Guangliang Wu

Epidemiology of Major Depressive Disorder in Mainland China: A Systematic Review

Background Major depressive disorder (MDD) is one of the important causes of disease burden in the general population. Given the experiencing rapid economic and social changes since the early 1990s and the internationally recognized diagnostic criteria and interview instruments across the surveys during 2001–2010 in china, the epidemiological studies on MDD got varied results. We performed this meta-analysis to investigate current, 12-month and lifetime prevalence rates of MDD in mainland China. Methods PubMed, Embase, Chinese Biological Medical Literature database (CBM), Chinese National Knowledge Infrastructure database (CNKI), and the Chinese Wanfang and Chongqing VIP database were searched for associated studies. We estimated the overall prevalence of MDD using meta-analysis. Conclusions Seventeen eligible studies were included. Our study showed that the overall estimation of current, 12-month and lifetime prevalence of MDD was 1.6, 2.3, 3.3%, respectively. The current prevalence was 2.0 and 1.7% in rural and urban areas, respectively; between female and male, it was 2.1 and 1.3%, respectively. In addition, the current prevalence of MDD diagnosed with SCID (Structured Clinical Interview for DSM-IV) was 1.8% and that diagnosed with CIDI (Composite International Diagnostic Interview) was 1.1%. In conclusion, our study revealed a relatively high prevalence rate in the lifetime prevalence of MDD. For current prevalence, MDD diagnosed with SCID had a higher prevalence rate than with CIDI; males showed a lower rate than females, rural residents seemed to have a greater risk of MDD than urban residents.

Trends in prevalence, awareness, treatment, and control of diabetes mellitus in mainland china from 1979 to 2012.

Diabetes mellitus (DM) is one of the primary causes of premature death and disability worldwide. We performed a systematic review and meta-analysis of the published literature regarding the trends in prevalence, awareness, treatment, and control of diabetes mellitus in mainland China. PUBMED, EMBASE, Chinese Biomedical Database, China National Infrastructure database, Chinese Wan Fang database, and Chongqing VIP database were searched. Fifty-six eligible studies were included. Increasing trends in the prevalence, treatment, and control of diabetes in mainland China from 1979 to 2012 were observed. The pooled prevalence, awareness, treatment, and control of diabetes mellitus were 6.41%, 45.81%, 42.54%, and 20.87%, respectively. A higher prevalence of diabetes mellitus was found in urban (7.48%, 95%CI = 5.45~9.50) than rural (6.53%, 95%CI = 4.30~8.76) areas. Furthermore, an increasing chronological tendency was shown in different subgroups of age with regard to the prevalence of diabetes. A higher awareness of DM was found in urban (44.25%, 95%CI = 32.60~55.90) than rural (34.27%, 95%CI = 21.00~47.54) populations, and no significant differences were found in the treatment, and control of diabetes among the subgroups stratified by gender and location. From 1979 to 2012, the prevalence, treatment, and control of diabetes mellitus increased; nevertheless, there was no obvious improvement in the awareness of diabetes.

Prevalence of epilepsy in the People's Republic of China: a systematic review.

To date there has not been a nationwide systematic analysis of the prevalence of epilepsy in China. The aim of this study was to estimate the prevalence of epilepsy in mainland China from the published studies and analyze the prevalence of epilepsy by survey method, gender, location, age, seizure type and prevalence of date. We searched the PubMed, Embase, Chinese Biological Medical Literature (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Wanfang and Chongqing VIP databases for epidemiological studies on the prevalence of epilepsy. Thirty-eight studies were included that comprised a total sample size of 7,695,961, among whom 13,224 had epilepsy. The overall prevalence of epilepsy was 2.89‰. The prevalence of males and females were 3.83‰ and 3.45‰, respectively. The location-specific prevalence in urban and rural areas was 2.34‰ and 3.17‰, respectively. Prevalence by age groups, 0-9, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69 and ≥70 were 2.21‰, 3.23‰, 3.14‰, 2.83‰, 2.96‰, 2.61‰, 2.76‰ and 2.22‰, respectively. In the subgroup analysis by prevalence date, prevalence rate of epilepsy ranged from 1.19‰ to 6.70‰. As for the seizure types, the overall prevalence of generalized seizures, partial seizures and unclassifiable seizures were 3.12‰, 0.57‰ and 0.23‰, respectively. Overall, the prevalence rate of epilepsy is different for each area in mainland China. A higher prevalence of epilepsy is found in the subgroup analysis by male, rural, age group of 10-19 and generalized seizures. However, more epidemiological studies are needed from other provinces to estimate the overall prevalence of epilepsy in mainland China.

The Role of TNF-α 308G>A Polymorphism in the Risk for Ischemic Stroke

Background:Stroke is a common health problem; however, its pathogenesis is not clear. Several studies have examined the association of −308G>A promoter polymorphism in the tumor necrosis factor-&agr; gene (TNF-&agr;) with ischemic stroke susceptibility. However, the results of these studies are inconsistent and the sample sizes of most of the studies were small. Thus, a meta-analysis was conducted to provide a more robust estimate of the effect of the TNF-&agr; 308G>A polymorphism on the risk for ischemic stroke. Methods:Odds ratios with 95% confidence intervals were used to assess the strength of the association of TNF-&agr; polymorphisms with ischemic stroke. Cochrans Q statistic and the inconsistency index (I2) were used to explore heterogeneity. Eggers test and inverted funnel plots were used to investigate publication bias. Results:Thirteen studies met the inclusion criteria involving 3515 cases and 3949 controls. A significant association was found between TNF-&agr; 308G>A polymorphism and the development of ischemic stroke in the Asian population. However, no statistically significant association was observed in the overall analysis and in the Caucasian population. In the subgroup analysis by age, a significant association was found in the juvenile and adult populations, showing that TNF-&agr; 308G>A polymorphism is associated with the risk for juvenile ischemic stroke. Conclusions:This study suggests that TNF-&agr; 308G>A polymorphism is associated with the risk for juvenile ischemic stroke, whereas it is a protective factor for ischemic stroke in Asians and the adult population. However, in the overall analysis and in Caucasians, a significant association was not found.

AGT M235T polymorphisms and ischemic stroke risk: A meta-analysis

Recently, the association between AGT M235T polymorphism and ischemic stroke (IS) has attracted widespread attention, and many investigations have been performed. However, the results were inconsistent. Therefore, we performed a meta-analysis to further evaluate the association between M235T and IS. All of the relevant studies were identified from PubMed, EMBASE, Chinese National Knowledge Infrastructure database (CNKI), Chinese Biological Medical Literature database (CBM), Chinese Wanfang and Chongqing VIP database up to January 2013. Statistical analyses were conducted with STATA software version 11.1. Odds ratios with 95% confidence interval were applied to evaluate the strength of the association. We performed the cumulative meta-analysis to assess the tendency of pooled OR over time. Heterogeneity was evaluated by Q-test and the I(2) statistic. The funnel plots and Eggers regression test were used to assess the publication bias. A significant association between AGT M235T polymorphism and IS was found under the dominant model (OR=1.368, 95% CI=1.070-1.749), recessive model (OR=1.66, 95% CI=1.310-2.103), over-dominant model (OR=1.285, 95% CI=1.085-1.523), co-dominant model (OR=1.574, 95% CI=1.276-1.942) and allele model (OR=1.447, 95% CI=1.207-1.735). Besides the Caucasian and the population-based controls, significant association could be found in the subgroup analysis of Asian and hospital-based controls. Results from cumulative analysis showed a tendency of significant association of this polymorphism with IS. However, the opposite trend was observed among Caucasians. Results from our meta-analysis indicated that the AGT M235T polymorphism might be a risk factor for IS among Asians, but not for Caucasians. More studies are required to further confirm our findings.

Association between the apolipoprotein E gene polymorphism and ischemic stroke in Chinese populations: New data and meta-analysis

Ischemic stroke (IS) is a complex multifactorial inherited disease. Many studies have focused on the potential genetic effects of apolipoprotein E (ApoE) gene polymorphism on IS. However, inconsistencies still exist in the association of ApoE gene polymorphism with IS. The aim of this study was to investigate the ApoE gene polymorphism in relation to IS in the Guangxi Han populations and assess the risk of various ApoE genotypes associated with IS in Chinese populations. We conducted a case-control study involving a total of 166 IS cases and 192 healthy controls to investigate the association of ApoE gene polymorphism with IS in the Guangxi Han populations. Furthermore, we performed a meta-analysis to investigate whether the ApoE gene polymorphism is associated with IS in Chinese populations. There was no evidence for a significant association between ApoE gene polymorphism and IS in the Guangxi Han populations (ɛ2/ɛ2 vs. ɛ3/ɛ3: OR=1.25, 95% CI=0.08–20.17; ɛ2/ɛ3 vs. ɛ3/ɛ3: OR=1.49, 95% CI=0.79–2.79; ɛ2/ɛ4 vs. ɛ3/ɛ3: OR=1.25, 95% CI=0.17–9.00; ɛ3/ɛ4 vs. ɛ3/ɛ3: OR=1.10, 95% CI=0.60–2.04; ɛ4/ɛ4 vs. ɛ3/ɛ3: OR=2.50, 95% CI=0.22–27.87; allele ɛ2 vs. allele ɛ3: OR=1.39, 95% CI=0.80–2.44; allele ɛ4 vs. allele ɛ3: OR=1.16, 95% CI=0.68–1.98). In our meta-analysis, a significant association of ApoE gene polymorphism with IS was found in the genetic model of ɛ2/ɛ4 vs. ɛ3/ɛ3 (OR=2.04, 95% CI=1.45–2.85), ɛ3/ɛ4 vs. ɛ3/ɛ3 (OR=1.93, 95% CI=1.42–2.62), ɛ4/ɛ4 vs. ɛ3/ɛ3 (OR=3.41, 95% CI=2.17–5.34) and allele ɛ4 vs. allele ɛ3 (OR=2.34, 95% CI=1.91–2.86). However, no clear associations were found in the model of ɛ2/ɛ2 vs. ɛ3/ɛ3 (OR=1.56, 95% CI=0.90–2.71), ɛ2/ɛ3 vs. ɛ3/ɛ3 (OR=0.93, 95% CI=0.79–1.09) and allele ɛ2 vs. allele ɛ3 (OR=1.10, 95% CI=0.97–1.25). In conclusion, no association was found between ApoE gene polymorphism and IS in the Guangxi Han populations, while the results of the meta-analysis indicate that the ApoE mutation allele ɛ4 increases the risk of IS in Chinese populations.

Association between phosphodiesterase 4D polymorphism SNP83 and ischemic stroke.

Iceland scientists identified the relationship between the PDE4D gene and ischemic stroke (IS) in 2003. Since then, many researches have emerged to estimate this association, but the results are contradictory. In order to confirm this association, we conduct this meta-analysis with a larger sample size. PubMed, Embase and four Chinese databases were searched to identify the relevant studies through January 2013. The odds ratio (OR) with 95% confidence interval (CI) was used to calculate the association between the SNP83 polymorphism and IS risk. Twenty-five publications comprised of 8878 cases and 12306 controls were included in this meta-analysis. There was a significant association between SNP83 and IS risk, especially in Asian and Chinese populations, but not in Caucasians (dominant model: OR=0.87, 95% CI=0.69-1.11; recessive model: OR=0.95, 95% CI=0.84-1.07; allele model: OR=0.95, 95% CI=0.84-1.08; co-dominant model 1: OR=0.96, 95% CI=0.85-1.08; co-dominant model 2: OR=0.95, 95% CI=0.83-1.09). The cumulative meta-analysis among the overall population and Chinese population indicated a stable trend of association between SNP83 and IS from 2009 to 2012. In conclusion, we found an association between SNP83 and IS in the overall population and in the Asian and Chinese populations, but not among Caucasians.

Genetic polymorphism of ITGA2 C807T can increase the risk of ischemic stroke

Background: The role of genetic variants in the pathogenesis of stroke has not been fully elucidated. Several studies have been examined the association of the Integrin alpha2 (ITGA2) gene-C807T (rs1126643) polymorphism with ischemic stroke susceptibility. However, the results of these studies are inconsistent. In order to explore this association more deeply, we performed a meta-analysis. Methods: We collected case–control studies concerning the relationship between the C807T polymorphism and ischemic stroke, and odd ratios (OR) with corresponding 95% confidence intervals (CI) were used to describe the relationships. Inconsistency index (I2) and Cochrans Q statistic were used to check heterogeneity. Publication bias was tested by funnel plots and Eggers test. Results: Fifteen studies with 2242 cases and 2408 controls were included. Our meta-analysis results indicated an association between the C807T polymorphism and the risk of ischemic stroke in the overall population, Asians and the subgroup of hospital-based people. However, statistically association was not observed for Caucasians and non-hospitalized individuals. Conclusions: The ITGA2 gene C807T polymorphism may be a susceptible predictor of the risk of ischemic stroke. More data are needed to elucidate the relationship further.

Influence of the β-fibrinogen-455G/A polymorphism on development of ischemic stroke and coronary heart disease

BACKGROUND Ischemic stroke (IS) and coronary heart disease (CHD) are two vascular disorders that are a common cause of death worldwide. Several studies have assessed the association of the β-fibrinogen-455G/A (FGB-455G/A) polymorphism and risk of IS and CHD, but the results are still inconsistent. Our study aimed to investigate whether the FGB-455G/A polymorphism was associated with susceptibility to IS and CHD by using meta-analysis. METHODS Relevant studies were identified from PubMed, Embase and four Chinese database up to July 2013.Data were analyzed and processed by Stata 11.2. A pooled OR with 95% CI was calculated to estimate the strength of the genetic association. Cumulative meta-analysis was performed to assess the tendency of pooled OR over time. RESULTS 45 studies based on a total of 7238 cases and 7395 controls were included in our meta-analysis. The results indicated that the FGB-455G/A polymorphism is associated with the risk of IS when compared with the dominant model (OR=1.518, 95%CI=1.279-1.802 for AA+GA vs. GG). In the subgroup analysis by ethnicity, significantly elevated risks were associated with the A allele in Asians (OR=1.700, 95%CI=1.417-2.040), but not in Caucasians (OR=0.942, 95%CI=0.813-1.091). Both the hypertension and non-hypertension subgroups reached significant results, but no significance was found when stratified according to sex or subtype of IS. Results indicate that the FGB-455G/A polymorphism is associated with CHD (OR=1.802, 95%CI=1.445-2.246). CONCLUSION Our meta-analysis suggests that the FGB-455G/A polymorphism contributes to susceptibility to IS and CHD.

Association Between TNF-δ 238G/A Polymorphisms and the Risk of Ischemic Stroke

ABSTRACT Background: Stroke is the second highest cause of morbidity and functional disability around the world. In addition, it is the second most common cause of death worldwide [1]. However, the genetic pathology of stroke is still unclear. Published data on the association between TNF-a 238G/A polymorphisms and ischemic stroke risk are inconsistent and controversial. To provide a more robust estimate about TNF-a 238G/A polymorphisms on the risk of ischemic stroke, we conducted this meta-analysis. Methods: We used the pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) to investigate the relationship between TNF-α238G/A polymorphisms and ischemic stroke. Publication bias was tested by Beggs test and inverted funnel plot, and Heterogeneity was checked by Cochrans Q statistic and the inconsistency index (I2). Results: There are 7 studies that include 1,766 cases and 1,560 controls in this meta-analysis. The results indicated a significant association between TNF-α238G/A polymorphisms and ischemic stroke in overall analysis, Caucasian and Adult. However, statistical association was not observed in Juvenile and Asian. Conclusions: This meta-analysis suggests that TNF-α238G/A polymorphisms increases the risk of ischemic stroke in Adult, Caucasian, and overall analysis. However, in Juvenile and Asian analysis, significant associations between TNF-α238G/A and ischemic stroke were not found.