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Objective To assess the disease burden on uterine fibroids in China in 1990 and 2016.Methods Data were extracted from the Global Burden of Disease Study 2016.Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016,with key indicators including number of cases,prevalence rates,disability-adjusted life year (DALY) and the rates of DALY.The WHO world standard population,2010-2035 was used to calculate the agestandardized rates.Results In 1990 and 2016,there were 13 695 567 and 27 169 312 women aged 15 years and older,suffered from uterine fibrosis respectively,with prevalence rate as 2.48％ and 4.10％,DALY as 146 045.05 life years and 281 976.67 life years,and the DALY rate as 26.40/100 000 and 42.50/100 000,in 1990 and 2016 respectively.Both the prevalence rate and the DALY rate increased with age,reaching the peak on the 45-49 years-old,in both 1990 and 2016.Women aged 40-54 years accounted for 55.60％ (1990) and 66.74％ (2016) of the total cases while 48.37％ (1990) and 60.65％ (2016) of the total DALY.The first three provinces with highest DALYs were Shandong (1990:12 574.67 life year;2016:22 728.12 life year),Henan (1990:10 849.29 life year;2016:18 454.32 life year) and Jiangsu (1990:10 501.55 life year;2016:18 274.10 life year),while the three provinces with leading standardized DALY rates were Heilongjiang (1990:48.20/100 000;2016:47.00/100 000),Shanxi (1990:44.50/100 000;2016:47.70/100 000) and Tianjin (1990:43.80/100 000;2016:46.40/100 000) in both 1990 and 2016.Compared with 1990,the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as:98.38％),standardized prevalence rate increased by 1.88％,DALY value increased by 135 931.62 life years (with the rate of change as 93.08％) and standardized DALY rate increased by 5.92％ among Chinese women,in 2016.Conclusion Menopausal women were the ones hard hit by uterine fibrosis.Compared with data from 1990,the disease burden of uterine fibrosis increased rapidly in China,in 2016.
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Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
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Objective To assess the disease burden on uterine fibroids in China in 1990 and 2016.Methods Data were extracted from the Global Burden of Disease Study 2016.Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016,with key indicators including number of cases,prevalence rates,disability-adjusted life year (DALY) and the rates of DALY.The WHO world standard population,2010-2035 was used to calculate the agestandardized rates.Results In 1990 and 2016,there were 13 695 567 and 27 169 312 women aged 15 years and older,suffered from uterine fibrosis respectively,with prevalence rate as 2.48％ and 4.10％,DALY as 146 045.05 life years and 281 976.67 life years,and the DALY rate as 26.40/100 000 and 42.50/100 000,in 1990 and 2016 respectively.Both the prevalence rate and the DALY rate increased with age,reaching the peak on the 45-49 years-old,in both 1990 and 2016.Women aged 40-54 years accounted for 55.60％ (1990) and 66.74％ (2016) of the total cases while 48.37％ (1990) and 60.65％ (2016) of the total DALY.The first three provinces with highest DALYs were Shandong (1990:12 574.67 life year;2016:22 728.12 life year),Henan (1990:10 849.29 life year;2016:18 454.32 life year) and Jiangsu (1990:10 501.55 life year;2016:18 274.10 life year),while the three provinces with leading standardized DALY rates were Heilongjiang (1990:48.20/100 000;2016:47.00/100 000),Shanxi (1990:44.50/100 000;2016:47.70/100 000) and Tianjin (1990:43.80/100 000;2016:46.40/100 000) in both 1990 and 2016.Compared with 1990,the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as:98.38％),standardized prevalence rate increased by 1.88％,DALY value increased by 135 931.62 life years (with the rate of change as 93.08％) and standardized DALY rate increased by 5.92％ among Chinese women,in 2016.Conclusion Menopausal women were the ones hard hit by uterine fibrosis.Compared with data from 1990,the disease burden of uterine fibrosis increased rapidly in China,in 2016.
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Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
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Objective@#To analyze the lung cancer deaths attributable to ambient PM2.5 exposure in China in 2016.@*Methods@#All data were from the Global Burden of Disease Study 2016 (GBD 2016). Multiple-source data, including satellite observation, ground measurement, chemical migration model simulation, etc., and the data integration model for air quality (DIMAQ) were used to estimate the grid-level exposure to ambient PM2.5. Data from the vital registry and cancer registry were used to establish statistical model to estimate the lung cancer deaths by province, age and gender. The lung cancer deaths attributable to PM2.5 were calculated based on the calculation of population attributable fraction (PAF). The GBD world population age structure was adopted to calculate age-standardized rates for comparison among provinces (including 31 provinces, autonomous regions and municipalities directly under the central government, as well as Hong Kong and Macao special administrative regions, excluding Taiwan of China).@*Results@#In 2016, the lung cancer deaths attributable to ambient PM2.5 exposure in China were 14.56×104 (95% uncertainty interval (UI): 9.63×104-19.55×104), accounting for 24.66% (95%UI: 16.38%-33.12%) of total lung cancer deaths. The lung cancer death rate attributable to PM2.5 increased with age, with the lowest among 25-29 age group (0.25/105, 95%UI: 0.17/105-0.34/105), the highest among ≥80 age group (90.70/105, 95%UI: 59.85/105-122.20/105). The lung cancer death rate attributable to PM2.5 among males (14.84/105, 95%UI: 9.78/105-19.93/105) was higher than that in females (6.21/105, 95%UI: 4.07/105-8.40/105). The age-standardized death rates (ASDR) of lung cancer attributable to PM2.5 among males and females in China were higher than the global average level. The attributable ASDR of lung cancer varied among provinces, highest in Shandong (13.51/105, 95%UI: 9.14/105-18.20/105) and lowest in Tibet (0.85/105, 95%UI: 0.44/105-1.51/105).@*Conclusion@#In 2016, the lung cancer deaths attributable to ambient PM2.5 exposure in China was heavy, and varied in different age groups, genders and provinces.
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Objective@#To analyze the disease burden of pancreatic cancer in China in 1990 and 2017.@*Methods@#Province-specific data in China from the Global Burden of Disease Study (GBD) 2017 were used to describe the change of death status, disease burden of pancreatic cancer in Chinese population by specific province and age groups, including incidence, mortality, disability-adjusted life years (DALY), years of life lost (YLL) due to premature mortality and years lived with disability (YLD) in 1990 and 2017. Meanwhile the incidence, mortality, DALY rate, YLL rate, YLD rate were standardized by the GBD global standard population in 2017.@*Results@#In 2017, the new cases of pancreatic cancer, incidence and age-standardized incidence accounted for 83.6 thousand, 5.92/100 000 and 4.37/100 000 in China, with an increase of 230.94%, 180.45% and 49.88% compared with 1990, respectively. The total number of deaths, mortality and age-standardized mortality appeared as 85.1 thousand, 6.02/100 000, 4.48/100 000, with an increase of 236.08%, 184.80% and 47.51% respectively. The incidence and mortality of pancreatic cancer increased with age and accelerated from the age of 55 to 59 both in 1990 and 2017. The highest incidence and mortality showed in 85-89 years old in 2017 and in 90-94 years old in 1990. The standardized DALY rate of pancreatic cancer increased from 71.00/100 000 in 1990 to 94.32/100 000 in 2017, increased by 32.84%. The standardized YLL rate increased from 70.39/100 000 to 93.42/100 000, increased by 32.72%. The standardized YLD rate increased from 0.62/100 000 to 0.90/100 000, increased by 45.80%. In terms of age distribution, DALY rate, YLL rate and YLD rate of pancreatic cancer basically showed an increasing trend with age in 1990 and 2017. In 2017, Jiangsu (7.61/100 000), Shanghai (7.52/100 000) and Liaoning (6.84/100 000) ranked the top three provinces in terms of standardized mortality. Compared with 1990, Henan (104.28%), Sichuan (94.02%) and Hebei (90.39%) saw the fastest increase in standardized mortality.@*Conclusions@#The incidence, mortality and disease burden of pancreatic cancer in China increased significantly from 1990 to 2017. Prevention and control measures should be strengthened to reduce the disease burden of pancreatic cancer.
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Objective To analyze the deaths attributed to ambient air pollution in China between 2006 and 2016.Methods The data were collected from the project of Global Burden of Disease in 2016 (GBD2016).The Data Integration Model for Air Quality were used to estimate exposure to particulate matter smaller than 2.5 μm in aerodynamic diameter (PM2.5).The attributable death number was calculated based on the calculation of population attributable fraction (PAF),and the results were compared by gender,diseases and provinces.An average world population age structure was adopted to calculate age-standardized rates.Results In 2016,a total of 1 075 000 deaths attributed to ambient air pollution occurred in China,accounting for 11.1％ of the total deaths,and 57.6％ of the deaths attributed to ambient air pollution were due to ischemic heart disease and stroke.The death number among men was 1.7 times higher than that in women,Compared with 2006,the proportion of ambient air pollution related deaths in total deaths decreased by 6.8％;the agestandardized death rate attributed to ambient air pollution decreased by 26.5％ and the decrease rate of lower respiratory infections (37.6％) and chronic obstructive pulmonary disease (42.1％) were greater than ischemic heart disease (5.3％).The age-standardized rate of death attributed to ambient air pollution decreased both in men and in women,but the decrease rate was higher in women (34.8％) than that in men (20.4％).The PAFs varied among provinces,it was highest in Tianjin (13.9％),lowest in Tibet (6.1％),and it was relatively higher in Beijing,Hebei,Shandong,Henan and the three provinces in the northeast and relatively lower in Hong Kong,Macao,Fujian and Hainan etc..The agestandardized rate of death attributed to ambient air pollution was highest in Xinjiang (120.1/100 000) and lowest in Hong Kong (30.9/100 000),and it was relatively higher in Qinghai,Guizhou,Henan and relatively lower in Macao,Shanghai and Fujian,etc..Compared with 2006,the PAFs of 17 provinces decreased,the decrease rate ranged from 4.1％ to 16.8％,whereas the PAF of Jilin (5.0％) and Heilongjiang (8.1％) increased,and the PAFs of other 14 provinces showed no significant change.The attributable age-standardized death rate decreased in all provinces with the decrease rate ranging from 11.9％ (Heilongjiang) to 43.2％ (Fujian),and the decrease rate was relatively higher in Guangdong,Zhejiang and Guizhou,and lower in the three provinces in the northeast,Hubei and Hebei etc.Conclusions In 2016,the disease burden attributable to PM2.5 in China was heavy,but mitigated compared with 2006.The gender and area specific distributions of deaths attributed to ambient air pollution were observed.
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Objective To analyze the rates on prevalence,awareness,status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49,in 2013.Methods Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis.Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age,with 46 674 premenopausal women aged 18-49.Plasma glucose and hemoglobin A 1 c levels were determined after a 10-hour overnight fast for all the participants,before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes.Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥ 11.1 mmol/L.After being weighed,according to complex sampling scheme and post-stratification,the sample was used to estimate the rates of prevalence,awareness,treatment and control of type 2 diabetes mellitus by age,education,urban and rural areas,and geographic locations.Results The overall prevalence of type 2 diabetes mellitus was 5.6％ among the Chinese premenopausal women aged 18-49.No statistical difference on the prevalence rates (5.7％ and 5.4％,respectively) was seen,between participants from the rural or the urban areas.Prevalence rates in the eastern,central or western geographic areas were 5.8％,6.2％ and 4.4％ respectively.The rates of awareness,treatment and control of diabetes appeared as 29.3％,27.9％ and 29.4％ in childbearing women aged 18-49.The rate of treatment was 95.4％ among those who knew their diabetic situation in childbearing women aged 18-49 years.The control rate of diabetes was 38.9％ among those who had taken measures to control glucose,in 18-49-year-old childbearing women.The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas.There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test.Conclusion The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high,but with low rates on awareness,treatment and control.However,statistical difference was seen on awareness,between urban and rural areas.
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Objective To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013.Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used.The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction.Results In 2013,alcohol use resulted in 381 200 deaths,including 97 100 hemorrhagic stroke deaths,88 200 liver cancer deaths,61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths,and prevented 76 500 deaths,including 68 500,4 900 and 3 100 deaths which might be caused by ischemic heart disease,hemorrhagic stroke and diabetes respectively.If risk factor of alcohol use is removed,the people's life expectancy would rise by an average of 0.43 years,especially in westem China by 0.52 years,which was 0.12 years higher than that in eastern and central China,and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively.Conclusions Although alcohol has a protective effect on reducing ischemic heart disease,stroke and diabetes deaths,alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China.It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
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Objective To analyze the deaths attributed to ambient air pollution in China between 2006 and 2016.Methods The data were collected from the project of Global Burden of Disease in 2016 (GBD2016).The Data Integration Model for Air Quality were used to estimate exposure to particulate matter smaller than 2.5 μm in aerodynamic diameter (PM2.5).The attributable death number was calculated based on the calculation of population attributable fraction (PAF),and the results were compared by gender,diseases and provinces.An average world population age structure was adopted to calculate age-standardized rates.Results In 2016,a total of 1 075 000 deaths attributed to ambient air pollution occurred in China,accounting for 11.1％ of the total deaths,and 57.6％ of the deaths attributed to ambient air pollution were due to ischemic heart disease and stroke.The death number among men was 1.7 times higher than that in women,Compared with 2006,the proportion of ambient air pollution related deaths in total deaths decreased by 6.8％;the agestandardized death rate attributed to ambient air pollution decreased by 26.5％ and the decrease rate of lower respiratory infections (37.6％) and chronic obstructive pulmonary disease (42.1％) were greater than ischemic heart disease (5.3％).The age-standardized rate of death attributed to ambient air pollution decreased both in men and in women,but the decrease rate was higher in women (34.8％) than that in men (20.4％).The PAFs varied among provinces,it was highest in Tianjin (13.9％),lowest in Tibet (6.1％),and it was relatively higher in Beijing,Hebei,Shandong,Henan and the three provinces in the northeast and relatively lower in Hong Kong,Macao,Fujian and Hainan etc..The agestandardized rate of death attributed to ambient air pollution was highest in Xinjiang (120.1/100 000) and lowest in Hong Kong (30.9/100 000),and it was relatively higher in Qinghai,Guizhou,Henan and relatively lower in Macao,Shanghai and Fujian,etc..Compared with 2006,the PAFs of 17 provinces decreased,the decrease rate ranged from 4.1％ to 16.8％,whereas the PAF of Jilin (5.0％) and Heilongjiang (8.1％) increased,and the PAFs of other 14 provinces showed no significant change.The attributable age-standardized death rate decreased in all provinces with the decrease rate ranging from 11.9％ (Heilongjiang) to 43.2％ (Fujian),and the decrease rate was relatively higher in Guangdong,Zhejiang and Guizhou,and lower in the three provinces in the northeast,Hubei and Hebei etc.Conclusions In 2016,the disease burden attributable to PM2.5 in China was heavy,but mitigated compared with 2006.The gender and area specific distributions of deaths attributed to ambient air pollution were observed.
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Objective To analyze the rates on prevalence,awareness,status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49,in 2013.Methods Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis.Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age,with 46 674 premenopausal women aged 18-49.Plasma glucose and hemoglobin A 1 c levels were determined after a 10-hour overnight fast for all the participants,before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes.Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥ 11.1 mmol/L.After being weighed,according to complex sampling scheme and post-stratification,the sample was used to estimate the rates of prevalence,awareness,treatment and control of type 2 diabetes mellitus by age,education,urban and rural areas,and geographic locations.Results The overall prevalence of type 2 diabetes mellitus was 5.6％ among the Chinese premenopausal women aged 18-49.No statistical difference on the prevalence rates (5.7％ and 5.4％,respectively) was seen,between participants from the rural or the urban areas.Prevalence rates in the eastern,central or western geographic areas were 5.8％,6.2％ and 4.4％ respectively.The rates of awareness,treatment and control of diabetes appeared as 29.3％,27.9％ and 29.4％ in childbearing women aged 18-49.The rate of treatment was 95.4％ among those who knew their diabetic situation in childbearing women aged 18-49 years.The control rate of diabetes was 38.9％ among those who had taken measures to control glucose,in 18-49-year-old childbearing women.The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas.There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test.Conclusion The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high,but with low rates on awareness,treatment and control.However,statistical difference was seen on awareness,between urban and rural areas.
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Objective To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013.Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used.The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction.Results In 2013,alcohol use resulted in 381 200 deaths,including 97 100 hemorrhagic stroke deaths,88 200 liver cancer deaths,61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths,and prevented 76 500 deaths,including 68 500,4 900 and 3 100 deaths which might be caused by ischemic heart disease,hemorrhagic stroke and diabetes respectively.If risk factor of alcohol use is removed,the people's life expectancy would rise by an average of 0.43 years,especially in westem China by 0.52 years,which was 0.12 years higher than that in eastern and central China,and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively.Conclusions Although alcohol has a protective effect on reducing ischemic heart disease,stroke and diabetes deaths,alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China.It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
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Objective To assess the disease burden for gynecological disease in China in 2016. Methods Data were extracted from the global burden of disease study 2016(GBD 2016). The burden of gynecological disease among age groups and provinces groups was assessed by prevalence rate, mortality rate, years lived with disability (YLD), years of life lost due to premature mortality (YLL) and disability-adjusted life years(DALY). An average world population age-structure for the period 2010-2035 was adopted to calculate age-standardized rates. Results In 2016, the prevalence rate of gynecological disease in women aged 15 years and above in China was 24.94%, of which was 36.71%to women of childbearing age. The number of DALY from gynecological disease was 2727637.82 life years in 2016, with the DALY rate was 411.12/100000 and standardized DALY rate was 341.80/100000. The first three gynecological diseases with highest DALY and DALY rate among Chinese women aged ≥15 years were premenstrual syndrome(815004.64 life years, 122.84/100000), uterine fibroids(281976.67 life years, 42.5/100000) and endometriosis (154792.89 life years, 23.33/100000). The DALY caused by gynecological disease in Guangdong (220871.19 life years), Shandong (190968.72 life years), Henan (171273.92 life years), Jiangsu(168404.27 life years)and Sichuan(144358.5 life years)were higher than other provinces. The standardized DALY rate attributable to gynecological disease were highest in Xinjiang Uygur Autonomous Region(404.00/100000), Shanghai(394.90/100000), Heilongjiang(382.00/100000), Beijing(365.70/100000)and Jiangsu (357.50/100000). Conclusions Gynecological disease is a great threat to women' s reproductive health. Effective measures should be taken to address the issue, especially to women of childbearing age.
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Objective To investigate the epidemiological characteristics of obesity and its relationships to five common chronic diseases among the Chinese elderly population.Methods In 2013,The 4th Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces.A multistage cluster sampling method was used at 298 National Disease Surveillance Points(DSPs).A total of 51778 adults aged 60 and over received a standardized questionnaire,physical examinations,and laboratory tests for blood lipid & glucose levels.The body mass index(BMI)was used for obesity measurement and waist circumference(WC)for central obesity measurement.After weighting adjustment of the sample,the prevalence of obesity and central obesity was compared between different genders,among different age groups,and among different regions.The unconditional Logistic regression model was applied to analyze the relationships of five selected chronic diseases with BMI and WC.Population attributable fractions (AFP)were also calculated.Results Among the elderly,the prevalence of obesity and central obesity was 13.2 ％ and 55.4 ％,respectively.Both were higher in women(16.3％ and 64.4％)than in men(9.9％ and 46.0％)and higher in the urban areas (15.6％ and 62.0％) than in the rural areas (12.0％ and 52.1％) (all P ＜ 0.05).The increased prevalence of five common chronic diseases was correlated with increased BMI and WC(all P＜0.05).After adjustment for confounders,obesity was associated with increased prevalence of hypertension,diabetes,dyslipidemia,and stroke (ORs:1.43-2.68,AFP s:0.05-0.18);central obesity was associated with increased prevalence of the five chronic diseases (ORs:1.35-1.88,AFPs:0.16-0.33)Conclusions High prevalence of obesity and central obesity can be seen in aged women and the urban elderly population.Obesity and central obesity are both related to hypertension,diabetes,dyslipidemia,and stroke.Besides,central obesity is also associated with myocardial infarction.
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Objective To assess the mortality attributable to low fruit intake among people over 25 years old in China,2013,and its effect on life expectancy.Methods Based on data collected from China Chronic Disease and Risk Factor Surveillance in 2013,the average fruit intake in different genders and areas were calculated.Potential impact fraction (PIF) was used to examine the impact on deaths,mortality and life expectancy.Results The average daily fruit intake was (113.3 ± 168.9)g among people over 25 years old,with (103.6± 160.1) g for men and (122.7± 176.6) g for women,in China in 2013.Fruit intake for urban residents was significantly higher than that in rural residents and higher in eastern regions than that in central or western regions.Scores that attributable to low fruit intake accounted for 15.21％ of the total deaths and the population attributable fraction of inadequate intake of fruits to associated diseases was 35.00％.PIF for all the deaths in rural residents (16.50％)appeared higher than that of the urban residents (13.88％),and higher in the residents living in the eastern region (15.48％) than that in the central (16.27％) or western (13.75％) regions.Number of deaths that attributable to low fruit intake was 1.348 4 million.Deaths caused by related diseases appeared as:ischemic heart disease (472.5 thousands),hemorrhagic stroke (338.8 thousands),ischemic stroke (259.0 thousands),lung cancer (208.4 thousands),esophageal cancer (60.7 thousands),laryngeal cancer (5.4 thousands) and oral cancer (3.6 thousands).Numbers of all deaths and related diseases for urban residents were lower than that of the rural residents,with central regions (452.7 thousands) higher than that in the eastern (531.1 thousands) or western (364.6 thousands) regions.The average life expectancy loss caused by low fruit intake was 1.73 years,1.80 years for men and 1.58 years for women,in this country.Loss of life expectancy in the rural residents was higher than that of the urban residents,and higher in central regions than that in the eastern or western regions.Conclusions The intake of fruit was far lower than the recommended standard set for the Chinese people.Population attributable fraction was related to the associated diseases caused by inadequate intake of fruits which also made serious impact on life expectancy.
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Objective To analyze the attribution of mortality and impact on life expectancy caused by insufficient physical activity in different gender and areas in adults aged ≥25 years among Chinese people.Methods Data from the programs related to Chinese death surveillence,risk factors of chronic survey,health outcomes of physical activity as well as relative risk (RR) on Global Burden of Disease (GBD) study were used.Population attributable fraction (PAF) of different health outcomes attributable to deaths that caused physical activity and the influence of life expectancy in adults aged ≥25 years in Chinese people were calculated.Results The overall PAF for all cause of death due to physical activity in adults aged ≥25 years was 4.24％,with 4.86％ in females and 3.82％ in males.The health outcomes of inadequate physical activity would include breast cancer,colorectal cancer,ischemic heart disease,ischemic stroke and diabetes with relative PAFs as 9.04％,13.96％,14.96％,17.80％ and 16.92％,respectively.The attribution of death on Physical activity was 388 954.The most attributed death was ischemic heart disease,followed by ischemic stroke.With the elimination of physical inactivity,the total life expectancy was expected to lose by 0.43 years,with 0.47 years in women,and 0.39 years in men.Conclusion The increase of physical activity may benefit on health condition so to reduce the burden of chronic diseases and increase the life expectancy.
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Objective To analyze deaths that attributable to high fasting plasma glucose and its impact on life expectancy among Chinese residents in 2013.Methods Data from the Mortality Surveillance Programs in National Disease Surveillance Points System and the China Chronic Disease Surveillance (2013) were used.Death attributed to high fasting plasma glucose and its impact on the life expectancy of Chinese residents were estimated,based on the principle of population attributable fraction.Results In 2013,the total number of deaths attributed to high fasting plasma glucose among aged ≥25 years old was 621 thousand,with 333 thousand males and 288 thousand females.Diseases related to the number of deaths caused by high fasting plasma glucose would include ischemic heart disease (212 thousand) as the most important one.Cerebrovascular disease appeared the 2nd place,with around 181 thousand cases and then followed by diabetes (145 thousand),chronic kidney disease (52 thousand) and tuberculosis (31 thousand).After removal of the effects on high blood glucose exposure,the life expectancy of Chinese residents in 2013 would have reached 76.5 years old,an average increase of 0.7 years,compared to the average life expectancy of all deaths,with men having an increase of 0.7 years and women of 0.8 years,respectively.Conclusions High fasting plasma glucose appeared an important risk factor for mortality and life expectancy on the Chinese residents.Programs related to prevention and control of high fasting plasma glucose and related diseases should be strengthened.
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Objective To quantitatively estimate the deaths and life expectancy losses attributable to diet high in sodium in China,and examine the gains and shifts under different control scenarios of sodium consumption.Methods Based on data from the cause-of-death through the National Mortality Surveillance System,and 24 hours urinary sodium values from Global Burden of Disease study on Chinese's estimates,population attributable fractions with the framework of comparative risk assessment were used to analyze the deaths and life expectancy losses due to diet high in sodium.The same methods were followed to examine the gains and shifts under different control scenarios of sodium consumption.Results In 2013,1 430 (940 for men and 490 for women)thousand deaths were attributable to diet high in sodium,accounting for 15.6％ (17.4％ for men and 13.0％ for women) of all-cause deaths in China,which causing 2.17 (2.49 for men and 1.71 for women) years of life expectancy loss.Diet with high sodium in 2013 caused 1 200,50 and 180 thousand deaths from cardiovascular disease,chronic kidney disease and stomach cancer respectively,accounting for 31.5％,30.8％ and 64.8％ of those specific causes.Comparing to the baseline in 2013,if the targets of 10％ decrease of sodium consumption by 2020 and 15％ by 2030 for Chinese chronic disease prevention and treatment planning,and 30％ decrease by 2030 for WHO non-communicable disease monitoring framework are achieved,220,340 and 730 thousand deaths will be averted,which may gain 0.30,0.45 and 0.95 years of life expectancy,respectively.Conclusions As one of the leading risk factors,diet high in sodium had caused heavy burden of disease from cardiovascular disease,chronic kidney disease and stomach cancer on Chinese residents.Intervention programs on sodium-reductionare urgently needed in China and related cost-effectiveness is highly expected.
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Objective To estimate the effect of high total cholesterol (TC) on life expectancy in China.Methods Population attributable fractions (PAF) of high TC were calculated in both urban,rural areas and regions,using data related to TC levels from the chronic disease risk factor surveillance in China,2013.Together with PAFs,data related to death registry,demographics,attributable deaths from high TC and its effect on life expectancy,were estimated.Results In 2013,the TC level in Chinese population aged 25 and above appeared as (4.8± 1.0) mmol/L,higher in urban areas [(4.8±1.0) mmol/L] than that in rural areas [(4.7± 1.0) mmol/L)],with the highest in eastern regions [(4.9 ±1.0) mmol/L] and lowest in the central regions [(4.6 ± 1.0) mmol/L].TC level appeared as (4.8 ± 1.0)mmol/L in both sexes.A total of 2.9％ of all the deaths were attributed to high TC (264 998 deaths),among which 89.3％ were caused by ischemic heart disease (236 540 deaths).PAF was seen higher in females (3.7％) than that in males (2.3％),higher in urban (3.4％) than that in rural areas (2.4％),with the highest in eastern (3.7％) and lowest in western regions (2.1％).Mortality that attributed to high TC was 19.6/100 000,higher in females (21.2/100 000) than that in males (18.0/100 000),higher in urban (20.8/100 000) than that in rural areas (18.2/100 000),with the highest in eastern (23.2/100 000) and lowest in western regions (15.6/100 000).In 2013,the loss of life expectancy that caused by high TC was 0.30 year,higher in females (0.35 year) than in males (0.26 year),higher in urban (0.34 year) than that in rural areas (0.28 year),with the highest seen in the eastern (0.36 year) and lowest (0.23 year) in the western regions.Conclusion In 2013,the effect of high TC on life expectancy appeared different between genders,urban and rural areas or regions,with greater impact on females,urban and eastern areas of the country.
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Objective To estimate the deaths (mortality) and life expectancy that attributable to high blood pressure in people from different regions and gender,in China in 2013.Methods Data was from the ‘China Chronic Disease Risk Factor Surveillance 2013'and the ‘China National Mortality Surveillance 2013'.According to the comparative risk assessment theory,population attributable fraction (PAF) of high blood pressure by gender,urban-rural,east-central-west regions was calculated before the estimations on deaths (mortality) and life expectancy attributable to high blood pressure was made.Results In 2013,among the Chinese people aged 25 years old and above,the mean SBP was (129.48 ± 20.27) mmHg.High blood pressure [SBP＞(115 ± 6) mmHg] caused 20.879 million deaths and accounted for 22.78％ of the total deaths.SBP,deaths,mortality rate and standardized mortality rate that attributable to high blood pressure all appeared higher in men [(131.15 ± 18.73) mmHg,11.517 million,165.56/100 000 and 106.97/100 000,respectively] than in women [(127.79 ± 21.60) mmHg,9.362 million,141.99/100 000 and 68.93/100 000,respectively].SBP,deaths,mortality rate and PAF were all seen higher in rural [(130.25±20.66) mmHg,11.234 million,178.58/100 000 and 23.59％,respectively] than in urban [(128.58± 19.77) mmHg,9.645 million,132.87/100 000 and 21.54％,respectively] areas.However,levels of SBP were similar in the east,central or west regions,with attributable deaths,attributable mortality rate and PAF the highest as 7.658 million 179.93/100 000,and 26.72％ respectively.In 2013,among the Chinese people aged 25 years old and above,deaths caused by cardiovascular disease and chronic kidney disease attributable to high blood pressure were 19.912 million and 0.966 million,accounting for 52.31％ of the total deaths due to cardiovascular diseases and 62.11％ to the total chronic kidney diseases.The top three deaths attributable to high blood pressure were ischemic heart disease (6.656 million),hemorrhagic stroke (5.331 million) and ischemic stroke (3.593 million).When the effect of high blood pressure had been eliminated,the life expectancy per capita would have increased by 2.86 years old,with higher in women than in men (3.07 and 2.64 years old,respectively),higher in central than in east and west (3.48,2.56 and 2.58 years,respectively) areas,in rural than in urban (2.97 and 2.59 years,respectively) areas.Conclusions In 2013,the number of deaths attributable to high blood pressure was around 20.9 million,accounting for 22.78％ of the total deaths,and appeared higher in men than in women,in rural than in urban,in central than in east and west areas.The mortality burden induced by ischemic heart disease,hemorrhagic stroke and ischemic stroke was most serious since the high blood pressure brought about 2.86 years of lost in life expectancy.