Association between sleep duration and stroke in adults / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the association between sleep duration and stroke in adults.</p><p><b>METHODS</b>Baseline data of 57 704 subjects who were aged 30-79 years and enrolled into China Kadoorie Biobank (CKB) study from Tongxiang county, Zhejiang province were analyzed. Multiple logistic regression analysis was conducted to investigate the putative association between sleep duration and stroke after adjusting for potential confounders.</p><p><b>RESULTS</b>The mean age of the subjects was (53.15 ± 10.20) years in males and (51.72 ± .69) years in females, respectively. There were 14.43% of males and 15.30% of females reporting sleep durations ≤ 6 hours per day and 5.39% of males and 5.95% of females reporting long duration of sleep (≥ 10 hours per day). The prevalence of stroke was 0.92% in males compared with 0.44% in females. The prevalence of stroke showed a U-shaped distribution with sleep duration. Compared with 7 hours sleep duration per day, long sleep duration (≥ 10 hours per day) was associated with stroke. The odds ratios (OR) were 2.11 (95%CI: 1.32-3.37) for males and 2.13 (95%CI: 1.24-3.65) for females after adjusting for age, socioeconomic status, health behaviors and health status. No statistical significant association was found between short sleep duration and stroke. Meanwhile, frequent sleep snoring was found to be associated with stroke in females (OR=1.63, 95% CI: 1.11-2.40).</p><p><b>CONCLUSION</b>Longer sleep duration was found to be associated with higher risk of stroke in both males and females. Frequent sleep snoring would increase the risk of stroke in females.</p>

Association between type 2 diabetes mellitus and risk of cancers: a cohort study / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the association between type 2 diabetes and the risk of cancers.</p><p><b>METHODS</b>Data related to type 2 diabetes mellitus (T2DM) cases and cancer cases were collected from Zhejiang Chronic Disease Surveillance Information and Management System (CDSIMS) , between January 1, 2007 and December 31, 2013. Cumulative incidence and relative risk (RR) with 95% confidence interval (CI) were calculated.</p><p><b>RESULTS</b>From 2007 to 2013, a total of 327 268 T2DM and 7 435 cancer cases were respectively reported and 778 439 person-years completed the followed-up program. Among the T2DM patients, incidence of cancers was 955.12 per 100 000, with standardized incidence as 458.05 per 100 000. Compared with people without T2DM, the risk of cancer incidence increased in T2DM patients (RR=1.68, 95%CI: 1.68-1.70). Risk appeared the highest in 20-39 year age group but decreased when the increase of age. In addition, the increased risk was still significant in T2DM patients aged ≥60 years (RR=1.21, 95%CI: 1.18-1.25).</p><p><b>CONCLUSION</b>Results from the study suggested that T2DM was associated with the increased risk of cancers, statistically.</p>

The association between socioeconomic status and blood pressure control in diagnosed hypertension patients / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the association between socioeconomic status (SES) and blood pressure control in diagnosed hypertension patients.</p><p><b>METHODS</b>The database of Zhejiang provincial survey on metabolic syndrome which implemented in 2010 in which prior hypoertensive patients were brought into this sutdy. Descriptive statistics were applied to test the distributive differences of relevant factors (age, sex, marital status, hypertension duration, BMI, education level, per capita household yearly income, smoking, alcohol drinking, fruit and vegetable intake) between patients with optimally-controlled blood pressure and those without. The SES of diagnosed hypertension patients was measured separately by two common indicators: education level and the per capita household yearly income. Univariate and multivariate logistic regression models were used to differentiate the association between those two SES indicators and blood pressure control, and the trend of the association was also tested.</p><p><b>RESULTS</b>Totally, 2 394 hypertension patients were diagnosed and identified. Of the patients analysed, the overall mean was (61.53 ± 10.64) years, and 55.7% (1 334 cases) had ≤ 5 years' disease duration. 1 090 achieved optimal blood pressure control, which accounted for a proportion of 45.5%. 1 676 had elementary school education and below, accounting for 70.1%. The patients with per capita household yearly income of < 5 000 Yuan and 5 000-14 999 Yuan groups were 401 (29.4%) and 690 (50.5%) respectively. 416 (17.4%) were smokers and 541 (22.6%) were alcohol drinkers. Based on the statistical tests, we found that the distributions of age, marital status, hypertension duration, body mass index, smoking and alcohol drinking were different between two groups (t or χ² values were 4.57, 5.44, 6.40, 6.21, 5.99, 3.98, respectively, all P values were < 0.05). Optical blood pressure control in higer education level group was significantly better than that of in lower education level (χ² = 12.65, P < 0.001), and there was no statistical significance association between per capita household yearly income and optimal blood pressure control (χ² = 2.78, P = 0.249). Multivariate logistic regression models revealed that, of those two SES indicators, a positive association was shown between education level and optimal blood pressure control: compared with patients in the category of 'elementary school and below, those of 'junior high school and above observed an OR of 1.40 (95% CI: 1.09-1.81). And in further trend χ² test, we identified a trend of such association (χ² trend = 12.74, P = 0.002). However, no significant association has been recognized between per capita household yearly income and optimal blood pressure control: compared with patients in the category of < 5 000 Yuan group, those of 5 000-14 999 Yuan and ≥ 15 000 Yuan groups had OR of 0.93 (95% CI: 0.72-1.20) and 1.04 (95% CI: 0.83-1.31) respectively.</p><p><b>CONCLUSION</b>Among all diagnosed hypertension patients, those with lower education level have poorer blood pressure control and should be labelled as the key population for intense health education and standardized management to improve their blood pressure control status.</p>

Analysis on the characteristics and factors associated with avoidance of activity induced by fear of falling in the community-dwelling elderly / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiologic characteristics and factors associated with the avoidance of activity, that induced by fear of falling in the community-dwelling elderly so as to provide evidence for preventing elderly from falling and to increase the quality of life.</p><p><b>METHODS</b>A cross-sectional study was conducted in 1 972 elderly in Zhejiang. Data were collected through face-to-face interview. Both Univariate and multivariate logistic regression models were used to explore the related factors on the avoidance of activity induced by fear of falling.</p><p><b>RESULTS</b>Of the 1 972 elderly, 43.15% (95% CI: 40.97%-45.34%) appeared avoidance of activity induced by fear of falling. There were no significant difference between males (41.79%, 95% CI: 38.61%-44.98%) and females (44.36%, 95% CI: 41.34%-47.38%), with χ² = 1.32, P > 0.05. The corresponding figures of the 60-69 years group, 70-79 years group and the ≥ 80 years group were 37.07%, 44.87% and 59.04%, respectively (Trend χ² = 48.93, P < 0.01). Of those elderly who ever fell in the past 12 months, 51.94% (95% CI: 46.34%-57.53%) of them were afraid of falling which would lead to avoid of engaging in physical activities. Of the elderly who had no histories of falling in the past 12 months, 41.52% (95% CI: 39.14%-43.89%) feared of falling and avoided engaging in related activities (χ² = 11.56, P < 0.01). Results from the Multivariate logistic regression analysis showed that the related factors would include general/poor perceived health status (OR = 1.53-1.69), impaired vision (OR = 1.95-2.98), impaired hearing (OR = 1.77), use of assistive devices (OR = 2.71), osteoporosis (OR = 3.35), dizziness (OR = 3.05), age ≥ 80 years old (OR = 1.56) and the level of received education.</p><p><b>CONCLUSION</b>Avoidance of physical activity induced by fear of falling among community-dwelling elderly was commonly seen. Health education and intervention measures should be strengthened to the elderly, so as to encourage them to engaging in physical activities and to improve their quality of life.</p>