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BMJ Open ; 9(4): e027696, 2019 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-30967410


OBJECTIVES: Chronic hepatitis B virus (HBV) infection is associated with a higher risk of liver diseases. Substantial uncertainty remains, however, about the associations of HBV infection with mortality from extrahepatic causes, especially from subtypes of cardiovascular diseases. We prospectively examined the association of chronic HBV infection with total and cause-specific mortality. DESIGN: Population-based prospective cohort study. SETTING: China Kadoorie Biobank in which participants from 10 geographically diverse areas across China were enrolled between 2004 and 2008. PARTICIPANTS: 475 801 participants 30-79 years of age without reporting major chronic diseases at baseline were enrolled. Hepatitis B surface antigen (HBsAg) was tested using an on-site rapid test strip at baseline. PRIMARY AND SECONDARY OUTCOME MEASURES: Total and cause-specific mortality. RESULTS: A total of 35 822 deaths were recorded during ~10 years of follow-up. In multivariable-adjusted analyses, compared with HBsAg-negative participants, HBsAg-positive participants had an increased risk of total mortality (HR=2.01, 95% CI: 1.91 to 2.12), which was higher in men (HR=2.16, 95% CI: 2.01 to 2.31) than in women (HR=1.74, 95% CI: 1.60 to 1.90). Presence of HBsAg was associated with increased mortality from liver cancer (1339 deaths, HR=13.95, 95% CI: 12.46 to 15.62), infections (410 deaths, HR=10.30, 95% CI: 8.21 to 12.94), digestive diseases (688 deaths, HR=6.83, 95% CI: 5.49 to 8.50), intracerebral haemorrhage (4077 deaths, HR=1.38, 95% CI: 1.14 to 1.68) and ischaemic heart diseases (4624 deaths, HR=1.31, 95% CI: 1.09 to 1.58). The positive association between HBsAg status and risk of death was stronger in participants younger than 50 years, smokers, physically active or non-hypertensive participants. CONCLUSIONS: Among Chinese adults, chronic HBV infection was associated with increased mortality from a range of hepatic and extrahepatic diseases.

Artigo em Inglês | MEDLINE | ID: mdl-29473843


Background: Oral clefts (OCs) are common human birth defects. Children with OCs in underdeveloped regions are more likely to suffer from poverty and hardship in their future lives. Here, we attempted to estimate the prevalence of OCs among live births in Gansu Province in 2008 to understand the epidemiologic pattern of the disease. Methods: A cross-sectional study was conducted from January 2008 to December 2008 in Gansu Province. The live births delivered between January and December 2008 with OCs were investigated through face-to-face questionnaire survey. Results: A total of 468 infants with OCs were identified among 347,137 live births in 2008 in Gansu Province, which yielded a prevalence of 1.35 per 1000 live births. The majority of these cases were CL (cleft lip) (prevalence = 0.85 per 1000 live births), and the prevalence of CLP (cleft lip and palate) and CP (cleft palate) was 0.34 and 0.11 per 1000 live births, respectively. We also found that the prevalence of OCs in Jiayuguan (3.39 per 1000 live births) and Dingxi (2.71 per 1000 live births) was higher than those of other cities in Gansu Province. Additionally, we failed to detect significant correlation between economic conditions of the cities and the prevalence of OCs in our study. Conclusions: The prevalence of OCs among live births in Gansu Province in 2008 was higher than the prevalence of OCs in other provinces in China. The high prevalence may reflect the need for further etiological studies to explore the potential risk factors in this region. In addition, more subtype information needs to be collected in future prevalence studies for better understanding of the epidemiologic pattern of the disease.

Cidades/estatística & dados numéricos , Fenda Labial/epidemiologia , Pobreza/estatística & dados numéricos , China/epidemiologia , Fissura Palatina/epidemiologia , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Nascimento Vivo , Masculino , Gravidez , Prevalência , Fatores de Risco
Int J Epidemiol ; 47(2): 399-408, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29161448


Background: Prenatal exposure to famine and adulthood obesity have been independently related to the risk of type 2 diabetes; however, little is known about the joint effects of these risk factors at different stages of life on adulthood diabetes risk. Methods: The analysis included 88 830 participants of the China Kadoorie Biobank, who were born around the time of the Chinese Great Famine and without diabetes, cardiovascular diseases, or cancer at baseline. We defined famine exposure subgroups as nonexposed (born between 1 October 1962 and 30 September 964), fetal-exposed (born between 1 October 1959 and 30 September 1961) and early-childhood exposed (born between 1 October 1956 and 30 September 1958). General obesity was assessed by body mass index (BMI: overweight ≥ 24.0, obesity ≥ 28.0) and abdominal obesity assessed by waist-to-hip ratio (WHR, men/women: moderate ≥ 0.90/0.85, high ≥ 0.95/0.90). Results: During a median 7.3 years (642 552 person-years) of follow-up, we identified 1372 incident cases of type 2 diabetes. Compared with nonexposed and early-childhood exposed participants combined as a single comparison group, fetal-exposed participants showed an increased risk of diabetes in adulthood [hazard ratio (HR) = 1.25; 95% confidence interval (CI): 1.07-1.45]. The association between general obesity and diabetes was consistent across subgroups according to famine exposure (P for interaction > 0.05). A stronger association between abdominal obesity and diabetes was observed in the fetal-exposed subgroup than in other subgroups (P for interaction = 0.025 in the whole population). This interaction was more obvious in women (P = 0.013) but not in men (P = 0.699). Compared with normal-BMI and -WHR participants, those with both general (BMI ≥ 24.0) and abdominal (WHR ≥ 0.90/0.85) obesity in adulthood had 5.32 (95% CI: 3.81-7.43)-, 3.13 (2.48-3.94)- and 4.43 (3.45-5.68)-fold higher risks if these were carried during, before and after times of famine, respectively. Conclusions: Coexistence of prenatal experience of undernutrition and abdominal obesity in adulthood was associated with a higher risk of type 2 diabetes.

Zhonghua Liu Xing Bing Xue Za Zhi ; 33(1): 106-10, 2012 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-22575122


To compare the differences on current ethical issues in the areas of epidemiological practice between China and America, to identify the major ethical problems existing in the epidemiological studies in China. Through searching and reviewing papers published on Chinese Journal of Epidemiology and American Journal of Epidemiology from Jan. 2006 to Dec. 2010, we made a comparison on ethical issues involved in the original studies that focusing on human beings. In total, 749 Chinese articles and 1221 American articles were recruited, with the following findings: (1) The proportion with announcements of "Informed consent by the subjects" was 29.24% in Chinese literature and 38.08% in the Americans (χ² = 16.02, P < 0.001). The proportion with "having had approvals from the ethic committees" was 29.24% in Chinese, while 38.08% in American (χ² = 604.40, P < 0.0001). (2) Both in China and America, there had been an increase of ethical issues in the last 5 years. (3) Articles derived from trial studies had better involvement on ethics than those from observational studies. (4) The level on ethical issues in the American Research Institutes exceeded those in China (5) American studies also had showed better ideas on Ethic issues on biological specimens collection and privacy protection, than those in Chinese studies. Among the studies on Chinese Journal of Epidemiology, the proportion of 'informed consent' was higher than in ethical review, but both ethical review and awareness on 'informed consent' had left far behind than the American Journal of Epidemiology. This could be seen at the institution level of the writers, during specimen collection and privacy protection, as well as at the overall level. The results reminded us that the Departments of Technology Management should spend more efforts on the improvement of public education regarding ethics for researchers and to update the process of edition for Journals as well as to reinforce the rules of ethics in epidemiological research.

Epidemiologia , Ética Médica , Publicações Periódicas como Assunto , China , Estados Unidos
Zhonghua Liu Xing Bing Xue Za Zhi ; 31(6): 659-61, 2010 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-21163098


OBJECTIVE: To investigate the number and distribution of un-repaired cleft lip/palate patients in Gansu province. METHODS: A census was conducted by staff members of the health system and Population and Family Planning Committee (PFPC) in Gansu province. Standardized - Questionnaires were administered to collect demographic, domestic and diagnosis-related information. RESULTS: In 2008, the total number of un-repaired cleft lip/palate patients was 4675, with a detection rate of 1.84/10 000 in Gansu province. Rates of detection were higher in males (2.11/10 000), young age group (4.86/10 000), rural areas (2.23/10 000), poor counties (2.19/10 000) than in females (1.43/10 000), medium (0.97/10 000)/old age group (0.68/10 000), township areas (0.62/10 000), or richer counties (1.35/10 000). Among all the cities and prefectures of Gansu, Baiyin city (2.7/10 000) had the highest while Jinchang city (0.7/10 000) had the lowest prevalence rates. CONCLUSION: Un-repaired cleft lip/palate had been a disease burden to Gansu province, especially in the rural area and poorer counties.

Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem