Study on the death and disease burden caused by high sugar-sweetened beverages intake in China from 1990 to 2019.

BACKGROUND: To analysis the death and disease burden caused by high sugar-sweetened beverages intake in China from 1990 to 2019. METHODS: Data were obtained from the 2019 Global Burden of Disease Study. We analyzed the death cases caused by high sugar-sweetened beverages intake in China and provinces from 1990 to 2019, as well as the disease burden (including disability-adjusted of life year), years of life lost and years lived with disability, and compared the changes of death in 1990 and 2019. RESULTS: In 2019, the number of deaths attributed to sugar-sweetened beverages in China reached 46 633 with an increase of 95% compared with 1990. The proportion of deaths caused by excessive consumption of carbon-containing beverages increased from 0.34% in 1990 to 0.46% in 2019, an increase of 35%. In 2019, the top five provinces in China with more deaths caused by excessive intake of sugary beverages were Shandong, Henan, Hebei, Hunan and Guangdong, with the number of death cases 4337, 3881, 3010, 2762 and 2611, respectively. CONCLUSIONS: The number of deaths and disease burdens caused by high sugar-sweetened beverages intake in China has increased significantly over the past three decades. The burden of disease due to high intake of sugary beverages varies widely from province to province. We suggest that attention should be paid to the problem of excessive intake of high sugar-sweetened beverages for Chinese population. In addition to regular monitoring and investigation of sugar-sweetened beverage intake, comprehensive measures should be taken in China's sugar control work.

Self-rated health and health-related quality of life among Chinese residents, China, 2010.

BACKGROUND: Self-rated health (SRH) and health-related quality of life (HRQOL) are two outcome measures used to assess health status. However, little is known about population-based SRH and HRQOL in China. METHODS: Data from the 2010 China Chronic Disease and Risk Factor Surveillance, a nationally representative sample of 98,658 adults (≥18-year-old) residing in China, were analyzed. SRH was assessed by asking "Would you say that, in general, your health is very good, good, general, poor, or very poor?" HRQOL was assessed by asking "For about how many days during the past 30 days was your health not good due to physical illnesses, injuries, or mental unhealthy?". RESULTS: Overall, 6.3 % of participants rated their health as poor or very poor. The prevalence of poor/very poor health increased with advancing age ranging from 2.0 % in the 18-24 year-olds to 14.9 % in those ≥75 years-old, while it decreased with education levels from 13.0 % in illiterates/those with some primary school education to 2.2 % in college graduates or above. Additionally, women were more likely than men to rate their health as poor or very poor (7.2 % vs. 5.4 %). The reported rate of poor/very poor health was higher in western region residents compared to those in the east (7.4 % vs. 5.3 %). The mean numbers of self-reported physically unhealthy days, injury-caused unhealthy days, or mentally unhealthy days during the past 30 days were 1.48, 0.20, and 0.54, respectively. Older adults had more physically unhealthy days than the younger ones ranging from 2.92 days in those ≥ 75 year-old to 0.95 days in 18-24 year-olds. Women had more physically unhealthy days and mentally unhealthy days than men (1.72 vs. 1.23; 0.62 vs. 0.46, respectively). The highest mean number of physically unhealthy days (2.32) was reported by illiterates or those with some primary school education. The highest mean number of mentally unhealthy days (0.86) reported by college graduates or above. CONCLUSIONS: Substantial variations existed in SRH and HRQOL among age groups, gender groups, education groups, and across regions in China. Considering these disparities will be important when developing health policies and allocating resources.

[Evaluation on the status quo of self monitoring of blood glucose and self-efficacy of diabetes patients in community].

OBJECTIVE: To investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group. METHODS: Beijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy. RESULTS: There were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (ß' = -0.076) and a positive correlation between education and self-efficacy (ß' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (ß' = 0.193)(t = -2.46, 3.71, 7.18, P < 0.05). CONCLUSION: Community diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients. The worst parts were SMBG and foot care. Place of residence, education, and diabetes knowledge awareness are factors that influence patients' self efficacy.

Disease burden of Parkinson's disease in China and its provinces from 1990 to 2021: findings from the global burden of disease study 2021.

Background: Parkinson's disease (PD) has become a public health concern with global ageing. However, comprehensive assessments of the temporal and geographical trend of PD disease burden in China remain insufficient. This study aimed to examine the burden of PD by age, gender, and geographical region in China during 1990-2021. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we analysed the incidence, prevalence, mortality, and DALY burden of PD in 33 Chinese provinces/regions. We compared the national figure with the global average and the corresponding estimates from the G20 countries. The estimated annual percentage change (EAPC) was used to quantify the temporal trends of PD burden during 1990-2021. We further assessed the PD burden by age and gender during 1990-2021. We used a decomposition analysis to investigate the changes in the number of new cases, patients, and deaths of PD during 1990-2021. Findings: In 2021, China recorded the highest age-standardised incidence and prevalence of PD among the G20 countries, at 24.3 per 100,000 and 245.7 per 100,000, respectively, figures that were much higher than the global average. During 1990-2021, the age-standardised incidence of PD in China increased by 89.7%, and the age-standardised prevalence by 167.8%, both marking the largest increases among the G20 countries. In contrast, the age-standardised mortality for PD has significantly decreased since 1990, whereas the age-standardised DALY rate for PD has remained relatively unchanged since 1990. The PD burden gradually increased with age, especially in the elderly population aged ≥65 years. During 1990-2021, the burden in males consistently surpassed that in females, with the gender difference widening over time. The increase in new cases and patients of PD was primarily driven by changes in age-specific rates, while the rise in PD-related deaths was largely attributable to population ageing. The disease burden of PD varied considerably across the Chinese provinces. In 2021, age-standardised incidence and prevalence of PD were generally higher in China's southeastern coastal regions than in the western regions, and age-standardised DALY rates were higher in the northern regions than in other regions. Interpretation: The disease burden of PD in China has consistently risen over the past three decades, particularly among elderly men. The increasing causative factors and population aging highlight the need for enhancing public health intervention and resource allocation, especially in etiological research, early diagnosis, preventive strategies, and region-specific management for PD. Funding: Ministry of Science and Technology of the People's Republic of China (2022YFC2304900, 2022YFC2505100); National Key R&D Program of China (2022YFC2505100, 2022YFC2505103, 2018YFC1315300); Outstanding Young Scholars Support Program (grant number: 3111500001); Epidemiology modeling and risk assessment (grant number: 20200344), and Xi'an Jiaotong University Young Scholar Support Grant (grant number: YX6J004).

[Self-rated health status among Chinese residents, China, 2010].

OBJECTIVE: To investigate the self-rated health status among Chinese residents in 2010. METHODS: Data was from the Non-communicable Disease & Risk Factor Surveillance in China, 2010. A total of 98 638 adults aged ≥ 18 years were included in the study. Self-rated health was assessed by four questions: (1) Would you assess your health status as very good or good, general (not good/not poor), poor or very poor? (2) How many days was your health not good for physical illness during the past 30 days? (3) How many days was your health not good for injury during the past 30 days? (4) How many days was your health not good for mental illness, which include stress and problem with emotions depression during the past 30 days? After being weighed according to complex sampling scheme and post-stratification, the sample was used to estimate the prevalence of self-rated health. The Rao-scott χ(2) test with different samples was adopted for comparison among groups. RESULTS: In total, 57.5% (95%CI:55.5%-59.5%) of the participants rated their health as being either very good or good, 36.2% (95%CI:34.5%-37.8%) as general, and only 6.3% (95%CI:5.7%-6.9%) as poor or very poor; In different age groups and gender, the differences were statistically significant (χ(2) values were 1179.88, 85.36, both P values were < 0.05) . The reported rate of poor or very poor health increased significantly with advancing age ranging from 2.0% (95%CI:1.5%-2.4%)in 18-24 year-old group to 14.9% (95%CI:12.6%-17.2%) in ≥ 75 year-old group; Females were more likely than males to rate their health as poor or very poor , respectively (7.2%; 95%CI 6.5%-7.9% and 5.4%; 95%CI:4.9%-5.9%). During the past 30 days 18.5% (95%CI:17.1%-19.8%) of the participants was not in good health for physical illness. The reported rate of physical illness increased significantly with advancing age (χ(2) = 211.99, P < 0.01), and it was the lowest in 25-34 year-old group (15.4%; 95%CI:13.7%-17.0%), and the highest in ≥ 75 year-old group (28.3%; 95%CI:24.9%-31.6%) . It was statistically higher among females (21.1%; 95%CI:19.5%-22.6%) compared to males (15.9%; 95%CI:14.6%-17.3%) (χ(2) = 231.81, P < 0.01); the reported rates of physical illness were 17.4% (95%CI:15.3%-19.5%) among residents in the east region, 17.2% (95%CI:14.7%-19.6%) in the middle region, and 21.5% (95%CI:18.7%-24.4%) in the western region(χ(2) = 6.75, P < 0.01). During the past 30 days 2.7% (95%CI:2.3%-3.2%) of the participants was not in good health for injure. The reported rate of injure decreased significantly with advancing age (χ(2) = 25.54, P < 0.01), and it was the highest in 18-24 year-old group (3.8%; 95%CI:2.6%-5.0%), and the lowest in 35-44 year-old group (2.3%; 95%CI:1.8%-2.7%) . It was statistically higher among males (3.0%; 95%CI:2.4%-3.5%) compared to females (2.5%; 95%CI:2.1%-2.9%) (χ(2) = 8.89 P < 0.01) ; the reported rates of injure were 2.3% (95%CI:1.9%-2.7%) among residents in the east region , 2.1% (1.7%-2.4%) in the middle region, and 4.1% (95%CI:2.6%-5.6%) in the west region (χ(2) = 16.26, P < 0.01). During the past 30 days 10.0% (95%CI:8.8%-11.3%) of the participants was not in good health for mental illness. The reported rate of mental illness decreased significantly with advancing age (χ(2) = 92.14 P < 0.01), and it was the highest in 18-24 year-old group (12.9%; 95%CI: 10.6%-15.2%), and the lowest in ≥ 75 year-old group (5.7%; 95%CI: 4.4%-7.0%) .It was statistically higher among females (10.8%; 95%CI:9.5%-12.1%) than males (9.2%; 95%CI:7.9%-10.5%) (χ(2) = 21.59, P < 0.01). CONCLUSION: The self-rated health status among Chinese residents was good in 2010. Substantial variation exists in self-rated health status across age groups, between genders, and across regions. Considering these disparities will be important for developing health policy and allocating resources.

Prevalence and Patterns of Multimorbidity Among Adults Aged 18 Years and Older - China, 2018.

What is already known about this topic?: Multimorbidity is becoming more common and poses a major challenge to healthcare systems. However, the prevalence and patterns of multimorbidity among Chinese adults aged ≥18 years are largely unknown. What is added by this report?: This study found that 46.5% of Chinese adults had multimorbidity in 2018. And the prevalence of multimorbidity prevalence is increased with age. Prevalence of multimorbidity was higher among men, Han Chinese, adults with lower educational level, and those with lower household income. The most common multimorbidity pattern is a combination of three chronic conditions, hypertension, dyslipidemia, and obesity. What are the implications for public health practices?: As multimorbidity diversifies characteristics and patterns, guideline development, clinical management, and public intervention should consider the complexity of multimorbidity.

Comprehensive assessment of resources for prevention and control of chronic and non-communicable diseases in China: a cross-sectional study.

OBJECTIVE: This study aims to comprehensively evaluate the resources for prevention and control of chronic and non-communicable diseases (NCDs) in China to provide a reference basis for optimising the resource allocation for prevention and control of NCDs. METHODS: China Chronic Disease and Risk Factor Surveillance sites and National Demonstration Areas for Integrated Chronic and Non-communicable Disease Prevention and Control (NCDDA) were selected as investigation objects. In December 2021, the district (or county) resource allocation for NCD prevention and control was investigated through the NCDDA management information system. According to the index system of NCD prevention and control, 31 indicators of 6 dimensions were collected, and the weighted technique for order preference by similarity to an ideal solution, weighted rank-sum ratio and fuzzy comprehensive evaluation methods were used for comprehensive evaluation of resources for prevention and control of NCDs. RESULTS: The 653 districts (or counties) in this study cover 22.96% of China's districts (or counties). The top three weights were full-time staff for NCD prevention and control (0.1066), the amount of funds for NCD prevention and control (0.0967), and the coverage rate of districts (or counties) establishing chronic obstructive pulmonary disease surveillance information system (0.0886). The comprehensive evaluation results for the resources for prevention and control of NCDs by the three methods were basically the same. The results of fuzzy comprehensive evaluation showed that the resource allocation in urban areas (0.9268) was better than that in rural areas (0.3257), the one in eastern region (0.9016) was better than that in central (0.3844) and western regions (0.3868), and the one in NCDDA (0.9625) was better than that in non-NCDDA (0.2901). CONCLUSION: The resources in China for NCD prevention and control differ among different regions, which should be taken into account in future policymaking and resource allocation.

[Methodology of infant and young child feeding index for children aged 6-24 months in China].

OBJECTIVE: To establish a infant and young child feeding index (ICFI) in China to comprehensive evaluate the feeding of children aged 6-24 months. METHODS: Based on the feed index concept defined by Ruel and Menon in 2002, and according to the feeding principle by WHO and Chinese dietary guidelines for children aged 0-6 years, the feed index for infants and young children was built and the variables were scored. Then using WAZ, HAZ and WHZ, the correlation between ICFI and Z score for children in urban and rural of three provinces (Sichuan, Hebei and Heilongjiang) was evaluated. RESULTS: The ICFI was constituted by 7 parts: continued breast-eeding, bottle-feeding, dietary diversity for the past 24 h, frequency of feeding solids/semisolids for the past 24 h, food frequency for the past 7d, the supplementary time of the formula milk and other foods. The difference of ICFI score between urban and rural group was significant (P < 0.05). In urban, the ICFI score of children aged 6-8 months was lower than that of children aged 9-24 months. In urban, the negatively correlation between ICFI and WAZ WHZ was significant (P < 0.05). In rural, the negatively correlation between ICFI and WHZ was significant (P < 0.05), while the positively correlation between ICFI and HAZ was significant (P < 0.05). CONCLUSION: ICFI is effective to evaluate the infant feeding in China.

[Study on effects of eating behaviors intervention for 3-5 years old children in Beijing and Shanghai].

OBJECTIVE: To improve the unhealthy eating behaviors in 3-5 years old children and enrich the nutrition knowledge of their parents by the multi-channel health education intervention, and evaluate the effects of intervention. METHODS: By random multi-stage cluster sampling, 810 children (3-5 years old) and their parents were selected from Beijing and Shanghai respectively. The period of intervention was 6 months. Questionnaire surveys about children's eating behavior and the knowledge of their parents were conducted before and after the intervention. RESULTS: After the intervention, the proportion of partial eclipse and drinking beverage declined from 44.5% and 70.4% to 35.5% and 31.7% respectively. The proportion of having regular meal time, fixed dining place, eating by oneself, fix quantify diet and concentrating on food elevate from 80.0%, 87.3%, 73.4%, 32.1% and 27.1% to 92.1%, 90.2%, 83.7%, 44.3% and 40.1%. The awareness about nutrition in parents increased and the attitude to the children's eating behaviors improved after the intervention. CONCLUSION: The intervention has some effects on the improvement of the children' s unhealthy eating behaviors and their parents' nutrition knowledge and attitude.

[Association of pre-pregnancy body weight, gestational weight gain and postpartum weight retention among women in Beijing].

OBJECTIVE: To investigate the relationship of pre-pregnancy body weight, gestational weight gain and postpartum weight retention among women in Beijing. METHODS: Using a cohort design, 600 pregnant women who went to district obstetrics and gynecology hospital in Beijing to establish preconception health care card from 5(th) February to 15(th) March 2009 were recruited. A total of 112 subjects (109 with valid data), 20% of that in baseline, were followed up at 6 months after delivery.70 subjects (66 with valid data) were followed up at one year after delivery. Weight, weight changes and postpartum weight retention were measured for low weight (BMI < 18.5 kg/m(2)), normal weight (18.5 kg/m(2) ≤ BMI ≤ 24.0 kg/m(2)) and overweight or obesity (BMI > 24.0 kg/m(2)) group. RESULTS: The pre-pregnancy weight and antenatal weight were (54.8 ± 8.0) and (70.8 ± 9.3) kg respectively. Gestational weight gain was (16.0 ± 7.0) kg. The postpartum weight of 6 and 12 months were (60.5 ± 9.4) and (57.6 ± 8.6) kg respectively. Comparing to pre-pregnancy, postpartum weight retention in 6 months and 12 months were (5.7 ± 4.5) and (2.7 ± 4.5) kg, weight retention rates were (10.6 ± 8.6)% and (5.2 ± 9.3)%. Antenatal weight among low pre-pregnancy weight group, normal weight and overweight and obese women were (62.6 ± 5.7), (69.9 ± 6.6) and (84.2 ± 9.9) kg, and weight at postpartum 12 months among 3 groups were (49.3 ± 3.2), (56.5 ± 6.9) and (70.5 ± 6.0) kg respectively (F = 25.3, P < 0.01); At postpartum 12 months, low pre-pregnancy weight group ((5.6 ± 5.9) kg), overweight and obese women group ((4.7 ± 1.9) kg) postpartum weight retention was significantly higher than that of the normal weight group ((1.8 ± 4.3) kg) (F = 3.82, P < 0.05). CONCLUSION: The pre-pregnancy body weight is a key risk factor in weight gain during pregnancy and postpartum weight retention.

Lasting Effects of a Community-Based Self-Management Intervention for Patients With Type 2 Diabetes in China: Outcomes at 2-Year Follow-up of a Randomized Trial.

This research is to evaluate the lasting effects of a community-based self-management intervention for patients with type 2 diabetes at 2-year follow-up in China. Five hundred patients with diabetes were recruited and randomly divided into intervention group and control group. Eight times standardized self-management intervention group activities were conducted. The results of physical examination, biochemical laboratory examination, health behavior, and self-efficacy information were collected before intervention, 3 months after intervention, and 2 years after intervention. The total score for self-efficacy in the intervention group increased from 96.12 ± 17.48 to 112.90 ± 14.58 after intervention and decreased after 2 years (106.98 ± 18.03; F = 6.64, P = .0014). The number of days of self-blood glucose monitoring in the intervention group was increased from 1 day per week to 2 days per week after intervention, and 2 days per week at 2-year follow-up (F = 8.02, P = .0003). The frequency of average number of aerobic exercises in the intervention group increased from 6 days per week to 7 days per week after intervention and was 7 days per week at 2-year follow-up (F = 3.63, P = .0269). Community-based self-management group intervention for patients with diabetes has long-term effects.

Neck pain is the leading cause of disability burden in China: Findings from the Global Burden of Disease Study 2017.

BACKGROUND: Neck pain (NP) is a common musculoskeletal problem; however, the prevalence and years lived with disability (YLD) of NP in China are still unclear. This study sought to estimate the age-, sex- and province-specific prevalence and YLD of NP in China. METHODS: Adopting the methodology framework and analytical strategies used in the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2017), the prevalence and YLD of NP in China were estimated by age, sex, year, and provinces/regions. RESULTS: In China, the age-standardized point prevalence rate of NP was 4,532.6 per 100,000 persons in 1990 and increased slightly to 4,634.4 per 100,000 persons in 2017. The prevalence of NP was 48.0 million in 1990 and rose dramatically to 87.3 million in 2017 (an increase of 82.0%). The age-standardized YLD rate of NP was 454.0 per 100,000 persons in 1990, and there was a slight increase to 465.6 per 100,000 persons in 2017. The all-age YLD of NP was 4.8 million in 1990 and rose to 8.8 million in 2017 (which represents an increase of 81.1%). In 1990, NP was the third leading cause of YLD in China, and in 2017, NP was the leading cause of disability burden. CONCLUSIONS: This study estimated the prevalence and disability burden of NP in China. NP is currently the leading cause of disability burden in China; however, it is currently inadequately recognized and should receive further attention and be subject to further research.

Long-term effectiveness of group-based diabetes self-management on glycosylated haemoglobin for people with type 2 diabetes in community: a protocol of systematic review and meta-analysis.

INTRODUCTION: The rapid rise in the prevalence of diabetes has a negative impact on patients' quality of life. Diabetes self-management group education is cost-effective and efficient for patients to control blood glucose. However, there are no consistent standards for self-management group education, and its long-term effects (≥12 months) are unclear. Although a few systematic reviews evaluated the long-term effects, they did not make clear provisions on the content of self-management, and the number and sample size of included studies were small, which may lead to misclassification bias and reporting bias. Therefore, we plan to conduct this systematic review to evaluate the long-term effects of self-management group education and determine the effects of different self-management characteristics on glycosylated haemoglobin (HbA1c). METHODS AND ANALYSIS: We will retrieve Chinese databases (Wanfang, Chinese Hospital Knowledge Warehouse) and English databases (PubMed, ScienceDirect, EMBASE, Web of Science, Bailian Platform, Cochrane Central Register of Controlled Trials, Google Scholar) for randomly controlled trials and cluster randomly controlled trials of which participants are adults with type 2 diabetes mellitus. We will manually search citation lists and trial registries, and consult authors to obtain relevant articles. The retrieval time range will be from the establishment of the database to July 2020 to avoid omitting relevant studies. The primary outcome will be HbA1c. The secondary outcomes will be fasting plasma glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference and death event. Two reviewers will independently conduct article screening and assessment of risk of bias, with a third reviewer arbitrating if necessary. We will give priority to the use of meta-analysis to evaluate the pooled effects of all outcomes. For the outcomes of unrecognised sources of heterogeneity, missing data and less than three related studies, narrative synthesis approach will be used. ETHICS AND DISSEMINATION: Ethical approval is not required for this systematic review. We plan to present the findings in a peer-reviewed scientific journal, relevant and responsible organisations, and training meetings. PROSPERO REGISTRATION NUMBER: CRD42020209011.

The prevalence and year lived with disability of atopic dermatitis in China: Findings from the global burden of disease study 2019.

BACKGROUND: Atopic dermatitis (AD) is a chronic disease with growing prevalence and has become a global public health problem. However, little is known about the burden caused by AD in China. OBJECTIVE: To access the prevalence and burden of AD in China. METHODS: We estimated the prevalence and year lived with disability (YLD) of AD in China, by different age and sex groups. We also compared the burden of AD in China with other countries in the Group of Twenty (G20). We analyzed the changes in the number of AD patients and their YLDs by cause decomposition from 1990 to 2019. RESULTS: AD was the twenty-fourth leading cause of the burden of 369 diseases in China in 2019. From 1990 to 2019, the age-standardized prevalence and YLD rate of AD in China increased by 1.04% and 1.43% respectively, which were the second and the largest increase among the G20 and both higher than the global average (-4.29% and -4.14%). The number of patients with AD increased by 25.65%, of which 20.16% was due to population growth, 3.85% due to population aging, and 1.64% due to age-specific prevalence. Both the prevalence and YLD rate of AD were higher in 1 to 4 year-olds and 95+ years age group. Before the age of 10, the prevalence and YLD rate of AD in males were higher than those in females, while there was a marked sex shift at the ages of 10 to 14. CONCLUSION: AD is a serious public health problem in China. Substantial variations exist in burden due to AD between male and female, and in age groups. Considering these findings will be important for developing preventive strategies and treatments to reduce the burden of AD.

[Effects of pre-pregnancy BMI on blood glucose, blood pressure and weight in pregnancy].

OBJECTIVE: To investigate the effect of pre-pregnancy body mass index (BMI) on blood glucose, blood pressure and body weight during pregnancy in women. METHODS: 600 pregnant women in Beijing Haidian Maternal and Child Health Hospital were followed from 5th, Feb. 2009 to 15th, Mar. 2009 as a cohort study. Height, weight, blood glucose and blood pressure were detected in all the pregnant period. RESULTS: The pre-pregnancy BMI correlated significantly with gestational weight in different pregnancy phases (P < 0.05). The rates of impaired glucose tolerance, diabetes mellitus and hypertension during pregnant in overweight and obesity women are much higher than the rates in low and normal body weight women (P < 0.05). CONCLUSION: The pre-pregnancy BMI is a crucial risk factor of gestational hypertension, gestational high blood glucose and the gestational body weight. To carry out pre-pregnancy health education is an important measure to prevent complications of pregnancy.

Burden of depression in China, 1990-2017: Findings from the global burden of disease study 2017.

BACKGROUND: Depression in China has risen from the 15th leading cause of all-cause disability-adjusted life years (DALYs) in 1990 to the 10th in 2017. However, the burden of depression and the epidemiological trend in Chinese provinces remain unclear. This study aimed to estimate the prevalence and burden of depression among different sexes, ages, disease types and provincial administrative units in China. METHODS: Based on a general analysis of the Global Burden of Disease study (GBD) in 2017, we analyzed the age- sex- and province-specific prevalence and DALYs of depression in China from 1990 to 2017. RESULTS: From 1990 to 2017, the all-age prevalence rate of depression per 100,000 rose from 3224.6 (95% UI:2976.6-3509.1) to 3990.5 (95% UI: 3667.8-4353.0), and the DALY rate per 100,000 rose from 525.1 (95% UI: 373.5-719.0) to 607.4 (95% UI: 427.7-820.2). The prevalence rate decreased in the population aged 5-54 years, and increased in the population aged over 55 years. In 2017, the prevalence rate of females (5039.6, 95% UI: 4630.0-5502.8) was significantly higher than that of males (2984.9, 95% UI: 2736.0-3265.3). The prevalence and DALY rate increased in all provinces. However, the age-standardized prevalence and DALYs rate decreased in 31 provinces. CONCLUSIONS: Depression has gradually become a major public health issue in China. The government should take measures to prevent the development of depression immediately. Women and the elderly are at high risk for depression.

Prevalence and causes of vision loss in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019.

BACKGROUND: Vision loss is an important public health issue in China, but a detailed understanding of national and regional trends in its prevalence and causes, which could inform health policy, has not been available. This study aimed to assess the prevalence, causes, and regional distribution of vision impairment and blindness in China in 1990 and 2019. METHODS: Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used to estimate the prevalence of moderate and severe vision impairment and blindness in China and compare with other Group of 20 (G20) countries. We used GBD methodology to systematically analyse all available demographic and epidemiological data at the provincial level in China. We compared the age-standardised prevalences across provinces, and the changes in proportion of vision loss attributable to various eye diseases in 1990 and 2019. We used two different counterfactual scenarios with respect to population structure and age-specific prevalence to assess the contribution of population growth and ageing to trends in vision loss. FINDINGS: In 2019, the age-standardised prevalence was 2·57% (uncertainty interval [UI] 2·28-2·86) for moderate vision impairment, 0·25% (0·22-0·29) for severe vision impairment, and 0·48% (0·43-0·54) for blindness in China, which were all below the global average, but the prevalence of moderate and severe vision impairment had increased more rapidly than in other G20 countries from 1990 to 2019. The prevalence of vision loss increased with age, and the main causes of vision loss varied across age groups. The leading causes of vision impairment in China were uncorrected refractive error, cataract, and macular degeneration in both 1990 and 2019 in the overall population. From 1990 to 2019, the number of people with moderate vision impairment increased by 133·67% (from 19·65 to 45·92 million), those with severe vision impairment increased by 147·14% (from 1·89 to 4·67 million), and those with blindness increased by 64·35% (from 5·29 to 8·69 million); in each case, 20·16% of the increase could be explained by population growth. The contributions to these changes by population ageing were 87·22% for moderate vision impairment, 116·06% for severe vision impairment, and 99·22% for blindness, and the contributions by age-specific prevalence were 26·29% for moderate vision impairment, 10·91% for severe vision impairment, and -55·04% for blindness. The prevalence and specific causes of vision loss differed across provinces. INTERPRETATION: Although a comprehensive national policy to prevent blindness is in place, public awareness of visual health needs improving, and reducing the prevalence of moderate and severe vision impairment should be prioritised in future work. FUNDING: China National Key Research and Development Programme and Beijing Municipal Special Funds for Medical Research on Public Welfare Development and Reform.

The prevalence and years lived with disability caused by low back pain in China, 1990 to 2016: findings from the global burden of disease study 2016.

The aim of this work was to quantify the prevalence and years lived with disability (YLDs) caused by low back pain (LBP) in China from 1990 to 2016. Data from the GBD 2016 (Global Burden of Diseases, Injuries, and Risk Factors Study 2016) were used. We analyzed the age-sex-province-specific prevalence and YLDs for LBP of 33 provinces/regions in China. Comparisons were made with the data retrieved from the 1990 GBD study. We estimated that 5.45 × 10 individuals had LBP in 1990, which rose to 6.73 × 10 in 2016. The age-standardized prevalence of LBP decreased from 5.6% (95% uncertainty interval [95% UI]: 4.9%-6.3%) in 1990 to 4.2% (95% UI: 3.8%-4.8%) in 2016. The YLDs for LBP increased from 6.2 million (95% UI: 4.3-8.3 million) in 1990 to 7.7 million (95% UI: 5.4-10.2) in 2016. Age-standardized YLD rate (per 100,000 person) decreased from 637.5 (95% UI: 449.9-848.8) in 1990 to 481.9 (95% UI: 338.6-637.0) in 2016. A female preponderance was observed for prevalence and YLDs. The prevalence and YLDs rate for LBP slightly decreased from 1990 to 2016 in China; however, the total individuals and YLDs increased. Low back pain still ranks as the second leading cause of YLD burden disease in China. Considerable attention should be paid for LBP, especially in the female population.

Social and spatial inequalities in allostatic load among adults in China: a multilevel longitudinal study.

OBJECTIVES: To investigate potential geographical and socioeconomic patterning of allostatic load (AL) in China. DESIGN: Multilevel longitudinal study of the 2010 Chronic Disease Risk Factor Surveillance linked to the National Death Surveillance up to 31 December 2015. SETTING: All 31 provinces in China, not including Hong Kong, Macao or Taiwan. PARTICIPANTS: 96 466 ≥ 18 years old (women=54.3%). EXPOSURES: Person-level educational attainment and mean years of education in counties. OUTCOME: AL was measured using clinical guidelines for nine biomarkers: body mass index; waist circumference; systolic blood pressure; diastolic blood pressure; fasting blood glucose; total cholesterol; triglycerides; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol. RESULTS: Multilevel logistic regressions adjusted for sex, age, marital status, person-level education, county mean years of education and urban/rural reported ORs of 1.22 (95% CI 1.08 to 1.38) for 5-year all-cause mortality (n=3284) and 1.20 (1.04-1.37) for deaths from non-communicable diseases (n=2891) among people in AL quintile 5 (high) compared with quintile 1 (low). The median rate ratio estimated from unadjusted multilevel negative binomial regression showed AL clustered geographically (province=1.14; county=1.12; town=1.11; village=1.14). After adjusting for aforementioned confounders, AL remained higher with age (rate ratio 1.02, 95% CI 1.02 to 1.02), higher in women compared with men (1.17, 1.15 to 1.19), lower among singletons (0.83, 0.81 to 0.85) and widowers (0.96, 0.94 to 0.98). AL was lower among people with university-level compared with no education (0.92, 0.89 to 0.96), but higher in counties with higher mean education years (1.03, 1.01 to 1.05). A two-way interaction suggested AL was higher (1.04, 1.02 to 1.06) among those with university-level compared with no education within counties with higher mean years of education. Similar results were observed for alternative constructions of AL using 75th and 80th percentile cut-points. CONCLUSIONS: AL in China is patterned geographically. The degree of association between AL and person-level education seems to be dependent on area-level education, which may be a proxy for other contextual factors that warrant investigation.

Burden of vision loss associated with eye disease in China 1990-2020: findings from the Global Burden of Disease Study 2015.

AIMS: To assess the burden of vision loss due to eye disease in China between 1990 and 2015, and to predict the burden in 2020. METHODS: Data from the GBD 2015 (Global Burden of Diseases, Injuries, and Risk Factors Study 2015) were used. The main outcome measures were prevalence and years lived with disability (YLDs) for vision loss due to cataract, glaucoma, macular degeneration, other vision loss, refraction and accommodation disorders and trachoma. RESULTS: Prevalence for eye diseases increased steadily from 1990 to 2015, and will increase until 2020. From 1990 to 2015, the most common eye disorder was refraction and accommodation disorders. From 1990 to 2015, the vision loss burden due to eye disease decreased for those aged 0-14 years, and increased for those aged 15 years and above, with the most notable increases occurring among those aged 50 years and above. China ranked 10th when comparing YLDs for vision loss due to eye disease with the other members of the G20 (Group of Twenty, an international forum for the governments from 20 major economies) . Age-standardised YLD rates for vision loss due to eye disease declined in all 19 countries, except for China. The burden from vision loss due to eye disease ranked 12th and 11th among all causes of health loss in China in 1990 and 2015, respectively. CONCLUSION: Alone among major economies, China has experienced an increase in the burden of age-standardised vision loss from eye disease over the last two decades. In the future, China may expect a growing burden of vision loss due to population growth and ageing.