3.Study on genetic structure differences and adjustment strategies in different areas of China.
M ZHU ; J LYU ; C Q YU ; G F JIN ; Y GUO ; Z BIAN ; W ROBIN ; M IONA ; Z M CHEN ; H B SHEN ; Z B HU ; L M LI
Chinese Journal of Epidemiology 2019;40(1):20-25
		                        		
		                        			
		                        			Objective: To describe the genetic structure of populations in different areas of China, and explore the effects of different strategies to control the confounding factors of the genetic structure in cohort studies. Methods: By using the genome-wide association study (GWAS) on data of 4 500 samples from 10 areas of the China Kadoorie Biobank (CKB), we performed principal components analysis to extract the first and second principal components of the samples for the component two-dimensional diagram generation, and then compared them with the source of sample area to analyze the characteristics of genetic structure of the samples from different areas of China. Based on the CKB cohort data, a simulation data set with cluster sample characteristics such as genetic structure differences and extensive kinship was generated; and the effects of different analysis strategies including traditional analysis scheme and mixed linear model on the inflation factor (λ) were evaluated. Results: There were significant genetic structure differences in different areas of China. Distribution of the principal components of the population genetic structure was basically consistent with the geographical distribution of the project area. The first principal component corresponds to the latitude of different areas, and the second principal component corresponds to the longitude of different areas. The generated simulation data showed high false positive rate (λ=1.16), even if the principal components of the genetic structure was adjusted or the area specific subgroup analysis was performed, λ could not be effectively controlled (λ>1.05); while, by using a mixed linear model adjusting for the kinship matrix, λ was effectively controlled regardless of whether the genetic structure principal component was further adjusted (λ=0.99). Conclusions: There were large differences in genetic structure among populations in different areas of China. In molecular epidemiology studies, bias caused by population genetic structure needs to be carefully treated. For large cohort data with complex genetic structure and extensive kinship, it is necessary to use a mixed linear model for association analysis.
		                        		
		                        		
		                        		
		                        			China
		                        			;
		                        		
		                        			Genetic Structures
		                        			;
		                        		
		                        			Genome-Wide Association Study
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Linear Models
		                        			;
		                        		
		                        			Principal Component Analysis
		                        			
		                        		
		                        	
4.Relationship between educational level and long-term changes of body weight and waist circumference in adults in China.
Y L TAN ; Z W SHEN ; C Q YU ; Y GUO ; Z BIAN ; P PEI ; H D DU ; J S CHEN ; Z M CHEN ; J LYU ; L M LI
Chinese Journal of Epidemiology 2019;40(1):26-32
		                        		
		                        			
		                        			Objective: To evaluate the association of educational level with anthropometric measurements at different adult stages and their long-term changes in adults who participated in the second re-survey of China Kadoorie Biobank (CKB). Methods: The present study excluded participants who were aged >65 years, with incomplete or extreme measurement values, or with major chronic diseases at baseline survey or re-survey. The weight at age 25 years was self-reported. Body height, body weight and waist circumference at baseline survey (2004-2008) and re-survey (2013-2014) were analyzed. Results: The present study included 3 427 men and 6 320 women. Both body weight and waist circumference (WC) increased with age. From age 25 years to baseline survey (mean age 45.2±6.5), the mean weight change per 5-year was (1.70±2.63) kg for men and (1.27±2.10) kg for women. From baseline survey to re-survey (53.2±6.5), the mean changes per 5-year for body weight were (1.12±2.61) kg for men and (0.90±2.54) kg for women; and that for WC was (3.20±3.79) cm for men and (3.83±3.85) cm for women. Among women, low educational level was consistently associated with higher body mass index (BMI) and WC at age 25 years, baseline survey and re-survey. Among men, low educational level was associated with higher BMI at age 25 years. At baseline survey and re-survey, the educational level in men was not statistically associated with BMI; but men who completed junior or senior high school showed slight higher WC and increase of WC from baseline survey to re-survey than other male participants. Conclusions: Body weight and WC increased with age for both men and women. The associations of educational level with BMI and WC were different between men and women.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Asian People/statistics & numerical data*
		                        			;
		                        		
		                        			Body Height
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			Body Weight
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Educational Status
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Obesity/ethnology*
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Sex Distribution
		                        			;
		                        		
		                        			Waist Circumference/ethnology*
		                        			
		                        		
		                        	
5.Incidence of fall related injury in people aged 50 and above and risk factors in 8 provinces in China: a cross-sectional study.
Y F GUO ; W J MA ; Q J ZHANG ; M YU ; Y Z XIAO ; X L GUO ; Y L ZHU ; F LIU ; Y RUAN ; S Y SUN ; Z Z HUANG ; Y ZHENG ; F WU
Chinese Journal of Epidemiology 2018;39(3):258-263
		                        		
		                        			
		                        			Objective: To estimate the incidence and distribution characteristics of fall related injury in people aged ≥50 years in 8 provinces in China and related physiological, psychological and social risk factors. Methods: Cross-sectional data were collected from adults aged ≥50 years participating in the World Health Organization (WHO) study on global ageing and adult health (SAGE) round 1 in China. Two-level hierarchical logistic model was used to identify the related factors for fall-related injury. All the models were stratified by living area (urban/rural). Results: Estimated incidence of fall related injury (road traffic injury was not included) was 3.2%. Ageing and multiple chronic conditions (OR=2.55, 95%CI: 1.41-4.64) was significantly associated with the incidence of fall related injury in urban area. In rural area, depression (OR=4.33, 95% CI: 2.52-7.42) and multiple chronic conditions (OR=2.46, 95%CI: 1.37-4.41) were associated with the incidence of fall related injury. Conclusions: This study estimated the incidence of fall related injury in adults aged ≥50 years in 8 provinces in China. A significant association between multiple chronic conditions and fall related injury were found in both urban and rural residents. Targeted measures should be taken for the prevention and control of chronic diseases in elderly population.
		                        		
		                        		
		                        		
		                        			Accidental Falls/statistics & numerical data*
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Chronic Disease/epidemiology*
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Depression/epidemiology*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Rural Population
		                        			;
		                        		
		                        			Wounds and Injuries/etiology*
		                        			
		                        		
		                        	
6.Prevalence of HIV infection and syphilis and related behaviors in clients in Ya'an of Sichuan province.
P L LI ; D M LI ; L GE ; X YUE ; L LIANG ; W GUO ; Y CUI
Chinese Journal of Epidemiology 2018;39(3):329-332
		                        		
		                        			
		                        			Objective: To understand the prevalence of HIV infection and syphilis in clients in Ya'an of Sichuan province. Methods: A survey was conducted in clients recruited through snowball method in Ya'an of Sichuan from April 2014 to December 2015. The information of the clients, including basic demography characteristics, AIDS knowledge awareness, high-risk behaviors and others, were collected through face-to-face interviews. Blood sample (5 ml) was taken from each client to test antibodies against HIV and syphilis. Statistical software SPSS 18.0 was used for data analysis. Results: Among the 708 clients, the constituent ratio of those aged ≥50 years was 51.27% (363/708), those in Han ethnic group was 99.72% (706/708), those with junior high school educational level or below was 90.11% (638/708), those who got married or cohabitated with others was 74.15% (525/708), and those who used condoms at each sex was 27.40% (194/708). Seven HIV positive cases were detected and 4 cases were aged ≥50 years. Seven syphilis cases were detected and all the cases were aged ≥50 year. No HIV-syphilis co-infection case was detected. The prevalence of HIV infection and syphilis were all 0.99% (95%CI: 0.30%-1.70%). Results from the multivariate logistic regression analysis showed that the clients who had their first commercial sex behavior at age <30 years (OR=6.61, 95%CI: 1.09-40.18) would have higher HIV positive rate. Conclusion: The rate of condom use was low in the clients in Ya'an and they didn't pay enough attention to their self-protection in sexual activities. Especially the clients aged ≥50 years were with low educational level and had high risk commercial sexual behaviors for HIV infection and syphilis. Close attention needs to be paid to them.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Coinfection/epidemiology*
		                        			;
		                        		
		                        			Condoms/statistics & numerical data*
		                        			;
		                        		
		                        			HIV Infections/ethnology*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Sex Work
		                        			;
		                        		
		                        			Sexual Behavior/ethnology*
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Syphilis/ethnology*
		                        			
		                        		
		                        	
7.Association between obesity and DNA methylation among the 7-16 year-old twins.
C X LI ; Y GAO ; W J GAO ; C Q YU ; J LYU ; R R LYU ; J L DUAN ; Y SUN ; X H GUO ; S F WANG ; B ZHOU ; G WANG ; W H CAO ; L M LI
Chinese Journal of Epidemiology 2018;39(4):443-448
		                        		
		                        			
		                        			Objective: On whole-genome scale, we tried to explore the correlation between obesity-related traits and DNA methylation sites, based on discordant monozygotic twin pairs. Methods: A total of 90 pairs of 6-17 year-old twins were recruited in Chaoyang district, Yanqing district and Fangshan district in Beijing in 2016. Information on twins was gathered through a self-designed questionnaire and results: from physical examination, including height, weight and waist circumference of the subjects under study. DNA methylation detection was chosen on the Illumina Human Methylation EPIC BeadChip. R 3.3.1 language was used to read the DNA methylation signal under quality control on samples and probes. Ebayes function of empirical Bayes paired moderated t-test was used to identify the differential methylated CpG sites (DMCs). VarFit function of empirical Bayes paired moderated Levene test was used to identify the differentially variables CpG sits (DVCs) in obese and normal groups. Results According to the obesity discordance criteria, we collected 23 pairs of twins (age range 7 to 16 years), including 12 male pairs. A total of 817 471 qualified CpG loci were included in the genome-wide correlation analysis. According to the significance level of FDR set as <0.05, no positive sites would meet this standard. When DMC CpG site cg05684382, with the smallest P value (1.26E-06) as on chromosome 12, the DVC CpG site cg26188191 with the smallest P value (6.44E-06) appeared in CMIP gene on chromosome 16. Conclusions: In this study, we analyzed the genome-wide DNA methylation and its correlation with obesity traits. After multiple testing corrections, no positive sites were found to have associated with obesity. However, results from the correlation analysis demonstrated sites cg05684382 (chr: 12) and cg26188191 (chr: 16) might have played a role in the development of obesity. This study provides a methodologic reference for the studies on discordance twins related problems.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Bayes Theorem
		                        			;
		                        		
		                        			Beijing
		                        			;
		                        		
		                        			Body Weight
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			DNA Methylation/genetics*
		                        			;
		                        		
		                        			Epigenesis, Genetic
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Genome-Wide Association Study
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Obesity/genetics*
		                        			;
		                        		
		                        			Twins, Monozygotic
		                        			;
		                        		
		                        			Waist Circumference
		                        			
		                        		
		                        	
8.Association between total cholesterol and risk of lung cancer incidence in men: a prospective cohort study.
Z Y LYU ; N LI ; G WANG ; K SU ; F LI ; L W GUO ; X S FENG ; L P WEI ; H D CHEN ; Y H CHEN ; F W TAN ; W J YANG ; S H CHEN ; J S REN ; J F SHI ; H CUI ; M DAI ; S L WU ; J HE
Chinese Journal of Epidemiology 2018;39(5):604-608
		                        		
		                        			
		                        			Objective: To assess the association and intensity of baseline TC level with the incidence of lung cancer in men in China. Methods: Since May 2006, all the male workers, including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study. Information about demographics, medical history, anthropometry and TC level were collected at the baseline interview, as well as the information of newly-diagnosed lung cancer cases during the follow-up period. According to guidelines for blood lipids in Chinese adults and the distribution in the population, TC level was classified into five groups as followed: <160, 160-, 180-, 200- and ≥240 mg/dl, with the second quintile group (160- mg/dl) serving as the referent category. Cox proportional hazards regression model and restricted cubic spline (RCS) model were used to evaluate the association and the nonlinear association between baseline TC level and the risk of lung cancer in the men. Results: By December 31, 2014, for the 109 884 men, a follow up of 763 819.25 person-years was made with a median follow-up period of 7.88 years. During the follow up, 808 lung cancer cases were identified. After adjustment for age, education level, income level, smoking status, alcohol consumption level, history of dust exposure, FPG level and BMI, HR (95%CI) of lung cancer for men with lower TC level (<160 mg/dl) and higher TC level (≥240 mg/dl) were 1.34 (1.04- 1.72) and 1.45 (1.09-1.92), respectively, compared with men with normal TC level (160- mg/dl). The results didn't change significantly after exclusion of newly diagnosed cancer cases within 2 years of follow up and subjects with the history of hyperlipidemia. Conclusion: Our results showed that TC might be associated with higher risk of lung cancer. Men with lower TC level or higher TC level had higher risk for lung cancer. Keep moderate TC level might be one of the effective precaution for the prevention of lung cancer.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Asian People
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Cholesterol/blood*
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Lipids
		                        			;
		                        		
		                        			Lung Neoplasms/ethnology*
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Proportional Hazards Models
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
9.Prevalence and characteristics of overweight and obesity in Chinese children aged 0-5 years.
D M YU ; L H JU ; L Y ZHAO ; H Y FANG ; Z Y YANG ; H J GUO ; W T YU ; F M JIA ; W H ZHAO
Chinese Journal of Epidemiology 2018;39(6):710-714
		                        		
		                        			
		                        			Objective: To study the prevalence and characteristics of overweight and obesity among Chinese children aged 0-5 years, in 2010-2013. Methods: Data was from the'China Nutrition and Health Surveillance-0-5-Years-Old Children and Lactating Women'project in 2013. Stratified multistage cluster sampling method was used to select 55 districts/counties from 30 provinces (autonomous regions, municipalities) with the sample size of children as 32 862. Definition of overweight and obesity were according to both the WHO 2006 growth standard in children less than 5-year-old and the WHO 2007 growth reference in children of 5-years-old. Results: were calculated by complex weight based on national census from the National Bureau of Statistics in 2010. Results The overall prevalence of overweight was 8.4% among the 0-5-year-old in 2013, with 9.4% in boys and 7.2% in girls. Both of the rates from urban and rural areas were the same, as 8.4%. The prevalence rates of overweight in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups appeared as 13.0%, 11.1%, 8.3%, 6.0%, 4.8%, 3.9% and 15.9%, respectively. The rates of overweight in low, medium and high income families were 8.0%, 8.8% and 8.9%, respectively. The prevalence of obesity was 3.1% among the 0-5-year-old, with 3.6% in boys and 2.5% in girls. There was no significant difference seen in urban (3.3%) and rural areas (2.9%). The prevalence rates for obesity in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups were 5.8%, 3.8%, 2.5%, 1.6%, 1.2%, 1.3% and 7.8%, respectively. The rates of obesity in low, medium and high income families were 2.8%, 3.3% and 3.5%, respectively. Conclusion: The prevalence rates of both overweight and obesity were increasing among the 0-5-year-olds in China, suggesting that it is necessary to timely conduct the surveillance and intervention programs on overweight and obesity in this target population.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Asian People/statistics & numerical data*
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			Body Weight
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Income
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Lactation
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Nutritional Status
		                        			;
		                        		
		                        			Obesity/ethnology*
		                        			;
		                        		
		                        			Overweight/ethnology*
		                        			;
		                        		
		                        			Prevalence
		                        			
		                        		
		                        	
10.Interaction between dietary cholesterol intake and the risk of gestational diabetes mellitus.
J X SHEN ; L L GUO ; S H RU ; Y WANG ; M LI ; W W WU ; Y L FENG ; P ZHANG ; H L YANG ; S P WANG ; Y W ZHANG
Chinese Journal of Epidemiology 2018;39(6):830-835
		                        		
		                        			
		                        			Objective: To investigate the influence of dietary cholesterol intake on gestational diabetes mellitus (GDM), at one year prior to and first and second trimesters of pregnancy. Methods: Between March 2012 and September 2016, the pregnant women from the First Affiliated Hospital of Shanxi Medical University were asked to fill in a set of questionnaires, by which information on general demographic characteristics, diagnosis of GDM and dietary cholesterol intake was collected. Unconditional logistic regression method was used to analyze the influence of dietary cholesterol intake on GDM, at one year prior to and first and second trimesters of pregnancy. The association on dietary cholesterol intake and GDM between age groups was also analyzed. Results: Data on 9 005 subjects, including 1 388 pregnant women with GDM, was collected. When the amount of cholesterol intake was stratified into quartile, results from the unconditional logistic regression showed that dietary cholesterol intake appeared ≥76.50 mg/d, both in the periods of one year prior to and the second trimester of pregnancy. This amount of dietary cholesterol intake would increase the risk of GDM (one year prior to pregnant: OR=1.230, 95%CI: 1.018-1.485; second trimester: OR=1.228, 95%CI:1.014- 1.486). Women who took ≥76.50 mg/d of daily cholesterol during the period of one year prior to, or 46.75-76.50 mg/d during the second trimester of pregnancy, the risks of GDM (OR=4.644, 95%CI: 1.106-19.499) would increase. Women with daily cholesterol intake over 76.50 mg/d during the period of one year prior to or at the second trimester of pregnancy, there appeared a risk on GDM (OR=1.217, 95%CI: 1.012-1.463). When maternal age was divided in two different subgroups and the cholesterol intake level was ≥76.50 mg/d both in the period of one year prior to pregnancy or at the second trimester, the risk of GDM appeared in the subgroup of<35 years old (OR=1.336, 95%CI:1.083-1.647; OR=1.341, 95%CI: 1.087-1.654). However, no significant association was found in the maternal age group of ≥35 years old. Conclusion: High level of dietary cholesterol intake would increase the risk of GDM, both in the period of one year prior to and at the second trimester of pregnancy.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Asian People/statistics & numerical data*
		                        			;
		                        		
		                        			Cholesterol, Dietary
		                        			;
		                        		
		                        			Diabetes, Gestational/epidemiology*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Pregnancy Trimester, First
		                        			;
		                        		
		                        			Pregnancy Trimester, Second
		                        			;
		                        		
		                        			Risk Factors
		                        			
		                        		
		                        	
            
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