohol drinking were associated with P10 000 and PCW (P<0.05 for all).@*Conclusion@#The Motivational Healthy Walking Program had positive effect on promoting healthy walking among occupational population. Group-motivated and self-motivated activities were associated with healthy walking.
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Objective: To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013. Methods: The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used. The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction. Results: In 2013, alcohol use resulted in 381 200 deaths, including 97 100 hemorrhagic stroke deaths, 88 200 liver cancer deaths, 61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths, and prevented 76 500 deaths, including 68 500, 4 900 and 3 100 deaths which might be caused by ischemic heart disease, hemorrhagic stroke and diabetes respectively. If risk factor of alcohol use is removed, the people's life expectancy would rise by an average of 0.43 years, especially in western China by 0.52 years, which was 0.12 years higher than that in eastern and central China, and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively. Conclusions: Although alcohol has a protective effect on reducing ischemic heart disease, stroke and diabetes deaths, alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China. It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
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Humans , Male , Middle Aged , Alcoholism/mortality , Cause of Death , China/epidemiology , Life Expectancy , Risk Assessment , Risk Factors , Rural Population/statistics & numerical data , Urban Population/statistics & numerical dataABSTRACT
Objective: To explore the relations between the prevalence of multiple chronic diseases and cigarette smoking behavior in the Chinese adults. Methods: Based on the results: from the 2013 Chronic Disease Risk Factor Surveillance (NCD Surveillance), 176 534 Chinese residents aged 18 years and above, covering 298 counties (districts) in 31 provinces, was randomly recruited, using the multi-stage stratified clustering sampling method. Information on demographics, cigarette smoking (status, quantity and period) was obtained through face-to-face interviews and questionnaires. Anthropometric data and blood samples were collected and properly stored for analysis. Results In total, 175 386 adults were included for statistical analyses, with 42.7% as males and 57.3% as females. The prevalence rates of hypertension, high total cholesterol and high triglycerides were 30.4%, 7.2% and 18.0% in male smokers, 35.6%, 14.0%, 10.3% and 15.9% in female smokers respectively, which were all higher than those in the respective non-smokers. Male smokers were found under lower risk on hypertension, but 19% higher on total glycerides when compared with non-smokers of the same sex(OR=1.19, 95%CI:1.10-1.30), when multiple risk factors were under control. Male current smokers with more than 20 cigarettes per day have 41% (OR=1.41, 95%CI: 1.28-1.55) higher risk of high TG than non-smokers. Female smokers presented 40% (OR=1.40, 95%CI: 1.15-1.70) higher risk in high glycerides than the non-smokers. Specifically, women smoking longer than 20 years have 60% (OR=1.60, 95%CI: 1.31-1.95) higher risk of high TG than women smoking less than 20 years. Conclusions: Prevalence rates of certain chronic diseases were seen higher in smokers of both genders. People with longer history of smoking or being heavier smokers, appeared at advanced risk on developing chronic diseases.
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Adult , Aged , Female , Humans , Male , Asian People , Chronic Disease/ethnology , Cigarette Smoking/ethnology , Hypertension/epidemiology , Prevalence , Risk Factors , Sex Distribution , Sex Factors , Smoking Cessation , Surveys and QuestionnairesABSTRACT
Objective: To study the relationship between blood pressure level and major risk factors for cardiovascular diseases in adults in China. Methods: A total of 179 347 adults aged ≥18 years were recruited from 298 surveillance points in 31 provinces in China in 2013 through complex multistage stratified sampling. The survey included face to face interview and physical examination to collect information about risk factors, such as smoking, drinking, diet pattern, physical activity, overweight or obesity, and the prevalence of hypertension. The blood pressure was classified into 6 levels (ideal blood pressure, normal blood pressure, normal high blood pressure and hypertension phase Ⅰ, Ⅱ and Ⅲ). The relationship between the prevalence or co-prevalence of risk factors for cardiovascular disease and blood pressure was analyzed. Results: The adults with ideal blood pressure, normal blood pressure, normal high pressure, hypertension phase Ⅰ, Ⅱ and Ⅲ accounted for 36.14%, 22.77%, 16.22%, 16.43%, 5.97% and 2.48%, respectively. Among them, the blood pressure was higher in men, people in Han ethnic group and those married, and the blood pressure was higher in those with older age, lower income level and lower education level, the differences were all significant (P<0.05). Whether taking antihypertensive drug or not, co-prevalence of risk factors influenced the blood pressure levels of both sexes (P<0.05), and the blood pressure levels of those taking no antihypertensive drug was influenced more by the co-prevalence of risk factors. Finally, multiple logistic analysis showed that the risks for high blood pressure in adults with 1, 2 and ≥3 risk factors were 1.36, 1.79 and 2.38 times higher, respectively, than that of the adults without risk factor. Conclusion: The more the risk factors for cardiovascular disease in adults, the higher their blood pressure were. It is necessary to conduct comprehensive behavior intervention targeting ≥ 2 risk factors for the better control of blood pressure in general population.
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Adolescent , Adult , Female , Humans , Male , Alcohol Drinking/epidemiology , Antihypertensive Agents/therapeutic use , Blood Pressure/physiology , Cardiovascular Diseases/epidemiology , China/epidemiology , Diet , Hypertension/epidemiology , Obesity/epidemiology , Overweight , Prevalence , Risk Factors , Smoking/epidemiology , Surveys and QuestionnairesABSTRACT
Objective: To investigate the prevalence and influencing factors on respiratory disease related symptoms (coughing, expectoration, persistent coughing and persistent expectoration) in Chinese people ≥40 years old. Methods: Data was collected from 162 surveillance points in the China Non-communicable and Chronic Disease Surveillance Project in 2010. A total number of 56 066 people, aged ≥40 years, were selected by multi-stage cluster random sampling method in this study. The prevalence rates of coughing, expectoration, persistent coughing and persistent expectoration were calculated according to gender by χ(2) test. Multivariate logistic regression model was used to analyze the related influencing factors. Results: The prevalence rates of coughing, persistent coughing, expectoration and persistent expectoration in men were significantly higher than that in women (P<0.01). The prevalence rate of respiratory symptoms was positively correlated with age and duration and amount of cigarette smoking (P<0.01), while negatively correlated with participants'education level (P<0.01). Results from multivariate logistic regression analysis showed that gender, age, education level, smoking-related parameters, areas of residency (in urban or rural areas), etc. were appeared as influencing factors on the prevalence of respiratory symptoms. Conclusion: The symptoms of chronic respiratory diseases appeared prevalent in Chinese population aged ≥40 years. Factors as older age, living in the central/western regions and smoking-related parameters were identified as of higher risks.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Asian People/statistics & numerical data , China/epidemiology , Chronic Disease/epidemiology , Cough/epidemiology , Logistic Models , Noncommunicable Diseases/epidemiology , Prevalence , Risk Factors , Rural Population , SmokingABSTRACT
Objective To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013.Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used.The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction.Results In 2013,alcohol use resulted in 381 200 deaths,including 97 100 hemorrhagic stroke deaths,88 200 liver cancer deaths,61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths,and prevented 76 500 deaths,including 68 500,4 900 and 3 100 deaths which might be caused by ischemic heart disease,hemorrhagic stroke and diabetes respectively.If risk factor of alcohol use is removed,the people's life expectancy would rise by an average of 0.43 years,especially in westem China by 0.52 years,which was 0.12 years higher than that in eastern and central China,and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively.Conclusions Although alcohol has a protective effect on reducing ischemic heart disease,stroke and diabetes deaths,alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China.It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
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Objective To explore the relations between the prevalence of multiple chronic diseases and cigarette smoking behavior in the Chinese adults.Methods Based on the results from the 2013 Chronic Disease Risk Factor Surveillance (NCD Surveillance),176 534 Chinese residents aged 18 years and above,covering 298 counties (districts) in 31 provinces,was randomly recruited,using the multi-stage stratified clustering sampling method.Information on demographics,cigarette smoking (status,quantity and period) was obtained through face-to-face interviews and questionnaires.Anthropometric data and blood samples were collected and properly stored for analysis.Results In total,175 386 adults were included for statistical analyses,with 42.7% as males and 57.3% as females.The prevalence rates of hypertension,high total cholesterol and high triglycerides were 30.4%,7.2% and 18.0% in male smokers,35.6%,14.0%,10.3% and 15.9% in female smokers respectively,which were all higher than those in the respective non-smokers.Male smokers were found under lower risk on hypertension,but 19% higher on total glycerides when compared with non-smokers of the same sex (OR=1.19,95%CI:1.10-1.30),when multiple risk factors were under control.Male current smokers with more than 20 cigarettes per day have 41% (OR=1.41,95%CI:1.28-1.55) higher risk of high TG than non-smokers.Female smokers presented 40% (OR=1.40,95%CI:1.15-1.70) higher risk in high glycerides than the non-smokers.Specifically,women smoking longer than 20 years have 60%(OR=l.60,95% CI:1.31-1.95) higher risk of high TG than women smoking less than 20 years.Conclusions Prevalence rates of certain chronic diseases were seen higher in smokers of both genders.People with longer history of smoking or being heavier smokers,appeared at advanced risk on developing chronic diseases.
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Objective To study the relationship between blood pressure level and major risk factors for cardiovascular diseases in adults in China.Methods A total of 179 347 adults aged ≥18 years were recruited from 298 surveillance points in 31 provinces in China in 2013 through complex multistage stratified sampling.The survey included face to face interview and physical examination to collect information about risk factors,such as smoking,drinking,diet pattern,physical activity,overweight or obesity,and the prevalence of hypertension.The blood pressure was classified into 6 levels (ideal blood pressure,normal blood pressure,normal high blood pressure and hypertension phase Ⅰ,Ⅱ and Ⅲ).The relationship between the prevalence or co-prevalence of risk factors for cardiovascular disease and blood pressure was analyzed.Results The adults with ideal blood pressure,normal blood pressure,normal high pressure,hypertension phase Ⅰ,Ⅱ and Ⅲ accounted for 36.14%,22.77%,16.22%,16.43%,5.97% and 2.48%,respectively.Among them,the blood pressure was higher in men,people in Han ethnic group and those married,and the blood pressure was higher in those with older age,lower income level and lower education level,the differences were all significant (P<0.05).Whether taking antihypertensive drug or not,co-prevalence of risk factors influenced the blood pressure levels of both sexes (P<0.05),and the blood pressure levels of those taking no antihypertensive drug was influenced more by the co-prevalence of risk factors.Finally,multiple logistic analysis showed that the risks for high blood pressure in adults with 1,2 and ≥3 risk factors were 1.36,1.79 and 2.38 times higher,respectively,than that of the adults without risk factor.Conclusion The more the risk factors for cardiovascular disease in adults,the higher their blood pressure were.It is necessary to conduct comprehensive behavior intervention targeting ≥ 2 risk factors for the better control of blood pressure in general population.
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Objective To investigate the prevalence and influencing factors on respiratory disease related symptoms (coughing,expectoration,persistent coughing and persistent expectoration) in Chinese people ≥40 years old.Methods Data was collected from 162 surveillance points in the China Non-communicable and Chronic Disease Surveillance Project in 2010.A total number of 56 066 people,aged ≥40 years,were selected by multi-stage cluster random sampling method in this study.The prevalence rates of coughing,expectoration,persistent coughing and persistent expectoration were calculated according to gender by x2 test.Multivariate logistic regression model was used to analyze the related influencing factors.Results The prevalence rates of coughing,persistent coughing,expectoration and persistent expectoration in men were significantly higher than that in women (P< 0.01).The prevalence rate of respiratory symptoms was positively correlated with age and duration and amount of cigarette smoking (P<0.01),while negatively correlated with participants' education level (P<0.01).Results from multivariate logistic regression analysis showed that gender,age,education level,smoking-related parameters,areas of residency (in urban or rural areas),etc.were appeared as influencing factors on the prevalence of respiratory symptoms.Conclusion The symptoms of chronic respiratory diseases appeared prevalent in Chinese population aged ≥40 years.Factors as older age,living in the central/western regions and smoking-related parameters were identified as of higher risks.
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Objective@#To investigate the current status, temporal trend and achieving Health China 2030 reduction target of probability of premature mortality caused by four main non-communicable diseases (NCDs) including cardiovascular and cerebrovascular diseases, tumour, diabetes, and chronic respiratory disease in China both at national and provincial level during 1990 to 2015.@*Methods@#Using the results of Global Burden of Disease study 2015 (GBD 2015), according to the method of calculating premature mortality probability recommended by WHO, the current status and temporal trend by different gender from 1990 to 2015 were calculated, analyzed, and compared. Referring to " Health China 2030" target of reduction 30% of probability of premature mortality caused by major NCDs, we evaluated the difficulty of achieving the reduction target among provinces (not including Taiwan).@*Results@#From 1990 to 2015, the probabilities of premature mortality in cardiovascular and cerebrovascular diseases, tumour, and chronic respiratory disease were all declined consistently for both men and women in China, the total of four main NCDs decreased from 30.69% to 18.54% with higher decreasing in women (from 25.97% to 12.40%) than that in men (from 34.94% to 24.19%). In 2015, the top five provinces in terms of probability of premature mortality caused by four main NCDs were Qinghai (28.81%), Tibet (25.88%), Guizhou (24.67%), Guangxi (23.56%), and Xinjiang (23.21%) in turn, while the top five provinces with the lowest probability were Shanghai (8.40%), Beijing (9.39%), Hong Kong (10.10%), Macao (10.31%), and Zhejiang (11.70%). If achieving the " Health China 2030" target, the probabilities of premature mortality in Qinghai and Tibet with the highest probability should decline to about 20.17%, and 18.12%, respectively in 2030, while 5.88%, and 6.57% in Shanghai and Beijing, respectively. From 1990 to 2015, the probability of premature mortality of four main NCDs declined by 2.00% a year on average, the top five provinces with the fastest decline were Beijing (3.48%), Shanghai (3.24%), Zhejiang (2.81%), Fujian (2.75%), and Guangdong (2.67%), and 11 provinces including these five provinces could achieve the " Health China 2030" target by the usual rate of decline, while other 22 provinces could not achieve the target, they need greater rate of decline in order to achieve the target.@*Conclusion@#From 1990 to 2015, the probabilities of premature mortality of four main NCDs were declined consistently in China both at national and provincial level, compared with women, the men had higher probabilities and declined slower, there were significant different in probabilities of premature mortality and their change speed among provinces. Based on the results from 1990 to 2015, there were about two thirds of the provinces, which the task of achieving the Health China 2030 target will be daunting.
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Objective@#To analyze the burden of disease attributable to low fruit intake among Chinese population aged ≥15 years old between 1990 and 2013.@*Methods@#We used data from the 2013 Global Burden of Disease Burden of Disease Study to study the situation in China. The population attributable fraction was calculated to estimate and compare the death and disability-adjusted life years (DALY) attributed to low fruit intake between 1990 and 2013 in China (excluded Taiwan, China). An average world population age structure of the period 2000-2025 was adopted to calculate age-standardized rates.@*Results@#Deaths attributable to low fruit intake accounted for 11.02% of all death in 2013, which were higher than it in 1990 (10.38%). In 2013, the number of deaths attributed to low fruit intake in China increased to 1 046 500 from 793 800 in 1990. From 1990-2013, the age-standardized death rate attributable to low fruit intake decreased from 113.04/100 000 to 79.80/100 000. DALYs caused by low fruit intake increased from 18.346 5 million in 1990 to 21.296 7 million in 2013. Compared with 1990, the age-standardized DALY rate attributed to low fruit intake decreased by 34.67%. In 2013, the top three provinces with the highest burden of disease attributed to low fruits intake were Tibet, Guizhou and Xinjiang provinces, with standardized DALY rate at 2 612.53/100 000, 2 281.85/100 000 and 2 198.22/100 000, respectively. Compared with the results in 1990, the standardized DALY attributed to low fruits intake decreased, especially in Tianjin, where decreased by 63.61%; followed by Aomen, Zhejiang, Shanghai and Beijing, where decreased by 59.74%, 59.53%, 56.64% and 53.88%, respectively.@*Conclusion@#Compared with the situation in 1990, the burden of disease attributable to low fruit intake decreased in 2013, but the situation is still serious, especially in Tibet, Guizhou and Xinjiang provinces, where the burden decreased comparatively slowly.
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Objective@#The objective of this study is to analyze the trend of burden of ischemic heart disease (IHD) in China between 1990 and 2015.@*Methods@#Data were collected from the results of 2015 Global Burden of Disease Study. We arranged and analyzed the mortality and disability-adjusted life year (DALY) for IHD by sexes, ages and provinces (excluding Taiwan, China) in China between 1990 and 2015. The age-standardized rates were determined using the average world population age structure in the period of 2010-2035 as a reference, and the changes of the related indicators were calculated.@*Results@#In 2015, IHD caused 1 461 thousand deaths, and its age-standardized death rate was 114.8 per 100 000. Number of DALYs from IHD were 25 765 thousand in 2015, with the age-standardized DALY rate at 1 760.2 per 100 000. From 1990 to 2015, the age-standardized death rate for IHD in China increased by 13.3% but age-standardized DALY rate decreased by 3.9%. Number of IHD DALYs among male (16 664 thousand) was higher than it among female (9 101 thousand) in China in 2015, and 83.5% of total DALYs from IHD occurred among people aged over 50 years old. Province with highest age-standardized death rate was Heilongjiang, with rate at 187.4 per 100 000 in 2015. Qinghai (54.0%) increased most and Macao (-52.3%) decreased most from 1990 to 2015. Province with highest age-standardized DALY rate was Xinjiang, with rate at 3 040.8 per 100 000 in 2015. Qinghai (33.2%) increased most while Macao (-59.0%) decreased most between 1990 and 2015.@*Conclusion@#Burden of IHD in China increased remarkably from 1990 to 2015, especially among males and people aged over 50 years old. The differences among provinces were obvious.
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Objective To explore the effect of fime particulate matters with an aerodynamic diameter less than 2.5 μtm (PM2.5) on daily cardiovascular disease mortality in seven cities of China.Methods Daily average concentrations of PM2.5,cardiovascular disease mortality data and environmental data were collected from January 1,2013 to December 31,2015 in seven cities of China,including Shijiazhuang,Haerbin,Shanghai,Wuhan,Guangzhou,Chengdu and Xi'an.We linked generalized additive model with Quasi-Poisson distribution to evaluate the association between daily concentrations of PM2.5 and cardiovascular disease mortality at single-city level and multi-city level,after adjusting for the long-term and seasonal trend,as well as meteorological factors and the effect of "days of week".Results The single-pollutant model indicated that there were marked differences in association strength in these cities,among which the effect in Guangzhou was strongest.At multi-city level,a 10 μg/m3 increase of PM2.5 was associated with an increase of 0.315% (95%CI:0.133%-0.497%) of daily cardiovascular disease mortality.From lag0 to lag2,the effect of PM2.5 on cardiovascular disease mortality decreased,while it was strongest on lag01.In the two-pollutant model,the estimated effect decreased in all the cities with the adjustments of SO2 or NO2.The insignificant combined results suggested that PM2.5 might have combined effect with other pollutants.Each 10 μg/m3 increase of PM2.5 was associated with increases of 0.371% (95%CI:0.141%-0.600%) and 0.199% (95% CI:0.077%-0.321%) of cardiovascular disease mortality in males and females,respectively.The effect of PM2.5 on cardiovascular disease mortality increased with age and decreased with educational level,although the differences between different subgroups were insignificant.The dose-response relationship between PM2.5 and cardiovascular disease mortality was non-linear and non-threshold,with a steeper curve at lower concentrations.Conclusion The increases of PM2.5 concentration can result in the increase of daily cardiovascular mortality.
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Objective To analyze deaths that attributable to high fasting plasma glucose and its impact on life expectancy among Chinese residents in 2013.Methods Data from the Mortality Surveillance Programs in National Disease Surveillance Points System and the China Chronic Disease Surveillance (2013) were used.Death attributed to high fasting plasma glucose and its impact on the life expectancy of Chinese residents were estimated,based on the principle of population attributable fraction.Results In 2013,the total number of deaths attributed to high fasting plasma glucose among aged ≥25 years old was 621 thousand,with 333 thousand males and 288 thousand females.Diseases related to the number of deaths caused by high fasting plasma glucose would include ischemic heart disease (212 thousand) as the most important one.Cerebrovascular disease appeared the 2nd place,with around 181 thousand cases and then followed by diabetes (145 thousand),chronic kidney disease (52 thousand) and tuberculosis (31 thousand).After removal of the effects on high blood glucose exposure,the life expectancy of Chinese residents in 2013 would have reached 76.5 years old,an average increase of 0.7 years,compared to the average life expectancy of all deaths,with men having an increase of 0.7 years and women of 0.8 years,respectively.Conclusions High fasting plasma glucose appeared an important risk factor for mortality and life expectancy on the Chinese residents.Programs related to prevention and control of high fasting plasma glucose and related diseases should be strengthened.
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Objective To investigate the prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity,and overweight or obesity in floating population and influencing factors in China,2012.Methods Data from the 2012 China Chronic Disease Risk Factor Survey in Floating Population in China were used.In this survey,48 704 people aged 18-59 years in floating population were selected through stratified multistage clustering sampling in 170 counties and districts from 31 province (autonomous regions and municipalities) and Xinjiang Production and Construction Corps.The gender specific prevalence and co-prevalence of five risk factors were estimated,and the rank sum test was used for result comparison.Results Among the people surveyed,27.4% had one risk factor,37.1% had two risk factors,28.5% had ≥3 risk factors.The prevalence or co-prevalence of risk factors were positively correlated with age (P<0.05),income level (P<0.05) and migration time (P<0.05),and negatively correlated with educational level (P<0.05).People who were males,in Han ethnic group,engaged in construction and from other provinces were more likely to have more risk factors (P<0.05).Conclusion The prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity and overweight or obesity were high in floating population in China,suggesting that it is necessary to strengthen the comprehensive behavior intervention in floating population.
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Objective To explore the effect of fime particulate matters with an aerodynamic diameter less than 2.5 μtm (PM2.5) on daily cardiovascular disease mortality in seven cities of China.Methods Daily average concentrations of PM2.5,cardiovascular disease mortality data and environmental data were collected from January 1,2013 to December 31,2015 in seven cities of China,including Shijiazhuang,Haerbin,Shanghai,Wuhan,Guangzhou,Chengdu and Xi'an.We linked generalized additive model with Quasi-Poisson distribution to evaluate the association between daily concentrations of PM2.5 and cardiovascular disease mortality at single-city level and multi-city level,after adjusting for the long-term and seasonal trend,as well as meteorological factors and the effect of "days of week".Results The single-pollutant model indicated that there were marked differences in association strength in these cities,among which the effect in Guangzhou was strongest.At multi-city level,a 10 μg/m3 increase of PM2.5 was associated with an increase of 0.315% (95%CI:0.133%-0.497%) of daily cardiovascular disease mortality.From lag0 to lag2,the effect of PM2.5 on cardiovascular disease mortality decreased,while it was strongest on lag01.In the two-pollutant model,the estimated effect decreased in all the cities with the adjustments of SO2 or NO2.The insignificant combined results suggested that PM2.5 might have combined effect with other pollutants.Each 10 μg/m3 increase of PM2.5 was associated with increases of 0.371% (95%CI:0.141%-0.600%) and 0.199% (95% CI:0.077%-0.321%) of cardiovascular disease mortality in males and females,respectively.The effect of PM2.5 on cardiovascular disease mortality increased with age and decreased with educational level,although the differences between different subgroups were insignificant.The dose-response relationship between PM2.5 and cardiovascular disease mortality was non-linear and non-threshold,with a steeper curve at lower concentrations.Conclusion The increases of PM2.5 concentration can result in the increase of daily cardiovascular mortality.