Major depressive disorder in relation with coronary heart disease and stroke in Chi-nese adults aged 30 -79 years / 北京大学学报(医学版)

Objective:To investigate the associations of major depressive disorder with coronary heart disease (CHD)and stroke in Chinese adults aged 30 -79 years.Methods:In 2004 -2008,China Ka-doorie Biobank was conducted in 1 0 geographically defined regions (5 urban and 5 rural)of China.A to-tal number of 51 2 891 participants aged 30 -79 years were recruited in the baseline survey.A laptop-based electronic questionnaire was administrated face-to-face by trained health workers,collecting the general demographic and socio-economic status,dietary and other lifestyle behaviours (e.g.smoking,al-cohol drinking,physical activity),medical history and family history of common chronic diseases.Major depressive episodes (MDE)in the past 1 2 months were assessed with the World Health Organization composite international diagnostic interview-short form (CIDI-SF).The physical measurements included the heights and weights,which were used to calculate the body mass indexes (BMI).Chi squared and t test were used to compare the differences in participants characteristics according to their major depressive disorder.Logistic models were employed to estimate the odds ratios (OR)and 95% CI of their major de-pressive disorder with prevalent coronary heart disease and stroke.Results:Among the 51 2 891 partici-pants,3 281 (0.6%)showed an MDE in the preceding 1 2 months,1 5 472 (3.0%)reported prevalent CHD,and 8 884 (1 .7%)reported prevalent stroke.Major depressive disorder was significantly associa-ted with an increased risk of CHD and risk of stroke.Age-and gender-adjusted ORs (95% CI)were 1 . 80 (1 .53 -2.1 2)for CHD and 2.53 (2.09 -3.05)for stroke.The associations were significant after further adjustment for potential confounders,such as other socio-demographic status,smoking,alcohol drinking,physical activity,and BMI,prevalent hypertension,diabetes as well as family history of cardio-vascular diseases (OR =1 .83,95% CI =1 .54 -2.1 8 for CHD;OR =2.1 9,95% CI =1 .79 -2.69 for stroke).Moreover,gender significantly interacted with MDE on prevalent stroke (P for multiplicative in-teraction =0.01 3).The men with an MDE in the past 1 2 months had the highest risk of stroke in the joint analyses of gender and depression disorder (OR =5.02,95% CI =3.70 -6.82).Conclusion:The findings from this large cross-sectional study suggest that the presence of MDE is a risk factor for both CHD and stroke in Chinese adults aged 30 -79 years,but further prospective studies are warranted to validate the results.

Status of prevalence, awareness, treatment and controll on hypertension among adults in 10 regions, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the status of prevalence, awareness, treatment, and control of hypertension among half a million adults in 10 regions under the China Kadoorie Biobank (CKB) cohort.</p><p><b>METHODS</b>The baseline survey of CKB was performed in 10 areas across China during 2004-2008, included 512 891 adults aged from 30 to 79 years. Regional differences of prevalence, awareness, treatment and control of hypertension were compared after adjustment for age and/or sex.</p><p><b>RESULTS</b>The overall prevalence of hypertension from the CKB was 35.2% (180 612/512 891), with the highest as 44.4% in Zhejiang and the lowest as 22.0% in Haikou. Prevalence in the rural areas (35.1%) was higher than that in the urban areas (32.1%), with statistical significance (P<0.001). Among all the participants with hypertension, 59 703 (33.1%) were aware of hypertension, 65 172 (36.1%) were receiving anti-hypertension treatment and 22 329 (12.4%) were under controll. However, only a small part of those receiving treatment were under controll (30.5%, 19 884/65 172) in this study. The control of hypertension and of those receiving treatment were higher in Suzhou for males (17.4%, 39.1%), while were higher in Liuzhou for females (23.5%, 42.6%) than those in other regions.</p><p><b>CONCLUSIONS</b>Participants under the CKB presented relatively high prevalence of hypertension, but lower rates on awareness, treatment and control of hypertension. Distribution of awareness, treatment, and control of hypertension varied greatly among the ten areas, under the CKB.</p>

Epidemiology of major depressive episodes among Chinese adults aged 30-79 years: data from the China Kadoorie Biobank / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the socio-demographic patterns on 12-month major depressive episodes (MDE) among Chinese adults aged 30-79 years.</p><p><b>METHODS</b>Socio-demographic variables from half a million Chinese people aged 30-79 years in the China Kadoorie Biobank study during 2004-2008, were collected. For those showing signs of depression, an additional World Health Organization Composite International Diagnostic Interview-Short Form (CIDI-SF) was face to face administrated, to assess the MDE according to Diagnostic and Statistical Manual of Mental Disorder (DSM)- IV criteria. Chi squared and non-parametric tests were used to compare the differences between socio-demographic categories, depressive symptoms and help-seeking behaviors. Associations with MDE for socio-demographic variables were examined by logistic models.</p><p><b>RESULTS</b>A total of 3 281(6.40‰) studied subjects showed an MDE in the preceding 12 months. Gender, marital status, occupation and household income were correlated with MDE. Somatization was common in Chinese MDE patients while symptoms as weight change (99.91%), sleeping disorder (83.60%) and feeling tired (81.59%), stood for the top 3. As for each episode, the proportions and the total number of depressive symptoms appeared higher among females (P < 0.05). One third of the patients did not seek for any social support or psychotherapy with only 8.99% had ever taken antidepressant drugs.</p><p><b>CONCLUSION</b>Rates of depression varied significantly between social groups in Chinese adults aged 30-79. In this study, only 65.19% of the MDE patients ever has sought help or received treatment.</p>

Regional differences on patterns of physical activity and leisure sedentary time: findings from the China Kadoorie Biobank study, including a million people from 10 regions / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the gender and regional differences in patterns of physical activity and sedentary behavior across 10 study areas through data from the China Kadoorie Biobank (CKB) that involving half a million adults.</p><p><b>METHODS</b>The baseline survey of CKB took place in 5 urban and 5 rural areas across China during 2004-2008. After excluding those who had a prior history of heart disease, stroke and/or cancer, 486 514 participants (age: 30-79 y) were included in the analyses. MET-h/d was calculated for each one of the participant, based on the type, duration and intensity of self-reported physical activity, along with time spent on sedentary activity. These data were compared, after standardization for age between sex and study areas.</p><p><b>RESULTS</b>The mean total physical activity was 22.9 MET-h/d among men, 20.6 MET-h/d among women, and the mean sedentary leisure time appeared 3.1 h/d in men and 2.9 h/d in women. In men, the total physical activity ranged from 13.3 MET-h/d in Haikou to 31.3 MET-h/d in Zhejiang, while in women it ranged from 14.7 MET-h/d to 30.2 MET-h/d across the 10 areas. For sedentary leisure time, it ranged from 2.0 h/d in Zhejiang to 3.8 h/d in Sichuan in men and 1.6 h/d to 3.7 h/d in women. In both men and women, occupational physical activities (77.6% and 59.8% respectively) accounted for most of the daily activities, while leisure time physical activities accounted for the least (3.1% in both men and women). Among men, the proportion of occupational physical activity ranged from 86.5% in Zhejiang to 69.4% in Haikou (69.4%), while in women it ranged from 74.8% in Zhejiang to 40.9% in Henan. Gansu (men 17.8%, women 18.1%) reported the highest proportion of transportation physical activities. Among women, areas reporting the highest proportion of physical activity at home would include Henan (54.0%) and Hunan (39.1%), whereas adults in Zhejiang (20.0%) reported the lowest proportion. Among men, Hunan (18.0%) reported the highest proportion of physical activity at home. Compared with rural areas, male and female participants from urban areas tended to have more leisure time for physical activity and less vigorous-intensity physical activity.</p><p><b>CONCLUSION</b>The patterns of physical activity and sedentary behavior including the levels of physical activity, domains and intensity of physical activities. Sedentary leisure time appeared all various greatly across different regions in China.</p>

Differences in diet intake frequency of adults: findings from half a million people in 10 areas in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the differences in diet intake frequency of adults in 10 areas surveyed by China Kadoorie Biobank (CKB) project.</p><p><b>METHODS</b>CKB project recruited voluntary residents aged 30-79 years from 5 urban areas and 5 rural areas in China. The baseline survey was conducted among 512 891 eligible subjects during 2004-2008. The intake frequencies of 12 food groups were assessed through in-person interviews and analyzed. The results were adjusted for age and sex structure of the study population.</p><p><b>RESULTS</b>Rice was the main cereal consumed every day in urban areas (99.0%) and rural areas (99.9%) in southern China, while wheat was the main cereal consumed every day in rural areas (99.0%) and Qingdao (88.4%) in northern China. Most subjects in Henan (98.8%) consumed other staple food every day. The lowest proportion of daily intake of fresh vegetables was observed in Gansu (74.0%) . In both southern and northern areas, urban subjects had higher proportions of daily intakes of fresh fruits, preserved vegetables, and meat than rural subjects. Similar results were found when comparing the proportions of intakes of poultry and fish/seafood at least 1 day every week. Contrast to southern China (urban: 6.5%, rural: 6.9%) , the proportions of daily intake of fresh eggs were higher in both urban areas (37.1%) and rural areas (14.6%) in northern China. The highest proportions of daily intake of soybean products and dairy products were observed in Harbin (10.0%) and Qingdao (34.3%).</p><p><b>CONCLUSION</b>The intake of cereal, fresh eggs and soybean products differed between the south and the north of China. The intake of meat, poultry, fish/seafood, fresh fruits, preserved vegetables and dairy products varied considerably between urban areas and rural areas.</p>

Regional specific differences in prevalence of overweight/obesity in China: findings from China Kadoorie Biobank study in 10 areas in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe gender and regional differences in the prevalence of overweight/obesity in adults found by China Kadoorie Biobank (CKB) study, involving 512 489 adults, in 10 areas in China.</p><p><b>METHODS</b>The baseline survey of CKB was conducted in 5 urban areas and 5 rural areas in China during 2004-2008. After excluding those with extreme value of BMI (<15.0 kg/m(2) or >50 kg/m(2)), 512 489 subjects were included in the analysis. Overweight/obesity was classified according to BMI and WC, and diagnosed according to the guideline for prevention and control of overweight/obesity in Chinese adults. The gender and regional specific distributions of overweight/obesity were compared after adjusting for age.</p><p><b>RESULTS</b>The overall prevalence of overweight/obesity was higher in females (45.3%) than in males (41.7%), and the prevalence of central obesity was also higher in females (44.6%) than in males (38.3%). Both the prevalence of overweight/obesity (66.9% in males and 67.5% in females) and the central obesity (63.3% in males and 64.9% in females) were highest in Qingdao. The area specific difference in the prevalence was more obvious in males than in females. Rural areas all had the low prevalence except Henan. Moreover, central obesity was diagnosed in some subjects (15.3% in females, 9.8% in males) with normal/low BMI (<24.0 kg/m(2)). This phenomenon was more obvious in Qingdao (22.2% in males and 23.2% in females).</p><p><b>CONCLUSION</b>The prevalence of overweight/obesity in adults varied greatly across different areas in China.</p>

Regional differences in adults' tea drinking pattern: findings from China Kadoorie Biobank study in 10 areas in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the gender and regional differences in adults' tea drinking pattern found in China Kadoorie Biobank (CKB) survey, involving half million adults, in 10 areas in China.</p><p><b>METHODS</b>The baseline survey of CKB was conducted in 5 urban areas and 5 rural areas in China during 2004-2008. The information on tea drinking of 512 891 adults aged 30-79 years was collected and analyzed.</p><p><b>RESULTS</b>The overall prevalence of regular tea drinking (i.e., weekly) was 50.7% in males and 21.3% in females. Among 10 areas, Hunan reported the highest regular tea drinking prevalence (74.3% in males, 76.6% in females), while Henan reported the lowest regular tea drinking prevalence (5.5% in males, 1.0% in females). Most regular tea drinkers consumed green tea except those from Zhejiang and Haikou. Hunan reported the highest tea consumption per time (3.8 g in males, 3.1 g in females), per day (6.2 g in males, 4.1 g in females) and per week (38.4 g in males, 25.0 g in females).</p><p><b>CONCLUSION</b>The adults' tea drinking pattern i.e. frequency, type, amount of tea and preferred concentration of tea water, varied greatly among the 10 regions covered by CKB study.</p>

Regional differences in adults' smoking pattern: findings from China Kadoorie Biobank study in 10 areas in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the regional differences in adults' smoking pattern found by China Kadoorie Biobank (CKB) study involving half million adults in 10 areas in China.</p><p><b>METHODS</b>After exclusion of the adults with self reported histories of coronary heart disease, stroke, cancer and chronic obstructive pulmonary disease at baseline survey, the area specific differences in smoking pattern of 452 829 subjects aged 30-79 years was analyzed.</p><p><b>RESULTS</b>The overall rate of current smoker was higher in males (64.2%) than in females (2.1%). For females, the current smoker rate was higher in Harbin (10.5%) and Sichuan (8.5%) than in other areas. For males, the current smoker rate and the average numbers of cigarettes smoked per day were high in Hunan (68.8%, 20.9) and Sichuan (67.2%, 21.5) ; the current smoker rate was lowest (49.9%) but the average number of cigarettes smoked per day was highest (21.9) in Haikou. On the other hand, Gansu showed the highest rate of current smoker (71.4% ) with a lower mean number of cigarettes smoked per day (14.9). Most current smokers in males (88.3% ) smoked filter cigarettes, while hand-rolled cigarettes were commonly used in Sichuan (38.8%) and Gansu (37.8%) and pipes or water pipe were mainly used in Henan (14.6%).</p><p><b>CONCLUSION</b>The rate of current smoker and other patterns of smoking including cigarette type, daily amount and inhalation depth varied greatly among the adults in 10 areas covered by CKB study.</p>

Area specific differences in lung function indices and prevalence of airflow obstruction in adults: findings from people in 10 areas in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the area specific differences in lung function indices and prevalence of airflow obstruction (AFO) in adults found by China Kadoorie Biobank (CKB) study, involving 512 495 adults, in 10 areas in China.</p><p><b>METHODS</b>The detailed information on lung function indices (FEV, and FVC) and prevalence of AFO (diagnosed according to GOLD and LLN criteria) of subjects aged 30-79 years were analyzed, those with abnormal lung function indices at baseline survey were excluded.</p><p><b>RESULTS</b>The FEV1 and FVC among males (2.66 L, 3.16 L) were higher than those among females (1.99 L, 2.35 L). The FEV1 and FVC were highest in Henan and Harbin. The prevalence of AFO diaonosed according to GOLD criteria was 5.13% in males, higher than that in females (3.75%). The prevalence of AFO was higher in rural area than in urban area (males: 6.32% vs. 3.47%; females: 4.26% vs. 2.97%). The prevalence of AFO was highest in Sichuan (13.34% in males, 10.70% in females), followed by that in Suzhou, Henan and Hunan. The prevalence of AFO diagnosed according to LLN criteria (6.93% in males, 6.29% in females) was higher than that diagnosed according to GOLD criteria, but the area specific difference was similar.</p><p><b>CONCLUSION</b>The lung function indices and the prevalence of AFO in adults varied greatly among the 10 areas covered by CKB study.</p>

Regional differences in patterns of alcohol consumption: findings from the China Kadoorie Biobank study on half a million people from 10 regions / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the regional differences on patterns of alcohol consumption across 10 study in the China Kadoorie Biobank (CKB) areas involving half a million adults.</p><p><b>METHODS</b>The baseline survey of CKB took place in 5 urban and 5 rural areas across China during 2004-2008. Detailed information on alcohol consumption of 512 891 participants aged 30-79 years was gathered and analyzed.</p><p><b>RESULTS</b>were directly standardized on age (in 10-age groups) and education (5 groups) structure of the study population for different sex.</p><p><b>RESULTS</b>The overall prevalence rates of regular drinking (i.e., at least weekly) were 33.1% among men and 2.2% among women. Among men, the prevalence rate was seen highest in Harbin (52.0%) and Sichuan (50.2%), but lowest in Gansu (8.1%) and Haikou (18.8%). Most regular drinkers in Sichuan, Hunan, and Gansu habitually drank strong spirits (≥ 40% alcohol content), whereas beer was most commonly consumed in Harbin and Qingdao, with rice wine most commonly used in the southern regions (Haikou, Suzhou,Zhejiang and Liuzhou). Mean alcohol consumption was highest in Sichuan (414.6 g/week). Although the mean alcohol consumptions appeared lower on regular occasion in Gansu (195.2 g/week) and Henan (239.6 g/week) than in other regions, the amount consumed on special occasions in these two regions were the highest (Henan:202.3 g/day; Gansu:171.2 g/day). Similar patterns were also seen in women. Of all the regular drinkers, 82.6% of men and 56.6% of women reported heavy drinking episodes (men: >60 g, women: >40 g) on special occasions.</p><p><b>CONCLUSION</b>The patterns of alcohol consumption including prevalence, frequency, amount, binge drinking pattern, and type of alcohol beverage varied greatly among the ten areas of CKB under study.</p>