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Microglia regulate synaptic function in various ways, including the microglial displacement of the surrounding GABAergic synapses, which provides important neuroprotection from certain diseases. However, the physiological role and underlying mechanisms of microglial synaptic displacement remain unclear. In this study, we observed that microglia exhibited heterogeneity during the displacement of GABAergic synapses surrounding neuronal soma in different cortical regions under physiological conditions. Through three-dimensional reconstruction, in vitro co-culture, two-photon calcium imaging, and local field potentials recording, we found that IL-1ß negatively modulated microglial synaptic displacement to coordinate regional heterogeneity in the motor cortex, which impacted the homeostasis of the neural network and improved motor learning ability. We used the Cre-Loxp system and found that IL-1R1 on glutamatergic neurons, rather than that on microglia or GABAergic neurons, mediated the negative effect of IL-1ß on synaptic displacement. This study demonstrates that IL-1ß is critical for the regional heterogeneity of synaptic displacement by coordinating different actions of neurons and microglia via IL-1R1, which impacts both neural network homeostasis and motor learning ability. It provides a theoretical basis for elucidating the physiological role and mechanism of microglial displacement of GABAergic synapses.
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Aprendizagem , Microglia , Cálcio , Neurônios GABAérgicos , Interleucina-1beta , SinapsesRESUMO
BACKGROUND: We sought to explore the associations of outdoor light at night (LAN) and air pollution with the risk of cerebrovascular disease (CeVD). METHODS: We included a total of 28â 302 participants enrolled in Ningbo, China from 2015 to 2018. Outdoor LAN and air pollution were assessed by Satellite-derived images and land-use regression models. CeVD cases were confirmed by medical records and death certificates and further subdivided into ischemic and hemorrhagic stroke. Cox proportional hazard models were used to estimate hazard ratios and 95% CIs. RESULTS: A total of 1278 CeVD cases (including 777 ischemic and 133 hemorrhagic stroke cases) were identified during 127â 877 person-years of follow-up. In the single-exposure models, the hazard ratios for CeVD were 1.17 (95% CI, 1.06-1.29) for outdoor LAN, 1.25 (1.12-1.39) for particulate matter with an aerodynamic diameter ≤2.5 µm, 1.14 (1.06-1.22) for particulate matter with aerodynamic diameter ≤10 µm, and 1.21 (1.06-1.38) for NO2 in every interquartile range increase. The results were similar for ischemic stroke, whereas no association was observed for hemorrhagic stroke. In the multiple-exposure models, the associations of outdoor LAN and PM with CeVD persisted but not for ischemic stroke. Furthermore, no interaction was observed between outdoor LAN and air pollution. CONCLUSIONS: Levels of exposure to outdoor LAN and air pollution were positively associated with the risk of CeVD. Furthermore, the detrimental effects of outdoor LAN and air pollution might be mutually independent.
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Poluentes Atmosféricos , Poluição do Ar , Transtornos Cerebrovasculares , Acidente Vascular Cerebral Hemorrágico , AVC Isquêmico , Humanos , Estudos de Coortes , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Exposição Ambiental/efeitos adversos , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/etiologia , China/epidemiologiaRESUMO
Previous studies on temperature and infectious diseases primarily focused on individual disease types, yielding inconsistent conclusions. This study collected monthly data on notifiable infectious disease cases and meteorological variables across 7 provinces in China from 2011 to 2019. A distributed lag nonlinear model was used to evaluate the association between ambient temperature and infectious diseases within each province, and random meta-analysis was applied to evaluate the pooled effect. Extreme hot temperature (the 97.5th percentile) was positively associated with the risk of respiratory infectious diseases with the relative risk (RR) of 1.45 (95%CI: 1.01-2.08). Conversely, extreme cold temperature (the 2.5th percentile) was negatively associated with intestinal infectious diseases and zoonotic diseases and vector-borne diseases, reporting RRs of 0.43 (95%CI: 0.30-0.60) and 0.46 (95%CI: 0.38-0.57), respectively. This study described the nonlinear association between ambient temperature and infectious diseases with different transmission routes, informing comprehensive prevention and control strategies for temperature-related infectious diseases.
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AIMS/HYPOTHESIS: The age-specific associations between type 2 diabetes and cancer risk are not fully understood. The aim of this study was to assess how age at diagnosis modifies the associations between type 2 diabetes and cancer risk. METHODS: We used data from the Yinzhou Health Information System, and included 42,279 individuals who were newly diagnosed with type 2 diabetes between 2010 and 2014, as well as 166,010 age- and sex-matched control individuals without diabetes who were selected randomly from the electronic health records of the entire population. Patients were divided into four age groups according to age at diagnosis: <50, 50-59, 60-69 and ≥70 years. Stratified Cox proportional hazards regression models, with age as the time scale, were used to estimate the HRs and 95% CIs for the associations of type 2 diabetes with the risks of overall and site-specific cancers. Population-attributable fractions were also calculated for outcomes associated with type 2 diabetes. RESULTS: During median follow-up periods of 9.20 and 9.32 years, we identified 15,729 incident cancer cases and 5383 cancer deaths, respectively. Patients diagnosed with type 2 diabetes before 50 years of age had the highest relative risks of cancer incidence and mortality, with HRs (95% CI) of 1.35 (1.20, 1.52) for overall cancer incidence, 1.39 (1.11, 1.73) for gastrointestinal cancer incidence, 2.02 (1.50, 2.71) for overall cancer mortality, and 2.82 (1.91, 4.18) for gastrointestinal cancer mortality. Risk estimates decreased gradually with each decade increase in diagnostic age. The population-attributable fractions for overall cancer and gastrointestinal cancer mortality also decreased with increasing age. CONCLUSIONS/INTERPRETATION: The associations of type 2 diabetes with cancer incidence and mortality varied by age at diagnosis, with a higher relative risk among patients who were diagnosed at a younger age.
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Diabetes Mellitus Tipo 2 , Neoplasias , Humanos , Idoso , Estudos de Coortes , Estudos Retrospectivos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Incidência , Neoplasias/epidemiologia , Neoplasias/etiologia , Fatores de RiscoRESUMO
Evidence regarding associations of general and abdominal obesity with the risk of conventional adenomas (ADs) and serrated polyps (SPs) from Asian population is scarce. Our study aimed to investigate the independent and joint associations of general obesity assessed by body mass index (BMI) and abdominal obesity assessed by waist circumference (WC) or waist-to-hip ratio (WHR) with the risk of ADs and SPs among 25 222 participants recruited by a population-based screening program. Compared to participants with normal BMI, those with a BMI ≥28 kg/m2 had increased risk of ADs (odds ratio [OR] 1.52, 95% confidence interval [CI]: 1.36-1.70) and SPs (OR 1.69, 95% CI: 1.38-2.07). For participants with a WC ≥102 cm (≥88 cm for females), the risk of ADs (OR 1.37, 95% CI: 1.25-1.51) and SPs (OR 1.81, 95% CI: 1.52-2.16) was higher than that of the reference group. For participants with a WHR ≥0.95 (≥0.90 for females), the risk of ADs (OR 1.26, 95% CI: 1.16-1.36) and SPs (OR 1.46, 95% CI: 1.26-1.69) was higher than that of the reference group. Moreover, participants with both BMI ≥28 kg/m2 and WC ≥102 cm (≥88 cm for females) had 61% and 119% higher risk of ADs (OR 1.61, 95% CI: 1.39-1.85) and SPs (OR 2.19, 95% CI: 1.70-2.82) compared to those with both normal BMI and WC. These findings indicate that both general and abdominal obesity are associated with SPs and ADs, presenting stronger association with SPs than ADs. Moreover, the association is more evident when both obesities exist.
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Adenoma , Obesidade Abdominal , Feminino , Humanos , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Relação Cintura-Quadril , Circunferência da Cintura , Índice de Massa Corporal , Ásia Oriental , Adenoma/epidemiologia , Adenoma/etiologia , Fatores de RiscoRESUMO
BACKGROUND: Sleep disorders are a common syndrome and could affect the life quality of the older adults. AIMS: This study aimed to investigate the association between nutritional status and sleep quality in the Chinese community-dwelling older adults. METHODS: A total of 2,878 participants ≥ 65 years old from the Yiwu Elderly Cohort were included in the study. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF). Participants were categorized as subjects with malnutrition, at risk of malnutrition or well-nourished based on their MNA-SF score. Pittsburgh Sleep Quality Index (PSQI) was used to identify sleep disorders. PSQI score ≥ 6 was categorized as poor sleep quality. RESULTS: Among the 2,878 participants (mean age 72.71 ± 5.79 years, 50.3% men), 31.5% (n = 906) were classified as having sleep disorders, and 25.5% were identified as malnutrition or at risk of malnutrition. We found a significantly relationship between nutritional status and sleep quality in older adults, and the results showed well-nourished decreased the risk of sleep disorders (OR = 0.32, 95% CI = 0.13, 0.75). And well-nourished status was significantly associated with less daytime dysfunction, adequate sleep duration, and good subjective sleep quality (all P < 0.05). CONCLUSION: There was a close association of nutritional status and sleep quality in older adults. We should pay more attention to the nutritional status of older people with sleep problems, as well as the sleep quality of older adults with malnutrition.
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Desnutrição , Estado Nutricional , Masculino , Idoso , Humanos , Feminino , Vida Independente , População do Leste Asiático , Qualidade do Sono , Avaliação Geriátrica/métodos , Desnutrição/epidemiologia , Avaliação NutricionalRESUMO
BACKGROUND: Essential trace elements (ETEs) are essential nutrients for keeping the nervous system functioning. Associations between ETEs and cognitive function are still inconclusive and limited. OBJECTIVES: We aimed to investigate the individual and joint associations between ETEs and cognitive function among older adults. METHODS: A population (N = 2181) at an average age≥ 65 from Yiwu cohort in China was available for this study. Whole blood chromium (Cr), selenium (Se), manganese (Mn), and copper (Cu) concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), consisting of five specific cognitive domains: orientation, registry, attention and calculation, recall, and language and praxis. Linear regression, restricted cubic spline (RCS) analysis, and Bayesian kernel machine regression (BKMR) were used to analyze the individual and joint associations between ETEs and cognitive function. RESULTS: The association between Cr and MMSE score presented an inverted-U shape (Q3 versus Q1: ß = 0.774, 95 % CI: 0.297, 1.250; Q4 versus Q1: ß = 0.481, 95 % CI: 0.006, 0.956); and Cr was especially associated with the registry, recall, and language and praxis. Per IQR (36.32 µg/L) increase of Se was positively associated with the MMSE score (ß = 0.497, 95 % CI: 0.277, 0.717) and all five cognitive domains. The BKMR showed that the dose-response association between Se and cognitive function increased initially and then decreased with increasing Se concentration when fixed the other ETEs in median. ETEs mixture was positively associated with cognitive function, and Se (posterior inclusion probabilities, PIPs = 0.915) was the most important contributor within the ETEs mixture. CONCLUSIONS: The nonlinear association between Cr and cognitive function suggested further exploration of an appropriate concentration range for ETEs. A positive association between mixed ETEs and cognitive function is a reminder that their joint association should be considered. Further prospective studies or intervention studies are warranted to validate our findings in the future.
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Selênio , Oligoelementos , Humanos , Idoso , Estudos Prospectivos , Teorema de Bayes , Cromo , CogniçãoRESUMO
Patients with conventional adenoma removal are recommended to undergo colonoscopy surveillance to prevent colorectal cancer (CRC). However, evidence supporting the guidelines of colonoscopy surveillance is limited, especially among the Chinese population. We investigated the association between colonoscopy adenoma findings and CRC risk among individuals aged 40 to 74 years who underwent baseline colonoscopy from 2007 to 2016 in Jiashan and Haining, Zhejiang, China; 34 382 participants were categorized into advanced adenoma, nonadvanced adenoma and no adenoma based on adenoma findings. A multivariable Cox regression model was used to estimate the hazard ratio (HR) of CRC incidence with adjustment for potential confounding factors. After a median follow-up time of 7.7 years, 113 incident cases of CRC were identified (18 occurred in 1632 participants with advanced adenoma, 16 in 3973 participants with nonadvanced adenoma and 79 in 28 777 participants with no adenoma). Compared to no adenoma group, the adjusted HR for CRC in advanced adenoma group was 4.01 (95% CI, 2.37-6.77). For nonadvanced adenomas, individuals with ≥3 adenomas showed an increased risk of CRC (HR, 3.65; 95% CI, 1.43-9.31), but no significantly increased risk of CRC was found for 1 to 2 nonadvanced adenomas, compared to those with no adenoma. Our study suggested that the risk of subsequent CRC increased in individuals with high-risk adenoma (at least one advanced adenoma or ≥3 nonadvanced adenomas), but not in those with 1 to 2 nonadvanced adenomas. These results provide the first evidence from the Chinese population for the current surveillance guidelines.
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Adenoma/cirurgia , Colonoscopia , Neoplasias Colorretais/etiologia , Detecção Precoce de Câncer , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de RiscoRESUMO
Evidence on the link between healthy lifestyle and colorectal cancer (CRC) precursors is limited. Our study aimed to examine and compare the associations of healthy lifestyle with CRC precursors in adenoma (AD)-carcinoma and serrated pathways. A total of 24 480 participants including 6309 ADs, 1343 serrated polyps (SPs), and 16 828 polyp-free controls were included. A healthy lifestyle score (HLS) was constructed based on five lifestyle factors including cigarette smoking, alcohol drinking, physical activity, diet and body weight, and categorized into least, slightly, moderately and most healthy. Multivariable logistic regressions were used to estimate odds ratio (OR) and 95% confidence interval (CI). Inverse dose-response associations between the HLS and risk of ADs were observed (OR per 1 score increment for ADs: 0.82 [95% CI 0.79-0.84]; for SPs: 0.73 [95% CI 0.69-0.78]), and the association with SPs was more evident than with ADs (OR 0.90, 95% CI 0.85-0.96). Compared to participants with the least healthy lifestyle, those with the most healthy lifestyle had 47% lower risk of ADs (OR 0.53, 95% CI 0.47-0.59) and 70% lower risk of SPs (OR 0.30, 95% CI 0.23-0.39), respectively. These inverse associations were consistent across lesion stage and anatomic subsite and not modified by any stratification factors. The risk advancement periods for the most vs the least healthy lifestyle were -9.49 years for ADs and -20.69 years for SPs. Our findings help confirm the preventive role of healthy lifestyle in colorectal carcinogenesis.
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Adenoma , Pólipos do Colo , Neoplasias Colorretais , Adenoma/epidemiologia , Adenoma/patologia , Pólipos do Colo/diagnóstico , Pólipos do Colo/epidemiologia , Colonoscopia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/prevenção & controle , Estilo de Vida Saudável , Humanos , Fatores de RiscoRESUMO
Epigenetics play an essential role in colorectal neoplasia process. There is a need to determine the appropriateness of epigenetic biomarkers for early detection as well as expand our understanding of the carcinogenic process. Therefore, the aim of the study was to assess how DNA methylation pattern of GALR1 gene evolves in a sample set representing colorectal neoplastic progression. The study was designed into three phases. Firstly, Methylation status of GALR1 was assessed with genome-wide DNA methylation beadchip and pyrosequencing assays in colorectal lesions and paired normal tissues. Then, linear mixed-effects modeling analyses were applied to describe the trend of DNA methylation during the progression of colorectal neoplasia. In the third phase, quantitative RT-PCR was used to examine GALR1 expression in patients with precursor lesion and colorectal cancer. We found that significant hypermethylation of GALR1 promoter was a widely existent modification in CRCs (P < 0.001). When further examined methylation pattern of GALR1 during neoplastic progression of CRC, we found that DNA methylation level of GALR1 showed a significant stepwise increase from normal to hyperplastic polyps, to adenomas and to carcinoma samples (P < 0.001). Besides, loss of mRNA expression is a common accompaniment to adenomas and carcinomas. Public omics data analyses showed an inverse correlation between gene expression and DNA methylation (P < 0.001). Our findings indicate that epigenetic alteration of GALR1 promoter is gradually accumulated during the colorectal neoplastic progression. It can potentially be a promising biomarker used for screening and surveillance of colorectal cancer.
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Adenoma , Neoplasias Colorretais , Receptor Tipo 1 de Galanina/genética , Adenoma/diagnóstico , Adenoma/genética , Adenoma/patologia , Biomarcadores Tumorais/genética , Carcinogênese/genética , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Metilação de DNA , Epigênese Genética , Regulação Neoplásica da Expressão Gênica , Humanos , Regiões Promotoras GenéticasRESUMO
BACKGROUND: Cervical cancer screening is vital for its prevention. Adherence is a crucial indicator that implies the individual willingness to take cervical cancer screening. We aimed to estimate the global and regional adherence rates of cervical cancer screening in 2019 and identify its associated factors among general women. METHOD: We searched studies in PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Database, ProQuest theses database and Google Web, without a lower time limit and until 23 June, 2021. Survey studies were considered eligible if they investigated cervical cancer screening adherence among general women, with data on sample size, the number of adherent subjects, and/or adherence rate. Random-effects were used to pool the odds ratios (ORs) of associated factors of adherence. Using modelling analysis, we estimated 2019 overall and age-specific adherence rates at the global and regional levels in women aged 20-69 years. RESULTS: Eight thousand two hundred ninety records were identified, and 153 articles were included. Being married (vs not married: OR, 1.34; 95% confidence interval [CI]: 1.23-1.46), higher educational attainment (higher than high school vs less than high school: OR, 1.44; 95% CI: 1.35-1.53), having healthcare (OR, 1.64; 95% CI: 1.43-1.88), former smoking (OR, 1.20; 95% CI: 1.07-1.34), physical activity (OR, 1.19; 95% CI: 1.05-1.36), parity (OR, 1.07; 95% CI: 1.01-1.12), and chronic disease (OR, 1.17; 95% CI: 1.04-1.32) were associated with better adherence, whereas obesity (vs normal: OR, 0.85; 95% CI: 0.74-0.97) and current smoking (vs former/never: OR, 0.64; 95% CI: 0.54-0.76) were associated with worse adherence. In 2019, the adherence was at 33.66% (95% CI: 23.34-39.30%) worldwide, and was higher in high-income countries (HICs) (75.66, 95% CI: 66.74-82.81%) than in low and middle-income countries (LMICs) (24.91, 95% CI: 14.30-30.24%). It varied across regions, the highest in the European region (65.36, 95% CI: 55.40-74.19%), but the lowest in the African region (5.28, 95% CI: 3.43-8.03%). CONCLUSIONS: Cervical cancer screening adherence remained low globally, exhibiting geographical discrepancy with HICs higher than LMICs. Further implementations of screening programs should comprehensively consider the local economy, social benefits, and demographic structure to adapt delivery for vulnerable or underserved women to boost screening adherence.
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Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Gravidez , Feminino , Humanos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Renda , Fumar , Doença Crônica , Programas de RastreamentoRESUMO
BACKGROUND: Chronic hepatitis B (CHB) can progress to cirrhosis, but there are limited noninvasive tools available to estimate cirrhosis risk, including in patients receiving antiviral therapy. This study developed and validated a simple model to assess risk in CHB patients. METHODS: The derivation cohort included 3000 CHB patients from 6 centers in the United States, with 52.60% receiving antiviral therapy. External validation was performed for 4552 CHB individuals from similar cohorts in Taiwan, with 21.27% receiving therapy. Cox proportional hazards regression analyses were used to screen predictors and develop the risk score for cirrhosis. Areas under receiver operating characteristic curves (AUROCs) were calculated for predictive value. RESULTS: Sex, age, diabetes, antiviral treatment status/duration, hepatitis B e-antigen, and baseline alanine aminotransferase/aspartate aminotransferase levels were significantly associated with increased cirrhosis risk. A 13-point risk score was developed based on these predictors. The AUROCs for predicting cirrhosis risk were 0.82 at 3 years, 0.85 at 5 years, and 0.89 at 10 years in the derivation cohort, and 0.82, 0.79, and 0.77 in the validation cohort, respectively. CONCLUSIONS: We developed and validated a simple cirrhosis prediction model with an independent external cohort that can be applied to both treatment-naive and treatment-experienced CHB patients in diverse settings and locations.
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Hepatite B Crônica/epidemiologia , Cirrose Hepática/epidemiologia , Adulto , Idoso , Antivirais/uso terapêutico , Povo Asiático , Progressão da Doença , Feminino , Hepatite B Crônica/tratamento farmacológico , Humanos , Cirrose Hepática/etiologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Medição de Risco , Fatores de RiscoRESUMO
BACKGROUND: Cervical cancer is 1 of the most common cancers in females worldwide. Understanding the most recent global patterns and temporal trends of cervical cancer burden might be helpful for its prevention and control. METHODS: Data on cervical cancer (International Classification of Diseases, Tenth Revision, code C53) incidence and mortality in 2018 were extracted from the GLOBOCAN 2018 database and further analyzed for their correlations with the Human Development Index. Temporal trends were analyzed using the annual percent change with joinpoint analysis among 31 countries with highly qualified data from the Cancer Incidence in Five Continents Plus and World Health Organization mortality databases. Future trends for the next 15 years were predicted using an open-source age-period-cohort model. RESULTS: Cervical cancer incidence and mortality rates were both negatively correlated with the Human Development Index (r = -0.56 for incidence, r = -0.69 for mortality; P < .001) in cross-sectional analysis, and both remained stable in 12 countries or even decreased in 14 and 18 countries for incidence and mortality, respectively, during the most recent 10 data years. Similar findings were observed for the next 15 years. CONCLUSIONS: Cervical cancer burden was correlated with socioeconomic development. An overwhelming majority of countries had stable or decreasing trends in incidence and mortality rates, especially in those with effective cervical cancer screening programs and human papillomavirus vaccination. LAY SUMMARY: The authors investigated the most up-to-date data from official databases released by the International Agency for Research on Cancer and found that cervical cancer incidence and mortality were negatively correlated with socioeconomic development. Among the 31 countries analyzed, most (26 countries were analyzed for incidence, and 30 were analyzed for mortality) had stable or even decreasing temporal trends over the most recent 10 years, especially in those with effective cervical cancer screening programs. In addition, the predicted trends for the next 15 years were basically consistent with the observed trends among most of the analyzed countries (19 countries for incidence and 26 countries for mortality).
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Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Estudos Transversais , Detecção Precoce de Câncer , Feminino , Saúde Global , Humanos , Incidência , Mortalidade , Neoplasias do Colo do Útero/epidemiologiaRESUMO
BACKGROUND: Though growing evidence has linked air pollution to Parkinson's disease (PD), the results remain inconsistent. Less is known about the relevance of road proximity and surrounding green. We aimed to investigate the individual and joint associations of air pollution, road proximity and surrounding green with the incidence of PD in a prospective cohort study. METHODS: We used data from a prospective cohort of 47,516 participants recruited from July 2015 to January 2018 in Ningbo, China. Long-term exposure to particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5) and ≤10 µm (PM10) and nitrogen dioxide (NO2) estimated by land-use regression models, road proximity and surrounding green assessed by Normalized Difference Vegetation Index (NDVI) were calculated based on the residential address for each participant. Cox proportional hazard models were used to analyze the individual and joint effects of air pollution, road proximity, and surrounding green on PD. RESULTS: In single-exposure models, PM2.5, PM10, NO2 and road proximity was associated with increased risk of PD (e.g. Hazard Ratio (HR) = 1.51, 95%CI:1.02, 2.24 per interquartile range (IQR) increase for PM2.5) while surrounding green was associated with decreased risk of PD (e.g. HR = 0.80, 95%CI:0.65, 0.98 per IQR increase for NDVI in 300 m buffer). In two-exposure models, the associations of PM2.5 and surrounding green persisted while the associations of NO2 and road proximity attenuated towards unity. CONCLUSIONS: We found that PM2.5 were associated with increased risk of incident PD while surrounding green was associated with decreased risk of PD. Future studies about PD etiology may benefit from including multiple environmental exposures to address potential joint associations.
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Poluentes Atmosféricos , Poluição do Ar , Doença de Parkinson , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , China/epidemiologia , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Doença de Parkinson/epidemiologia , Doença de Parkinson/etiologia , Material Particulado/análise , Material Particulado/toxicidade , Estudos ProspectivosRESUMO
BACKGROUND: Peptic ulcer disease (PUD) continued to be a source of significant morbidity and mortality worldwide. Recently, it has been reported that exposure to air pollution is a potential risk factor for PUD, but evidence on the association still remains inconsistent. METHODS: We performed an ecological study to examine the association between short-term exposure to air pollution and daily hospital visits for PUD in Yinzhou, China from January 1st, 2017 to December 31st, 2019. Distributed lag nonlinear models were used to estimate the nonlinear and lag-response effects of air pollutants. Subgroup analyses stratified by sex, age and season were conducted to examine the effect modifications. RESULTS: Overall, we found that short-term exposure to air pollution including SO2, NO2, CO, O3 and PM2.5 was significantly associated with hospital visits for PUD among all subjects. The lag-response effects of SO2, NO2 and O3 varied at different concentrations and lag days. The cumulative risk ratios of CO and PM2.5 showed nearly linear adverse effects and increased to maxima of 2.68 (95% CI: 1.49-4.78) and 2.40 (95% CI: 1.36-4.24) with their ranges from the references to the maximum concentrations, respectively. Moreover, the cumulative risks of particulate matters on hospital visits for PUD increased significantly in cold seasons, but not in warm seasons. CONCLUSIONS: Our findings could provide growing evidence regarding the adverse health effects of air pollution on PUD, thereby strengthening the hypothesis that air pollutants have harmful impacts on digestive system.
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Poluentes Atmosféricos , Poluição do Ar , Úlcera Péptica , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , China/epidemiologia , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Hospitais , Humanos , Material Particulado/análise , Material Particulado/toxicidade , Úlcera Péptica/induzido quimicamente , Úlcera Péptica/epidemiologia , Estações do AnoRESUMO
BACKGROUND AND AIMS: High-density lipoprotein cholesterol (HDL-C) concentration and variability are both important factors of cardiovascular disease (CVD) and mortality. We aimed to explore the associations of HDL-C and longitudinal change in HDL-C with risk of mortality. METHODS AND RESULTS: We recruited a total of 69,163 participants aged ≥40 years and had medical examination records of HDL-C during 2010-2014 from the Yinzhou District, Ningbo, China. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. We observed a non-linear association of HDL-C with risks of non-accidental and CVD mortality. Compared with the moderate concentration group (1.4-1.6 mmol/L), HDL-C <1 mmol/L was associated with a higher risk of non-accidental mortality (HR: 1.13 (95% CI: 1.01-1.27)) and both HDL-C <1 mmol/L and ≥2 mmol/L were associated with a higher risk of CVD mortality (HRs: 1.23 (95% CI: 1.01-1.50) and 1.37 (95% CI: 1.03-1.82), respectively). Compared with the stable group ([-0.1, +0.1 mmol/L]), a large decrease ([-0.5, -0.3 mmol/L]) and very large decrease (<-0.5 mmol/L) in HDL-C were associated with a higher risk of non-accidental mortality (HRs: 1.40 (95% CI: 1.21-1.63) and 1.78 (95% CI: 1.44-2.20), respectively). Similar results were observed for CVD mortality and cancer mortality. CONCLUSION: Extremely low or high HDL-C and a large decrease or very large decrease in HDL-C were associated with a higher risk of cause-specific mortality. Monitoring of HDL-C may have utility in identifying individuals at higher risk of mortality.
Assuntos
HDL-Colesterol/sangue , Dislipidemias/mortalidade , Hipercolesterolemia/mortalidade , Adulto , Idoso , Biomarcadores/sangue , China/epidemiologia , Dislipidemias/sangue , Dislipidemias/diagnóstico , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de TempoRESUMO
OBJECTIVE: Unprecedented rigorous public health measures were implemented during the coronavirus disease 2019 (COVID-19) epidemic, but it is still unclear how the intervention influenced hospital visits for different types of diseases. We aimed to evaluate the impact of the intervention on hospital visits in Yinzhou District, Ningbo, Zhejiang province, China. METHODS: We conducted an interrupted time-series analysis from 1 January 2017 to 6 September 2020 based on the Yinzhou Health Information System in Ningbo, Zhejiang province. The beginning of the intervention was on 23 January 2020, and thus, there were 160 weeks before the intervention and 32 weeks after the implementation of the intervention. Level changes between expected and observed hospital visits in the post-intervention period were estimated using quasi-Poisson regression models. RESULTS: Compared with the expected level, there was an estimated decrease of -22.60% (95% confidence interval (CI): -27.53%, -17.36%) in the observed total hospital visits following the intervention. Observed hospital visits for diseases of the respiratory system were found to be decreased dramatically (-62.25%; 95% CI: -65.62%, -58.60%). However, observed hospital visits for certain diseases were estimated to be increased, including diseases of the nervous system (+11.17%; 95% CI: +3.21%, +19.74%); diseases of pregnancy, childbirth and the puerperium (+27.01%; 95% CI: +17.89%, +36.85%); certain conditions originating in the perinatal period (+45.05%; 95% CI: +30.24%, +61.56%); and congenital malformation deformations and chromosomal abnormalities (+35.50%; 95% CI: +21.24%, +51.45%). CONCLUSIONS: Our findings provided scientific evidence that cause-specific hospital visits evolve differently following the intervention during the COVID-19 epidemic.
Assuntos
COVID-19 , Hospitais/estatística & dados numéricos , COVID-19/epidemiologia , China/epidemiologia , Feminino , Humanos , Análise de Séries Temporais Interrompida , Pandemias , Gravidez , SARS-CoV-2RESUMO
BACKGROUND: Sleep disorders have been verified to be associated with adverse health outcomes. Recent studies have linked ambient air pollution to sleep disorders. However, evidence with large sample size and especially prospective studies is very limited. METHODS: We used data from a prospective cohort study established from 2015 to 2018 in Ningbo, China. Participants were followed-up after baseline survey through linkage to the regional Health Information System (HIS). Sleep disorders were defined based on International Classification of Disease 10 (ICD-10). Spatial-temporal land-use regression (LUR) models were used to estimate the annual exposure to particulate matter with diameter ≤ 2.5 µm (PM2.5), ≤ 10 µm (PM10) and nitrogen dioxides (NO2). The associations between long-term exposure to air pollutants and prevalence of sleep disorders were examined using logistic regression models, and Cox regression models for the effects of air pollution on the incidence of sleep disorders. A generalized weighted quantile sum (gWQS) regression was used in the multipollutant analysis. RESULTS: A total of 38,775 participants were included in the final analysis. Based on baseline data, we observed significant positive associations between air pollution exposure and increased odds of prevalent sleep disorders (Odds Ratio (OR)= 1.48, 95% confidence interval (CI): 1.41-1.55 for PM2.5; OR= 1.47,95%CI:1.38-1.57 for PM10; OR= 1.38, 95%CI:1.31-1.46 for NO2). In the longitudinal analysis, hazard ratios for incident sleep disorders associated with per interquartile range (IQR) increase in PM2.5, PM10 and NO2 were 1.14 (1.03, 1.25), 1.13 (1.01, 1.27) and 1.13 (1.04, 1.23), respectively. A gWQS regression analysis showed significant association between air pollution mixture and incident sleep disorders (OR=1.11, 95%CI: 1.03-1.20). CONCLUSIONS: Long-term exposure to PM2.5, PM10 and NO2 were associated with increased risk of sleep disorders in a Chinese population. Our findings could provide evidence for a more general role in the adverse health impact of air pollution.
Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Transtornos do Sono-Vigília/epidemiologia , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar/análise , China/epidemiologia , Estudos de Coortes , Exposição Ambiental/análise , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Dióxido de Nitrogênio/análise , Razão de Chances , Material Particulado/análise , Prevalência , Estudos Prospectivos , Análise de RegressãoRESUMO
Increasing single nucleotide polymorphisms (SNPs) have been identified to be associated with colorectal cancer (CRC). We aimed to investigate whether genetic risk scores (GRS) that aggregate information from multiple genetic variants can predict the risk of CRC in a Chinese population. Fifty candidate SNPs were selected to explore the associations with CRC in a discovery sample with 1002 CRC cases and 999 healthy controls. We modeled the significant SNPs identified by the case-control study as a multilocus weighted GRS and estimated the association of GRS with CRC. Furthermore, 300 pairs of cases and controls were included as a validation sample to confirm the finding. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the predictive power of GRS in CRC. A total of seven SNPs were found to increase the risk of CRC, and two SNPs were found to be negatively associated with CRC in the discovery sample. Relative to participants with the lowest quartile of GRS, those with the highest quartile had a 2.64-fold (95% CI: 1.99-3.51) higher risk for CRC. For every 0.1 point of GRS increase, the risk of CRC increase by 11% (95% CI: 8-14%). AUROC for GRS alone were 0.59 (95% CI: 0.57-0.62) and 0.52 (95% CI: 0.46-0.58) in the discovery and validation sample, respectively. AUROC increased to 0.62 (95% CI: 0.59-0.64) and 0.71 (95% CI: 0.65-0.76) by combining environmental risk factors. Our findings support an association between GRS and risk of CRC, which provides evidence of improved prediction model for CRC in China.
Assuntos
Neoplasias Colorretais/genética , Predisposição Genética para Doença , Adulto , China/epidemiologia , Neoplasias Colorretais/patologia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética , Curva ROC , Medição de Risco , Fatores de RiscoRESUMO
BACKGROUND: Population aging is an inevitable trend and previous studies have showed the relationship between social health related factors and health-related quality of life (HR-QOL) in the elderly. The objective of this study is to investigate the association of social health status with HR-QOL among community-dwelling elderly in Zhejiang. METHODS: This cross-sectional study was based on community-dwelling elderly individuals from July 2018 to September 2018 in Zhejiang, China. HR-QOL was measured by the 12-item Short-Form Health Survey (SF-12). Social health status was estimated by the long-form of the Social Health Scale for the Elderly (SHSE-L) and classified into three categories (poor, moderate and good). Multivariable linear regression models were conducted to evaluate the association between social health status and HR-QOL (PCS, MCS and SF-12 total score). RESULTS: A total of 2952 elderly participants were included in this study. The mean age was 70.68 ± 7.75 years (mean ± SD); of the eligible participants, more than half (50.4%) were females; the mean scores were 48.10 ± 8.49, 47.70 ± 7.09 and 47.90 ± 5.86 for PCS, MCS and SF-12 total score, separately. Results from the multivariable models showed that social health status was positively related to HR-QOL after adjusting for covariates. Compared with individuals with a poor social health status, those who had a moderate or good social health status were more likely to report better HR-QOL (for moderate social health status: ß = 1.90(95%CI: 1.09, 2.71) for PCS, ß = 1.78(1.08, 2.48) for MCS, ß = 1.84(1.29, 2.39) for SF-12 total score; for good social health status: ß = 3.29(2.24, 4.34) for PCS, ß = 3.10(2.12, 4.01) for MCS, ß = 3.20(2.48, 3.91) for SF-12 total score). CONCLUSION: In our study, we found that social health status was positively associated with HR-QOL among the elderly in Zhejiang. Our findings could provide valuable information for decision-makers to develop interventions to improve the HR-QOL of the elderly.