Changgui Kou

Rural–Urban Differences in the Prevalence of Chronic Disease in Northeast China

Rural–urban differences in the prevalence of chronic diseases in the adult population of northeast China are examined. The Jilin Provincial Chronic Disease Survey used personal interviews and physical measures to research the presence of a range of chronic diseases among a large sample of rural and urban provincial residents aged 18 to 79 years (N = 21 435). Logistic regression analyses were used. After adjusting for age and gender, rural residents had higher prevalence of hypertension, chronic ischemic heart disease, cerebrovascular disease, chronic low back pain, arthritis, chronic gastroenteritis/peptic ulcer, chronic cholecystitis/gallstones, and chronic lower respiratory disease. Low education, low income, and smoking increased the risk of chronic diseases in rural areas. Reducing rural–urban differences in chronic disease presents a formidable public health challenge for China. The solution requires focusing attention on issues endemic to rural areas such as poverty, lack of chronic disease knowledge, and the inequality in access to primary care.

Prevalence and Correlates of Prehypertension and Hypertension among Adults in Northeastern China: A Cross-Sectional Study

Background: Prehypertension is a category between normotension and hypertension that is becoming increasingly common in China. However, limited data are available on the prevalence and correlates of prehypertension in northeastern China. Methods: A cross-sectional study using stratified, clustered multistage, and random sampling methods was performed on 17,584 participants. Results: The prevalence of prehypertension and hypertension was 36.0% and 30.8% in northeastern China, respectively. As age increased, the prevalence of prehypertension in males declined (p-trend < 0.001), in parallel to an increase in the prevalence of hypertension (p-trend < 0.001). The prevalence of hypertension for females increased as age increased (p-trend < 0.001). Logistic regression analysis showed that age, gender, location, drinking, Body Mass Index (BMI), abdominal obesity, hypertriglyceridemia, and hypercholesterolemia correlated with prehypertension and hypertension (p-trend < 0.05). Conclusions: This study revealed a high prevalence of prehypertension and hypertension in an adult population of northeastern China and some correlates of prehypertension and hypertension.

Genetic association between BDNF gene polymorphisms and phobic disorders: A case–control study among mainland Han Chinese

INTRODUCTION Phobic disorders are a common group of syndromes comprising persistently recurring, irrational severe anxiety of specific objects, activities, or situations with avoidance behavior of the phobic stimulus. The present study investigated the association between whole region polymorphisms, (including the Val66Met variant), in the BDNF gene and phobic disorders among Han Chinese young adults. METHODS We conducted a case-control study to investigate the genetic association between BDNF polymorphisms and phobic disorders among mainland Chinese. One hundred and twenty young adults with phobic disorders and 267 matched controls were recruited. Three tag SNPs of BDNF were successfully genotyped by using PCR-based ligase detection reaction (PCR-LDR). RESULTS We found significant differences in allele distributions of SNP rs10835210 (P<0.001) between the experimental and the control groups. In the haplotype analysis based on linkage-disequilibrium across this gene locus, we demonstrated significant association between phobic disorders and BDNF haplotype CAC (P=0.004). Association was significant after 10(4) permutation tests (P<0.001). CONCLUSION To the best of our knowledge, this is the first study showing that the BDNF gene may play a significant role in the etiology of phobic disorders in the Han Chinese population.

Interactions of Environmental Factors and APOA1-APOC3-APOA4-APOA5 Gene Cluster Gene Polymorphisms with Metabolic Syndrome

Objective The present study investigated the prevalence and risk factors for Metabolic syndrome. We evaluated the association between single nucleotide polymorphisms (SNPs) in the apolipoprotein APOA1/C3/A4/A5 gene cluster and the MetS risk and analyzed the interactions of environmental factors and APOA1/C3/A4/A5 gene cluster polymorphisms with MetS. Methods A study on the prevalence and risk factors for MetS was conducted using data from a large cross-sectional survey representative of the population of Jilin Province situated in northeastern China. A total of 16,831 participations were randomly chosen by multistage stratified cluster sampling of residents aged from 18 to 79 years in all nine administrative areas of the province. Environmental factors associated with MetS were examined using univariate and multivariate logistic regression analyses based on the weighted sample data. A sub-sample of 1813 survey subjects who met the criteria for MetS patients and 2037 controls from this case-control study were used to evaluate the association between SNPs and MetS risk. Genomic DNA was extracted from peripheral blood lymphocytes, and SNP genotyping was determined by MALDI-TOF-MS. The associations between SNPs and MetS were examined using a case-control study design. The interactions of environmental factors and APOA1/C3/A4/A5 gene cluster polymorphisms with MetS were assessed using multivariate logistic regression analysis. Results The overall adjusted prevalence of MetS was 32.86% in Jilin province. The prevalence of MetS in men was 36.64%, which was significantly higher than the prevalence in women (29.66%). MetS was more common in urban areas (33.86%) than in rural areas (31.80%). The prevalence of MetS significantly increased with age (OR = 8.621, 95%CI = 6.594–11.272). Mental labor (OR = 1.098, 95%CI = 1.008–1.195), current smoking (OR = 1.259, 95%CI = 1.108–1.429), excess salt intake (OR = 1.252, 95%CI = 1.149–1.363), and a fruit and dairy intake less than 2 servings a week were positively associated with MetS (P<0.05). A family history of diabetes (OR = 1.630, 95%CI = 1.484–1.791), cardiovascular disease or cerebral diseases (OR = 1.297, 95%CI = 1.211–1.389) was associated with MetS. APOA1 rs670, APOA5 rs662799 and rs651821 revealed significant differences in genotype distributions between the MetS patients and control subjects. The minor alleles of APOA1 rs670, APOA5 rs662799 and rs651821, and APOA5 rs2075291 were associated with MetS (P<0.0016). APOA1 rs5072 and APOC3 rs5128, APOA5 rs651821 and rs662799 were in strong linkage disequilibrium to each other with r2 greater than 0.8. Five haplotypes were associated with an increased risk of MetS (OR = 1.23, 1.58, 1.80, 1.90, and 1.98). When we investigated the interactions of environmental factors and APOA1/C3/A4/A5 gene cluster gene polymorphisms, we found that APOA5 rs662799 had interactions with tobacco use and alcohol consumption (PGE<0.05). Conclusions There was a high prevalence of MetS in the northeast of China. Male gender, increasing age, mental labor, family history of diabetes, cardiovascular disease or cerebral diseases, current smoking, excess salt intake, fruit and dairy intake less than 2 servings a week, and drinking were associated with MetS. The APOA1/C3/A4/A5 gene cluster was associated with MetS in the Han Chinese. APOA5 rs662799 had interactions with the environmental factors associated with MetS.

Smoking Prevalence and Associated Factors as well as Attitudes and Perceptions towards Tobacco Control in Northeast China.

Objectives: The present study aimed to investigate the prevalence of smoking and environmental tobacco smoke (ETS), the associated factors of current smoking among adults, and their attitudes and perceptions towards tobacco control. Methods: A population-based cross-sectional survey was conducted in 2012 using a self-reported questionnaire. A representative sample of adults aged 18–79 years was collected in the Jilin Province of Northeast China by a multistage stratified random cluster sampling design. Descriptive data analysis was conducted, and 95% confidence intervals (CI) of prevalence/frequency were calculated to enable comparisons between the alleged differences and similarities. Multivariable logistic regressions were used to examine the risk factors associated with current smoking. Results: 21,435 adults responded to the survey (response rate: 84.9%). The overall prevalence of ever smoking, current smoking, and former smoking or smoking cessation was 39.1% (95% CI: 38.3–39.9), 31.8% (95% CI 31.1–32.6), and 7.3% (95% CI: 6.9–7.7), respectively. The proportion of ETS exposure among adult non-smokers in Jilin Province was 61.1% (95% CI: 60.1–62.1), and 23.1% (95% CI: 22.3–24.0) of the non-smokers reported daily ETS exposure. The proportion of ETS exposure at home was 33.4% (95% CI: 32.5–34.4), but the proportion of ETS exposure at restaurants was lower (6.5%) (95% CI: 6.0–7.1). More than 90% of the participants had positive attitudes and perceptions towards tobacco control, but 23.2% (95% CI: 22.5–24.0) of them did not agree with the perception of “smoking is fully quit in public places”, and almost half of the adults (49.5%) (95% CI: 48.7–50.3) did not agree with the perception of “hazards of low-tar cigarettes are equal to general cigarettes”. Conclusions: Smoking and exposure to ETS are prevalent among adults from the Jilin Province of Northeast China. Our findings suggest that tobacco control should be advocated in Northeast China. Anti-smoking campaigns and legislation should be built into the public health curriculum and government policy.

Cross-Sectional Associations between Body Mass Index and Hyperlipidemia among Adults in Northeastern China

Background: There is evidence that body mass index (BMI) is closely related to hyperlipidemia. This study aimed to estimate the cross-sectional relationship between Body Mass Index (BMI) and hyperlipidemia. Methods: We recruited 21,435 subjects (aged 18–79 years and residing in Jilin province, China) using the multistage stratified cluster random sampling method. Subjects were interviewed with a standardized questionnaire and physically examined. We analyzed the cross-sectional relationship between BMI and hyperlipidemia. Results: The prevalence of hyperlipidemia was 51.09% (52.04% in male and 50.21% in female). The prevalence of overweight and obesity was 31.89% and 6.23%, respectively. Our study showed that underweight (OR = 0.499, 95% CI: 0.426–0.585), overweight (OR = 2.587, 95% CI: 2.428–2.756), and obesity (OR = 3.614, 95% CI: 3.183–4.104) were significantly associated with hyperlipidemia (p < 0.001) in the age- and sex-adjusted logistic regression. After further adjusting for age, gender, region, district, ethnicity, education, marital status, main occupation, monthly family income per capita, smoking, drinking, exercise, central obesity, waist and hip, underweight (OR = 0.729, 95% CI: 0.616–0.864), overweight (OR = 1.651, 95% CI: 1.520–1.793), and obesity (OR = 1.714, 95% CI: 1.457–2.017) were independently associated with hyperlipidemia (p < 0.001). The restricted cubic spline model illustrated a nonlinear dose-response relationship between levels of BMI and the prevalence of hyperlipidemia (Pnonlinearity < 0.001). Conclusion: Our study demonstrated that the continuous variance of BMI was significantly associated with the prevalence of hyperlipidemia.

Survival of patients with incident dementia who had a pre-existing psychiatric disorder: a population-based 7-year follow-up study

Although it is widely accepted that psychiatric disorders and dementia coexist and survival data for dementia patients have been published, there is a paucity of information regarding the survival of patients with a psychiatric disorder who develop dementia. This study fills this information gap providing survival data on patients with such comorbidity and identifies mortality risk factors.

Prevalence and Associated Factors of Passive Smoking among Women in Jilin Province, China: A Cross-Sectional Study

Background: The present study aimed to investigate the prevalence and associated socio-demographic factors of passive smoking among women in Jilin Province, China. Methods: A cross-sectional study was conducted in 2012, using a self-reported questionnaire interview. A representative sample of 9788 non-smoking women aged 18–79 years was collected in Jilin Province of China by a multistage stratified random cluster sampling design. Descriptive data analysis and 95% confidence intervals (CI) of prevalence/frequency were conducted. Multivariable logistic regressions were used to examine the associated socio-demographic factors of passive smoking. Results: The overall prevalence of passive smoking among non-smoking women in Jilin Province was 60.6% (95% CI: 59.3–61.8), 58.3% (95% CI: 56.7–59.9) from urban areas, and 63.4% (95% CI: 61.6–65.3) from rural areas. Twenty-six percent (95% CI: 24.9–27.1) of the non-smoking women reported daily passive smoking, of which 42.9% (95% CI: 41.6–44.1) reported passive smoking at home, and 5.1% (95% CI: 4.5–5.7) reported passive smoking in restaurants. Women in urban areas were less likely to be passive smokers than those in rural ones (OR-Odds Ratio: 0.825, 95% CI: 0.729–0.935), elderly women were less likely to be passive smokers than younger women (55–64 years OR: 0.481, 95% CI: 0.342–0.674; 65–79 years OR: 0.351, 95% CI: 0.241–0.511). Seperated/divorced women were less likely to be passive smokers (OR: 0.701, 95% CI: 0.500–0.982), and widowed women (OR: 0.564, 95%CI: 0.440–0.722), as the married were the reference group. Retired women second-hand smoked due to environmental causes significantly less than manual workers (OR: 0.810, 95% CI: 0.708–0.928). Women with a monthly family income of more than 5000 RMB were less likely to be passive smokers than those with an income less than 500 RMB (OR: 0.615, 95% CI: 0.432–0.876). Conclusions: The prevalence of passive smoking is lower than that reported in 2010 Global Adult Tobacco Survey (GATS) China, but passive smoking is still prevalent and has been an acute public health problem among non-smoking women in Jilin Province, China. Our findings suggest an urgent need for tobacco control and the efforts of public health should be both comprehensive and focus on high-risk populations in Jilin Province, China.

Associations of histone deacetylase-2 and histone deacetylase-3 genes with schizophrenia in a Chinese population.

To explore the association between histone deacetylase‐2 (HDAC2) and histone deacetylase‐3 (HDAC3) gene polymorphisms and schizophrenia.

The China Mental Health Survey (CMHS): I. background, aims and measures

The China Mental Health Survey (CMHS) is the first nationally representative community survey on mental disorders and mental health services in China. One-step diagnoses for mood disorders, anxiety disorders and substance use disorders were obtained using the Composite International Diagnostic Interview-3.0 (CIDI-3.0), according to the criteria and definition of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). A two-step procedure was applied for schizophrenia and other psychotic disorders, using psychosis screening section in CIDI-3.0 as a screening instrument and the Structured Clinical Interview for DSM-IV Axis I disorders (SCID) as a diagnostic tool. Dementia was diagnosed by the 10/66 dementia diagnosis package in a two-step design. The main aims of the CMHS were: (1) to investigate the prevalence of mood disorders, anxiety disorders, substance use disorders, schizophrenia and other psychotic disorders, and dementia; (2) to obtain data of service use of individuals with mental disorders in China; and (3) to analyse the social and psychological risk factors or correlates of mental disorders and mental health services. This paper presents a brief review of the background of the CMHS, its aims and measures.