Social contacts patterns relevant to the transmission of infectious diseases in Suzhou, China following the COVID-19 epidemic.

BACKGROUND: The COVID-19 pandemic has profoundly affected human social contact patterns, but there is limited understanding regarding the post-pandemic social contact patterns. Our objective is to quantitatively assess social contact patterns in Suzhou post-COVID-19. METHODS: We employed a diary design and conducted social contact surveys from June to October 2023, utilizing paper questionnaires. A generalized linear model was utilized to analyze the relationship between individual contacts and covariates. We examined the proportions of contact type, location, duration, and frequency. Additionally, age-related mixed matrices were established. RESULTS: The participants reported an average of 11.51 (SD 5.96) contact numbers and a total of 19.78 (SD 20.94) contact numbers per day, respectively. The number of contacts was significantly associated with age, household size, and the type of week. Compared to the 0-9 age group, those in the 10-19 age group reported a higher number of contacts (IRR = 1.12, CI: 1.01-1.24), while participants aged 20 and older reported fewer (IRR range: 0.54-0.67). Larger households (5 or more) reported more contacts (IRR = 1.09, CI: 1.01-1.18) and fewer contacts were reported on weekends (IRR = 0.95, CI: 0.90-0.99). School had the highest proportion of contact durations exceeding 4 h (49.5%) and daily frequencies (90.4%), followed by home and workplace. The contact patterns exhibited clear age-assortative mixing, with Q indices of 0.27 and 0.28. CONCLUSIONS: We assessed the characteristics of social contact patterns in Suzhou, which are essential for parameterizing models of infectious disease transmission. The high frequency and intensity of contacts among school-aged children should be given special attention, making school intervention policies a crucial component in controlling infectious disease transmission.

Reductions in mortality resulting from COVID-19 quarantine measures in China.

BACKGROUND: To explore the impact of quarantine measures on the cause of death. METHODS: We use time series analysis with the data from death cause surveillance database of Suzhou from January 2017 to December 2019 to estimate the expected deaths from January to June 2020 and compare these expected deaths with the reported numbers of deaths. RESULTS: After the implementation of epidemic prevention measures in Suzhou in the first 3 months, overall number of all-cause deaths declined for 5.36, 7.54 and 7.02% compared with predicted numbers. The number of deaths from respiratory causes and traffic accidents declined shapely by 30.1 and 26.9%, totally. When quarantine measures were released (April-June), however, the observed numbers of total deaths exceeded the predicted deaths. People aged over 70 accounted for 91.6% of declined death number in respiratory causes and people aged over 60 accounted for 68.0% of declined death number in traffic accidents. Women over the age of 80 benefited the most from respiratory prevention (accounts for 41% of all reductions), whereas women aged over 60 benefited the most from traffic control (44%). CONCLUSIONS: Overall, the whole population benefited from the epidemic prevention measures especially elderly females. This study is a useful supplement to encourage the government to develop regular preventive measures under the era of normalized epidemic.

Effects of Cystatin C on Cognitive Impairment in Older Chinese Adults.

OBJECTIVE: To find a suitable dividing value to classify cystatin C and evaluate the association between cognition and levels of cystatin C. METHODS: Using data from the China Health and Retirement Longitudinal Study, We conducted a longitudinal analysis of a prospective cohort of 6,869 middle-aged and older Chinese without cognitive impairment at baseline. Levels of cystatin C were categorized into 2 groups by method of decision tree. Logistic regression models evaluated whether cystatin C was related to cognitive impairment. RESULTS: Respondents were categorized as lower levels of cystatin C and higher levels of cystatin C, cut-point was 1.11 mg/L. Higher levels of cystatin C was associated with the odds of cognitive impairment (OR, 1.56; 95% CI, 1.10-2.22) after multivariable adjustment. Respondents with higher levels of cystatin C had worse cognition scores. CONCLUSIONS: We found a suitable dividing value of cystatin C in middle-aged and older Chinese.

Changes in health inequalities for patients with diabetes among middle-aged and elderly in China from 2011 to 2015.

BACKGROUND: The purpose of this paper is to measure income-related health inequality among middle-aged and elderly patients with diabetes in China from 2011 to 2015 and to investigate factors that might be related to this inequality. METHODS: The data for this study were obtained from the China Health and Retirement Longitudinal Study that was carried out in 2011, 2013 and 2015. In total, 48,519 Chinese middle-aged and elderly population were included (15,457 in 2011, 16,576 in 2013 and 16,486 in 2015). A principal component analysis was performed to measure asset-based economic status. The concentration index was used to measure income-related inequality in patients with diabetes. Additionally, by used generalized linear model, we decomposed the concentration index to identify factors that explained wealth-related inequality in patients with diabetes. RESULTS: The prevalence of self-reported diabetes among middle-aged and elderly Chinese was 5.61, 7.49 and 8.99% in 2011, 2013 and 2015, respectively. The concentration indices and 95% confidence intervals for diabetes were 0.1359 (0.0525-0.0597), 0.1207 (0.0709-0.0789), 0.1021 (0.0855-0.0942) in 2011, 2013, and 2015, respectively, which are indicative of inequality that favors the rich. The decomposition of the concentration index showed that residence (39.38%), BMI (31.16%), education (7.28%), and region (6.09%) had positive contributions to the measured inequality in diabetes in China in 2015. Age (- 29.93%) had a negative contribution to inequality. CONCLUSION: The findings confirm a health inequality in diabetes that favor the rich. Furthermore, the inequality declined from 2011 to 2015. We suggest that policy and intervention strategies should be developed to alleviate this health inequality, such as narrow the gap between urban and rural areas by improving the urban-rural medical insurance scheme, implementing strategies to enhance hygiene health education, control obesity rate.

Longitudinal Average Glucose Levels and Variance and Risk of Stroke: A Chinese Cohort Study.

BACKGROUND: Diabetes is a known independent risk factor for stroke. However, whether higher glucose levels (126-139.9 mg/dl) can increase the risk of stroke in people without diabetes is still unknown. Moreover, as a fluctuating parameter, long-term glucose levels may also be related to the risk of stroke outcome. It is important to explore the correlation between long-term average blood glucose, as well as its variability, and stroke. METHODS: We used 40,975 clinical measurements of glucose levels and 367 measurements of glycated hemoglobin A1c levels from 12,321 participants without stroke to examine the relationship between glucose levels and the risk of stroke. Participants were from the Weitang Geriatric Diseases study, including 5,707 men and 6,614 women whose mean age at baseline was 60.8 years; 1,011 participants had diabetes, and 11,310 did not. We estimated the long-term average blood glucose level based on the multilevel Bayesian model and fit in Cox regression models, stratified according to diabetes status. RESULTS: Over a median follow-up period of 5 years, stroke developed in 279 of the 12,321 participants (244 without diabetes and 35 with). For people with an average glucose level of 126-139.9 mg per deciliter, compared with 90-99.9 mg per deciliter, the adjusted hazard ratio (HR) for total stroke was 1.78 (95% confidence interval (CI), 1.16-2.75), and the HR for levels higher than 140 mg per deciliter was 1.89 (95% CI, 1.09-3.29). Among those without diabetes whose glucose level was higher than 140 mg per deciliter, compared with 90-99.9 mg per deciliter, the adjusted HRs for total stroke and fatal stroke were 3.66 (95% CI, 1.47-9.08) and 5 (95% CI, 1.77-14.15), respectively. For a glucose standard deviation level higher than 13.83 mg per deciliter, compared with that lower than 5.91 mg per deciliter, the adjusted HR for total stroke was 2.31 (95% CI, 1.19-4.48). CONCLUSIONS: Our results suggest that higher average glucose levels (126-139.9 mg/dl) and variance may be risk factors for stroke, even among people without diabetes diagnosis.

Reclassified cognitive leisure activity and risk of cognitive impairment in Chinese older adults aged ≥80 years: A 16-year prospective cohort study.

AIM: There is accumulating evidence that participation in cognitive leisure activities might be related to a reduced risk of cognitive impairment. However, there is no consensus regarding the classification of cognitive leisure activities, and it cannot clearly define each activity and quantitatively evaluate the effect of it. In the present study, we propose a new classification method, and examine the relationship between reclassified cognitive leisure activities and cognitive function. METHODS: The analysis included 4830 participants of the Chinese Longitudinal Healthy Longevity Survey, who were aged >80 years and free of cognitive impairment at 1998. They were followed up six times. Six cognitive leisure activities were mainly grouped into intrapersonal and interpersonal cognitive leisure activity by categorical principal component analysis. Cox proportional hazards analysis was used to evaluate the relationship between reclassified cognitive leisure activities and the risk of cognitive impairment. RESULTS: After a median follow-up period of 16 years, 1763 participants suffered from cognitive impairment (Mini-Mental State Examination score <24). Reading newspapers or books, taking part in some social activities and sometimes playing cards or mahjong were associated with a decreased risk of cognitive impairment (P < 0.05 for all). In multivariable adjusted models, compared with those with lower intensities, the hazard ratios (95% confident intervals) of cognitive impairment were 0.86 (0.74-0.99) and 0.71 (0.60-0.83) for participants with high intensities of intrapersonal and interpersonal cognitive leisure activity, respectively. CONCLUSION: A high frequency of participation in intrapersonal and interpersonal cognitive leisure activities showed a lower risk of cognitive impairment among the oldest-old in China. Geriatr Gerontol Int 2019; 19: 1041-1047.

Determination of Clinical Cut-Off Values for Serum Cystatin C Levels to Predict Ischemic Stroke Risk.

BACKGROUND: The association between cystatin C and risk of ischemic stroke is inconsistent and the cut-off values of cystatin C are diverse in different articles. We aimed to investigate the association between cystatin C levels and the development of ischemic stroke and to explore the clinical cut-off values of serum cystatin C levels for ischemic stroke. METHODS: This prospective cohort study included 7658 participants from the China Health and Retirement Longitudinal Study who were free of cardiovascular diseases and cancer at baseline. A decision-tree model was used to find reasonable cut-off values for cystatin C levels. Logistic regression models were used to analyze the association between different levels of cystatin C and the risk of ischemic stroke. RESULTS: The whole cohort was divided into the following 3 groups according to the decision tree: group-low (<.901 mg/L), group-moderate (.901∼1.235 mg/L), and group-high (>1.235 mg/L). After 4 years of follow-up, we identified 156 cases of ischemic stroke. After adjusting for potential confounding factors, the odds ratios (95% confidence intervals) of ischemic stroke were 1.637 (1.048-2.556) for group-moderate and 2.326 (1.285-4.210) for group-high) compared with the low group of cystatin C. Subgroup analyses showed that the association between cystatin C levels and the incidence of ischemic stroke was more pronounced in males or old people than in females or young people. CONCLUSIONS: We found 2 suitable cut-off values for serum cystatin C levels and found that high levels of cystatin C were associated with an increased risk of ischemic stroke.

Disparity of the Chinese elderly's health-related quality of life between urban and rural areas: a mediation analysis.

OBJECTIVES: This study aimed to examine the urban-rural disparity in health-related quality of life (HRQoL) of the Chinese elderly and to explore the mediating roles of socioeconomic status (SES) and frequency of contact with children in the relationship between urban/rural areas and HRQoL. METHODS: This cross-sectional study used data from China Health and Retirement Longitudinal Study for 2015-2016, involving 12 369 Chinese aged 45 years and over. HRQoL of respondents was measured by three-level EuroQol five dimensions (EQ-5D-3L). SES, based on principal components analysis, was combined by the individual possessions of durable consumer goods and houses. Frequency of contact with children was derived from the responses to whether they live with children and how often they contact with them. Mediation analyses were performed to examine the mediating effects of SES and frequency of contact in the relationship between urban/rural areas and HRQoL. RESULTS: Urban respondents had higher scores of HRQoL than rural respondents (p<0.05). As SES and frequency of contact with children increased, the scores of HRQoL of the elderly went up as well. Mediation analyses proved the possible mediating effects of SES and frequency of contact in the relationship between urban/rural areas and HRQoL (0.0713 and 0.0064). The indirect effects induced by SES and frequency of contact were 65.45% and 5.90%, respectively. CONCLUSIONS: There was a significant difference in HRQoL between urban and rural middle-aged and elderly participants, which was partially mediated by urban-rural disparities in SES and frequency of contact with children. Higher SES and frequency of contact with children contributed to higher health status in the Chinese elderly.

The relationship between obesity subtypes based on BMI and cardio-cerebrovascular disease.

The purpose of this study was to identify the effects of various obesity phenotypes and metabolic abnormalities on cardio-cerebrovascular disease. We performed a large-scale, cross-sectional study including 10,089 participants aged ≥18 years in the National High-Technology district of Suzhou, China, from March 2016 to April 2016. Cardio-cerebrovascular disease included stroke and coronary heart disease. The prevalence rates of cardio-cerebrovascular disease among people with normal weight, overweight, and obesity in the unhealthy metabolism subgroup were higher than those among the three BMI groups in the healthy metabolism subgroup. Multivariate logistic regression analyses showed that after adjustment, the odds ratio (OR) of metabolically healthy obesity (MHO) with cardio-cerebrovascular disease was not statistically significant and that metabolically unhealthy obesity (MUO) was statistically associated with cardio-cerebrovascular disease, with an OR of 2.106 (1.294-3.429) in Model 1 and 3.043 (1.510-6.133) in Model 2. This study also found that regardless of whether in Model 1 or Model 2, the number of participants with MHO was much lower than that of those with MUO. Therefore, the obese population usually had metabolic abnormalities. Although MHO was not statistically associated with cardio-cerebrovascular disease, obesity should be controlled along with metabolic abnormalities to reduce the risk of cardio-cerebrovascular disease.

[Meta-analysis on the association of G894T polymorphism in endothelial nitric oxide synthase gene and essential hypertension in Chinese population].

OBJECTIVE: To evaluate the relationship between G894T (Glu298Asp) polymorphism in the endothelial nitric oxide synthase (eNOS) gene and essential hypertension in Chinese population from different regions. METHODS: Odds ratios (ORs) of G894T genotype and allele distributions in essential hypertension patients against healthy controls were analyzed. All the relevant studies were screened with poor-qualified studies eliminated. Meta-analysis software MIX (Meta-analysis with interactive explanations-version 1.71), was applied for investigating and analyzing heterogeneity among individual studies and summarizing the effects across studies, and the risk of publication bias was evaluated. RESULTS: A total of 1900 cases and 1216 controls from 10 studies were included. The heterogeneity between studies was significant (P = 0.013; P = 0.011) and there were substantial sources of publication bias (P = 0.049; P = 0.038). The pooled OR (with 95%CI) of GT + TT vs. GG genotype was 1.79 (1.33 - 2.42) (Z = 3.83, P < 0.001), and the pooled OR (with 95%CI) of T vs. G allele was 1.73 (1.32 - 2.27) (Z = 3.92, P < 0.001). CONCLUSION: In Chinese population, mainly the Hans ethnic group, 894G-->T mutation in the eNOS appeared to be related to essential hypertension.