Jianxiong Long

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.

The prevalence of schizophrenia in mainland China: evidence from epidemiological surveys

Schizophrenia is a severe mental disorder. Its prevalence appears inconsistent in different regions of China; thus, we conducted this meta‐analysis to estimate the prevalence of schizophrenia in mainland China.

HTR2A−1438A/G polymorphism influences the risk of schizophrenia but not bipolar disorder or major depressive disorder: A meta‐analysis

The incidence of psychiatric disorders has been shown to have a strong genetic component, and we conducted this study to investigate whether the −1438A/G polymorphism of the HTR2A gene was associated with susceptibility to schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD). Pooled odd ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using data obtained from a total 27 studies that investigated an association between the HTR2A −1438A/G polymorphism and SZ (15), BD (7), and MDD (4). We failed to observe an association between the HTR2A −1438A/G polymorphism and BD and MDD, and we found contrary results with regard to SZ. Our results showed that the −1438A/G polymorphism was a risk factor for SZ, especially in Caucasians (allele model: OR, 1.12; 95% CI, 1.05–1.20; I2 = 17.3%; dominant model: OR, 1.14; 95% CI, 1.03–1.27; I2 = 15.3%; recessive model: OR, 1.20; 95% CI, 1.06–1.37; I2 = 0.0%; codominant model 1: OR, 1.16; 95% CI, 1.01–1.32; I2 = 0.0%). We found that the association of the HTR2A −1438A/G polymorphism with SZ depends on the ethnic origin of the study population, and this genetic variant does not modify the susceptibility to BD or MDD.

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.

GSTM1 and GSTT1 genetic polymorphisms and risk of anti-tuberculosis drug-induced hepatotoxicity: an updated meta-analysis

The results of studies investigating the associations between GSTM1 and GSTT1 polymorphisms and anti-tuberculosis drug-induced hepatotoxicity (ADIH) risk exhibit much controversy. Therefore, a meta-analysis was performed in order to examine the associations between GST variants and ADIH risk. A total of 451 relevant studies were identified through the digital medical databases Medline, Embase, and CBM published up to October 2012. Thirteen individual case–control studies were eventually recruited for GSTM1 null polymorphism (including 951 ADIH cases, 1,922 controls) and 12 studies for GSTT1 null polymorphism (847 cases, 1,811 controls). Pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were appropriately calculated from fixed-effects or random-effects models. Subgroup analyses were stratified by ethnicity and different treatment combinations. The overall ORs of relevant studies that exhibited elevated ADIH risk was significantly associated with GSTM1 null genotypes (OR = 1.36, 95 % CI 1.04–1.79), but for the GSTT1 polymorphism, no difference was found (OR = 0.98, 95 % CI 0.82–1.18). In the subgroup analyses, the pooled results showed that GSTM1 null allele carriers had a significant association with ADIH risk in East Asians and the patients who used isoniazid (INH) + rifampicin (RMP) + pyrazinamide (PZA) + ethambutol (EMB), or + streptomycin (SM) (HRZES), but the opposite result was observed for patients using HR. Moreover, the GSTT1 null genotype evaluated the susceptibility to ADIH for tuberculosis using HRZ. This meta-analysis provides evidence that there may be an increased risk of ADIH in individuals with null genotypes of GSTM1 in the total population, especially East Asians and patients receiving HRZE or HRZES. However, polymorphisms of the GSTT1 null genotype seem to have no association with susceptibility to ADIH, except for patients receiving HRZ.

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.

XRCC1 Arg399Gln and Arg194Trp polymorphisms in childhood acute lymphoblastic leukemia risk: a meta-analysis.

The purpose of this study was to evaluate the association between X-ray repair cross-complementing group 1 (XRCC1) gene Arg399Gln and Arg194Trp polymorphisms and childhood acute lymphoblastic leukemia risk (ALL) risk. A systematic search of three databases was conducted. Odds ratios (ORs) with 95% confidence intervals (CIs) for XRCC1 polymorphisms and childhood ALL were calculated with fixed-effects models and random-effects models. This meta-analysis showed that Arg399Gln polymorphism was associated with increased risk of childhood ALL (Gln/Arg vs. Arg/Arg, OR = 1.25, 95% CI = 0.95–1.65, p = 0.032; Gln/Gln vs. Arg/Arg, OR = 1.44, 95% CI = 1.07–1.93, p = 0.448; dominant model, OR = 1.27, 95% CI = 0.98–1.66, p = 0.026; recessive model, OR = 1.16, 95% CI = 0.88–1.53, p = 0.646), while failing to detect links with the Arg194Trp polymorphism studied. In subgroup analyses, the pooled results showed that Arg399Gln polymorphism was associated with an increased risk of childhood ALL in Asians and larger sample size. However, no evidence of a significant association was observed in any subgroup of the Arg194Trp polymorphism. Our results provide evidence that the XRCC1 Arg399Gln polymorphism is associated with an increased risk of childhood ALL in the total population, especially Asians.

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 of endometriosis risk and genetic polymorphisms involving biosynthesis of sex steroids and their receptors: an updating meta-analysis

The objective of our study is to assess the association of endometriosis risk and genetic polymorphisms involving biosynthesis of sex steroids and their receptors. A systematic search of three databases was conducted. Twenty-seven studies on the association of the cytochrome P450 subfamily 17 (CYP17), estrogen receptor gene (ER), progesterone receptor gene (PR), 17-beta-hydroxysteroid dehydrogenase type 1 gene (HSD17B1), and cytochrome P450 subfamily 19 (CYP19) polymorphisms with endometriosis risk were identified. When all groups were pooled, we found an association between HSD17B1 (A variant allele vs. G wild allele: odds ratio (OR)=1.42, 95% confidence interval (CI)=1.10-1.84, P=0.007) and PR (P2 variant allele vs. P1 wild allele, OR=1.43, 95% CI=0.99-2.08, P=0.058) polymorphisms and endometriosis risk, while failing to detect links with CYP17, ER, and CYP19 polymorphisms examined. In the subgroup analysis, a significant association of CYP17 and ERα-PvuII polymorphisms with endometriosis was found neither in a Caucasian population nor in an Asian population. The findings of our study suggest that HSD17B1 and PR polymorphisms are associated with an increased risk of endometriosis. Further investigation into the association between CYP17, ER, PR, HSD17B1, and CYP19 polymorphisms and endometriosis risk is warranted and should include larger sample sizes.