Relationship between parental reproductive age and the risk of overweight and obesity in offspring / 中华预防医学杂志

Objective: To explore the role of parental reproductive age on the risk of overweight and obesity in offspring. Methods: The participants were derived from physical examination data of students aged 6-18 years in seven provinces in China, and questionnaire survey was used to collect demographic characteristics and lifestyle information of the students and their parents. A total of 41 567 children with complete data were included. According to the restricted cubic spline curve, maternal reproductive age was divided into three categories, 14-23, 24-28, and 29-38 years, and paternal reproductive age was divided into 14-23, 24-30, and 31-42 years. Multivariate logistic regression model was used to analyze the association between parental reproductive age and parental nutritional status and the risk of overweight and obesity in offspring. Results: The mean age of 41 567 children was (10.6±3.2) years, and the mean paternal and maternal age were (27.9±4.4) years and (25.8±4.0) years, respectively. The detection rate of overweight and obesity was 23.4%. After adjusting factors of children diet and behaviors, the OR(95%CI)of offspring overweight and obesity in groups of fathers aged 24-30 years and mothers aged 24-28 years was 1.11 (1.04-1.18) and 1.16 (1.08-1.24), respectively. When none parents were overweight and obese, the difference of obesity risk was not statistically significant. When both parents were overweight and obese, the OR(95%CI)of offspring overweight and obesity in groups of fathers aged 24-30 years and mothers aged 14-28 years old was 1.27 (1.00-1.62) and 1.33 (1.07-1.65) respectively. Conclusion: Parental reproductive age and parental overweight and obesity status may both increase the risk of overweight and obesity in offspring, with a significant interaction effect.

Predicting Metabolic Syndrome Using Anthropometric Indices among Chinese Adolescents with Different Nutritional Status: A Multicenter Cross-sectional Study / 生物医学与环境科学（英文）

Objective@#To evaluate the predictive performance of anthropometric indices for metabolic syndrome (MetS) among Chinese adolescents with different nutritional status.@*Methods@#We recruited 9,513 adolescents aged 10-18 years from seven provinces in China during September 2014. Anthropometric indices and blood pressure were measured at recruitment, and blood samples were collected for determining fasting plasma glucose and lipid profile. Receiver operating characteristic (ROC) analyses were used to assess the predictive performance of anthropometric indices, including body mass index (BMI) percentile, waist circumference percentile, waist-height ratio, and waist-hip ratio.@*Results@#Overall, the four anthropometric indices showed good accuracy for predicting MetS with areas under ROC curves (AUCs) ranging from 0.86 to 0.94; similar AUCs ranging from 0.73 to 0.99 were observed for participants with normal weight. The performance of all four indices was poor in overweight and obese participants, with AUCs ranging from 0.66 to 0.77 and from 0.60 to 0.67, respectively. Waist circumference showed relatively better performance in all the subgroup analyses.@*Conclusions@#We suggest using anthropometric indices with the cutoff values presented here for predicting MetS in the overall and normal-weight adolescent population, but not in the overweight and obese adolescent population where more specific screening tests are required.

Epidemiological characteristics of infectious diseases of group A, B and C among Chinese students' population / 北京大学学报(医学版)

OBJECTIVE@#To analyze the secular trend, ranking change, age- and regional- characteristics of leading infectious diseases among Chinese students population aged 6 to 22 years from 2008 to 2017.@*METHODS@#Data were drawn from the national surveillance from 2008 to 2017, and the participants were students aged from 6 to 22 years who were diagnosed with notifiable infectious diseases. A total of 40 infectious diseases were classified into three groups based on national notifiable infectious diseases classification of A, B and C. The morbidity and mortality rates from infectious diseases were calculated using the numbers of students published by the ministry of education as the denominator. The age- and province-specific infectious diseases with the highest incidence were selected as the leading infectious diseases for analysis.@*RESULTS@#From 2008 to 2017, the incidence rate, the number of cases and the number of deaths of infectious diseases among the boys aged 6-22 years in China were higher than that of the girls, and the overall trend was downward during the study period. The incidence rates in the boys and girls decreased from 2008 to 2015 with decrease of 43.4% and 40.1%, respectively. However, by 2017, the increase rate rebounded with the increases of 47.1% and 53.8%. The rebound trend was mainly caused by the increase of group C of infectious diseases. During the past decade, the top leading three diseases of groups A and B of infectious diseases were viral hepatitis, tuberculosis and dysentery in 2018, respectively, which changed to tuberculosis, scarlet fever and viral hepatitis in 2017. The top leading three infectious diseases in terms of mortality were rabies, tuberculosis, and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in 2008, which were transformed into HIV/AIDS, rabies, and tuberculosis in 2017. There was no significantly obvious change in the incidence and mortality order of group C of infectious diseases during the decade. In the analysis of age groups and regions, the leading infectious diseases in groups A and B transferred from viral hepatitis to scarlet fever and tuberculosis, while in group C, mumps and infectious diarrhoea almost always dominated the leading infectious diseases. But in recent years, influenza and hand-foot-and-mouth disease increased significantly in the eastern region.@*CONCLUSION@#During the past decade, China has got remarkable achievements in the prevention and control of children infectious disease. However, the change patterns and characteristics of notifiable infectious diseases among children and adolescents show the urgent need for prevention and control of respiratory tract infectious diseases, HIV/AIDS and other sexually transmitted diseases as well as new emerging infectious diseases in China in the future. This study provides important basis for policy making of Chinese national school-based infectious disease prevention and control mechanism.

Subjective Well-being and Family Functioning among Adolescents Left Behind by Migrating Parents in Jiangxi Province, China / 生物医学与环境科学（英文）

We sought to identify the differences between adolescents left behind in their home villages/towns (LBA) and non-left behind adolescents (NLB) on subjective well-being and family functioning due to parental migration in south China. We used a stratified cluster sampling method to recruit middle school students in a city experiencing population-emigration in Jiangxi Province in 2010. Participants included adolescents from families with: (1) one migrant parent, (2) both parents who migrated, or (3) non-left behind adolescents (i.e., no migrant parent). To determine predictors of subjective well-being, we used structural equation models. Adolescents left behind by both parents (LBB) were less likely to express life satisfaction (P = 0.038) in terms of their environments (P = 0.011) compared with NLB. A parent or parents who migrated predicts lower subjective well-being of adolescents (P = 0.051) and also lower academic performance. Being apart from their parents may affect family functioning negatively from an adolescent's viewpoint. Given the hundreds of millions of persons in China, many who are parents, migrating for work, there may be mental health challenges in some of the adolescents left behind.

Association between the blood pressure status and nutritional status among Chinese students aged 7-18 years in 2014: based on the national blood pressure reference for Chinese children and adolescents / 北京大学学报(医学版)

OBJECTIVE@#To analyze the epidemic situation of blood pressure (BP) status and its association with nutritional status among Chinese children and adolescents aged 7-18 years old in 2014, and to provide important scientific basis for the control of students' hypertension.@*METHODS@#All the subjects aged 7 to 18 years in both genders were sampled from 2014 Chinese national surveys on students' constitution and health. BP status was evaluated according to Chinese national gender-, age- and height-specific references, including hypertension (HTN), elevated hypertension (elevated HTN), isolated systolic HTN (SHTN), isolated diastolic HTN (DHTN) and mix HTN. Their nutritional status was evaluated using the international obesity task force (IOTF) definition, including thinness (severe thinness and moderate thinness), normal, overweight and obesity (severe obesity and moderate obesity). The Logistics method was used to analyze the association between BP status and nutritional status. The population attributable risk (PAR%) of overweight and obesity for BP status was calculated.@*RESULTS@#The prevalence of HTN and elevated HTN among the Chinese children and adolescents aged 7-18 years in 2014 was 14.9% and 9.2%, respectively. And the prevalence of isolated SHTN, isolated DHTN and mix HTN was 3.1%, 8.8% and 3.0%, respectively. The prevalence estimates for HTN differed the greatest for the boys, those in rural, those with high age, those in the East, and those with high BMI. The highest prevalence of HTN was detected in those with severe obesity with 44.2% and 38.8% in the boys and girls respectively, which was 2.8-fold and 3.7-fold than those with normal groups. The negative association was detected between HTN and thinness, but the positive association with overweight and obesity. The PAR% of HTN due to overweight and obesity was 16.2%, and the expected prevalence of HTN was 12.5% if controlling for overweight and obesity. Higher PAR% of isolated SHTN and mix HTN due to overweight and obesity was detected in the Chinese children and adolescents with proportions of 28.7% and 35.1%.@*CONCLUSION@#The prevalence of HTN among the Chinese children and adolescents aged 7-18 years was still high, whose components mainly focused on isolated DHTN. Overweight and obesity can increase the risk of HTN in children and adolescents significantly, especially for isolated SHTN and mix HTN. Controlling for overweight and obesity can decrease the risk of HTN among Chinese national children and adolescents largely, which can play an important role in preventing the occurrence of chronic disease in adults.

Association between early age at menarche and blood pressure in Chinese girls aged 7 to 17 years / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the association between early age at menarche and blood pressure in Chinese girls aged 7 to 17 years.</p><p><b>METHODS</b>A total of 76 869 girls aged 7 to 17 years old were selected from the national physical fitness and health research in 2010, and probit analyses were used to calculate the average age of menarche for each province. Girls whose age were lower than the P 10 of age at menarche were judged as early age at menarche, and matched with two selected participant without menarche based on the age and the same urban or rural areas. High blood pressure was defined as whose systolic pressure and/or diastolic pressure was higher than P 95 of systolic pressure or diastolic pressure at the same age group. The difference of the rate of high blood pressure in girls with and without menarche by Chi-square test, and multilevel model was used to analyze the relationship between early age at menarche and blood pressure.</p><p><b>RESULTS</b>In 76 869 girls, the values of height and BMI were separately (152.2 ± 10.4) cm and (18.7 ± 3.1) kg/m(2), while the systolic pressure and diastolic pressure were (103.4 ± 11.0) mm Hg (1 mm Hg = 0.133 kPa) and (65.0 ± 9.1) mm Hg respectively. In 47 942 girls (62.4%) had occurred menstruation while 28 927 girls (37.6%) without menstruation. The girls began to report menstruation at the age of 9, and 81.5% (7123/8736) girls had already reported menstruation at the age of 13. The rate of high blood pressure in menstruation group from 11 to 13 years were separately 6.71% (100/1490), 5.99% (265/4423) and 5.38% (383/7123), which was significant higher than 3.78% (265/7005), 3.33% (144/4328) and 4.09% (66/1613) in the same age group of non-menstruation (the values of Chi-square were separately 25.62, 32.36, 4.46, and all P values < 0.05) . The mean age of early age at menarche was 9 to 11 years old, and the rate of high blood pressure, high systolic pressure, and high diastolic pressure at 11 years group was separately 6.08% (49/806), 4.84% (39/806) and 3.35% (27/806), which was significant higher than that in non-menstruation group (separately 3.11% (50/1607), 2.30% (37/1607) and 1.43% (23/1607), and the values of Chi-square were separately 12.02, 11.32 and 9.74, while all P values <0.01). After adjusted by region and age, early age at menarche were separately associated with the rate of high blood pressure (OR = 2.188; 95%CI: 1.254-3.818), high systolic pressure (OR = 1.925; 95%CI:1.097-3.379) and high diastolic pressure (OR = 2.088; 95%CI: 1.072-4.065).</p><p><b>CONCLUSION</b>Early age at menarche may be one of the influence factors of high blood pressure, which may contribute to early age of high blood pressure in Chinese children and adolescents.</p>