The Healthy China 2030 Plan set the goal of reducing premature deaths from diabetes by 30% by 2030. However, there has been a lack of assessment of premature mortality for diabetes since the action plan was issued. This study used data from the Global Burden of Disease Study 2021, calculated the premature deaths for diabetes by sex, provinces, and subtypes from 1990 to 2021. We explored the temporal trend of premature mortality using the average annual percent change (AAPC) for different sexes, provinces, and subtypes from 1990 to 2021. Furthermore, we predicted premature mortality for diabetes through 2030 for China and its provinces according to the average annual change rate from 2010 to 2021. There was a first slow upward trend in premature mortality for diabetes from 0.5% in 1990 to 0.6% in 2004, and then a decline until 2021 with premature mortality of 0.4%. By 2030, only Fujian (30.3%) will achieve the desired level of reduction, with only seven provinces meeting the target for females and none for males. There is a large range in the degree of decline between inland and coastal regions, showing obvious geographic differences, and there should be a focus on balancing medical resources.
Humans ; China/epidemiology* ; Female ; Male ; Mortality, Premature/trends* ; Diabetes Mellitus/mortality* ; Goals ; Middle Aged ; Adult

AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P<0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P<0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P<0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.

Objective:To investigate the annual growth rate of obesity prevalence of residents aged 18 and above in China and prevention keypoints for target populations from 2013 to 2018.Methods:This was a cross-sectional study. Subjects from China Chronic Disease and Risk Factor Surveillance project in 2013 and 2018 were included. The prevalence of obesity and growth rate in 31 provinces (autonomous regions and municipalities) in China were collected through survey questionnaires and on-site measurements. Other demographic data such as the proportion of obesity control measures, diet, exercise and drug use was also analyzed. Obesity among adults was defined as body mass index≥28.0 kg/m2.Results:A total of 174 736 residents, aged (51.5±14.2) years, which included 74 704 (42.8%) males were recruited in 2013, and 179 125 residents, aged (55.1±13.8) years, which included 79 337 (44.3%) males were included in 2018. The average annual increase rate of adult obesity prevalence in China from 2013 to 2018 was 3.2% (uncertainty interval ( UI) 2.7%-3.6%), and the average increase rate of obesity prevalence among men (5.2% ( UI 4.6%-5.9%)) was higher than that of women (0.9% ( UI 0.5%-1.3%)). For subgroups analysis, the average increase rate of obesity prevalence among residents aged 18 to 29 (7.4% ( UI 6.9%-7.9%)), education level beyond college degree (6.3% ( UI 5.5%-7.1%)), and unmarried population (11.2% ( UI 10.2%-12.1%)) were higher than that of other subgroups between 2013 and 2018. The residents in Hainan province showed the highest average annual growth rate of obesity. With the exception of Shanxi, Hunan, Gansu and Ningxia province, the annual growth rate of obesity prevalence among adults increased in all other provinces (autonomous regions and municipalities) from 2013 to 2018. For the obese population, the proportion of people who took weight control measures increased from 22.6% in 2013 to 32.7% in 2018. Conclusions:The prevalence of obesity growth characteristics in subpopulations and regions in China are obviously different. Accordingly the focus points of obesity prevention and control in different regions should have their own emphasis.

Objective:To improve the longevity genetic research study design by applying self-organizing maps to select a control group for longevity study.Methods:This study included the Han population aged 90 years and above or less than 80 years who have died (control group) from the natural population-based cohort formed by the fusion of the Chinese Chronic Diseases and Risk Factors Surveillance in 2013 and the China Death Surveillance System. The subjects who died of injury, infectious diseases, parasitic diseases, and malignant tumors were excluded. The self-organizing maps method, with multiple iterations and self-organizing clustering, was used to select similar factors among the population aged 90 years and above and the control group, including demographic characteristics, diseases, living habits, social behaviors, and mental and psychological factors. The study used PLINK 1.9 software to evaluate the quality of whole genome sequencing and to conduct logistic regression of single nucleotide polymorphisms (SNPs) and longevity on autosomes. Q-Q plots were used to visualize the P value associated with SNPs and longevity. Results:There were 1 019 samples selected from the baseline of 177 099 survey participants for genome sequencing, including 517 in the longevity group and 502 in the control group. The longevity and the control groups are generally similar in smoking, drinking, diet, sleep duration, blood lipid level, and self-assessment oral health status but differ significantly in socio-economic status, physical activity time, BMI, and self-assessment health status. The whole genome sequencing results were controlled, and 4 618 216 SNPs were involved in association analysis. The Q-Q plot of longevity-related SNPs analysis results showed that the enrichment of P value 1e-4 was significantly lower than the expected P value, and significant signals were also detected among P<1e-7 regions. Conclusions:The self-organizing maps can comprehensively consider the influence of socioeconomic and behavioral risk factors and select longevity control samples among samples with actual age and cause of death in a large-scale natural population cohort to improve the efficiency of longevity genome association analysis. This study provides a methodological reference for nested case-control study sample selection from the large-scale natural population cohort.

To study and establish a set technology systems of sampling, investigation, quality control, and data analysis of complex sampling for chronic diseases and risk factor surveillance in China based on the requirements of the WHO and China's national conditions, and provide evidence for the policy making and prevention and control evaluation of chronic diseases and technical support for the research of chronic diseases. Through the study of complex sampling technique, adjustment of surveillance points and evaluation of their representatives, a national and provincial representative surveillance system and a complex weighted data analysis were established. According to the relevant plans, actions, and policies in China and other countries, the surveillance content and index system were studied and constructed, which was in line with China's national conditions, "1 + X" steps surveillance, covering the content of questionnaire , physical measurement, and laboratory testing. Based on modern information technology, a three-level platform of information collection and a multi-center laboratory quality control technology system were established, including sampling, information collection, biological sample management, quality control, and result display. Relying on the above research techniques, a national epidemiological investigation was conducted in China, which covered cerebrovascular disease, mental disorders, digestive system disease, and diabetes complications, to obtain the national representative data. This study reflected the innovation of "combination of medicine and prevention" and multi department cooperation in the fields of clinical medicine and public health and provided some big data for the health policy making and the evaluation of the effects of chronic disease prevention and control.

Objective:To describe and compare the prevalence, sick status awareness, treatment and control of hypertension in adults aged 18 years and above in China.Methods:National Chronic Disease and Risk Factor Surveillance was conducted in 298 counties/districts in China in 2018, which covered 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method was used to select 194 779 permanent residents aged 18 years and above. Face to face questionnaire surveys were conducted to collect the information about their demographic characteristics, hypertension diagnosis and treatment as well as the blood pressures measurement. The systolic and diastolic blood pressure were measured using certified medical upper arm electronic sphygmomanometer for the adults. After excluding those with abnormal blood pressure, 179 873 adults were included in the final analyses. Gender, age and area or region specific mean blood pressure, the prevalence, sick status awareness, control and treatment rates of hypertension, and blood pressure measurement were evaluated for the adults surveyed. All the results were weighted according to complex sampling scheme and had post-stratification to represent the whole adult population in China.Results:The average systolic blood pressure was (127.7±18.8) mmHg (1 mmHg=0.133 kPa) and the average diastolic blood pressure was (76.8±11.2) mmHg in the adults aged 18 years and above in China in 2018. Among the adults without history of hypertension, 50.9%(95% CI:49.9%-51.9%) had prehypertension. The prevalence rate of hypertension in adults in China was 27.5% (95% CI: 26.6%-28.4%). In men, 30.8% (95% CI: 29.8%-31.9%) had hypertension, compared with 24.2% (95% CI: 23.3%-25.1%) in women. The rural adults had higher hypertension prevalence rate [29.4% (95% CI: 28.4%-30.3%)] compared with urban adults [25.7% (95% CI: 24.4%-27.1%), P<0.000 1]. The highest hypertension prevalence rate was observed in adults in northern China [33.3% (95% CI: 31.5%-35.2%)], followed by that in adults in northeastern China [32.7% (95% CI: 28.1%-37.4%)] compared with other regions in China, and with significant differences ( P<0.000 1). Among the adults with hypertension, 41.0% (95% CI: 39.7%-42.4%) were aware of their sick status, 34.9% (95% CI: 33.6%-36.1%) were taking antihypertensive medicines, and 11.0% (95% CI: 10.2%-11.8%) had their blood pressure controlled. In the hypertensive patients, women and urban residents were more likely to have higher rates of sick status awareness, treatment and control of hypertension compared with men and rural residents (all P<0.000 1). Among the adults without history of hypertension, 41.9%(95% CI: 40.7%-43.2%) had active or passive measurement of blood pressure in the past 3 months. Conclusions:Given the higher prevalence rate of hypertension and lower blood pressure measurement rate in Chinese adults, as well as unsatisfied status of awareness, treatment and control of hypertension in patients, more efforts should be made in hypertension prevention and control, such as improved risk factor intervention and case management, especially in rural areas.

Objective:To analyze the current situation of cardiovascular diseases and the exposure as well as control level of their risk factors in the Chinese residents.Methods:Based on the 2017 China Cardiovascular Health Index (hereafter referred to as CHI) study, data on the 29 indicators from three dimensions named as prevalence of cardiovascular disease, exposure to relevant risk factors, and prevention and control of risk factors of the 31 provinces in China (excluding Hong Kong, Macao and Taiwan) were obtained. To make a higher CHI score indicate better cardiovascular health levels, all the reverse metrics were firstly converted into positive metrics. Thenstandard normal conversion were adopted and a percentage score was assigned to each value according to its area proportion under the standard normal conversion distribution curve. Finally the scores of the three dimensions and the total CHI were calculated by weighted sum of these scores. Scores and ranks in each dimension were used to compare the performance in different provinces.Results:Heilongjiang, Tibet, Jilin, Henan, Xinjiang had the lowest scores in the prevalence of cardiovascular disease. Tianjin, Hebei, Liaoning, Shanxi and Beijing had the lowest scores in the exposure to relevant risk factors. Hainan, Guizhou, Yunnan, Shaanxi and Guangxi had the lowest in the prevention and control of risk factors. In terms of behavioral risk factors, smoking rates, rate of insufficient physical activity, obesity rate of adults aged 18 in the 31 provinces in China excluding Hong Kong, Macao, Taiwan were 26.80% (25.15%, 29.25%), 17.80% (11.60%, 19.45%) and 12.00% (8.90%, 17.95%), respectively. The daily per capital salt intake level was 8.6 (8.2, 9.3) g. As for metabolic risk factors, the prevalence of dyslipidemia (33.7%) exceeded hypertension (26.0%) and diabetes (9.7%), while its awareness rate (14.5%), treatment rate (7.9%) and control rate (5.4%) were all below the corresponding levels of hypertension and diabetes.Conclusion:Risk factors of cardiovascular disease in China is relatively severe and the prevention and control of dyslipidemia needs to be further strengthened.

Objective:To analyze the current situation of cardiovascular diseases and the exposure as well as control level of their risk factors in the Chinese residents.Methods:Based on the 2017 China Cardiovascular Health Index (hereafter referred to as CHI) study, data on the 29 indicators from three dimensions named as prevalence of cardiovascular disease, exposure to relevant risk factors, and prevention and control of risk factors of the 31 provinces in China (excluding Hong Kong, Macao and Taiwan) were obtained. To make a higher CHI score indicate better cardiovascular health levels, all the reverse metrics were firstly converted into positive metrics. Thenstandard normal conversion were adopted and a percentage score was assigned to each value according to its area proportion under the standard normal conversion distribution curve. Finally the scores of the three dimensions and the total CHI were calculated by weighted sum of these scores. Scores and ranks in each dimension were used to compare the performance in different provinces.Results:Heilongjiang, Tibet, Jilin, Henan, Xinjiang had the lowest scores in the prevalence of cardiovascular disease. Tianjin, Hebei, Liaoning, Shanxi and Beijing had the lowest scores in the exposure to relevant risk factors. Hainan, Guizhou, Yunnan, Shaanxi and Guangxi had the lowest in the prevention and control of risk factors. In terms of behavioral risk factors, smoking rates, rate of insufficient physical activity, obesity rate of adults aged 18 in the 31 provinces in China excluding Hong Kong, Macao, Taiwan were 26.80% (25.15%, 29.25%), 17.80% (11.60%, 19.45%) and 12.00% (8.90%, 17.95%), respectively. The daily per capital salt intake level was 8.6 (8.2, 9.3) g. As for metabolic risk factors, the prevalence of dyslipidemia (33.7%) exceeded hypertension (26.0%) and diabetes (9.7%), while its awareness rate (14.5%), treatment rate (7.9%) and control rate (5.4%) were all below the corresponding levels of hypertension and diabetes.Conclusion:Risk factors of cardiovascular disease in China is relatively severe and the prevention and control of dyslipidemia needs to be further strengthened.

Objective:To understand the relationship between joint bleeding and joint disease in hemophilia children, and to provide a theoretical basis for clinical treatment and prognosis.Methods:The patients with severe hemophilia A between 1 and 7 years old and with relevant nodal bleeding records were selected.All the patients admitted in Beijing Children′s Hospital, Capital Medical University, and Chengdu New Century Women′s and Children′s Hospital since June 2016 to January 2017.All the joint bleeding of each child was taken as the study joint, and the joint bleeding was collected during the last 3 months.The joints were assessed by using ultrasound, X-ray, magnetic resonance imaging(MRI) and Hemophilia Joint Health Score (HJHS) scoring systems.The correlation analysis was conducted between the joint bleeding, ultrasound, X-ray, MRI and HJHS scores.The correlation analysis was conducted for baseline ultrasound, X-ray, MRI and HJHS scores.Results:(1) There were 18 patients enrolled.The mean age was (5.6±1.8) years old.There were 30 joints bleeding in the observation period in total, with the annul median joint bleeding times of 4 (4-16 times), and the annul median target joint bleeding times of 8 (4-16 times). (2) Joint bleeding times of was correlated with ultrasound and X-ray evaluation ( r=0.390, P=0.033; r=0.517, P=0.008), and not correlated with HJHS or MRI(all P>0.05). (3) There was significantly positive correlation among ultrasound, X-ray, HJHS and MRI [ r=0.815(ultrasound vs.X-ray), r=0.510(ultrasound vs.HJHS), r=0.812(ultrasound vs.MRI), r=0.666(X-ray vs.HJHS), r=0.911(X-ray vs.MRI), r=0.781(HJHS vs.MRI), all P<0.01]. (4) There was no correlation between times and assessment for joints whose ultrasound and /or MRI in joints with abnormal ultrasound and /or MRI evaluation( P>0.05). Conclusions:The results of joint bleeding and joint evaluation are inconsistent.Joint bleeding can not truly reflect the situation of joint diseases.The assessment of hemophilia should include comprehensive evaluation of joint structure, function, activity ability and other aspects to guide the treatment of haemophi-lia children.

Objective: To understand the prevalence and disease burden of major chronic diseases in the elderly in China and provide scientific basis for the prevention and control of chronic diseases and for the rational allocation of health resources. Methods: We analyzed the prevalence of chronic diseases in residents aged ≥60 years in China by using national and provincial surveillance data of chronic diseases and related risk factors in China. We conducted the analysis on the burden of chronic diseases in the elderly in China by using the data of global burden of disease. Results: The prevalence rates of hypertension, diabetes and hypercholesterolemia were 58.3%, 19.4% and 10.5% respectively in residents aged ≥60 years in China. Up to 75.8% of the residents aged ≥60 years had at least one chronic disease. The prevalence rate was higher in women than in men, higher in urban area than in rural area. With the increase of age, the prevalence rate of chronic diseases also increased. The top three chronic diseases with heavy disease burden in residents aged ≥70 years were stroke, myocardial infarction, cancer and chronic obstructive pulmonary disease. Conclusion The prevalence of major chronic diseases in the elderly is high with three quarters of the elderly suffering from at least one chronic disease, and the burden of chronic diseases is increasing.