Analysis on the household secondary attack rates of the SARS-CoV-2 Delta variant and the associated factors / 中华预防医学杂志

Objective: To evaluate the household secondary attack rates of the SARS-CoV-2 Delta variant and the associated factors. Methods: A COVID-19 outbreak caused by the Delta variant occurred in Nanjing in July 2021. A total of 235 cases with current addresses in Nanjing were reported from 171 households. The subjects in this study were selected from household close contact(s) of infected cases. The information on household index cases and their contacts were collected, and the household secondary attack rate (HSAR) and the risk factors were analyzed by the multi-factor logistic regression model. Results: A total of 234 cases of household close contacts and 64 household secondary cases were reported from 103 households, and the HSAR was 27.4% (64/234, 95%CI:22.0% to 33.4%). The proportions of household size for 2 to 3, 4 to 5, and 6 to 9 were 64.1% (66), 26.2% (27) and 9.7% (10), respectively. A total of 35 cases of household cluster outbreaks were reported (35/103, 34.0%). The number of the first case in the household (FCH) was 103 and males accounted for 27.2% (28 cases), with the median age (Q1, Q3) of 49 (9, 56). The number of household close contacts was 234 and males accounted for 59.0% (138 cases), with the median age (Q1, Q3) of 42 (20, 55) and the median exposure period (Q1, Q3) of 3 (1, 3) days. The multi-factor logistic regression model showed that the higher HSAR was observed in the FCH with the features of airport staff (OR=2.913, 95%CI:1.469-5.774), detection from home quarantine screening (OR=6.795, 95%CI:1.761-26.219) and detection from mass screening (OR=4.239, 95%CI:1.098-16.368). Meanwhile, higher HSAR was observed in cases with longer household exposure (OR=1.221, 95%CI:1.040-1.432), non-vaccination (OR=2.963, 95%CI:1.288-6.813) and incomplete vaccinations (OR=2.842, 95%CI:0.925-8.731). Conclusion: The generation interval of the Delta variant is shortened, and the ability of transmission within the household is enhanced. In the outbreak in Nanjing, the associated factors of HSAR are occupation, detection route, vaccination and exposure period.

Relationship between dietary pattern and excess body weight among urban residents: a three-year follow-up study in Nanjing / 中华流行病学杂志

Objective To examine the relationship between the duration of diet and the risk related to excess body weight in residents of Nanjing city.Methods With multi-stage cluster random sampling method,a total number of 3376 local residents aged 30 and over in 7 communities from 2 urban districts were involved in this survey.Through diet balance index (DBI),nine dietary patterns were identified.Subjects with normal BMI in the baseline survey were selected to participate in the follow-up survey.Multiple linear regression and multivariate logistic regression analysis were used to estimate the incidence risks on overweight and obesity.Results Of 1898 eligible subjects with normal BMI in the baseline survey,1347 of them completed the 3-year follow-up survey,with a follow-up rate of 71.0％.By multiple linear regression method,on average,an increase in DBI_DQD of 1 unit was seen and associated with a 0.028 increase in BMI.DBI_DQD were also associated with BMI (β=0.022,P＜0.001)after adjusted for the covariates.By logistic regression,when compared with the group of healthy dietary pattern,the relative risk for excessive body weight was 1.37 for those with unhealthy dietary patterns.After adjusting the possible confounding factors,the excessive body weight was also associated with significantly increased risk (RR=1.51,95％ CI:1.09-2.09).Conclusion Results from this study provided evidence,showing that unhealthy dietary patterns could predict the increase risk of excessive body weight,suggesting that healthy dietary pattern was important in controlling the excessive body weight.

Dietary patterns and hyperglycemia in a follow-up study in Nanjing city / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the association between dietary patterns and the risk of developing hyperglycemia in Nanjing.</p><p><b>METHODS</b>Using multi-stage stratified random cluster sampling, the baseline survey was conducted on local residents older than 30 years in 7 communities from 2 urban districts from June to September 2007 in Nanjing. The total eligible subjects were 3376. Excluding the 476 previously diagnosed hyperglycemia patients, 2900 non-hyperglycemia subjects were used as the baseline sample for the follow-up survey from June to September 2010. Using specially designed food frequency questionnaire (FFQ), factor analysis was applied to identify food patterns. Multivariable linear and Cox regression models were used to analyze the association between different dietary patterns and risk of hyperglycemia.</p><p><b>RESULTS</b>The follow-up rate was 72.2%, with 2093 subjects participated the follow-up survey in 3 years. Three-year cumulative incidence of hyperglycemia was 7.5% (158/2093). The incidence rate was 7.1% (62/873) for males and 7.9% (96/1220) for females, but the differences were not statistically significant (χ(2) = 0.43, P = 0.513). Five dietary patterns were identified by factor analysis: condiment, animal and plant protein, traditional healthy, sweet food and alcohol drinking. By multivariable linear regression, on average, an increase in traditional healthy pattern and sweet food pattern of 1 unit was associated with a -0.054, 0.050 mmol/L increase in fasting blood glucose, respectively, and the differences were both statistically significant (t = -2.38, 2.27, respectively, P values were both less than 0.05). By multivariable Cox regression, the pattern sweet food was positively significantly associated with hyperglycemia risk in men. The incidence of hyperglycemia was 4.7% (14/295) for the lowest tertile of the factor score (T1), and 9.7% (26/269) for the highest tertile of the factor score (T3) (T3:T1: RR = 1.88, 95%CI: 1.04 - 3.54). The pattern traditional healthy was inversely associated with hyperglycemia risk in women. The incidence of hyperglycemia was 10.7% (45/421) for T1 and 6.3% (21/335) for T3 (T3:T1: RR = 0.59, 95% CI: 0.35 - 0.99). Conversely, a statistically significant positively association was observed for the pattern alcohol drinking in women. The incidence of hyperglycemia was 8.1% (38/472) for T1 and 11.1% (33/297) for T3 (T3:T1: RR = 1.35, 95%CI: 0.84 - 2.16).</p><p><b>CONCLUSION</b>Dietary patterns are associated with hyperglycemia. The sweet food pattern is a risk factor for hyperglycemia in men. In women, healthy dietary pattern is healthy and the alcohol drinking pattern is a risk factor for hyperglycemia.</p>

The relationship between body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio and hyperglycemia: a three-year follow-up study in Nanjing / 中华流行病学杂志

Objective To explore whether the increase of body mass index (BMI) , waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) can predict a higher risk of developing hyperglycemia. Methods A population-based cross-sectional study was conducted on local residents above 35 years of age in three urban districts and one rural county in July 2004. The subjects who were non-hyperglycemia in the baseline survey were selected to follow the survey in July 2007. Multivariable logistic regression analysis and area under curve (AUC) of receivcr-operating characteristics (ROC) were used to evaluate the predictive value of BMI, WC, WHR and WHtR. Results Of 3727 subjects without hyperglycemia who had completed in the baseline survey, 3031 of them participated in the follow-up survey, with a follow-up rate of 81.3%. The Three-year cumulative incidence of hyperglycemia was 6.7%,with male 6.3% and female 7.0%. By multiple linear regression, on average, an increase in BMI, WC, WHR, WHtR of 1 unit was associated with a 0.015 mmol/L, 0.023 mmol/L, 1.923 mmol/L, 2.382 mmol/L increase in fasting plasma glucose, respectively. The risk of developing hyperglycemia increased along with the increase of all the four indexes. When compared with other three indexes, the group which WHtR was more than 0.5, had the highest risk (male OR= 1.998, 95%CI:1.231-3.212, female OR= 1.832,95%CI: 1.157-2.902) of developing hyperglycemia. Data from ROC curve analysis showed that the AUC of WHtR was the highest in both males and females. Conclusion The increase of BMI, WC, WHR and WHtR could predict the higher risk causing the development of hyperglycemia. WHtR might serve as a simple but most effective index of hyperglycemia.

A case-control study on depression and anxiety in hypertensive patients / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the current situation of depression and anxiety from patients with hypertension as well as to provide reference for the development of control and prevention program.</p><p><b>METHODS</b>Participants older than 35-year including both hypertensive patients and healthy controls were randomly selected in 2 communities of Pukou district in Nanjing through Health Behavior Survey. All the subjects were assessed by the Zung's self-rating depression scale (SDS) and the Zung's self-rating anxiety scale (SAS).</p><p><b>RESULTS</b>Raw score and index score of SDS and SAS were both significantly (P < 0.01) greater in hypertensive patients than in healthy control group. The prevalence of depression of 17.9% and anxiety of 9.5% in patient group were found significantly higher than that in healthy control group as 11.5% and 4.3%. Data from logistic regression model analysis showed that depression and anxiety were possible risk factors of hypertension (OR = 1.677, 95% CI: 1.013-2.776; OR = 2.451, 95% CI: 1.228-4.894). There was a combined effect seen between depression and anxiety (OR = 5.238, 95% CI: 2.356-11.664) but interaction did not appear.</p><p><b>CONCLUSION</b>Depression and anxiety were possibly associated with hypertension and more attention needs to be paid to the mental health situation of hypertensive patients in order to improve their quality of life.</p>