Biomedical and Environmental Sciences

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Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary (30 day view times: 71)

National Center for Cardiovascular Diseases The Writing Committee of the Report on Cardiovascular Health and Diseases in China

2024, 37(9): 949-992. doi: 10.3967/bes2024.162

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Since 1990, China has made considerable progress in resolving the problem of “treatment difficulty” of cardiovascular diseases (CVD). The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors, and this situation is further worsened due to the accelerated aging population in China. CVD remains one of the greatest threats to the health of Chinese residents. In terms of the proportions of disease mortality among urban and rural residents in China, CVD has persistently ranked first. In 2021, CVD accounted for 48.98% and 47.35% of deaths in rural and urban areas, respectively. Two out of every five deaths can be attributed to CVD. To implement a national policy “focusing on the primary health institute and emphasizing prevention” and truly achieve a shift of CVD prevention and treatment from hospitals to communities, the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the “Report on Cardiovascular Health and Diseases in China” annually since 2005. The 2024 report is established based on representative, published, and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys, randomized controlled clinical trials, large sample registry studies, and typical community prevention and treatment cases, along with data from some projects undertaken by the National Center for Cardiovascular Diseases. These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

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Association of Body Mass Index with All-Cause Mortality and Cause-Specific Mortality in Rural China: 10-Year Follow-up of a Population-Based Multicenter Prospective Study (30 day view times: 43)

Juanjuan Huang, Yuanzhi Di, Lingyu Shen, Jianguo Liang, Jiang Du, Xuefang Cao, Weitao Duan, Aiwei He, Jun Liang, Limei Zhu, Zisen Liu, Fang Liu, Shumin Yang, Zuhui Xu, Cheng Chen, Bin Zhang, Jiaoxia Yan, Yanchun Liang, Rong Liu, Tao Zhu, Hongzhi Li, Fei Shen, Boxuan Feng, Yijun He, Zihan Li, Yaqi Zhao, Tonglei Guo, Liqiong Bai, Wei Lu, Qi Jin, Lei Gao, Henan Xin

2025, 38(10): 1179-1193. doi: 10.3967/bes2025.128

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Objective This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. Results Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m²) presented an increase in all-cause mortality (adjusted hazards ratio [aHR] = 2.00, 95% confidence interval [CI]: 1.66–2.41), while overweight (≥ 24.0 to < 28.0 kg/m²) and obesity (≥ 28.0 kg/m²) presented a decrease with an aHR of 0.61 (95% CI: 0.52–0.73) and 0.51 (95% CI: 0.37–0.70), respectively. Overweight (aHR = 0.76, 95% CI: 0.67–0.86) and mild obesity (aHR = 0.72, 95% CI: 0.59–0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m² (aHR = 0.95, 95% CI: 0.92–0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.

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Climate-Sensitive Infectious Diseases under Global Climate Change (30 day view times: 26)

Qiao Liu, Min Liu, Jue Liu

2025, 38(9): 1129-1141. doi: 10.3967/bes2025.077

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Climate and weather significantly influence the duration, timing, and intensity of disease outbreaks, reshaping the global landscape of infectious diseases. Rising temperatures and shifts in precipitation patterns driven by climate change can directly impact the survival and reproduction of pathogens and vector organisms. Moreover, climate change is expected to exacerbate extreme weather events, including floods and droughts, which can disrupt infrastructure and increase the risk of water- and foodborne diseases. There are potential shifts in the temporal and spatial patterns of infectious disease transmission owing to climate change. Furthermore, climate change may alter the epidemiology of vaccine-preventable diseases. These climatic variations not only affect the ecological characteristics of pathogens and vectors but also indirectly influence human behaviors and socioeconomic conditions, further amplifying disease transmission risks. Addressing this challenge requires an interdisciplinary collaboration and comprehensive public health strategies. This review aims to synthesize the current evidence on the impact of climate change on climate-sensitive infectious diseases and elucidate the underlying mechanisms and transmission pathways. Additionally, we explored adaptive policy strategies to mitigate the public health burden of infectious diseases in the context of climate change, offering insights for global health governance and disease control efforts.

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Interpretation of Annual Report on Cardiovascular Health and Diseases in China 2024 (30 day view times: 25)

Mingbo Liu, Xinye He, Xiaohong Yang, Zengwu Wang

2025, 38(8): 893-917. doi: 10.3967/bes2025.099

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Cardiovascular diseases (CVD) and their risk factors are exerting an increasingly significant impact on public health, and the incidence rate of CVD continues to rise. This article provides an interpretation of essentials from the newly published Annual Report on Cardiovascular Health and Diseases in China (2024), aiming to offer scientific evidence for CVD prevention, treatment, and the formulation of relevant policies.

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Environmental Temperature and the Risk of Hand, Foot, and Mouth Disease Transmission in the Yangtze River Region of China (30 day view times: 23)

Yanqing Yang, Min Chen, Jin Li, Kaiqi Liu, Xueyan Guo, Xin Xu, Qian Liang, Xinglu Wu, Suwen Lei, Jing Li

2025, 38(3): 290-302. doi: 10.3967/bes2025.011

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Objective To assess health equity in the Yangtze River region to improve understanding of the correlation between hand, foot, and mouth disease (HFMD) and socioeconomic factors. Methods From 2014–2016, data on HFMD incidence, population statistics, economic indicators, and meteorology from 26 cities along the Yangtze River were analyzed. A multi-city random-effects meta-analysis was performed to study the relationship between temperature and HFMD transmission, and health equity was assessed with respect to socio-economic impact. Results Over the study period, 919,458 HFMD cases were reported, with Shanghai (162,303) having the highest incidence and Tongling (5,513) having the lowest. Males were more commonly affected (male-to-female ratio, 1.49:1). The exposure-response relationship had an M-shaped curve, with two HFMD peaks occurring at 4 °C and 26 °C. The relative risk had two peaks at 1.30 °C (1.834, 95% CI: 1.204–2.794) and 31.4 °C (1.143, 95% CI: 0.901–1.451), forming an M shape, with the first peak higher than the second. The most significant impact of temperature on HFMD was observed between –2 °C and 18.1 °C. The concentration index (0.2463) indicated moderate concentration differences, whereas the Theil index (0.0418) showed low inequality in distribution. Conclusion The incidence of HFMD varied across cities, particularly with changes in temperature. Economically prosperous areas showed higher risks, indicating disparities. Targeted interventions in these areas are crucial for mitigating the risk of HFMD.

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Report on Cardiovascular Health and Diseases in China 2022: an Updated Summary (30 day view times: 23)

The Writing Committee of the Report on Cardiovascular Health and Diseases in China

2023, 36(8): 669-701. doi: 10.3967/bes2023.106

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In the past 30 years, the accessibility and quality index of medical care have made remarkable progress in China, ranking the first among middle-income countries. Many cardiovascular technologies are at or near the world's leading level, and significant progress has been achieved in China solving the problem of “treatment difficulty” of cardiovascular diseases (CVD). However, due to the prevalence of unhealthy lifestyles among Chinese residents, a huge population with CVD risk factors, accelerated population aging, and other reasons, the incidence and mortality rate of CVD are still increasing, and the turning point of the decline in disease burden has not appeared yet in China. In terms of proportions of disease mortality among urban and rural residents, CVD still ranks the first. In 2020, CVD accounted for 48.00% and 45.86% of the causes of death in rural and urban areas, respectively; two out of every five deaths were due to CVD. It is estimated that the number of current CVD patients in China is around 330 million, including 13 million stroke, 11.39 million coronary heart disease, 8.9 million heart failure, 5 million pulmonary heart disease, 4.87 million atrial fibrillation, 2.5 million rheumatic heart disease, 2 million congenital heart disease, 45.3 million peripheral artery disease, and 245 million hypertension cases. China has entered a new stage of transformation from high-speed development to high-quality development, and the prevention and control of CVD in China should also shift from previous emphasis on scale growth to strategies focusing more on strategic and key technological development in order to curb the trend of increasing incidence and mortality rates of CVD.

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Hypertrophic Cardiomyopathy: Mechanisms of Pathogenicity (30 day view times: 20)

Baoxi Wang, Yueting Zhou, Yipin Zhao, Yong Cheng, Jun Ren, Guanchang Tan, Xiaohu Wang

2025, 38(8): 988-1000. doi: 10.3967/bes2025.096

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Hypertrophic cardiomyopathy (HCM) is a major contributor to cardiovascular diseases (CVD), the leading cause of death globally. HCM can precipitate heart failure (HF) by causing the cardiac tissue to weaken and stretch, thereby impairing its pumping efficiency. Moreover, HCM increases the risk of atrial fibrillation, which in turn elevates the likelihood of thrombus formation and stroke. Given these significant clinical ramifications, research into the etiology and pathogenesis of HCM is intensifying at multiple levels. In this review, we discuss and synthesize the latest findings on HCM pathogenesis, drawing on key experimental studies conducted both in vitro and in vivo. We also offer our insights and perspectives on these mechanisms, while highlighting the limitations of current research. Advancing fundamental research in this area is essential for developing effective therapeutic interventions and enhancing the clinical management of HCM.

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Joint Effect of Multiple Air Pollutant Exposure on Dyslipidemia in Chinese Primary School Children (30 day view times: 20)

Yuanduo Zhu, Yingying Han, Dandan Li, Yanlong Xu

2025, 38(10): 1302-1307. doi: 10.3967/bes2025.130

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Deciphering the Role of VIM, STX8, and MIF in Pneumoconiosis Susceptibility: A Mendelian Randomization Analysis of the Lung-Gut Axis and Multi-Omics Insights from European and East Asian Populations (30 day view times: 20)

Chenwei Zhang, Binbin Wan, Yukai Zhang, Tao Xiong, Yishan Li, Xuesen Su, Gang Liu, Yangyang Wei, Yuanyuan Sun, Jingfen Zhang, Xiao Yu, Yiwei Shi

2025, 38(10): 1270-1286. doi: 10.3967/bes2025.028

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Objective Pneumoconiosis, a lung disease caused by irreversible fibrosis, represents a significant public health burden. This study investigates the causal relationships between gut microbiota, gene methylation, gene expression, protein levels, and pneumoconiosis using a multi-omics approach and Mendelian randomization (MR). Methods We analyzed gut microbiota data from MiBioGen and Esteban et al. to assess their potential causal effects on pneumoconiosis subtypes (asbestosis, silicosis, and inorganic pneumoconiosis) using conventional and summary-data-based MR (SMR). Gene methylation and expression data from Genotype-Tissue Expression and eQTLGen, along with protein level data from deCODE and UK Biobank Pharma Proteomics Project, were examined in relation to pneumoconiosis data from FinnGen. To validate our findings, we assessed self-measured gut flora from a pneumoconiosis cohort and performed fine mapping, drug prediction, molecular docking, and Phenome-Wide Association Studies to explore relevant phenotypes of key genes. Results Three core gut microorganisms were identified: Romboutsia (OR = 0.249) as a protective factor against silicosis, Pasteurellaceae (OR = 3.207) and Haemophilus parainfluenzae (OR = 2.343) as risk factors for inorganic pneumoconiosis. Additionally, mapping and quantitative trait loci analyses revealed that the genes VIM, STX8, and MIF were significantly associated with pneumoconiosis risk. Conclusions This multi-omics study highlights the associations between gut microbiota and key genes (VIM, STX8, MIF) with pneumoconiosis, offering insights into potential therapeutic targets and personalized treatment strategies.

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NFKBIE: Novel Biomarkers for Diagnosis, Prognosis, and Immunity in Colorectal Cancer: Insights from Pan-cancer Analysis (30 day view times: 19)

Chenyang Hou, Peng Wang, Fengxu Yan, Yanyan Bo, Zhenpeng Zhu, Xiran Wang, Shan Liu, Dandan Xu, JiaJia Xiao, Jun Xue, Fei Guo, Qingxue Meng, Rensen Ran, Weizheng Liang

2025, 38(10): 1320-1325. doi: 10.3967/bes2025.124

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Nutrition Guidelines of Complementary Feeding for Infants and Toddlers (WS/T 678—2020) (30 day view times: 18)

2023, 36(9): 899-901. doi: 10.3967/bes2023.117

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Cardiovascular Health and Disease Report in China: Two Decades of Progress (30 day view times: 17)

Shuyao Su, Fangchao Liu

2025, 38(8): 891-892. doi: 10.3967/bes2025.098

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Effects of Oral Vitamin D Supplementation on Vitamin D Levels and Glycemic Parameters in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-Analysis (30 day view times: 17)

Xiujuan Zhang, Hongfei Wang, Xia Gao, Yang Zhao

2025, 38(6): 716-726. doi: 10.3967/bes2025.066

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Objective Epidemiological studies have shown that vitamin D status affects glycemic control in individuals with type 2 diabetes mellitus (T2DM). However, findings from intervention studies remain inconsistent. Therefore, a network meta-analysis was conducted to evaluate the comparative efficacy of various vitamin D supplementation strategies on glucose indicators in adults with T2DM. Methods Eligible studies published before September 12, 2024, were retrieved from PubMed, EMBASE, Cochrane Library, and Web of Science. A network meta-analysis of multiple dosage strategies—low (< 1,000 IU/day, LDS), medium (1,000–2,000 IU/day, MDS), high (2,000–4,000 IU/day, HDS), and extremely high (≥ 4,000 IU/day, EHDS)—was performed. Results The network meta-analysis of 40 RCTs indicated that, compared with placebo, vitamin D₃ supplementation increased 25-hydroxyvitamin D [25-(OH)-D] levels, with pooled mean difference (MD) showing a stepwise increase from LDS to EHDS. Ranking probabilities showed a corresponding rise in 25-(OH)-D levels from LDS (46.7%) to EHDS (91.2%). EHDS reduced fasting blood glucose (FBG) relative to no treatment. LDS significantly decreased hemoglobin A1c (HbA1c), and vitamin D₂ significantly affected FBG levels. MDS led to a significant change in fasting insulin (FIN) compared to both placebo (MD: −4.76; 95% CI −8.91 to −0.61) and no treatment (MD: −7.30; 95% CI −14.44 to −0.17). Conclusion The findings suggest that vitamin D supplementation may be a viable approach for improving glycemic control in adults with T2DM, with lower doses potentially offering benefit. The analysis also showed a dose-dependent increase in 25-(OH)-D levels.

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Dietary Guide for Hyperuricemia and Gout Patients (WS/T 560—2017) (30 day view times: 17)

2023, 36(9): 897-898. doi: 10.3967/bes2023.118

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Molecular Characterization of New Recombinant Human Adenoviruses Detected in Children with Acute Respiratory Tract Infections in Beijing, China, 2022–2023 (30 day view times: 16)

Yinan Guo, Ri De, Fangming Wang, Zhenzhi Han, Liying Liu, Yu Sun, Yao Yao, Xiaolin Ma, Shuang Liu, Chunmei Zhu, Dong Qu, Linqing Zhao

2025, 38(9): 1071-1081. doi: 10.3967/bes2025.105

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Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus (HAdV), particularly in children with acute respiratory tract infections (ARIs). Therefore, continual monitoring of these events is essential for effective viral surveillance and control. Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023. The penton base, hexon, and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type. In cases with inconsistent typing results, genes were cloned into the pGEM-T vector to detect recombination events. Metagenomic next-generation sequencing (mNGS) was performed to characterize the recombinant HAdV genomes. Results Among 6,771 specimens, 277 (4.09%, 277/6,771) were positvie for HAdV, of which 157 (56.68%, 157/277) were successfully typed, with HAdV-B3 being the dominant type (91.08%, 143/157), and 14 (5.05%, 14/277) exhibited inconsistent typing results, six of which belonged to species B. The penton base genes of these six specimens were classified as HAdV-B7, whereas their hexon and fiber genes were classified as HAdV-B3, resulting in a recombinant genotype designated P7H3F3, which closely resembled HAdV-B114. Additionally, a partial gene encoding L1 52/55 kD was identified, which originated from HAdV-B16. Conclusion A novel recombinant, P7H3F3, was identified, containing sequences derived from HAdV-B3 and HAdV-B7, which is similar to HAdV-B114, along with additional sequences from HAdV-B16.

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Trends in Lipids Level and Dyslipidemia among Chinese Adults, 2002-2015 (30 day view times: 16)

SONG Peng Kun, MAN Qing Qing, LI Hong, PANG Shao Jie, JIA Shan Shan, LI Yu Qian, HE Li, ZHAO Wen Hua, ZHANG Jian

2019, 32(8): 559-570. doi: 10.3967/bes2019.074

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Objective To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015. Methods Data were collected from three nationally representative cross-sectional surveys. Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination. Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender. Results The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively; by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period. Similar trends in mean non-HDL-c and lipid-related ratios were observed. The weighted dyslipidemia prevalence linearly increased; in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2% (P for trend < 0.001). Conclusion Dyslipidemia increased among Chinese adults from 2002 to 2015. Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.

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Evidence on Invasion of Blood, Adipose Tissues, Nervous System and Reproductive System of Mice After a Single Oral Exposure: Nanoplastics versus Microplastics (30 day view times: 16)

YANG Zuo Sen, BAI Ying Long, JIN Cui Hong, NA Jun, ZHANG Rui, GAO Yuan, PAN Guo Wei, YAN Ling Jun, SUN Wei

2022, 35(11): 1025-1037. doi: 10.3967/bes2022.131

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Objective This study was designed to provide the evidences on the toxicokinetics of microplastics (MPs) and nanoplastics (NPs) in the bodies of mammals. Methods 100 nm, 3 μm, and 10 μm fluorescent polystyrene (PS) beads were administered to mice once by gavage at a dose of 200 mg/kg body weight. The levels and change of fluorescence intensity in samples of blood, subcutaneous fat, perirenal fat, peritesticular fat, cerebrum, cerebellum, testis, and epididymis were measured at 0.5, 1, 2, and 4 h after administration using an IVIS Spectrum small-animal imaging system. Histological examination, confocal laser scanning, and transmission electron microscope were performed to corroborate the findings. Results After confirming fluorescent dye leaching and impact of pH value, increased levels of fluorescence intensity in blood, all adipose tissues examined, cerebrum, cerebellum, and testis were measured in the 100 nm group, but not in the 3 and 10 μm groups except in the cerebellum and testis at 4 h for the 3 μm PS beads. The presence of PS beads was further corroborated. Conclusion After a single oral exposure, NPs are absorbed rapidly in the blood, accumulate in adipose tissues, and penetrate the blood-brain/testis barriers. As expected, the toxicokinetics of MPs is significantly size-dependent in mammals.

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Impact of PCSK9 Inhibitor Recaticimab on Hyperlipidemia and Plasma Glucose: A Randomized, Double-Blind, Placebo-Controlled Phase 1b/2 Study (30 day view times: 15)

Ye Hu, Chen Chen, Xiaohui He, Shuyu Zhang, Xuhong Wang

2025, 38(10): 1246-1254. doi: 10.3967/bes2025.123

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Objective Recaticimab (SHR-1209) significantly reduces low-density lipoprotein cholesterol levels. However, its effect on glucose metabolism remains unclear. This study aimed to evaluate its effect on glycemic parameters in a Chinese population. Methods Recaticimab versus placebo was administered in a 5:1 ratio to 110 hyperlipidemia patients who were followed up for 24 weeks. Glycated hemoglobin (HbA1c) levels were measured at baseline every 12 weeks. Fasting plasma glucose (FPG) levels were measured at baseline at week 1, 3, 5, 8, 12, 16, 20, and 24. Repeated-measures mixed-effects models were used to determine the longitudinal association between reacticimab and FPG and HbA1c levels. Results Among the 81 participants with normal glucose metabolism, HbA1c levels significantly decreased (F = 4.568, P = 0.036). In the 29 participants with abnormal glucose metabolism, a significant time effect was observed for FPG levels (F = 2.492, P = 0.016). For participants with normal and abnormal glucose metabolism, no significant group × time interaction effects on FPG or HbA1c levels were identified. Conclusion Recaticimab showed no adverse glycemic effects in participants with normal or abnormal glucose metabolism, indicating its safety in patients with or without diabetes.

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Cover (30 day view times: 15)

2025, 38(10).

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A Multi-site Analysis for the Economic Burden of Mortality Attributable to Cold Spells of Different Intensities in China, 2014–2019 (30 day view times: 14)

Cheng Zhao, Yu Wang, Rui Zhang, Shilu Tong, Jiang He, Yonghong Li, Xiaoyuan Yao

2025, 38(10): 1205-1216. doi: 10.3967/bes2025.122

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Objective The role of cold spells of different intensities in the economic burden of death is crucial for health adaptation to climate change, especially in a multi-site setting. The objective of the study was to explore the economic burden of mortality attributable to cold spells Methods We performed a two-stage time-series analysis using the Value of Statistical Life (VSL) approach to evaluate the economic impact of mortality related to cold spells of varying lengths and intensities. This analysis employed a case-crossover design, with a distributed lag nonlinear model (DLNM) used for analysis. Analysis was stratified according to age, sex, and region of origin. The results of the assessment show that cold spells have an enormous impact on the economic losses of mortality due to climate change and aging. Results Totally, 8.3% (95% CI: 0.0%, 16.0%) to 13.8% (95% CI: 1.0%, 24.8%) of VSL were ascribed to cold spells, accounting for economic losses of 4.71 (95% CI: 0.34, 8.47) to 11.45 (95% CI: 0.00, 21.00) billion CNY, in the cold season. The population aged over 65 y and females are particularly vulnerable. Economic impacts in warmer regions, such as the southern and subtropical zones, are more extensive than those in the northern and temperate zones. Conclusion Customizing cold spell prevention measures for vulnerable populations or regions is vital to alleviating the socioeconomic burden.

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