Objective:To analyze the prevalence of influenza B virus and its HA and NA genes characteristics during 2017—2020 in Songjiang district, Shanghai.Methods:Samples from suspected cases of influenza were detected using real-time fluorescence reverse transcription-polymerase chain reaction. Influenza B virus positive specimens were cultured by MDCK cells and embryonated chicken eggs. The hamagglutinin (HA) and neuraminidase (NA) genes of influenza virus B strains were sequenced and analyzed for gene evolution and amino acid variation. The sensitivity of the strains to oseltamivir and zanamivir was studied by neuraminidase inhibition assay.Results:The positive rate of influenza B virus in Songjiang district from 2017 to 2020 was 14.24% (506/3554). Influenza B virus circulated mainly in winter-spring season and alternated between B/Victoria and B/Yamagata subtypes. Subclade 1A (△3) B was the predominant Victoria lineage circulating in Songjiang district. Otherwise, the remaining strains belonged to subclade 1A(△2)and clade 1A. Compared with vaccine strain B/Brisbane/60/2008, the nucleotide homology of circulating strains HA (NA) was 97.62%~98.19% (98.11%~98.78%). The mutations of HA in 1A (△3) B subclade mainly were in 120 loop and 160 loop. All the Yamagata strains circulating in Songjiang district belonged to clade 3. Compared with vaccine strain B/Phuket/3073/2013, the nucleotide homology of HA and NA were 98.71%~99.04% and 98.69%~99.27%, respectively. No amino acid change was found in the antigenic clusters. Neuraminidase inhibition assay showed that the influenza B virus strains were sensitive to both oseltamivir and zanamivir.Conclusions:Inconsistence of the antigenicity between the vaccine strains and the circulating strains during 2017—2020, influenza B virus should be persistently monitored, including the epidemic situation and the etiological characteristics, which might be helpful in vaccine screening and drug development.

Urbanization has increased the population density and exposure to environmental risk factors, accelerated changes of people's lifestyles and aggravated population health disparities. A general population cohort in eastern China, Shanghai Suburban Adult Cohort and Biobank (SSACB), was established to understand the incidence and prevalence of chronic and non-communicable diseases, and identify environmental, lifestyle, and genetic risk factors in adults (aged 20-74 years old) living in the suburban of Shanghai, where urbanization process is rapid, and provide evidence for the precise prevention and control of chronic diseases. The cohort study was launched by School of Public Health,Fudan University depended on "Discipline Construction Project Shanghai Peak for Public Health and Preventive Medicine". Four districts in Shanghai, i.e. Songjiang, Jiading, Minhang and Xuhui, were selected. A total of 69 116 permanent residents aged 20-74 years were recruited. Epidemiological investigation, physical examination and laboratory tests were conducted to collect the basic information of the study subjects. Blood and urine samples were collected from them to establish a biobank. An information platform was established, from which the baseline data of the study subjects in electronic medical record system, chronic disease management system, cancer registry, infectious disease reporting system, and death registry can be shared. This paper introduces the design concept, process and future plan of SSACB.

Objective:To explore the incidence of chronic obstructive pulmonary disease (COPD) in a cohort aged 40 years and above in Songjiang District, Shanghai, and to analyze the association of Mediterranean diet pattern and dietary approaches in stopping hypertension pattern (DASH) with the risk of developing COPD.Methods:Based on a natural population cohort in Songjiang District, Shanghai, 27 474 adults aged 40 years and above who did not have COPD at baseline were enrolled in the study. The Cox proportional risk regression model was used to analyze the association of baseline Mediterranean diet pattern score and DASH score with the risk of COPD, and the hazard ratio ( HR) of the risk and its 95% CI were calculated. Restricted cubic spline was used to analyze the nonlinear association between the two diet scores and the risk of COPD. Stratified analyses were performed according to gender, age, smoking status, etcetera. Sensitivity analyses were conducted by censoring cases diagnosed within one year after the baseline survey or people with a history of malignant tumor disease. Results:As of June 30, 2023, after a median follow-up time of 6.21 years, there were 1 089 (4.0%) new COPD cases with an incidence density of 64.00 per 10 000 person-years. After adjusting for relevant confounders, in the Mediterranean tertile subgroups under diet pattern score, the risk of developing COPD could be reduced by approximately 14% in the intermediate scoring group ( HR=0.86, 95% CI: 0.75-0.99) and 15% in the highest scoring group ( HR=0.85, 95% CI: 0.72-0.99) compared to the lowest scoring group. The association remained after censoring cases diagnosed within one year of the baseline survey ( HR=0.82, 95% CI: 0.70-0.95; HR=0.82, 95% CI: 0.68-0.97) or censoring people with a history of malignant tumor disease ( HR=0.84, 95% CI: 0.73-0.97; HR=0.84, 95% CI: 0.71-0.99). No statistical association was found between the DASH score and the risk of COPD. Conclusions:The Mediterranean diet pattern was associated with a lower risk of COPD. Increasing the intake of vegetables, fruits, legumes, and whole grains and decreasing the intake of red meat and others can reduce the risk of COPD. No association was found between the DASH dietary pattern and the risk of COPD in this community population.

ObjectiveTo describe different non-alcoholic fatty liver disease （NAFLD） outcomes among community inhabitants， and further to explore the correlation between bio-indicator level variance and the outcomes. MethodsPhysical indicators （height， weight， waist circumstances， hip circumstances， blood pressure， etc）， biochemical indicators ［fasting plasma glucose， HbA1c， serum triglycerides（TG）， serum total cholesterol（TC）， low-density lipoprotein cholesterol（LDL-C）， high-density lipoprotein cholesterol（HDL-C）， liver related transaminase， etc］ and clinical imaging （B-scan ultrasonography） were collected during the follow-up from the Songjiang Natural Population Sub-cohort. The identification of NAFLD was supported by the definition criteria from Guidelines for the diagnosis and treatment of non⁃alcoholic fatty liver disease. Paired t-test and multifactorial logistic regression model were used to compare the difference between the indicator level of the subjects from different outcome subgroups and to further analyze the correlation between these indicator variance and different NAFLD outcomes. ResultsDuring a median follow-up time of 2.94 years， 12 076 subjects were involved. The cumulative NAFLD incidence and remission rate were 21.57% and 31.15%， respectively. The proportion of subjects who still had NAFLD was 27.96%. Among subjects with newly-developed NAFLD， indicators including blood pressure， BMI， fasting plasma glucose， and plasma lipid level increased， while in the remission subgroup， blood pressure， BMI（WHR）， waist-hip ratio（WHR）， and TG level were significantly decreased. Increased level of systolic pressure， WHR， BMI， HbA1c， and LDL-C might be the risk factors to the occurrence of NAFLD. While decreased level of WHR， BMI， TC and LDL-C level and elevated HDL-C level were likely to be the influencing factors of NAFLD remission process. ConclusionThe NAFLD morbidity in the community inhabitants is relatively high. BMI， WHR， fasting plasma sugar and plama lipid level variance may act as the influencing factors towards different NAFLD outcomes.

Objective:To evaluate the association between dietary pattern and type 2 diabetes mellitus (T2DM) in local residents aged 40 years and above in Songjiang district of Shanghai.Methods:Data was obtained from the baseline investigation of Shanghai Peak-Plan cohort. According to inclusion and exclusion criteria, we selected people with T2DM as the case group, and people without T2DM as controls, matched with gender, age and alcohol intake status. Dietary patterns were established by factor analysis. Conditional logistic regression model (CLRM) was used to explore the relationship between different dietary patterns and T2DM, as well as the association between multiplicative interactions of dietary patterns and T2DM.Results:We used factor analysis to obtain six dietary patterns: including meat, desserts-coarse cereals, condiment-egg, beverage, cereals-tubers and fruit-vegetable. Data from multivariate condition logistic regression suggested that condiment-egg patterns as ( OR=0.543, 95 %CI: 0.377-0.781), beverage ( OR=0.590, 95 %CI: 0.409-0.852), cereals-tubers ( OR=0.592, 95 %CI: 0.414-0.848), fruit-vegetable ( OR=0.604, 95 %CI: 0.417-0.876) were associated with the reduced risks for T2DM. After analyzing the multiplicative interactions between dietary patterns, there were three interaction items associated with T2DM with statistical significances: the multiplicative interaction between meat pattern and condiments-egg pattern was related with the increased risk for T2MD, and the multiplicative interactions between cereal-tubers pattern, meat pattern between cereal-tubers pattern and fruit-vegetable pattern were related with the reduced risks for T2MD. Conclusions:In the six dietary pattern under study, cereals-tubers pattern undwr studly, fruit-vegetable pattern might be more practical in preventing T2DM. In addition, the dietary pattern with cereals and potatos as the main ingredients, appropriate meat and reduced condiment intake might also play positive roles in reducing the risk for T2DM.

Objective:To evaluate the association of hyperuricemia with the risk for chronic kidney disease (CKD) in community adults.Methods:A community-based follow-up study comprising of 7 276 adults aged 20-74 years who attended the natural population cohort in Eastern China and had no CKD at baseline survey was performed in the Songjiang district, Shanghai. CKD was diagnosed according to the National Kidney Foundation Practice Guidelines for Chronic Kidney Disease criteria. Hyperuricemia was defined as serum uric acid level >420 μmol/L for men and >360 μmol/L for women. Cox proportional hazards model was used to examine the association of hyperuricemia with the risk for CKD.Results:During a median follow-up period of 2.65 year, 301 participants were newly diagnosed with CKD. The cumulative incidence rate and incidence density of CKD were 4.14%, and 16.01/1 000 person-years (95% CI: 14.20-17.82), respectively. A higher prevalence of hyperuricemia was observed in subjects with CKD compared with those without CKD. Multivariate Cox regression model analysis showed that hyperuricemia was associated with the increased risk for CKD, with an adjusted HR of 1.92 (95% CI: 1.46-2.53). Their positive associations remained in almost all the subgroups, including sex, age (<60, ≥60 years), BMI (<25.0, ≥25.0 kg/m 2), type 2 diabetes, and hypertension. A significant synergistic effect of the interaction between age and hyperuricemia on CKD was found, and the synergy index was 1.78 (95% CI: 1.18-2.68). Conclusion:The incidence of CKD in adults in Songjiang district was relatively high. Hyperuricemia is an independent risk factor for the development of CKD.

ObjectiveTo determine the epidemiological characteristics and risk factors of hypertension in residents in Songjiang District of Shanghai， and provide evidence for prevention and control of hypertension. MethodsLocal residents aged between 20 and 74 years were recruited from four towns in Songjiang District from 2016 to 2017 by using a multistage sampling strategy. Questionnaire surveys were conducted， and then physical examination， blood pressure measurement， glucose test and lipid test were performed. The data was analyzed by SPSS 16.0 software. Chi-square test was used to compare the differences in the prevalence of hypertension in residents， stratified by demographics and health conditions. Risk factors were determined by multivariate logistic regression. ResultsAmong 35 759 residents with a median age of 58 years and the proportion of male being 40.67%， crude prevalence of hypertension was 54.24% （19 395/35 759） and standardized prevalence was 31.69%. In the hypertensive patients， proportion of hypertension awareness was 61.09%， with 63.67% in male and 59.10% in female. Proportion of receiving treatment was 49.00%， with 50.91% in male and 47.51% in female. Furthermore， in the hypertensive patients with treatment， proportion of effectively controlling hypertension was 40.50%， with 44.46% in male and 37.21% in female. Multivariate logistic regression showed that male （OR=1.272）， senior age （40‒59 years old： OR=4.353， 60‒74 years old： OR=9.802）， overweight （OR=1.823）， obesity （OR=3.070）， central obesity （OR=1.380）， diabetes （OR=1.923）， dyslipidemia （OR=1.452）， and drinking （OR=1.338） were risk factors associated with hypertension. ConclusionPrevalence of hypertension is high， while the proportions of receiving treatment and effective control remain low in residents in Songjiang District. It warrants strengthening prevention and control of hypertension in targeted and young residents.

ObjectiveTo investigate the prevalence and influencing factors of diabetes mellitus among community population in Songjiang District of Shanghai， and to provide scientific basis for prevention and treatment of diabetes mellitus. MethodsBased on the baseline data of the Shanghai Suburban Adult Cohort （2016‒2017） and local medication database， the prevalence of diabetes in the cohort was described， and the influencing factors for the prevalence of diabetes in different genders were analyzed. ResultsAmong 35 928 participants， males accounted for 40.57%， and the median age was 58 years old. There were 5 342 diabetic patients with a crude prevalence rate of 14.87% and the standardized prevalence rate of diabetes mellitus was 7.57%. The prevalence rate of diabetes in males （15.81%） was significantly higher than that in females （14.23%， P<0.001）. Multivariate logistic regression analysis showed that the following factors were associated with high risk of diabetes mellitus in males： 40‒59 age group （OR=7.111，95%CI：4.900‒10.320）， 60‒74 age group （OR=8.994，95%CI：6.154‒13.144）， family history of diabetes （OR=3.369，95%CI：2.963‒3.83）， overweight （OR=1.272，95%CI：1.123‒1.439）， obesity （OR=1.912，95%CI：1.623‒2.252）， hypertension （OR=1.685，95%CI：1.512‒1.877）， and dyslipidemia （OR=1.396，95%CI：1.263‒1.542）. In females， the high risk of diabetes was associated with： 40‒59 age group （OR=2.718，95%CI：1.838‒4.02）， 60‒74 age group （OR=3.517，95%CI：2.34‒5.286）， family history of diabetes （OR=3.071，95%CI：2.761‒3.416）， overweight （OR=1.254，95%CI：1.125‒1.398）， obesity （OR=2.018，95%CI：1.764‒2.308）， central obesity （OR=1.515，95%CI：1.357‒1.692）， hypertension （OR=2.128，95%CI：1.929‒2.347）， dyslipidemia （OR=1.506，95%CI：1.379‒1.644）， exercise （OR=1.241，95%CI：1.137‒1.355）， and menopause （OR=1.967，95%CI：1.693‒2.286）. ConclusionThe prevalence rate of diabetes is high in Shanghai， and the related factors are different in different gender groups.

ObjectiveTo investigate the comorbidity of community patients with stroke in Songjiang District， Shanghai， determine the prevalence and characteristics of comorbidities and influencing factors， and provide scientific evidence for prevention and treatment of stroke. MethodsA natural population-based cohort study was conducted in several communities of Songjiang District from April 2016 to October 2017. Questionnaire survey， physical examination and biochemical examination were conducted in the cohort population to understand the comorbidity of 1 523 patients with stroke at baseline. ResultsThe prevalence of comorbidities in community patients with stroke was 74.0%， which was higher in female （76.36%） than that in male （70.76%）. The average number of comorbidities was 2.62±1.56， which was significantly higher in female （2.70±1.58） than that in male （2.52±1.54） （t=-2.31， P=0.021）. In this population， the most common two-comorbidity combination was hypertension+central obesity （35.85%）， and the most common three-comorbidity combination was hypertension+dyslipidemia+central obesity （17.20%）， with statistically significant differences by gender and age groups （P<0.05）. Multivariate analysis showed that age ≥65 years， urban population， hyperhomocysteinemia （HHcy）， and family history of hypertension were risk factors associated with comorbidities， whereas educational level of middle school and high school， and physical exercise 1‒3 days per week were protective factors. ConclusionPrevalence of comorbidity is high in community patients with stroke in Songjiang District， Shanghai. It is suggested to control blood pressure and body weight， adopt healthy lifestyle and take comprehensive prevention and treatment measures in this population.

Objective: To evaluate the relationship of serum uric acid with prediabetes and newly detected type 2 diabetes mellitus (T2DM) in adults. Methods: Data were obtained from the baseline investigation of Songjiang Peak-Plan cohort. According to the baseline fasting plasma glucose and glycosylated hemoglobin, the eligible subjects were divided into normal blood sugar group, prediabetes group, and newly detected T2DM group. Unconditional logistic regression model was used to explore the effect of serum uric acid level on prediabetes and newly detected T2DM, and restricted cubic spline (RCS) function was used to explore the nonlinear dose-response relationship of serum uric acid level with the prevalence of prediabetes and newly detected T2DM. Results: A total of 30 375 subjects were included in the analysis, with an average age of (55.36±11.52) years, and 60.2% (18 299) of them were women. The baseline survey found that the prevalence of prediabetes was 38.6% (11 739 cases), and the prevalence of newly detected T2DM was 6.6% (1 992 cases). Logistic regression analysis showed that, in women, for every 10µmol/L increase in serum uric acid, the risk of developing prediabetes and T2DM s increased by 2.4% (OR=1.024, 95%CI: 1.018-1.030), and 1.5% (OR=1.015, 95%CI: 1.005-1.025), respectively; in men, for every 10 µmol/L increase in serum uric acid, the risk of developing prediabetes and T2DM decreased by 0.8% (OR=0.992, 95%CI: 0.987-0.998) and 5.0% (OR=0.950, 95%CI: 0.939-0.960), respectively. The RCS function showed that the serum uric acid level showed a nonlinear dose-response relationship with newly detected T2DM (P=0.017), but not with prediabetes (P=0.670) in women and showed a nonlinear dose-response relationship with both prediabetes (P=0.040) and newly detected T2DM (P<0.001) in men. Conclusions: Adult women are at increased risk of prediabetes and newly detected T2DM with increase of serum uric acid level, and adult men are at decreased risk of newly diagnosed T2DM with the increase of serum uric acid level. There was no significant relationship between serum uric acid level and prediabetes in men.
Adult ; Male ; Female ; Humans ; Middle Aged ; Aged ; Prediabetic State/epidemiology* ; Uric Acid ; Diabetes Mellitus, Type 2/epidemiology* ; Glycated Hemoglobin ; Fasting