Epidemic status of patients with hypertension and diabetes among adults aged 35 years and older in Shanghai / 上海预防医学

Objective:To understand the epidemic status of patients with hypertension and diabetes among residents aged ≥35 years in Shanghai. Methods:The data of "Monitoring of Chronic Diseases and Behavioral Risk Factors in Shanghai in 2013" were used for analysis. Residents aged ≥35 years were selected to analyze the prevalence， awareness， treatment and control in patients with hypertension and diabetes. Results:The prevalence rate of patients with both hypertension and diabetes was 11.25% （95%CI：10.29%-12.29%） among residents aged ≥35 years in Shanghai. The older the age was， the higher the prevalence rated. The rate was the highest in urban area， second in rural area， and the lowest in urban-rural area. Education level of senior high school or above had lower rate than junior high school or below. The non-occupational group had the highest rate and the non-agricultural occupation group had the lowest. The widowed/separated/divorced groups had the highest rate and the married group had the lowest. The rate in obese people was the highest and normal people was the lowest. People with sleep time ≥6 h had a lower rate than those with sleep <6 h. All the above differences were statistically significant （χ2=890.98， 28.91， 61.92， 315.34， 123.72， 441.45， 8.77，all P<0.05）. The awareness rate was 50.09% （95%CI：46.54%-53.64%）， the highest in 60-74 years old group and the lowest in 35-44 years old group. The awareness rate in urban area was higher than that in the urban-rural junction， and the rural area was the lowest. The treatment rate was 45.67% （95%CI：42.45%-48.92%） and the age was proportional to the treatment rate. The treatment rate from high to low in order was city， urban and urban-rural junction， rural areas. The differences in age， region awareness rate and treatment rate were statistically significant （χ2=43.27， 35.19， 37.59， 37.56，all P<0.05）. Control rates was 6.45% （95%CI：5.17%-8.01%）， 60-74 age group had the highest， and the age group from 35 to 44 years old had the lowest， and the difference was statistically significant （χ2=20.35，P<0.05）. The treatment control rate was 14.11% （95%CI：11.54%-17.15%）. Conclusion:The prevalence rate of patients with co-existing hypertension and diabetes in Shanghai residents is high， the awareness rate and treatment rate are general， and the control rate is low. It is urgent to improve the comprehensive prevention and treatment level of patients with hypertension and diabetes.

Analysis on management of patients with hypertension in communities in Shanghai / 上海预防医学

Objective To understand the status of community-based management of hypertensive patients aged thirty-five or above in Shanghai . Methods Data from Shanghai Chronic Disease and Risk Factors Surveillance carried out in 2013 were used to analyze the community-based management and treat-ment and control of blood pressure of hypertensive patients aged thirty-five or above in Shanghai .Sample was weighted according to complex sampling scheme and post-stratification to calculate the rates with95 %confidence intervals ( CI) for the subgroups according to different characteristics .The Rao-Scottχ2 test was performed to test for the differences of the rates of the subgroups . Results There were 10 510 hyperten-sion patients were included in the study among which 7 343 patients were aware of their diagnosis , and a total of 3 815 patients had been under management in communities .After being weighted the rate of management of hypertensive patients in communities was 49.74%(95%CI:45.66%-53.83%).There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ2 =68 .120 , P=0 .002 ) , the rate of management among the patients aged sixty-five or above was 55.49%(95%CI:51.58%-59.32%), while among the patients aged thirty-five to forty-four was only 41.20% (95%CI: 30.73% -52.54%).The rate of management among females was 51.12%(95%CI:47.17%-55.05%), while males was 48.46% (95%CI:43.34%-53.61%), with no statistical significance (χ2 =5.194, P =0.216 ).The rates of management in urban areas , sub-urban areas and rural areas were 47 .66% ( 95%CI: 42 .55%-52 .82%) , 52 .92% ( 95%CI:43.41% -62.24%), 52.84% ( 95%CI: 44.96% -60.58%), respectively, with no statistical significance (χ2 =19 .281 , P =0 .432 ) . The follow-up rate in patients with hypertension under standardized management in communities was 21 .97%( 95%CI: 18 .61% -25 .74%) .There was a significant difference between different genders (χ2 =65.048, P =0.000 ).The rate of females was 27.42%(95%CI:227.7 %-32.61%), which was higher than the rate of males (16.61%,95%CI:13 .02%-209.3 %) .There were no significant differences among different age groups (χ2 =2 .017 , P=0 .834 ) and regions (χ2 =21 .244 , P=0 .111 ) .The treatment rate was 95 .47% ( 95%CI: 94 .08% -96 .54%) .There was a significant difference among different age groups (χ2 =403.46 , P=0 .006 ) .The treatment rate among the patients aged sixty-five or above was 96 .90% ( 95%CI:95 .39%-97 .93%) , while among the patients aged thirty-five to forty-four was 89.31%(95%CI:77.94% -95.19%).There were no significant differences among gender (χ2 =7.983 , P=0.055 ) and regions (χ2 =0.881, P=0 .807 ) .The control rate of hypertensive patients managed in communities was 38 .98% ( 95%CI:35 .55%-42 .51%) , There were no significant differences among different age groups (χ2 =23 .188 ,P=0.103), gender(χ2 =1.050,P =0.468) and regions( χ2 =0.529,P =0.938). Conclusion We should further expand the coverage of the standardized management of hypertension patients in the community , and make personalized intervention plan , so as to improve blood pressure control rates of hypertension patients in the community .

Epidemiology of Diabetes in Adults Aged 35 and Older from Shanghai, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study aimed to investigate the epidemiology of diabetes in adults from Shanghai, aged 35 and older, in 2013.</p><p><b>METHODS</b>We estimated the diabetes prevalence in a representative sample of 18,736 adults who were selected through a multistage stratified cluster sampling process. A standard questionnaire containing questions about demographic characteristics and lifestyle factors was distributed. After an overnight fast of at least 10 hours, a venous blood sample was collected from each participant. For each patient without a history of diabetes, another blood sample was drawn 120 min after an oral glucose tolerance test to identify undiagnosed diabetes and prediabetic condition.</p><p><b>RESULTS</b>Among Shanghai residents aged 35 and above, the overall weighted prevalence of diabetes was 17.6% [95% confidence interval (CI): 16.4%-18.8%]. The prevalences were 19.3% in men and 15.8% in women as well as 19.1%, 15.4%, and 16.1% in urban, suburban, and rural residents, respectively. In addition, the weighted prevalence of prediabetes was 16.5% (95% CI: 15.3%-17.8%), with the prevalences of 16.5% in men, 16.6% in women, 15.2% in urban residents, 18.0% in suburban residents, and 18.5% in rural residents. Among all patients with diabetes, 68.1% (95% CI: 64.3%-71.6%) were aware of their status, 63.5% (95% CI: 60.0%-66.9%) received diabetes treatment, but only 35.1% (95% CI: 32.4%-37.8%) had adequate glycemic control.</p><p><b>CONCLUSION</b>In Shanghai, diabetes and prediabetes are highly prevalent. However, 1/3rd of diabetes cases are undiagnosed, and the rate of glycemic control is low.</p>

Awareness of healthy lifestyle content among residents aged 18 -69 years in Shanghai / 上海预防医学

[Objective] To investigate the awareness of healthy lifestyle content among residents in Shanghai and to provide basis for future efforts . [ Methods] Stratified random sampling covered all 18 districts in Shanghai .A total of 8548 participants were recruited and questionnaire with them was completed by face to face interview. [Results] Among Shanghai residents aged 18-69 years, 67.8%of them had awareness of all five items of healthy lifestyle content .And 94.6%, 92.3%, 80.7%, 77.3%, and 81 .7%of them respectively had awareness of balanced diet , regular exercise , no smoking , no alcohol a-buse, and keeping mental balance .Analysis of Logistic regression showed that gender , age, area of resi-dence, and education level were factors influencing awareness rates mentioned above . [ Conclusion] The information about healthy lifestyle content was effectively spread by various departments concerned and the Shanghai government .And the above results suggest that specific information spread for different demo-graphic characteristics of different populations is beneficial for future improvement of healthy knowledge a -mong them.

Study on risk factors and behavior features related to chronic diseases among adults in Shanghai / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the risk factors and behavior features related to chronic diseases among adults in Shanghai.</p><p><b>METHODS</b>A total of 15 516 subjects aged over 18 years old were selected from the investigation project on chronic diseases and relevant risk factors in Shanghai in 2010. Questionnaire were used to investigate the general information of the subjects, such as behavior features as smoking, drinking, diet, physical activity as well as the prevalence and control of chronic diseases as hypertension and diabetes. The physical examination included height, weight, waist circumference, blood pressure, blood glucose and blood lipids.</p><p><b>RESULTS</b>Being preprocessed by complex weighting method, the data showed that the overweight rate of Shanghai adults aged above 18 was 32.4% (5288), separately 32.2% (2506) and 32.5% (2782) (χ(2) = 0.10, P = 0.844) in urban and rural areas; the obesity rate was 8.8% (1538), separately 8.7% (738) and 8.8% (800) (χ(2) = 0.06, P = 0.901) in urban and rural areas. The overweight rate was separately 36.0% (2888) in males and 28.6% (2400) in females (χ(2) = 96.61, P < 0.01); while the obesity rate was separately 8.7% (745) in males and 8.9% (793) in females (χ(2) = 0.06, P = 0.851). Abdominal obesity rate was 44.3% (7419), separately 47.8% (3892) in males and 40.6% (3527) in females (χ(2) = 81.23, P < 0.01), 46.5% (3703) in urban areas and 42.6% (3716) in rural areas (χ(2) = 24.37, P = 0.069). Current smoking rate was 25.0% (3813), separately 48.4% (3722) and 1.2% (91) in males and females (χ(2) = 4572.06, P < 0.01); 23.6% (1609) and 26.0% (2204) in urban and rural areas (χ(2) = 11.92, P = 0.018). The regular smoking rate was 22.1% (3402). The rate of having the habit of drinking at least once a month in males was 39.5% (3102), separately 35.1% (1262) and 42.7% (1840) in urban and rural areas (χ(2) = 45.98, P = 0.012). The rate of drinking almost every day was 16.3% (1380), and the percentage of excessive alcohol consumption was 28.9% (2483). The percentage in group of subjects aging between 45-59 years old was 38.5% (1191), which was higher than that in any other groups (22.8% (641) in group aging 18-44 years old and 22.9% (651) in group aging ≥ 60 years old) (χ(2) = 241.38, P < 0.01). The percentage of over-drinking in rural area was higher than that in urban area, which was 33.5% (1578) and 22.8% (905) respectively (χ(2) = 117.12, P < 0.01). The percentage of once over-drinking was 11.3% (903). It was higher in group aging between 45-49 years old (15.3% (461)) than in other groups (9.0% (222) in group aging 18-44 years old and 8.2% (220) in group aging ≥ 60 years old) (χ(2) = 78.21, P < 0.01). It was also higher in rural area (13.5% (605)) than in urban area (8.3% (298)) (χ(2) = 51.74, P < 0.01). There were 75.0% (11 993) of the Shanghai adults never took physical activity. And the most important problems in dietary habit were insufficient intake of dairy products (98.0%, 15 218), vegetables (53.0%, 7864) and fruits (84.6%, 13 372), excess consumption of sodium (52.0%, 8257) and oil (51.7%, 7884).</p><p><b>CONCLUSION</b>The risk factors of chronic diseases were highly prevalent in Shanghai. The prevalence of risk factors as overweight or obesity, lack of physical activity, smoking, over-drinking and unhealthy dietary habits were higher among adults living in suburban areas than those living in urban areas; the prevalence was also higher among the young adults than that among the elderly people, higher among males than that among females.</p>

Investigation on the perception of risk level of heat wave and its related factors in Guangdong province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the risk perception of heat wave, and further explore its related factors in Guangdong province.</p><p><b>METHODS</b>A total of 2183 adults were selected by a multi-stage sampling method in Guangdong province. Each subject was interviewed in their home with a structured questionnaire by a well trained investigator from September to November, 2010. The questionnaire contained socio-demographic characteristics, heat wave related knowledge, risk perception of heat wave, etc. Chi-square test and multivariate logistic regression were employed in this study.</p><p><b>RESULTS</b>The average age of total 2183 participants was (39.31 ± 14.16) years, among which 53.37% (1165/2183) were males, and 48.74% (1064/2183) were selected from urban. About 38.11% (832/2183) of participants heard about heat wave, and 38.52% (841/2183) of subjects thought the heat wave had higher impact on their health (risk perception score of heat wave ≥ 5 points). About 81.91% (1788/2183) of all participants thought the weather in most recent years was hotter than several years ago. Among these people, 30.48% (545/1788) thought the main reason of weather becoming hotter was due to emission of carbon dioxide, and 26.51% (474/1788) thought it was due to air pollution. Results from the multivariate logistic regression showed that the risk perception score of heat wave were higher in subjects with higher education (OR = 2.16, 95%CI: 1.41 - 3.30), from urban(OR = 1.37, 95%CI: 1.10 - 1.72), with higher score of trust(OR = 1.08, 95%CI: 1.01 - 1.14) and participants with higher score of heat wave related knowledge (OR = 1.39, 95%CI: 1.27 - 1.52). Furthermore, compared to hierarchist, egalitarian (OR = 1.73, 95%CI: 1.30 - 2.29), individualist (OR = 1.93, 95%CI: 1.41 - 2.65) and fatalist (OR = 1.80, 95%CI: 1.41 - 2.29) also had higher risk perception score of heat wave.</p><p><b>CONCLUSION</b>There is a lack of knowledge and risk perception to heat wave among the residents in Guangdong province. Risk perception of heat wave was higher in people who were from urban, had higher level of trust on government, experts and media, had higher health-related knowledge score, and non-hierarchists.</p>

Association between temperature and daily mortality in Guangzhou, 2006-2009: a time-series study / 中华流行病学杂志

Objective To study the association between temperature and daily mortality from June 1, 2006 to December 31, 2009 in Guangzhou. Methods Time series approach was used to estimate the impact of temperature on the rates of total and cause-specific daily mortality. We fitted generalized additive Poisson regression using non-parametric smooth functions to control for the long-term time trend, day of week, air pollution and other weather variables. Results A slight sloping U-like relationship between the total mortality and temperature was found, with an optimum average temperature (temperature with lowest mortality risk) value of 19.7 ℃ in Guangzhou. For temperature above the optimum value, the relative risk of total mortality increased by 3.0% (RR=1.030,95%CI: 1.011-1.050) for each increase of degree in Celsius. For average temperature below the optimum value, the relative risk of total mortality and diseases of circulatory system had a 3.3%(RR=0.967,95%CI: 0.936-0.997 ) decrease and a 3.6% ( RR= 0.964,95%CI:0.935-0.994 ) increase,for each degree of Celsius increase, respectively. Conclusion Our findings showed that the temperature had an impact on the daily mortality in Guangzhou. Countermeasures needed to be taken to reduce the temperature related mortality.

Association between distorted weight perception and suicide ideation among normal weight adolescents / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between distorted weight perception and suicide ideation among normal weight adolescents in Guangdong province.</p><p><b>METHODS</b>This study used the data of Guangdong Provincial Youth Health Risk Behavior Survey in 2004 and 2007. To identify the association between distorted weight perception and suicide ideation, a logistic regression analysis was performed. The effects of age, economic status, mother's education, mental health, and depression were also adjusted.</p><p><b>RESULTS</b>A total of 12 729 people participated in this study, 6096 males and 6633 females. The prevalence of suicide ideation among normal weight adolescents was 13.58% (1729/12 729) in the past 12 months, with higher prevalence in girls (16.15%, 1071/6633) than that in boys (10.79%, 658/6096) (χ(2) = 77.71, P = 0.00). It was common that the adolescents misperceived their weight. Only 44.93% (5719/12 729) of normal weight students correctly perceived their body weight while 43.52% (5540/12 729) of them overestimated their weight and 11.43% (1455/12 729) underestimated their weight. The distorted weight perception in girls (65.58%, 4350/6633) was higher than that in boys (43.39%, 2645/6096) (χ(2) = 993.91, P = 0.00). Distorted weight perception was significantly associated with suicide ideation after controlling for factors age, economic status, mother's education, mental health, and depression. The students who overestimate their body weight were more likely to have suicide ideation than that who correctly perceived their weight (OR = 1.43, 95%CI: 1.27 - 1.61).</p><p><b>CONCLUSION</b>The prevalence of distorted weight perception was high and it significantly associated with suicide ideation.</p>

Features on suicide attempts and its influencing factors among residents in Guangdong province / 中华流行病学杂志

Objective To understand the prevalence of suicide attempts and its related risk factors in Guangdong province to provide scientific basis information for suicide intervention.Methods Multi-stage stratified random sampling method was used to select the sample.42 sweets or towns were selected from 21 counties or districts through randomly sampling.4 communities were then chosen from every selected town or district,followed by 40 families chosen from every village or community.Questionnaire was used to collect data on suicide attempts and its related risk factors.SPSS 16.0 was used for data analysis.Results 6625 peoples were participated in the study.The 12-month incidence of suicidal attempts was 0.8%.It was higher for females ( 1.1% ) than that for males(0.5%) ,and the 25-35 years(1.6%) age group was among the highest.There was no significant difference between the prevalence rates in urban or rural residents.Results from multivariate analysis showed that factors as:being female (OR=2.1),experienced negative events of life (OR= 15.5),in poor sleeping condition ( OR = 1.6),feeling lonely (OR=1.5 ) and anxiety (OR = 1.8 ) were high risk for suicide attempts.Conclusion Suicide attempts in Guangdong province exhibited a high prevalence with complicated influencing factors.Comprehensive countermeasures are needed to prevent and reduce suicidal behaviors.