Associação entre Infecção por Heicobacter Pylori e Hipertensão Arterial Sistêmica: Metanálise / Association between Helicobacter Pylori Infection and Systemic Arterial Hypertension: A Meta-Analysis

Resumo Fundamento: Estudos epidemiológicos recentes demonstraram que alterações na microbiota e seus metabólitos estão associadas à hipertensão arterial sistêmica. A Helicobacter pylori (H. pylori) é um dos patógenos bacterianos mais comuns, e a possível associação entre a infecção por H. pylori e a hipertensão é controversa. Objetivos: Este estudo teve o objetivo de esclarecer a associação entre eles e proporcionar uma nova base teórica para detectar a patogênese da hipertensão. Métodos: Foram selecionados estudos caso-controle e transversais sobre a associação entre H. pylori e hipertensão, publicados de 1996 a 2019 indexados nos bancos de dados PubMed, Google Scholar, Chinese Wan Fang Data, e Chinese National Knowledge Infrastructure (CNKI). As razões de chance (RC) combinadas e o intervalo de confiança (IC) 95% foram estimados. O I² foi realizado para avaliar a heterogeneidade estatística. O viés de publicação foi avaliado utilizando-se os testes de Beggs e de Egger. Os dados extraídos foram analisados no software Stata 12.0. A significância estatística foi definida com um p-valor < 0,05. Resultados: Foram cadastrados 17 estudos envolvendo 6376 casos de hipertensão e 10850 controles. A taxa de infecção por H. pylori em pacientes hipertensos e em controles foi de 64,9% e 56,3%, respectivamente. Foi demonstrada uma associação significativamente positiva entre a infecção por H. pylori e a hipertensão, com uma RC global de 2,07 (IC 95%: 1,46-2,94; p < 0,05). A análise de subgrupos revelou que a prevalência de infecção por H. pylori foi associada à hipertensão na região da Ásia e no grupo de caso-controle, as RC (IC 95%) foram 2,26 (1,51-3,38) e 2,53 (1,72-3,72), respectivamente. Depois de estratificar por métodos de detecção, ainda existiam diferenças entre os subgrupos (todos p < 0,05). Conclusão: Esta metanálise indicou que a infecção por H. pylori está associada positivamente à hipertensão.

Abstract Background: Recent epidemiological studies have shown that alterations in microbiota and its metabolites are associated with systemic arterial hypertension. Helicobacter pylori (H. pylori) is one of the most common bacterial pathogens, and the potential association between H. pylori infection and hypertension are controversial. Objective: This study aimed to clarify their association and provide a new theoretical basis for uncovering the pathogenesis of hypertension. Methods: Case-control and cross-sectional studies on the association between H. pylori and hypertension published from 1996 to 2019 indexed in PubMed, Google Scholar, Chinese Wan Fang Data, and Chinese National Knowledge Infrastructure (CNKI). The pooled odds ratios (OR) and 95% confidence interval (CI) were estimated. I2 was performed to evaluate the statistical heterogeneity. Publication bias was evaluated using Begg's and Egger's test. The extracted data was analyzed in Stata 12.0. Statistical significance was defined as p-value < 0.05. Results: A total of 17 studies involving 6,376 cases of hypertension and 10,850 controls were enrolled. H. pylori infection rate in hypertension patients and controls were 64.9% and 56.3%, respectively. A significantly positive association was shown between H. pylori infection and hypertension with an overall OR of 2.07 (95% CI: 1.46-2.94; p < 0.05). Subgroup analysis revealed that the prevalence of H. pylori infection was associated with hypertension in the region of Asia and the case-control group, ORs (95% CI) were 2.26 (1.51-3.38) and 2.53 (1.72-3.72), respectively. After stratifying by detection methods, differences still existed in subgroups (all p < 0.05). Conclusion: This meta-analysis indicated that H. pylori infection is positively associated with hypertension.

Associação entre Ácido Úrico Sérico e Pré-Hipertensão e Hipertensão entre Adultos Chineses / Association between Serum Uric Acid and Pre-hypertension and Hypertension among Chinese Adults

Resumo Fundamento O ácido úrico , produto final do metabolismo dos nucleotídeos das purinas, participa dos processos de doenças metabólicas e cardiovasculares. Evidências experimentais sugerem que o ácido úrico é um mediador importante na resposta fisiológica ao aumento da pressão arterial. Objetivo Avaliar a associação entre os níveis séricos de AU e pré-hipertensão e hipertensão em uma população chinesa. Métodos Conduziu-se um estudo transversal entre março e setembro de 2017, e 1.138 participantes com idades entre 35 e 75 anos foram incluídos neste estudo, onde 223 normotensos, 316 pré-hipertensos e 599 hipertensos foram selecionados para avaliar a associação entre níveis séricos de AU e hipertensão. Considerou-se um valor de p<0,05 estatisticamente significativo. Resultados Os níveis séricos de AU foram significativamente maiores no grupo pré-hipertensão e hipertensão em comparação com o grupo controle em toda a população (p<0,05 para todos). A análise quantitativa das características indicou níveis séricos de AU (2,92±0,81, 3,06±0,85, 3,22±0,98 mg/d) linearmente aumentados em mulheres normotensas, pré-hipertensas e hipertensas, com um valor de p de 0,008. Os níveis séricos de AU nos quartis correlacionaram-se positivamente com a PAD (p<0,05), principalmente em mulheres. Após o ajuste para idade, sexo, índice de massa corporal (IMC), glicose (GLI), colesterol total (CT), triglicerídeos (TG), colesterol HDL (lipoproteína de alta densidade), as razões de chances ( odds ratios — ORs) e intervalos de confiança (IC) de 95% da pré-hipertensão, dos níveis séricos de AU mais baixos (referentes) aos mais altos foram 1,718 (1,028-2,872), 1,018 (0,627-1,654) e 1,738 (1,003-3,010). Além disso, o segundo quartil dos níveis séricos de AU esteve significativamente associado à hipertensão, com uma OR (IC 95%) de 2,036 (1,256-3,298). Conclusões O presente estudo sugere que níveis séricos mais elevados de AU estão positivamente associados à pré-hipertensão e hipertensão entre adultos chineses.

Abstract Background Uric acid (UA), the end product of purine nucleotide metabolism, participates in the processes of metabolic and cardiovascular diseases. Experimental evidence suggests it is an important mediator in the physiological response to blood pressure increase. Objective To evaluate the association between serum UA levels and pre-hypertension and hypertension in a Chinese population. Methods A cross-sectional study was conducted from March to September 2017, and 1,138 participants aged 35 to 75 were enrolled in this study, where 223 normotensive, 316 pre-hypertensive, and 599 hypertensive subjects were selected to evaluate the association between serum UA levels and hypertension. A p-value <0.05 was considered statistically significant. Results Serum UA levels were significantly higher in the pre-hypertension and hypertension group compared to the control group in the entire population (p<0.05 for all). Quantitative trait analysis indicated that serum UA levels were (2.92±0.81, 3.06±0.85, 3.22±0.98 mg/d) linearly increased in normotensive, pre-hypertensive and hypertensive females, with a p value of 0.008. Serum UA levels in the quartiles were positively correlated with DBP (p<0.05), particularly in females. After adjusting for age, gender, body mass index (BMI), glucose (GLU), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), the odds ratios (ORs) and 95% confidence intervals (CIs) of pre-hypertension from the lowest (referent) to the highest levels of serum UA were 1.718 (1.028-2.872), 1.018 (0.627-1.654) and 1.738 (1.003-3.010). Additionally, the second quartile of serum UA levels were significantly associated with hypertension, with an OR (95% CI) of 2.036 (1.256-3.298). Conclusions This study suggests that higher serum UA levels are positively associated with pre-hypertension and hypertension among Chinese adults.

Depression and anxiety and assciated factors among college students returned to campus during the outbreak of COVID-19 / 中国学校卫生

Objective@#The purpose of this study was to investigate the state of depression and anxiety and assciated factors of back to school college students during the outbreak of COVID-19, so as to provide theoretical basis for emotional counseling and psychological crisis intervention after long term school closure due to epidemic outbreak.@*Methods@#Cluster sampling was used to select the first batch of 2 697 back to school students in a high vocational college. The survey content includes basic information questionnaire, Depression Self rating Scale (SDS) and Anxiety Self rating Scale(SAS).@*Results@#The detection rate of depression and anxiety was 31.8% and 10.4% respectively. Multivariate Logistic regression analysis showed that the risk of depression in female college students was 1.28 times higher than that in male students. The risk of depression among college students with family loss experience caused by the outbreak of COVID-19 was 1.30 times that of those without family loss experience caused by the outbreak of COVID-19. Outgoing personality(OR=0.62), neutral (OR=0.55) and mild temper(OR=0.46), moderate frequency of physical exercise per week(1-2 times:OR=0.73, 3-4 times:OR=0.65) were protective effects for depression in college students.Low frequency of breakfast were the risk effects for depression in college. The risk of anxiety among college students who was the only child in the family was 1.61 times higher than that who was not the only child in the family. The risk of anxiety among college students with family loss experience caused by the outbreak of COVID-19 was 1.45 times higher than that college students without family loss experience caused by the outbreak of COVID-19. Neutral temper, mild temper and physical exercise 1-2 times a week were associated with lower level of anxiety in college students(OR=0.67,0.56,0.67). Breakfast skipping (OR=2.03) was associated with higher levvel of anxiety in college students.@*Conclusion@#During the outbreak of COVID-19, the first batch of back to school college students presented high level of depression. Colleges are suggested to promptly carry out effective emotional relief and psychological intervention for students, especially those whose family suffered in COVID-19, the only child in the family, with poor breakfast eating habits, as well as breakfast skipping and lack of physical exercise.

Analysis of mental health and influencing factors of college students in the online learning period during the outbreak of COVID-19 / 中国学校卫生

Objective@#To investigate the mental health and influencing factors of college students during online learning under the coronavirus disease 2019 (COVID-19) epidemic, and to provide a scientific basis for mental health education.@*Methods@#From June to July 2020, a cluster sampling method was used to select one medical and non-medical colleges and universities in southern Anhui Province. Among them, the Depression Anxiety and Stress Scale-21 (DASS-21) was used to conduct an online questionnaire survey among 3 781 medical and non-medical college students.@*Results@#The reporting rates of depression, anxiety and stress among medical college students (30.03%, 31.05% and 14.50%, respectively) were lower than those of non-medical college students(44.49%, 46.22%, 24.81%)(χ2=81.49, 88.26, 63.08, P<0.05). During the online learning period of college students, the depression and anxiety were mainly moderate(18.43%, 20.68%), and the stress was mainly mild and moderate(9.41%, 5.29%). Multivariate Logistic regression analysis showed that non-medical students, poor parent relationships, poor relationships with fathers, teachers inadequate preparation before class, and dissatisfaction with online teaching results were prone to depression(OR=1.84, 1.28, 1.63, 1.75,1.24), anxiety (OR=1.79, 1.22, 1.65, 1.77, 1.19) and stress(OR=2.09, 1.41, 1.58, 1.29,1.48)(P<0.05). Girls were less prone to depression (OR=0.82) and anxiety(OR=0.74); College students who live in rural areas were more likely to have anxiety symptoms(OR=1.27); Senior students were more likely to feel stress(P<0.05).@*Conclusion@#The detection rate of depression, anxiety and stress negative emotion in college students was higher during online study. Families and schools should pay attention to the mental health of college students during online learning, and provide targeted psychological counseling for different students.

Sleep quality and influencing factors of college students returning to school during COVID-19 epidemic / 中国学校卫生

Objective@#To investigate the sleep quality and influencing factors of the first batch of college students returning to school during COVID-19 epidemic, so as to provide scientific basis for taking corresponding measures.@*Methods@#An anonymous self-administered questionnaire survey was conducted among the first batch of college students returning from a certain university by cluster sampling, which included general demographic characteristics, Trait Coping Style Questionnaire (TCSQ) and Pittsburgh Sleep Quality Index(PSQI).@*Results@#The detection rate of sleep disorders was 19.33%(522/2 701). The mother s education level was high school or technical secondary school or below(OR=2.24, 95%CI=1.47-3.41), never eat breakfast(OR=3.25, 95%CI=1.86-5.68), families were damaged during the outbreak (OR=1.48, 95%CI=1.17-1.87) and negative coping (OR=1.15, 95%CI=1.12-1.17) were risk factors for sleep disorders(P<0.05). Compared to having a very poor relationship with parents, the relationship between parents was average(OR=0.23, 95%CI=0.06-0.89), better(OR=0.23, 95%CI=0.06-0.87), very good (OR=0.19, 95%CI=0.05-0.74) were protective factors for sleep disorders(P<0.05). Exercise once or twice a week during the epidemic(OR=0.76, 95%CI=0.58-1.00), positive coping (OR=0.93, 95%CI=0.91-0.96) were protective factors for sleep disorders(P<0.05).@*Conclusion@#In this COVID-19 epidemic, the sleep quality of returning college students was affected to different extent, and the relationship between parents, sports, mother s education, breakfast habits, and family damage during the COVID-19 were factors affecting their sleep quality. Targeted psychological intervention measures should be given to returning college students in the early stage.

Analysis of network usage and influencing factors among college students returning to a vocational college during COVID-19 epidemic / 中国学校卫生

Objective@#To understand the current situation and influencing factors of Internet addiction among college students after returning to school during the COVID-19 epidemic, and to provide scientific basis for timely intervention measures to adjust the risk factors of Internet addiction.@*Methods@#A cluster sampling method was adopted to conduct a questionnaire survey among 2 700 college students who firstly returned to college using general condition questionnaire and Internet Addiction scale.@*Results@#The detection rate of Internet addiction disorder was 32.4% among returning college students, moreover, the detection rate of Internet addiction in male students(36.0%) was higher than that in female students (31.2%) (χ 2=5.42,P<0.05). The degree of Internet addiction was negatively correlated with the physical health score (r-s=-0.20) and mental health score (r-s=-0.24) of college students (P<0.01). Multivariate Logistic regression analysis showed that compared with introversion, neutral (OR=0.67, 95%CI=0.55-0.82) and extroverted college students (OR=0.59, 95%CI=0.48-0.74) were protective factors for Internet addiction; compared with no exercise, physical exercise ≥3 times or more per week (exercise 3-4 times：OR=0.67, 95%CI=0.51-0.87; ≥5 times：OR=0.67, 95%CI=0.50-0.90) were the protective factors for Internet addiction among college students; family loss during the epidemic was a risk factor for Internet addiction among college students (OR=1.34, 95%CI=1.12-1.60); the risk of Internet addiction was 2.13 times higher for college students who actively sought psychological help than for those who did not seek psychological help (95%CI=1.14-3.96); college students who did not want to go back to school had 1.50 times the risk of Internet addiction as those who did (95%CI=1.26-1.77).@*Conclusion@#The current situation of college students online behaviors during COVID-19 is not optimistic, and should arouse sufficient attention from society and universities. In addition, college students returning to school should take more physical exercises and psychological counseling to detect and intervene in psychological problems in time, reduce their psychological burden, and enhance their psychological quality.

School adaptation and behavior of the first batch of college students returning to school during the COVID-19 epidemic / 中国学校卫生

Objective@#To analyze the school adaptation and behavioral performance of the first batch of students who return to school during the COVID-19 epidemic, and to provide a theoretical basis for further development of corresponding intervention measures.@*Methods@#The method of cluster sampling was adopted to conduct anonymous questionnaire survey on the first batch of college students who have returned to a certain university. The survey contents included the basic information of the students, the adaptability of the school after returning to school and the corresponding behavior performance.@*Results@#Male students reported high lever of satisfaction than female students on the dormitory environment health (t=10.28, P<0.01), but low satisfaction on school security and logistical support (t=2.26, P=0.02), rural students marked higher score than urban students for the school closed management system (t=2.82, P=0.01), in terns of school security, Logistics, the degree of school s attention to the epidemic prevention and epidemic prevention, non only-child gave high score than the only children; In terms of their own behavior, the rate of seek medical treatment immediately when they develop COVID-19 related symptoms (68.1%) was lower than that of others (81.3%)(χ 2=223.88，P<0.01)；In addition, the percentage of respondents who chose to report COVID-19 related symptoms (79.5%) was lower than that of others (88.7%)(χ 2=97.49，P<0.01). A total of 2 671 college students (98.9%) were able to wear masks every day and 2 457 (90.9%) chose to improve their diet to improve their immunity.@*Conclusion@#The first batch of college students who return to school have a high level of satisfaction on school management, and can take active measures to adapt to the life back to school and commit self-protection, however targeted measures to are still needed further strengthen students health education.