Association of alcohol drinking with the incident risk of type 2 diabetes among rural adult males in Deqing County， Zhejiang Province： a prospective cohort study / 上海预防医学

Objective:To investigate the association of alcohol drinking and the incident risk of type 2 diabetes in men and to provide evidences for early prevention of diabetes. Methods:Rural adult males without diabetes in Deqing County， Zhejiang Province were enrolled. A dynamic prospective cohort study was conducted. Data were collected through questionnaires， physical examination， experimental measurements and a electronic follow-up database. Cox multivariate regression was performed to assess the association of alcohol drinking and the incident risk of type 2 diabetes in men. Results:During the follow-up period （7.15±2.90 years）， 354 men developed diabetes， and the incidence rate was 4.15/1 000 person-years. After adjusting for confounding factors， the incident risk of type 2 diabetes among the men with high alcohol drinking frequency （≥7 times/week） and low single alcohol intake （0.1-19.9 g/occasion） was lower than that among non-alcohol drinkers， and the value of HR （95%CI） was 0.72 （0.56-0.94） and 0.54 （0.30-0.99）， respectively. Consumption of ≥40.0 g alcohol per occasion 3-6 times a week increased the incidence of type 2 diabetes， and consumption of <40.0 g alcohol per occasion over 7 times a week decreased the incidence of type 2 diabetes， with the value of HR （95%CI） of 1.53 （1.02-2.30） and 0.52 （0.28-0.99） respectively. Conclusion:Different alcohol drinking patterns affect the incident risk of type 2 diabetes among rural adult males in Deqing County. Further study on alcohol drinking and diabetes may have ethical and practical significance for the prevention and control of diabetes in rural China.

The prevalence and risk factors of diabetes and hypertension in Deqing rural community / 中华疾病控制杂志

Objective This study aimed to describe the prevalence of both type 2 diabetes (T2D) and hypertension, and to explore possible risk factors. Methods A Cross-sectional study was conducted in eight towns cluster-sampled randomly from Deqing County, Zhejiang Province. Totally. 29 306 subjects aged≥18 years old were recruited into this survey. Information on general information, life styles, health status and family history of chronic diseases was collected. Physical examinations including height, weight, blood pressure, etc. were done. Fasting plasma glucose was also tested. Results The prevalence of only T2DM, only hypertension and both of them was 3.34%, 28.72%, and 2.01%, respectively. Such prevalence of both reached a peak at the age of 70-79 years old.Family history of diabetes mellitus(OR=4.94, 95% CI:3.24-7.54, P<0.001) and having a spouse(OR=2.17, 95% CI: 1.18-4.00, P=0.013) were possible risk factors of diabetes mellitus, body mass index(BMI)<24 kg/m2(OR=0.48, 95% CI: 0.39-0.59, P<0.001) was the possible protective factor of diabetes mellitus, BMI<24 kg/m2(OR=0.60, 95% CI: 0.56-0.64, P<0.001), completing compulsory education(OR=0.54, 95% CI:0.49-0.59, P<0.001) and exercise(OR=0.77, 95% CI: 0.69-0.86, P<0.001) were protective factors of hypertension, drinking(OR=1.18 , 95% CI: 1.08-1.29, P<0.001) was the possible risk factor of hypertension. BMI<24 kg/m2(OR= 0.26, 95% CI: 0.21-0.31, P<0.001), completing compulsory education(OR=0.50, 95% CI: 0.35-0.72, P<0.001) and drinking tea(OR=0.80, 95% CI:0.64-0.99, P=0.045) were protective factors of these two diseases. Farmers(OR=1.35, 95% CI: 1.04-1.76, P=0.024), family history of diabetes(OR=4.21, 95% CI: 2.71-6.57, P<0.001) and family history of hypertension(OR=1.86, 95% CI: 1.31-2.64, P=0.001) were risk factors for the co occurrence of two diseases. Conclusions The prevalence of diabetes among adults in Deqing County was relatively lower than other places. The prevalence of hypertension was close to the level of other regions. Age, overweight, alcohol consumption, family history of diabetes and hypertension were the risk factors of diabetes and hypertension. Diabetes mellitus was a high-risk group of hypertension. Further means should be taken to strengthen the self-management and treatment of this group. Further intervention action should be taken to promote health and quality of life.

An observation on the long-term efficacy of recombinant hepatitis B vaccines among the newborns / 预防医学

Objective evaluate the long-term efficacy of the recombinant hepatitis B vaccines (HBV) among the newbornswith vaccination at birth. Methods During 1996-1997, 135 newborns were selected from Deqing according to the inclusioncriterion. They were divided into 2 groups: a group of 35 newborns whose mother was HBsAg positive) and a group of 100newbornswhose mother was HBsAg negative. All 135 newborns routinely received 3 doses of yeast -derived hepatitis Bvaccines (i.e. the first dose at birth, the second dose at 1 month old, and the third dose at 6 months old) . Serologicalmarkers to HBV were repeatedly assessed at 3 follow-up stages (i.e. the first follow-up at 12 months, the second follow-upat 2010, the third follow-up at 2012) . Results Participants remained in the study at 3 follow-upstages were 123(91.11%), 95(70.37%) and 46(34.07%) respectively. Participants' serum HBsAg were negative at all 3 follow-upstages. Among participants whose mothers were HBsAg positive, 3 participants were found to be HBcAb positive in 2010,and no new HBcAb positive participants were found in 2012. The rates of HBsAb positive at 3 follow-up stages were 88.89%, 81.48%, and 80.00% respectively. The HBsAb geometric mean concentrations (GMCs) of participants at their 12 monthsold were significantly positively associated with those in 2010 and those in 2012(P<0.05) . Among participants whosemothers were HBsAg negative, no HBcAb positive participants were found. The rates of HBsAb positive at 3 follow-up stageswere 91.18%, 54.41%, and 52.78% respectively. No correlation was found among HBsAb GMCs of participants at 12 monthsold, in 2010 and in 2012. No correlation was found between boost vaccination and the rate of HBsAg positive, afteradjustment of the HBsAg status of their mothers. Conclusion The efficacy of the yeast-derived HBV could sustain for at least13-15 years, and the general population do not need booster immunization. After the 3-dose immunization, the HBsAblevels of the healthy mothers' 12-months-old children were related to those of their adolescence.

An evaluation on immunization effect and the influencing factors after revaccination with 60 μg hepatitis B vaccine among non-response adults / 预防医学

Objective To explore vaccine immune effects of 60μg hepatitis B on adults who have no response to hepatitis B vaccination.Methods A Total of 689 healthy adults who were HBsAg and anti -HBs negative were selected,and they were received 3 doses of hepatitis B vaccine at dosage 10 μg.Those with anti-HBs<10 IU/L detected after full series vaccination were given 1 dose of hepatitis B vaccine at dosage 60 μg.One month later,anti-HBs detection was conducted for them.Results The non -responsiveness rate was 17.71% after primary hepatitis B vaccination.The multivariate logistic regression analysis showed that risk factors for primary non-responsiveness were the history of surgical operation, immunization schedule and "anti-HBc alone".The anti-HBs positive rate was 95.5 1% in 89 re-vaccinated people, and the geometric mean titers of anti -HBs(GMT)was 585.39 IU/L.Conclusion Re -immunization of hepatitis B vaccine at dosage 60 μg has good immunogenicity in people who have no response to primary vaccination,and weight control may improve the effect of hepatitis B re-immunization.

The long-term efficacy of recombinant hepatitis B vaccines for children / 预防医学

Objective To observe long-term efficacy of recombinant hepatitis B vaccines for children received fundamental immunization or booster dose. Methods 493 school students from Deqing county with complete information of immunization history were investigated and their serological markers were detected. 430 students received booster dose vaccines at 3-11 years old and were defined as booster group while the remaining 63 students were defined as fundamental group. Results All vaccines the 493 students received for fundamental immunization were recombinant. Compared with fundamental group(57. 14%),booster group had significantly higher Anti-HBs positive rate of 91. 40%(P<0. 01). And the Anti-HBs positive rate had a high level of 94. 99% when 0-5 years after booster immunization while it declined to 64. 71% after 8-15 years and showed no significant difference compared with fundamental group. Conclusion Anti-HBs level and anti -HBs positive rate can significantly increase for short periods after booster immunization,and may decline considerably for long-term. Immunologic amnesia rate is low when 3 -11 years after fundamental immunization among infants.

Prevalence of occult hepatitis B virus infection and its phylogenetic features among mother-teenager pairs / 中华流行病学杂志

Objective Prevalence of occult hepatitis B virus (HBV) infection (OBI) was investigated in a paired mother-teenager population and HBV S gene variation including overt and occult HBV,was determined.Methods A follow-up study based on an initial survey of 135 mother-teenager pairs was carried out through collection of questionnaires and blood samples HBsAg were detected by ELISA method,viral load by PCR amplification and HBV S gene by phylogenetic analysis.Results 102 pairs of subjects were followed-up.Blood samples from 94 mothers and 101children were collected.OBI prevalence in mothers was 10.0％ (6/60),significantly higher than 2.0％(2/101) in teenagers.Medians of viral load were 399.9 IU/ml and 247.6 IU/ml in overt and occult HBV strains,but without significant difference.1 occult HBV strain belonged to genotype B with serotype adw while the other 7 were genotype C with serotype adr.15 of the overt HBV strains belonged to genotype B with serotype adw and the other 8 were genotype C with serotype adr.Proportions of genotype-C strains were significantly higher in occult HBV strains than in overt HBV strains.Conclusion OBI was seen in teenage-mother population.

Study on the prevalence and genotype of hepatitis E virus among commercial swine population in Eastern and Southern China / 中华流行病学杂志

Objective To determine the prevalence and genotype of hepatitis E virus (HEV)among commercial swine population in Eastern and Southern China. Methods Six hundred specimens of swine bile collected from 5 slaughterhouses in Eastern and Southern China from 2007 to 2009 were tested for HEV RNA using nested RT-PCR. PCR products were sequenced for phylogenetic analysis. Results Forty-seven out of the 600 samples (7.83%) were positive for HEV RNA. Based on the 150 nt fragment within HEV ORF2, data from phylogenetic analysis revealed that all the 47 HEV isolates were identified to be genotype Ⅳ, sharing 75.0%-83.4%, 75.0%-84.6%, 71.9%-80.7% and 88.1%-91.5% nucleotide identities with prototype Ⅰ,Ⅱ,Ⅲ and Ⅳ HEV strains respectively while majority of the isolates clustered within their respective isolation sites. Conclusion HEV was widespread in commercial swine population in Eastern and Southern China that raised a serious concern about the safety regarding the consumption of pork products.