Efficacy of different questionnaires in screening COPD in the communities of Songjiang District， Shanghai / 上海预防医学

ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District， Shanghai， and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire （COPD-SQ）， the COPD population screener （COPD-PS） and the revised COPD diagnostic questionnaire （revised-CDQ）. Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve （AUC） of the subjects. DeLong test was used to compare the accuracy of different questionnaires； Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents， a total of 259 （8.1%） COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ （63.7% and 72.2%）， COPD-PS （12.0% and 96.1%）， and revised CDQ （78.8% and 52.7%）， with the COPD-SQ having the highest screening accuracy （AUC=0.754）. The optimal and recommended cut-off values for the three questionnaires differed in this population， but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female， and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening， but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening； a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.

Non-alcoholic fatty liver disease related health outcomes and influencing factors among community inhabitants / 上海预防医学

ObjectiveTo describe different non-alcoholic fatty liver disease （NAFLD） outcomes among community inhabitants， and further to explore the correlation between bio-indicator level variance and the outcomes. MethodsPhysical indicators （height， weight， waist circumstances， hip circumstances， blood pressure， etc）， biochemical indicators ［fasting plasma glucose， HbA1c， serum triglycerides（TG）， serum total cholesterol（TC）， low-density lipoprotein cholesterol（LDL-C）， high-density lipoprotein cholesterol（HDL-C）， liver related transaminase， etc］ and clinical imaging （B-scan ultrasonography） were collected during the follow-up from the Songjiang Natural Population Sub-cohort. The identification of NAFLD was supported by the definition criteria from Guidelines for the diagnosis and treatment of non⁃alcoholic fatty liver disease. Paired t-test and multifactorial logistic regression model were used to compare the difference between the indicator level of the subjects from different outcome subgroups and to further analyze the correlation between these indicator variance and different NAFLD outcomes. ResultsDuring a median follow-up time of 2.94 years， 12 076 subjects were involved. The cumulative NAFLD incidence and remission rate were 21.57% and 31.15%， respectively. The proportion of subjects who still had NAFLD was 27.96%. Among subjects with newly-developed NAFLD， indicators including blood pressure， BMI， fasting plasma glucose， and plasma lipid level increased， while in the remission subgroup， blood pressure， BMI（WHR）， waist-hip ratio（WHR）， and TG level were significantly decreased. Increased level of systolic pressure， WHR， BMI， HbA1c， and LDL-C might be the risk factors to the occurrence of NAFLD. While decreased level of WHR， BMI， TC and LDL-C level and elevated HDL-C level were likely to be the influencing factors of NAFLD remission process. ConclusionThe NAFLD morbidity in the community inhabitants is relatively high. BMI， WHR， fasting plasma sugar and plama lipid level variance may act as the influencing factors towards different NAFLD outcomes.

Prevalence and influencing factors of diabetes mellitus among a community population aged from 20 to 74 in Songjiang District， Shanghai / 上海预防医学

ObjectiveTo investigate the prevalence and influencing factors of diabetes mellitus among community population in Songjiang District of Shanghai， and to provide scientific basis for prevention and treatment of diabetes mellitus. MethodsBased on the baseline data of the Shanghai Suburban Adult Cohort （2016‒2017） and local medication database， the prevalence of diabetes in the cohort was described， and the influencing factors for the prevalence of diabetes in different genders were analyzed. ResultsAmong 35 928 participants， males accounted for 40.57%， and the median age was 58 years old. There were 5 342 diabetic patients with a crude prevalence rate of 14.87% and the standardized prevalence rate of diabetes mellitus was 7.57%. The prevalence rate of diabetes in males （15.81%） was significantly higher than that in females （14.23%， P<0.001）. Multivariate logistic regression analysis showed that the following factors were associated with high risk of diabetes mellitus in males： 40‒59 age group （OR=7.111，95%CI：4.900‒10.320）， 60‒74 age group （OR=8.994，95%CI：6.154‒13.144）， family history of diabetes （OR=3.369，95%CI：2.963‒3.83）， overweight （OR=1.272，95%CI：1.123‒1.439）， obesity （OR=1.912，95%CI：1.623‒2.252）， hypertension （OR=1.685，95%CI：1.512‒1.877）， and dyslipidemia （OR=1.396，95%CI：1.263‒1.542）. In females， the high risk of diabetes was associated with： 40‒59 age group （OR=2.718，95%CI：1.838‒4.02）， 60‒74 age group （OR=3.517，95%CI：2.34‒5.286）， family history of diabetes （OR=3.071，95%CI：2.761‒3.416）， overweight （OR=1.254，95%CI：1.125‒1.398）， obesity （OR=2.018，95%CI：1.764‒2.308）， central obesity （OR=1.515，95%CI：1.357‒1.692）， hypertension （OR=2.128，95%CI：1.929‒2.347）， dyslipidemia （OR=1.506，95%CI：1.379‒1.644）， exercise （OR=1.241，95%CI：1.137‒1.355）， and menopause （OR=1.967，95%CI：1.693‒2.286）. ConclusionThe prevalence rate of diabetes is high in Shanghai， and the related factors are different in different gender groups.

Epidemiological characteristics and risk factors of hypertension in residents in Songjiang District， Shanghai： a cohort based cross-sectional study / 上海预防医学

ObjectiveTo determine the epidemiological characteristics and risk factors of hypertension in residents in Songjiang District of Shanghai， and provide evidence for prevention and control of hypertension. MethodsLocal residents aged between 20 and 74 years were recruited from four towns in Songjiang District from 2016 to 2017 by using a multistage sampling strategy. Questionnaire surveys were conducted， and then physical examination， blood pressure measurement， glucose test and lipid test were performed. The data was analyzed by SPSS 16.0 software. Chi-square test was used to compare the differences in the prevalence of hypertension in residents， stratified by demographics and health conditions. Risk factors were determined by multivariate logistic regression. ResultsAmong 35 759 residents with a median age of 58 years and the proportion of male being 40.67%， crude prevalence of hypertension was 54.24% （19 395/35 759） and standardized prevalence was 31.69%. In the hypertensive patients， proportion of hypertension awareness was 61.09%， with 63.67% in male and 59.10% in female. Proportion of receiving treatment was 49.00%， with 50.91% in male and 47.51% in female. Furthermore， in the hypertensive patients with treatment， proportion of effectively controlling hypertension was 40.50%， with 44.46% in male and 37.21% in female. Multivariate logistic regression showed that male （OR=1.272）， senior age （40‒59 years old： OR=4.353， 60‒74 years old： OR=9.802）， overweight （OR=1.823）， obesity （OR=3.070）， central obesity （OR=1.380）， diabetes （OR=1.923）， dyslipidemia （OR=1.452）， and drinking （OR=1.338） were risk factors associated with hypertension. ConclusionPrevalence of hypertension is high， while the proportions of receiving treatment and effective control remain low in residents in Songjiang District. It warrants strengthening prevention and control of hypertension in targeted and young residents.

Epidemiological features of adult chronic kidney diseases in a community-based population in Songjiang district, Shanghai / 中华流行病学杂志

Objective: To investigate the prevalence and associated factors of chronic kidney diseases (CKD) in adult residents living in a community of Songjiang district, Shanghai. Methods: A total of 9 257 residents aged 20-75 years old in Xinqiao township of Songjiang district were selected by random cluster sampling. All the participants were interviewed to complete a set of personal questionnaire and undergo physical examinations. Urine and blood tests including markers of kidney damage and related associated factors with CKD, were carried out. Results: Eligible data from 8 207 subjects were enrolled in the study. After adjustment for age and gender, the prevalence of CKD was 8.4% (95%CI: 7.8%-9.0%), with majority of the patients (76.5%) appeared in the early stage (Ⅰ and Ⅱ) of the disease. The prevalence of CKD increased with age and higher prevalence was seen in females than in males (P<0.001). Results from logistic regression analysis showed that factors as: being elderly or female, having hypertension, hyperuricemia, and hyperlipidemia were all independently associated with CKD. Conclusions: The prevalence of CKD appeared relatively high in adult residents of Xinqiao township, Songjiang district where CKD had become a public health problem. Factors as: being female or elderly, hypertension, hyperuricemia, and hyperlipidemia were found to be associated with CKD. Our findings suggested that early prevention and control on CKD to reduce the incidence of end-stage renal diseases and related complications had called for more urgent attention.

Epidemiological features of adult chronic kidney diseases in a community-based population in Songjiang district, Shanghai / 中华流行病学杂志

Objective To investigate the prevalence and associated factors of chronic kidney diseases (CKD) in adult residents living in a community of Songjiang district,Shanghai.Methods A total of 9 257 residents aged 20-75 years old in Xinqiao township of Songjiang district were selected by random cluster sampling.All the participants were interviewed to complete a set of personal questionnaire and undergo physical examinations.Urine and blood tests including markers of kidney damage and related associated factors with CKD,were carried out.Results Eligible data from 8 207 subjects were enrolled in the study.After adjustment for age and gender,the prevalence of CKD was 8.4％ (95％CI:7.8％-9.0％),with majority of the patients (76.5％) appeared in the early stage (Ⅰ and Ⅱ) of the disease.The prevalence of CKD increased with age and higher prevalence was seen in females than in males (P＜0.001).Results from logistic regression analysis showed that factors as:being elderly or female,having hypertension,hyperuricemia,and hyperlipidemia were all independently associated with CKD.Conclusions The prevalence of CKD appeared relatively high in adult residents of Xinqiao township,Songjiang district where CKD had become a public health problem.Factors as:being female or elderly,hypertension,hyperuricemia,and hyperlipidemia were found to be associated with CKD.Our findings suggested that early prevention and control on CKD to reduce the incidence of end-stage renal diseases and related complications had called for more urgent attention.