2017 Vol. 30, No. 2


2017, 30(2): 1-1.
2017, 2(2): 2-2.
Original Articles
BMI and BMI Changes to All-cause Mortality among the Elderly in Beijing: a 20-year Cohort Study
WANG YunFeng, TANG Zhe, GUO Jin, TAO LiXin, LIU Long, LI HaiBin, LI DiTian, GUO XiuHua, YANG XingHua
2017, 30(2): 79-87. doi: 10.3967/bes2017.011
Objective To explore the association between body mass index (BMI) and all-cause mortality among the elderly in Beijing. Methods This analysis was based on the Beijing multidimensional longitudinal study of aging (BLSA), which included 2, 090 subjects over 55 years old and was followed-up from 1992 to 2012. BMI-mortality curves were drawn to find the optimal BMI range with the lowest mortality. Cox proportional hazard models were used to obtain the hazard ratios (HRs) for BMI and BMI changes in the overall population and in specific stratified populations. Results During follow-up, 1, 164 deaths were recorded; BMI-mortality curve was U-shaped, with the lowest mortality at a BMI of approximately 25 kg/m2. After adjusting for gender, age, smoking, drinking and some pre-existing diseases, HRs for underweight, overweight and obesity compared with normal weight were 1.372 (95% CI:1.154-1.631), 0.767 (95% CI:0.666-0.884) and 0.871 (95% CI:0.830-1.246), respectively. HR for BMI drop was 3.245 (95% CI:0.824-12.772) in the underweight group and 1.892 (95% CI:0.830-1.246) in the normal weight group, HR for BMI rise was 1.795 (95% CI:1.243-2.591) in normal weight group and 1.962 (95% CI:1.202-3.203) in the overweight group. Conclusion Keeping BMI in an overweight status and stable is related to a reduced mortality.
Surveys in Areas of High Risk of Iodine Deficiency and Iodine Excess in China, 2012-2014: Current Status and Examination of the Relationship between Urinary Iodine Concentration and Goiter Prevalence in Children Aged 8-10 Years
CUI Si Lu, LIU Peng, SU Xiao Hui, LIU Shou Jun
2017, 30(2): 88-96. doi: 10.3967/bes2017.012
Objective We aimed to evaluate goiter prevalence and iodine nutritional status in areas with high levels of water iodine; to monitor the prevalence of iodine deficiency disorders (IDD) in areas at high risk of IDD; and to compare the prevalence of goiter and urine iodine (UI) concentrations between children living in the two areas. Methods Based on surveillance from 2012-2014, we analyzed the concentration of UI and prevalence of goiter in 8-10-year-old children from 12 high-risk IDD provinces, and from 8 provinces and municipalities with excessive water iodine. We calculated goiter prevalence for each UI level according to World Health Organization (WHO) standards and constructed predictive prevalence curves. Results The goiter prevalence and median UI of children from areas with high water iodine were not optimal, being above the WHO standards (5% and 100-199 μg/L, respectively), whereas those in high-risk areas fell within the standard. UI and goiter prevalence exhibited a U-shaped relationship in high-risk endemic areas and a parabolic relationship in areas of iodine excess. Conclusion Iodine surplus in high-iodine areas leads to high goiter prevalence and UI. However, in high-risk areas, UI was optimal and goiter prevalence met the national criteria for IDD elimination.
Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students
JIN Shan Shan, BU Kai, CHEN Fang Fang, XU Hui Fang, LI Yi, ZHAO Dong Hui, XU Fang, LI Jing Yan, HAN Meng Jie, WANG Ning, WANG Lu
2017, 30(2): 97-105. doi: 10.3967/bes2017.013
Objective To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model (EPPM)-based integrated model. Methods A total of 3, 081 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. Results Among the participants, 1, 387 (46.7%) were male, 1, 586 (53.3%) were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect (r=0.23), perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education (r=0.40) and intention to engage in premarital sex (r=-0.16), respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex (intent-to-premarital-sex) had a poor indirect impact on condom-use self-efficacy (total effect was-0.06). Furthermore, attitude toward HIV health education (r=0.49) and intent-to-premarital-sex (r=-0.31) had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. Conclusion The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention.
Development and Validation of a Model for Predicting Diabetic Nephropathy in Chinese People
MIAO Dan Dan, PAN En Chun, ZHANG Qin, SUN Zhong Ming, QIN Yu, WU Ming
2017, 30(2): 106-112. doi: 10.3967/bes2017.014
Objective To develop a risk model for predicting later development of diabetic nephropathy (DN) in Chinese people with type 2 diabetes mellitus (T2DM) and evaluate its performance with independent validation. Methods We used data collected from the project 'Comprehensive Research on the Prevention and Control of Diabetes', which was a community-based study conducted by the Jiangsu Center for Disease Control and Prevention in 2013. A total of 11, 771 eligible participants were included in our study. The endpoint was a clear diagnosis of DN. Data was divided into two components:a training set for model development and a test set for validation. The Cox proportional hazard regression was used for survival analysis in men and women. The model's performance was evaluated by discrimination and calibration. Results The incidence (cases per 10, 000 person-years) of DN was 9.95 (95% CI; 8.66-11.43) in women and 11.28 (95% CI; 9.77-13.03) in men. Factors including diagnosis age, location, body mass index, high-density-lipoprotein cholesterol, creatinine, hypertension, dyslipidemia, retinopathy, diet control, and physical activity were significant in the final model. The model showed high discrimination and good calibration. Conclusion The risk model for predicting DN in people with T2DM can be used in clinical practice for improving the quality of risk management and intervention.
Distribution of Facial Exposure to Non-melanoma Biologically Effective UV Irradiance Changes by Rotation Angles
WANG Fang, YU Jia Ming, YANG De Qi, GAO Qian, HUA Hui, LIU Yang
2017, 30(2): 113-127. doi: 10.3967/bes2017.015
Objective To show the distribution of facial exposure to non-melanoma biologically effective UV irradiance changes by rotation angles. Methods This study selected the cheek, nose, and forehead as representative facial sites for UV irradiance measurements, which were performed using a rotating manikin and a spectroradiometer. The measured UV irradiance was weighted using action spectra to calculate the biologically effective UV irradiances that cause non-melanoma (UVBEnon-mel) skin cancer. The biologically effective UV radiant exposure (HBEnon-mel) was calculated by summing the UVBEnon-mel data collected over the exposure period. Results This study revealed the following:(1) the maximum cheek, nose and forehead exposure UVA and UVB irradiance times and solar elevation angles (SEA) differed from those of the ambient UV irradiance and were influenced by the rotation angles; (2) the UV irradiance exposure increased in the following order:cheek < nose < forehead; (3) the distribution of UVBEnon-mel irradiance differed from that of unweighted UV radiation (UVR) and was influenced by the rotation angles and exposure times; and (4) the maximum percentage decreases in the UVBEnon-mel radiant exposure for the cheek, nose and forehead from 0° to 180° were 48.41%, 69.48% and 71.71%, respectively. Conclusion Rotation angles relative to the sun influence the face's exposure to non-melanoma biologically effective UV.
Letters to the Editor
Association between Free Triiodothyronine Levels and Peripheral Arterial Disease in Euthyroid Participants
WANG Po, DU Rui, LIN Lin, DING Lin, PENG Kui, XU Yu, XU Min, BI Yu Fang, WANG Wei Qing, NING Guang, LU Jie Li
2017, 30(2): 128-133. doi: 10.3967/bes2017.016
This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease (PAD) among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine (FT3), free thyroxin (FT4), thyroid-stimulating hormone (TSH), and thyroid antibodies were measured. PAD was defined as ankle-brachial index (ABI) < 0.9. There were 91 (2.9%) PAD cases among the 3, 148 euthyroid study participants. Participants in the highest quartile of FT3 and free-triiodothyronine-to-free-thyroxin (FT3/FT4 ratio) had a decreased risk of prevalent PAD (multivariate-adjusted odds ratio, 95% confidence interval: 0.32, 0.15-0.62, P for trend=0.01 and 0.31, 0.13-0.66, P for trend=0.004, respectively) compared to those in the lowest quartile. To conclude, FT3 levels and the FT3/FT4 ratio was inversely associated with prevalent PAD in euthyroid Chinese population aged 40 years and above.
Effects of Selenium on Fusarium Growth and Associated Fermentation Products and the Relationship with Chondrocyte Viability
YIN Hong, ZHANG Yan, ZHANG Feng, HU Jin Tao, ZHAO Yu Meng, CHENG Bo Lun
2017, 30(2): 134-138. doi: 10.3967/bes2017.017
This study determined the effects of selenium on the growth of Fusarium strains and the effects of products extracted from the fungal cultures on relevant indicators of chondrocytes injury. The results showed that selenium supplementation resulted in differential effects on the mycelial growth of the strains. Levels of the chondrocyte injury indicators, including cell viability, proteoglycan and type Ⅱ collagen contents and their mRNA expressions, were all reduced to varying degrees when the chondrocytes were incubated with fermentation extracts, the inhibitory effect varied depending on selenium content supplemented to fungal culture media. The results indicated that certain chain relations existed between the content of selenium in the environment, the production of some metabolites by fungi, and the occurrence of chondrocyte damage. The extent of this relationship and the role it plays in Kaschin-Beck disease pathogenesis merit further study.
Prevalence and Risk Factors Associated with Adverse Drug Reactions among Previously Treated Tuberculosis Patients in China
HAN Xi Qin, PANG Yu, MA Yan, LIU Yu Hong, GUO Ru, SHU Wei, HUANG Xue Rui, GE Qi Ping, DU Jian, GAO Wei Wei
2017, 30(2): 139-142. doi: 10.3967/bes2017.018
We assessed the incidence of adverse drug reactions (ADRs) with anti-TB medications and evaluated the risk factors for developing ADRs in previously treated tuberculosis patients in China. All patients received the first-line anti-TB regimen (2HREZS/6HRE) as recommended by the national guidelines. Clinical and laboratory evaluations were performed once a month. Out of the 354 participants, 262 (74.0%) experienced ADRs such as hyperuricemia (65.0%, 230/354), hepatotoxicity (6.2%, 22/354) and hearing disturbances (4.8%, 17/354). ADRs were significantly associated with diabetes mellitus [OR (95% CI): 15.5 (2.07-115.87)]; however, weight more than 50 kg [OR (95% CI): 0.41 (0.22-0.85)] was a protective factor for occurrence of ADRs. Hyperuricemia is the most common adverse event but, most patients with hyperuricemia showed increased tolerance for high uric acid levels. Low body weight and diabetes mellitus increased the risk of the occurrence of ADRs during anti-TB treatment.
The Effect of PCDH15 Gene Variations on the Risk of Noise-induced Hearing Loss in a Chinese Population
XU Xiang Rong, WANG Jing Jing, YANG Qiu Yue, JIAO Jie, HE Li Hua, YU Shan Fa, GU Gui Zhen, CHEN Guo Shun, ZHOU Wen Hui, WU Hui, LI Yan Hong, ZHANG Huan Ling, ZHANG Zeng Rui, JIN Xian Ning
2017, 30(2): 143-146. doi: 10.3967/bes2017.019
Noise-induced hearing loss (NIHL) is a complex disease caused by interactions between environmental and genetic factors. This study investigated whether genetic variability in protocadherin related 15 (PCDH15) underlies an increased susceptibility to the development of NIHL in a Chinese population. The results showed that compared with the TT genotype of rs11004085, CT/CC genotypes were associated with an increased risk of NIHL [adjusted odds ratio (OR)=2.64; 95% confidence interval (CI): 1.14-6.11, P=0.024]. Additionally, significant interactions between the rs11004085 and rs978842 genetic variations and noise exposure were observed in the high-level exposure groups (P < 0.05). Furthermore, the risk haplotype TAGCC was observed when combined with higher levels of noise exposure (P < 0.05). Thus, our study confirms that genetic variations in PCDH15 modify the susceptibility to NIHL development in humans.
Research Highlight
Treatment and Prevention of Skeletal Fluorosis
YANG Chen, WANG Yan, XU Hui
2017, 30(2): 147-149. doi: 10.3967/bes2017.020
Policy Forum
Evaluation of the Sensitivity and Specificity of the New Clinical Diagnostic and Classification Criteria for Kashin-Beck Disease, an Endemic Osteoarthritis, in China
YU Fang Fang, PING Zhi Guang, YAO Chong, WANG Zhi Wen, WANG FuQi, GUO Xiong
2017, 30(2): 150-155. doi: 10.3967/bes2017.021
This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease (KBD) using six clinical markers: flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling. The survey included baseline characteristics and clinical diagnoses, and the sensitivity and specificity of the new criteria was evaluated. We identified 3, 459 KBD patients, of which 69 had early stage KBD, 1, 952 had stage Ⅰ, 1, 132 had stage Ⅱ, and 306 had stage Ⅲ. A screening test classified enlarged finger joints as stage Ⅰ KBD, with a sensitivity and specificity of 0.978 and 0.045, respectively. Shortened fingers were classified as stage Ⅱ KBD, with a sensitivity and specificity of 0.969 and 0.844, respectively, and dwarfism was classified as stage Ⅲ KBD with a sensitivity and specificity of 0.951 and 0.992, respectively. Serial screening test revealed that the new clinical classification of KBD classified stages Ⅰ, Ⅱ, and Ⅲ KBD with sensitivities of 0.949, 0.945, and 0.925 and specificities of 0.967, 0.970, and 0.993, respectively. The screening tests revealed that enlarged finger joints, shortened fingers, and dwarfism were appropriate markers for the clinical diagnosis and classification of KBD with high sensitivity and specificity.