Disease burden of diabetes attributable to high body mass index in China,1990-2016 / 中华流行病学杂志

Objective: To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016. Methods: Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI. Measurements for attributable BOD of diabetes included disability adjusted life years (DALY), years of lost life (YLL), years living with disability (YLD), death number and mortality rate. The average world population from 2010 to 2035 was used as a reference. Results: In 2016, death number of diabetes attributable to high BMI was 40 310, which was significantly higher than that in 1990 (15 008). Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016, which showed a more significant increasing trend in both males and people aged 15-49 years. DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years. YLL and YLD also showed increasing trends. The highest increasing rate of YLD was in people aged 15-49 years. High BMI was responsible for 26.01% of the diabetes deaths in 2016 in China, an increase of 39.39% compared with that in 1990 (18.66%). Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016. Inner Mongolia, Xinjiang, Zhejiang, Macao SAR, Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period. Conclusions: There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI, causing a heavy disease burden, in China from 1990 to 2016. The BOD varied in both different age and gender groups. More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.

Effect of intervention programs regarding community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus / 中华流行病学杂志

Objective: To analyze the effect of intervention programs and influencing factors regarding the community "5+1" staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL). Methods: A total of 12 community health service centers from Shanxi province, Jiangsu province, and Ningxia Hui autonomous region were selected as intervention group and control group, by stratified cluster sampling method. "5+1" model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up. Data was collected through a questionnaire on demographic and disease-related information, while the QOL was measured with SF-36. Multiple linear regression and conducted by SAS 9.4. Results: A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service. After intervention programs being implemented, the net effect of PCS score between the intervention and the control groups was 13.6, with the net effect of MCS score as 29.8. Results from the multiple linear regression showed that the main factors affecting PCS scores included age, type of medical insurance, baseline PCS score and regions of residency. Main factors related to MCS score included age, type of medical insurance, baseline MCS score, hypertension, and region of residency. Conclusion: Community "5+1" staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.

Trend on mortalities in all-cause and chronic non-communicable diseases among the labor force population in China, 2007-2016 / 中华流行病学杂志

Objective: To analyze the trends on mortalities of all-cause and deaths caused by chronic and non-communicable diseases (NCDs) among Chinese labor force population during 2007 to 2016. Methods: Data on cause-of-death that collected from the National Mortality Surveillance System was used to analyze the age and area-related specific crude mortality rates, age-standardized mortality rates and component ratios of NCDs, among the Chinese labor force population, during 2007 to 2016. Trend of crude mortality rates and mortality component ratios of the three major diseases (infectious diseases, maternal and infant diseases, nutritional deficiency diseases; NCDs; injuries) were analyzed. Age-standardized mortality of cancer, COPD, cardiovascular and cerebrovascular diseases were also analyzed by gender. Age-standardized mortality was calculated based on the Year 2010 Population Census of China. Joinpoint regression model was used to obtain annual percentage change and 95%CI was set for assessing the trend. Results: In 2016, the age-standardized all-cause mortality rate was 217.23 per 100 000 among the Chinese labor force population, but decreased by -2.8% (95%CI: -3.8%- -1.7%) annually from 2007 to 2016. The gap between different gender and regions gradually narrowed. The proportion of deaths caused by NCDs increased annually by 0.8% (95%CI: 0.7%-0.9%). The age-standardized mortality rate of NCDs appeared as 171.89/100 000, among the Chinese labor force population in 2016, showing a downward trend by -2.4% (95%CI:-3.3% - -1.4%). However, in females, there appeared the greatest decrease, with an average annual change of -3.3% (95%CI:-4.0% - -2.5%). Diseases as cancer, COPD, cardiovascular and cerebrovascular diseases all showed downward trends in the whole country, with an average range of -2.0% (95%CI: -2.6%--1.3%), -8.0% (95%CI: -8.9% - -7.1%), -1.5% (95%CI: -2.9% - -0.1%), -2.3% (95%CI: -2.8% - -1.8%) in a ten-year period, respectively. Conclusion: All-cause and age-standardized mortality rates caused by NCDs among Chinese labor force population were decreasing during 2007 to 2016. However, the constituent ratios appeared increasing, year by year. Close attention needs to be paid on NCDs which affecting the health of the labor force population in China.