Antagonizing Effects of Chromium Against Iron-Decreased Glucose Uptake by Regulating ROS-Mediated PI3K/Akt/GLUT4 Signaling Pathway in C2C12.

To investigate the effect of chromium and iron on glucose metabolism via the PI3K/Akt/GLUT4 signaling pathway. Skeletal muscle gene microarray data in T2DM (GSE7014) was selected using Gene Expression Omnibus database. Element-gene interaction datasets of chromium and iron were extracted from comparative toxicogenomics database (CTD). Gene ontology (GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using DAVID online tool. Cell viability, insulin-stimulated glucose uptake, intracellular reactive oxygen species (ROS) level, and protein expression level were measured in C2C12 cells. The bioinformatics research indicated that PI3K/Akt signaling pathway participated in the effects of chromium and iron associated with T2DM. Insulin-stimulated glucose uptake level was significantly higher in chromium picolinate (Cr group) and lower in ammonium iron citrate (FA group) than that for the control group (P < 0.05); chromium picolinate + ammonium iron citrate (Cr + FA group) glucose uptake level was higher than that for the FA group (P < 0.05). Intracellular ROS level was significantly higher in the FAC group than that for the control group (P < 0.05), and that for the Cr + FA group was lower than that for the FA group (P < 0.05). p-PI3K/PI3K, p-Akt/Akt, and GLUT4 levels were significantly lower in the FA group than that for the control group (P < 0.05), and the Cr + FA group had higher levels than the FA group (P < 0.05). Chromium might have a protective effect on iron-induced glucose metabolism abnormalities through the ROS-mediated PI3K/Akt/GLUT4 signaling pathway.

Social capital, depressive symptomatology, and frailty among older adults in the western areas of China.

We aimed to explore the relationship between social capital (SC) and frailty, and the mediation role of depressive symptoms in this relationship. A cross-sectional study among 2,591 older adults aged ≥60 years old was conducted from September 2020 to May 2021. SC, depressive symptoms, and frailty were measured using the social capital scale, the 9-item patient health questionnaire, and the FRAIL scale, respectively. The mediation model was tested by Bootstrap PROCESS. After controlling for socio-demographical covariates, the SC was negatively correlated with frailty (r = -0.07, P = 0.001), and depressive symptomatology (r = -0.08, P<0.001); while the depressive symptomatology was positively correlated with frailty (r = 0.33, P<0.001). Logistic regression results showed that SC was associated with a lower risk of frailty (OR = 0.94; 95% CI: 0.92-0.97; P<0.001). Depressive symptomatology partially mediated (explained 36.4% of the total variance) the association between SC and frailty. Those findings suggest that SC may protect older adults from frailty by reducing depressive symptoms. Prevention and intervention implications were also discussed.

Association of living arrangements with all-cause mortality among older adults: a propensity score-matched cohort study.

BACKGROUND: Many studies exist on the living arrangements and health status of older adults, but the findings have been inconsistent. Therefore, we examined the relationship between living arrangements and all-cause mortality in older adults. METHODS: This perspective study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018. We used a sample aged 65 years and over included in the study in 2011. Propensity score matching was performed to minimize bias and Cox proportional hazards regression models were conducted. RESULTS: A total of 7,963 participants were included. Of these, 1,383 were living alone, 6,424 were living with families, and 156 were living in nursing homes. In the propensity score-matched cohort, older adults living alone had a significantly lower risk of all-cause mortality than those living with families (hazard ratio 0.85; 95% confidence intervals 0.76 to 0.95). Living alone was prominently associated with a decline in mortality compared with living in nursing homes (hazard ratio 0.61; 95% confidence intervals 0.44 to 0.84). There was no significant difference in mortality between living in nursing homes and living with families (hazard ratio 1.19; 95% confidence intervals 0.89 to 1.60). Subgroup analyses indicated that there was no significant interaction with age, sex, education, or residence. CONCLUSIONS: The risk of all-cause mortality was significantly lower in older adults living alone than in those living with families or living in nursing homes. This article's findings suggest the need to adopt multiple approaches to meet the needs of senior care services.

Association study of selenium-related gene polymorphisms with geriatric depression in China.

Depression is a common mental health problem in older adults, but its cause remains unclear. Selenium is an essential micronutrient and a powerful antioxidant in the brain and nervous system. Several recent studies have reported a relationship between selenium levels and depression. This study aimed to investigate the relationship between 4 genes co-associated with selenium and geriatric depression. 1486 participants were included in this study from 5 communities in Ningxia Hui Autonomous Region during 2013 to 2016 in a health examination program for urban and rural residents. Polymorphisms of 4 selenium-related genes were analyzed in 1266 healthy volunteers and 220 patients with depression. The genotyping of rs2830072, rs2030324, rs6265, rs11136000, rs7982, rs10510412, rs1801282, rs1151999, rs17793951, rs709149, rs709154, and rs4135263 were performed by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) technology. The analysis of selenium-related genes showed that there were significant differences between depression and controls for allele and genotype frequencies of peroxisome proliferator activated receptor gamma (PPARG) rs10510412, rs709149, and rs709154 (all P < .05). In this study, when adjusting for age, sex, marital status, education, and alcohol consumption, results showed that rs709149 and rs709154 were still significantly correlated with geriatric depression in the codominant, dominant, overdominant, and log-additive models. Logistic regression analysis showed that rs709149 AG or GG gene carriers were 1.630 and 1.746 times more susceptible to depression than AA gene carriers (95% CI = 1.042-2.549; 1.207-2.526). The results of this study suggest that the rs709149 polymorphism of the selenium-related gene PPARG is a genetic risk factor for depression in older adults.

Trimethylamine N-Oxide and Related Metabolites in the Serum and Risk of Type 2 Diabetes in the Chinese Population: A Case-Control Study.

Background: Trimethylamine N-oxide (TMAO) and its precursors have an association with type 2 diabetes mellitus (T2DM); however, the evidence is unclear. The current study examined the association of serial measures of serum TMAO and related metabolite concentrations with the risk of T2DM. Methods: Our study was designed as a community case-control study with 300 participants (150 T2DM and 150 non-T2DM). We examined the association of serum concentrations of TMAO and its related metabolites [trimethylamine, choline, betaine, and L-carnitine] using UPLC-MS/MS. The association between these metabolites and the risk of T2DM was analyzed using a restricted cubic spline and binary logistic regression. Results: A higher serum choline concentration was significantly associated with an increased risk of T2DM. Serum choline > 22.62 µmol/L was independently associated with an increased risk of T2DM, and the odds ratio was 3.615 [95% CI: (1.453,8.993), P = 0.006]. Similarly, serum betaine and L-carnitine concentrations had a markedly decreased risk of T2DM even after adjusting for the traditional risk factors for T2DM and betaine (0.978 [95% CI:0.964-0.992], P = 0.002) and L-carnitine (0.949 [95% CI: 0.9222-0.978], P = 0.001), respectively. Conclusion: Choline, betaine, and L-carnitine are associated with the risk of T2DM and may be appropriate risk markers to protect high-risk individuals from T2DM.

Mediating role of depressive symptoms on the relationship between sleep duration and cognitive function.

Although some studies have shown the association between sleep duration and cognitive impairment is positive, the mechanism explaining how sleep duration is linked to cognition remains poor understood. The current study aims to explore it among Chinese population. A cross-sectional study of 12,589 participants aged 45 or over was conducted, cognition was assessed by three measures to capture mental intactness, episodic memory, and visuospatial abilities. The Center for Epidemiologic Studies Depression Scale 10 (CES-D10) was administered during the face-to-face survey to assess depressive status. Sleep duration was reported by the participants themselves. Partial correlation and linear regression were used to explore the association between sleep duration, cognition, and depression. The Bootstrap methods PROCESS program was used to detect the mediation effect of depression. Sleep duration was positively correlated with cognition and negatively with depression (p < 0.01). The CES-D10 score (r = - 0.13, p < 0.01) was negatively correlated with cognitive function. Linear regression analysis showed sleep duration was positively associated with cognition (p = 0.001). When depressive symptoms were considered, the association between sleep duration and cognition lost significance (p = 0.468). Depressive symptoms have mediated the relationship between sleep duration and cognitive function. The findings revealed that the relationship between sleep duration and cognition is mainly explained by depressive symptoms and may provide new ideas for interventions for cognitive dysfunction.

Effects of common plastic products heat exposure on cognition: Mediated by gut microbiota.

Considering plastic exposure patterns in modern society, the effects of exposure to leachate from boiled-water treated plastic products on cognitive function was probed in mice through changes in gut microbiota diversity. In this study, Institute for Cancer Research (ICR) mice were used to establish drinking water exposure models of three popular kinds of plastic products, including non-woven tea bags, food-grade plastic bags and disposable paper cups. 16S rRNA was used to detect changes in the gut microbiota of mice. Behavioral, histopathology, biochemistry, and molecular biology experiments were used to evaluate cognitive function in mice. Our results showed that the diversity and composition of gut microbiota changed at genus level compared to control group. Nonwoven tea bags-treated mice were proved an increase in Lachnospiraceae and a decreased in Muribaculaceae in gut. Alistipes was increased under the intervention of food grade plastic bags. Muribaculaceae decreased and Clostridium increased in disposable paper cups group. The new object recognition index of mice in the non-woven tea bag and disposable paper cup groups decreased, and amyloid ß-protein (Aß) and tau phosphorylation (P-tau) protein deposition. Cell damage and neuroinflammation were observed in the three intervention groups. Totally speaking, oral exposure to leachate from boiled-water treated plastic results in cognitive decline and neuroinflammation in mammals, which is likely related to MGBA and changes in gut microbiota.

A predictive model for the risk of cognitive impairment in community middle-aged and older adults.

Identifying individuals at high risk of cognitive impairment is essential for treatment and prevention strategies. We aimed to develop and validate a prediction model for evaluating the risk of cognitive impairment. Data were from the China Family Panel Studies (CFPS) and China Health and Retirement Longitudinal Study (CHARLS). A total of 14,265 subjects were selected for model development. The area under the curve(AUC) for the training, internal, and external validation sets were 0.775, 0.920, and 0.727, respectively. This model could be used to identify middle-aged and older adults aged 45 years and older at high risk of cognitive impairment.

Effects of oral exposure to leachate from boiled-water treated plastic products on gut microbiome and metabolomics.

By simulating plastic exposure patterns in modern society, the impact of daily exposure to plastic products on mammals was explored. In this study, Institute for Cancer Research (ICR) mice were used to establish drinking water exposure models of three popular kinds of plastic products, including non-woven tea bags, food-grade plastic bags and disposable paper cups. Feces and urine of mice were collected for gut microbiome and metabolomics analysis. Our results showed that the diversity and composition of gut microbiota changed at genus level compared to control group. Lactobacillus, Parabacteroides, Escherichia-shigella and Staphylococcus decreased while Lachnospiraceae increased treated with non-woven tea bags. Escherichia-shigella and Alistipes increased while Parabacteroides decreased treated with food grade plastic bags. Muribaculaceae decreased in the gut microbiota of mice treated with disposable paper cups. Metabolomics has seen changes in the number of metabolites and enrichment of metabolic pathways related to inflammatory responses and immune function. Inflammatory responses were found in histological and biochemical examination. In summary, this study demonstrated that long-term oral exposure to leachate form boiled-water treated plastic products might have effects on gut microbiome and metabolome, which further provided new insights about potential adverse effects for human beings.

Association of Parental Famine Exposure With Offspring Depression and Cognition Function.

Background: The effect of early exposure to famine on depression and cognition in adulthood has been shown, but the intergenerational association of famine remain to be explored. This study focused on exploring the association of parental famine exposure with depression and cognition in the offspring. Methods: Based on the Chinese Family Panel Studies database, which is a longitudinal survey, we included 5,150 individuals born between 1959 and 1961 and divided them into fetal-exposed, infancy-exposed (birth year = 1957-1958), school-age-exposed (birth year = 1949-1956), adolescent-exposed (birth year = 1946-1948), and unexposed groups. We used one-way analysis of variance, multiple linear regression, and one follow-up measurement to analyze the association between parental famine exposure and offspring depression and cognitive function. Results: Compared with the unexposed group, the correlations between parental famine exposure during fetal period and their cognitive function (mother: ß = -1.614, 95% CI: -2.535, -0.693; p = 0.001; father: ß = -2.153, 95% CI: -3.104, -1.202, p < 0.001) were significant. For the offspring, there was a negative correlation between famine exposure of fathers during the fetal period and depression in their offspring (ß = -0.477, 95% CI: -0.907, -0.047; p = 0.030). There was a negative correlation between maternal famine exposure during the infant and adolescent period and cognitive function in the offspring (math test: ß = -0.730, 95% CI: -1.307, -0.153; p = 0.013; word test: ß = -2.346, 95% CI: -4.067, -0.625; p = 0.008). Limitations: Not all variables related to depression and cognition function were included in the CFPS database, and the other unknown or unmeasured confounders may explain our results.

The association of depressive symptoms with disability among adults in China.

BACKGROUND: The symptoms that patients with major depressive disorder (MDD) experience are the dominant contributing factors to its heavy disease burden. This study sought to identify key symptoms leading to disability in patients with MDD. METHODS: Subjects consisted of patients who had a 12-month MDD diagnosis based on the China Mental Health Survey (CMHS). World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess the degree of disability. The associations between depressive symptoms and disability were analyzed using a linear regression and logistic regression with a complex sampling design. RESULTS: Of the 32,552 community residents, 655 patients were diagnosed with 12-month MDD. The disability rate due to MDD was 1.06% (95% CI: 0.85%-1.28%) among adults in Chinese community and 50.7% (95% CI: 44.3%-57.1%) among MDD patients. Depression was associated with all functional losses measured by the WHODAS. Feelings of worthlessness in life or inappropriate guilt, and psychomotor agitation or retardation were the key symptoms related to disability. Economic status, co-morbidity of physical diseases or anxiety disorders were correlates of disability scores. LIMITATIONS: The disability rate might be underestimated due to the exclusion of MDD patients living in hospitals. The effect of treatments on disability was excluded. CONCLUSIONS: Psychological symptoms, not somatic symptoms, contribute to disability in MDD patients. Disability worsens when physical diseases or anxiety disorders are present. More attention could be paid to psychological symptoms, physical diseases, and anxiety disorders in MDD patients with disabilities.

Association between reading and depression in Chinese adults.

Qualitative evidences have shown that having the habit of reading might be beneficial for mental health. The present study aims to examine the relationship between reading and depression. National cross-sectional survey data of adults aged >40 years in mainland China were used. The Center for Epidemiological Studies Depression Scale questionnaire was utilized to detect depression status. Multilevel binary logistic and linear regression models were employed to reveal the association, and restricted cubic spline with 4 knots was adopted to describe the non-linear association of reading quantity and depression. The prevalence of depression was 13.02% in the target population. It was found that the habit of reading was negatively associated with depression, the odds ratio was 0.809 (95% confidence interval: 0.657-0.997). Diverse association between reading and depression was observed in different age groups, and a significant association was identified among the elderly, but not in the middle-aged population. Restricted cubic spline showed several books read per year might lower the risk of depression and 20-items Center for Epidemiological Studies Depression Scale score. A lower prevalence of depression was observed in the target population. The habit of reading was negatively associated with depression. Age-specific association was observed. It is worth paying attention to the reading habit that could be beneficial in the elderly for mental health intervention, but it needs to be confirmed by experimental study.

Prevalence of Chronic Diseases and Alterations of Gut Microbiome in People of Ningxia China During Urbanization: An Epidemiological Survey.

The continuous development of urbanization has dramatically changed people's living environment and lifestyle, accompanied by the increased prevalence of chronic diseases. However, there is little research on the effect of urbanization on gut microbiome in residents. Here we investigated the relation between living environment and gut microbiota in a homogenous population along an urban-rural gradient in Ningxia China. According to the degree of urbanization, the population is divided into four groups: mountainous rural (MR) represents non-urbanized areas, mountainous urban (MU) and plain rural (PR) represent preliminary urbanization, and plain urban (PU) is a representative of complete urbanization. Studies have found that with the deepening of urbanization, the prevalence of chronic diseases, such as diabetes, dyslipidemia, fatty liver, gallstones, and renal cysts, have gradually increased. The intestinal richness and diversity of the microbial community were significantly reduced in the PR and the PU groups compared with the MR and the MU groups. Based on linear discriminant analysis selection, the significantly enriched genera Faecalibacterium, Prevotella, and Pseudobutyrivibrio in the MR group gradually decreased in the MU, the PR, and the PU groups. Effect size results revealed that both residence and diet had an effect on intestinal microbiota. Our results suggested that the disparate patterns of gut microbiota composition were revealed at different levels of urbanization, providing an opportunity to understand the pathogenesis of chronic diseases and the contribution of the "rural microbiome" in potential protection against the occurrence of chronic diseases.

Association Between Reading Habit and Sleep Among Age Over 40 Years Community Residents: A Population-Based Evidence Study.

PURPOSE: Sleep disturbance is a paramount public health concern that besets many modern middle-aged and elderly community residents. Reading is important to adults as it facilitates the completion of daily tasks, and might be associated with sleep issues. The present study aimed to analyze the association between reading and sleep using Chinese national survey data. PATIENTS AND METHODS: The 2018 China Family Panel Studies survey data were used, and the target sample was extracted according to age (>40 years). Reading behavior and reading quantity were chosen as independent variables, and sleep duration, sleep-onset time, and sleep quality were selected as dependent variables. A multilevel mixed linear/ordinal logistic regression model was employed to evaluate the association, and restricted cubic splines with 4 knots were employed to flexibly model the association of reading quantity and sleep duration. RESULTS: A total of 18,740 adults were selected, and the reading rate was 15.04%. Reading habit was significantly negatively associated with weekday sleep duration, but not with duration at weekends, as determined from the full set of confounders adjusted models. Reading behavior was also associated with delayed sleep-onset time (OR: 0.935, 95% CI: 0.908-0.964), but not with sleep quality. Reading quantity showed a nonlinear relationship with sleep duration, appropriate reading quantity was related with long sleep duration. CONCLUSION: Reading was associated with short sleep duration on weekdays, but not with sleep quality. Furthermore, reading was related to late sleep-onset time, and for the middle-aged and elderly Chinese populations, appropriate reading quantity was related with long sleep duration.

Early-life exposure to famine and late-life depression: Does leukocyte telomere length mediate the association?

BACKGROUND: A positive association between early-life famine exposure and depression has been demonstrated. However, the mechanisms by which famine exposure in early life leads to late-life depression remains unclear. The present study examines the impact of leukocyte telomere length (LTL) and/or religiosity on the relationship between early-life famine exposure and late-life depression in a Chinese minority sample. METHODS: A cross-sectional study of community-dwelling adults aged 55 or older was conducted in the Ningxia province of western China from 2013 to 2016. Multivariate ordinal logistic regression was used to examine the association between famine exposure and depression status, and a series mediation model was constructed to identify the mediation role of LTL and religiosity. RESULTS: Compared with famine exposure during adulthood, fetal famine exposure was associated with a higher risk of late-life depression (adjusted odds ratio of 3.17, 95% CI: 1.36-7.38). A cumulative effect of fetal famine exposure on the risk of late-life depression was observed. Participants born in 1961 (the third year of the famine) had the strongest association with late-life depression. LTL played a mediating role in the association between famine exposure and depression which accounted for 21% of the total effect. LIMITATIONS: The cross-sectional design prevents causal inferences regarding the relationships between famine and depression. CONCLUSIONS: Fetal famine exposure was associated with an increased risk of late-life depression in a Chinese minority community-dwelling population. Telomere shortening partially mediated this association.

Expression Profile Analysis of Selenium-Related Genes in Peripheral Blood Mononuclear Cells of Patients with Keshan Disease.

Keshan disease (KD) is an endemic cardiomyopathy, which mainly occurs in China. Selenium deficiency is believed to play an important role in the pathogenesis of KD, but the molecular mechanism of selenium-induced damage remains unclear. To identify the key genes involved in selenium-induced damage, we compared the expression profiles of selenium-related genes between patients with KD and normal controls. Total RNA was isolated, amplified, labeled, and hybridized to Agilent human 4 × 44 K whole genome microarrays. Selenium-related genes were screened using the Comparative Toxicogenomics Database. The microarray data were subjected to single-gene and gene ontology (GO) expression analysis using R Studio and Gene Set Enrichment Analysis (GSEA) software. Quantitative real-time PCR was conducted to validate the microarray results. We identified 16 upregulated and 11 downregulated selenium-related genes in patients. These genes are involved in apoptosis, metabolism, transcription regulation, ion transport, and growth and development. Of the significantly enriched GO categories in KD patients, we identified four apoptosis-related, two metabolism-related, four growth and development-related, and four ion transport-related GOs. Based on our results, we suggest that selenium might contribute to the development of KD through dysfunction of selenium-related genes involved in apoptosis, metabolism, ion transport, and growth and development in the myocardium.

The association between awareness and behavior concerning the need for protection when using pesticide sprays and neurologic symptoms: A latent class cluster analysis.

Pesticide exposure is a major health risk factor among agricultural workers, and poor protective behavior and a lack of awareness concerning the risks of pesticide use in developing countries may increase the intensity of pesticide exposure. This cross-sectional study aimed to explore the relationship between neurologic symptoms and protective behavior and awareness in relation to pesticide use in China. Latent class cluster analysis was used to categorize participants into 3 latent cluster subgroups, namely, a poor protective behavior subgroup, an excellent protective awareness and behavior subgroup, and a poor protective awareness subgroup, using a person-centered approach. Multivariate regression models were used to detect the association between the latent class cluster subgroups and self-reported neurologic symptoms. The results showed that poor protective behavior in pesticide use was an important negative predicator of neurologic symptoms such as reduced sleep quality, frequency of nightmares, debility, hypopsia, and hypomnesis. These findings suggest that targeted interventions for agricultural workers, especially local greenhouse farmers, are urgently needed to improve pesticide protection behavior.

Comparison of Self-Rated Health among Characteristic Groups of Vegetable Greenhouse Farmers Based on Exposure to Pesticide Residuals: A Latent Profile Analysis.

OBJECTIVE: The current study was aimed at using a latent profile analysis (LPA) model to classify greenhouse farmers into a potential cluster according to their exposure to pesticide residuals. Further, the association between self-rated health (SRH) and the cluster exposed to pesticide residual was explored. METHODS: Four hundred sixty-four farmers from vegetable greenhouses were selected, their SRH information was gathered through questionnaires from the "Self-Rated Health Measurement Scale (SRHMS)" Version 1.0, and the corresponding pesticide residuals were detected in a laboratory. The linear mixed regression model was employed for association assessment. RESULTS: Two latent clusters were extracted as samples, and the results showed that a high amount of pesticide residual accounted for poor physical health, but did not show statistical significance. In addition, an inverse significant association was observed between psychosocial symptoms and negative emotion and pesticide residual level. Furthermore, a diversity of significant relationship was observed in social health and its corresponding dimensions with latent cluster. CONCLUSIONS: LPA offers a holistic and parsimonious method to identify high-risk health clusters of greenhouse workers in various health aspects and allows for a personality-targeted intervention by a local health department.

Relationship between cumulative exposure to pesticides and sleep disorders among greenhouse vegetable farmers.

BACKGROUND: In the northern region of China, many greenhouse vegetable farmers are exposed to high cumulative levels of pesticides due to long-term work in greenhouses that impacts their health. The aim of the current study was to identify the relationship between cumulative pesticide exposure and sleep disorders among farmers in Yinchuan, Northwest China. METHODS: A cross-sectional study was conducted for 3 consecutive years in 2015, 2016 and 2017. Using a random sampling to select the resident teams, 1366 participants were enrolled, and information was collected via face-to-face interviews by trained investigators. Ordinal logistic, multinomial logistic and poisson logistic regression models were used to identify the associations between cumulative exposure intensity (CEI) and sleep disorders. RESULTS: High CEI (OR = 1.56, 95% CI: 1.02-3.38) was associated with short sleep duration when compared with low CEI in the Full Model. CEI was not associated with long sleep duration. Self-rated sleep quality was associated with medium (OR = 1.46, 95% CI: 1.10-2.00) and high (OR = 2.50, 95% CI: 1.83-3.40) CEI. Similarly, having difficulty sleeping was associated with medium (OR = 1.52, 95% CI: 1.02-2.24) and high (OR = 1.74, 95% CI: 1.16-2.62) CEI. Differences in the associations by gender were also noted. CONCLUSION: CEI was associated with sleep disorders, and gender differences were observed. Efforts should be made by local governments to address sleep problems that result from cumulative pesticide exposure in farmers, and gender differences should be considered.

Prevalence of mental disorders in China: a cross-sectional epidemiological study.

BACKGROUND: The China Mental Health Survey was set up in 2012 to do a nationally representative survey with consistent methodology to investigate the prevalence of mental disorders and service use, and to analyse their social and psychological risk factors or correlates in China. This paper reports the prevalence findings. METHODS: We did a cross-sectional epidemiological survey of the prevalence of mental disorders (mood disorders, anxiety disorders, alcohol-use and drug-use disorders, schizophrenia and other psychotic disorders, eating disorder, impulse-control disorder, and dementia) in a multistage clustered-area probability sample of adults from 157 nationwide representative population-based disease surveillance points in 31 provinces across China. Face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists with the Composite International Diagnostic Interview, the Structured Clinical Interview for DSM-IV Axis I disorders, the Community Screening Instrument for Dementia from the 10/66 dementia diagnostic package, and the Geriatric Mental State Examination. Data-quality control procedures included logic check by computers, sequential recording check, and phone-call check by the quality controllers, and reinterview check by the psychiatrists. Data were weighted to adjust for differential probabilities of selection and differential response as well as to post-stratify the sample to match the population distribution. FINDINGS: 32 552 respondents completed the survey between July 22, 2013, and March 5, 2015. The weighted prevalence of any disorder (excluding dementia) was 9·3% (95% CI 5·4-13·3) during the 12 months before the interview and 16·6% (13·0-20·2) during the participants' entire lifetime before the interview. Anxiety disorders were the most common class of disorders both in the 12 months before the interview (weighted prevalence 5·0%, 4·2-5·8) and in lifetime (7·6%, 6·3-8·8). The weighted prevalence of dementia in people aged 65 years or older was 5·6% (3·5-7·6). INTERPRETATION: The prevalence of most mental disorders in China in 2013 is higher than in 1982 (point prevalence 1·1% and lifetime prevalence 1·3%), 1993 (point prevalence 1·1% and lifetime prevalence 1·4%), and 2002 (12-month prevalence 7·0% and lifetime prevalence 13·2%), but lower than in 2009 (1-month prevalence 17·5%). The evidence from this survey poses serious challenges related to the high burdens of disease identified, but also offers valuable opportunities for policy makers and health-care professionals to explore and address the factors that affect mental health in China. FUNDING: National Health Commission of Health (Ministry of Health) and Ministry of Science and Technology of China.