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Depression, anxiety and defense mechanism among transgender populations
WANG Zhanqiang, DONG Hanwen, DI Xiaolan, YANG Kebing, NIU Yajuan
Preventive Medicine    2023, 35 (5): 392-395.   DOI: 10.19485/j.cnki.issn2096-5087.2023.05.006
Abstract   PDF (788KB)  
Objective To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations.
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Association between neonatal birth weight and maternal type 2 diabetes mellitus: a bidirectional Mendelian randomization study
SHEN Fangru, YANG Ke, LIU Houpu, ZHU Jiahao, LI Yingjun
Preventive Medicine    2023, 35 (5): 384-387,409.   DOI: 10.19485/j.cnki.issn2096-5087.2023.05.004
Abstract   PDF (1327KB)  
Objective To examine the association between neonatal birth weight and maternal type 2 diabetes (T2DM), so as to provide insights into the formulation of the early T2DM prevention and improvements of maternal and children health. Methods Single-nucleotide polymorphisms (SNPs) were collected from two genome-wide association studies (GWAS) that examined the association between neonatal birth weight and maternal T2DM. Inverse variance weighted method was employed for forward Mendelian randomization with 26 birth weight-associated SNPs as instrumental variables and maternal T2DM as the study outcome and for reverse Mendelian randomization with 18 maternal T2DM-associated SNPs as instrumental variables and maternal effects of neonatal birth weight as the study outcome. The heterogeneity was examined using Cochran's Q test, and the pleiotropy was evaluated using MR-Egger regression, while the robustness of the results was evaluated using leave-one-out test. Results Cochran's Q test detected heterogeneity across two studies (P=0.019, 0.038), and random effect models were employed. Mendelian randomization showed that an increase in neonatal birth weight by per standard error (approximately 488 g) resulted a 29.9% reduction in the risk of maternal T2DM (OR=0.701, 95%CI: 0.547-0.899), and maternal T2DM increased the neonatal birth weight by 0.074 standard errors (OR=1.074, 95%CI: 1.043-1.106). No horizontal pleiotropy was seen for instrumental variables (P=0.241, 0.188). With each SNP excluded in turn, the results of Mendelian randomization study were robust. Conclusion There are bidirectional associations between neonatal birth weight and risk of maternal T2DM.
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Risk factors of sarcopenia among the elderly: a case-control study
ZHANG Yuan, HAN Zhengfeng, MA Yan
Preventive Medicine    2023, 35 (6): 461-464.   DOI: 10.19485/j.cnki.issn2096-5087.2023.06.001
Abstract   PDF (756KB)  
Objective To investigate the risk factors of sarcopenia among the elderly, so as to provide insights into prevention of sarcopenia among the elderly. Methods A case-control study was conducted. A total of 371 patients with sarcopenia at ages of 60 years and older admitted to the First Affiliated Hospital of Xinjiang Medical University were selected as the case group, while 1∶1 matching healthy volunteers by gender, age and ethnicity in the hospital during the study period served as controls. Participants' demographics, disease history and nutrition were collected using questionnaire surveys, and factors affecting the development of sarcopenia were identified using a multivariable conditional logistic regression model. Results Participants in the case group included 171 men (46.09%), 254 Han ethnic populations (68.46%) and had a mean age of (73.04±7.83) years. Univariable conditional logistic regression analysis showed that participants with smoking, alcohol consumption, hypertension, diabetes, dyslipidemia, thyroid dysfunction and malnutrition had higher risk of developing sarcopenia (all P<0.05). Multivariable conditional logistic regression analysis identified hypertension (OR=1.851, 95%CI: 1.344-2.549), diabetes (OR=1.537, 95%CI: 1.068-2.213), dyslipidemia (OR=1.542, 95%CI: 1.112-2.140) and thyroid dysfunction (OR=2.575, 95%CI: 1.838-3.609) as risk factors of sarcopenia among the elderly. Conclusion Hypertension, diabetes, dyslipidemia and thyroid dysfunction may be risk factors of sarcopenia among the elderly.
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Epidemiological characteristics of hepatitis A and hepatitis E in Jiaxing City from 2005 to 2021
FU Xiaofei, LIU Yanqing, HU Jie, QI Yunpeng, GUO Feifei, ZHA Yiwei
Preventive Medicine    2023, 35 (9): 737-740.   DOI: 10.19485/j.cnki.issn2096-5087.2023.09.001
Abstract   PDF (910KB)  
Objective To investigate the epidemiological characteristics of hepatitis A and hepatitis E in Jiaxing City, Zhejiang Province from 2005 to 2021, so as to provide insights into prevention and control of hepatitis A and hepatitis E. Methods Data of hepatitis A and hepatitis E reported in Jiaxing City from 2005 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The temporal, spatial and population distribution of hepatitis A and hepatitis E were analyzed using a descriptive epidemiological method, and the trends in incidence of hepatitis A and hepatitis E were evaluated using annual percent change (APC). Results Totally 1 830 hepatitis A cases were reported in Jiaxing City from 2005 to 2021, with an annual average incidence of 2.44/105, and 2 deaths were reported, with a fatality rate of 0.11%. The incidence of hepatitis A appeared a tendency towards a decline from 2005 to 2012 (APC=-37.807%, P<0.05) and was relatively stable from 2012 to 2021 (APC=-1.277%, P>0.05), and the incidence peaked from July to September, with a monthly average incidence of 0.30/105. Higher annual average incidence of hepatitis A was seen in urban areas than in rural areas (3.91/105 vs. 1.92/105; P<0.05), among people at ages of 30 to 39 years (4.19/105), and among men than among women (3.00/105 vs. 1.93/105; P<0.05). Farmers were the predominant occupation (759 cases, 41.31%). Totally 2 176 hepatitis E cases were reported in Jiaxing City from 2005 to 2021, with an annual average incidence of 2.91/105, and 7 deaths were reported, with a fatality rate of 0.32%. The incidence of hepatitis E was relatively stable from 2005 to 2011 (APC=3.421%, P>0.05) and appeared a tendency towards a decline from 2011 to 2021 (APC=-4.294%, P<0.05), and the incidence peaked from January to March, with a monthly average incidence of 0.38/105. Higher annual average incidence of hepatitis E was seen in urban areas than in rural areas (3.50/105 vs. 2.70/105; P<0.05), among people at ages of 70 to 79 years (6.20/105), and among men than among women (3.74/105 vs. 2.05/105; P<0.05). Farmers were the predominant occupation (1 079 cases, 49.59%). Conclusions The incidence of hepatitis A and hepatitis E appeared a tendency towards a decline in Jiaxing City from 2005 to 2021. The incidence of hepatitis A was high in summer, and cases were mainly males, young and middle-aged people and farmers. The incidence of hepatitis E was high in winter, and cases were mainly males, elderly people and farmers.
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Dose-response relationship between pre-pregnancy body mass index and gestational diabetes mellitus
LI Nana, ZHANG Shijing, CHEN Qiaomin, LI Haoran, WANG Yali
Preventive Medicine    2023, 35 (10): 829-833.   DOI: 10.19485/j.cnki.issn2096-5087.2023.10.001
Abstract   PDF (1088KB)  
Objective To explore the dose-response relationship between pre-pregnancy body mass index (BMI) and gestational diabetes mellitus (GDM), so as to provide insights into the cut-off values of pre-pregnancy BMI and optimizing GDM prevention and control strategies. Methods Pregnant women that admitted to Zhengzhou Central hospital in 2021 were recruited, and demographics, family history, pregnancy and delivery history and blood glucose levels during pregnancy were collected. The dose-response relationship between pre-pregnancy BMI and GDM was analyzed using restricted cubic spline (RCS) analysis. The predictive ability of pre-pregnancy BMI for GDM risk was evaluated using receiver operating characteristic (ROC) curve. Results A total of 2 279 participants were included in the study. The median age was 29.0 (interquartile range, 5.0) years. The median pre-pregnancy BMI was 21.1 (interquartile range, 3.8) kg/m2. There were 312 underweight women (13.69%), 825 women with low-normal weight (36.20%), 730 women with high-normal weight (32.03%), 345 overweight women (15.14%) and 67 obese women (2.94%).The prevalence of GDM was 17.20%. RCS analysis suggested a linear dose-response relationship between age, pre-pregnancy BMI and GDM (P<0.05). When pre-pregnancy BMI was higher than 21.1 kg/m2, the risk of GDM increased with pre-pregnancy BMI (P<0.05). When women aged over 29.0 years, the risk of GDM increased with age, and the dose-response relationship of GDM caused by pre-pregnancy BMI was stronger in the women aged over 29.0 years than in the women aged 29.0 years and below (P<0.05). The area under curve (AUC) was 0.654 (95%CI: 0.624-0.684). If the cut-off value of pre-pregnancy BMI was 23.0 kg/m2, the Youden index, sensitivity and specificity was 0.238, 0.472 and 0.766, respectively. If it was 24.0 kg/m2, the Youden index, sensitivity and specificity was 0.195, 0.342 and 0.853, respectively. If it was 21.1 kg/m2, the Youden index, sensitivity and specificity was 0.213, 0.676 and 0.537, respectively. Conclusion There is a linear dose-response relationship between pre-pregnancy BMI and GDM, and higher than 21.1 kg/m2 of the pre-pregnancy BMI could increase the risk of GDM.
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Factors affecting dissociative tendency among middle school students
YU Zhitao, CHENG Qinglin, DENG Yuanyuan, WANG Liuxi, LI Yan, LI Zhifang
Preventive Medicine    2023, 35 (5): 369-373,379.   DOI: 10.19485/j.cnki.issn2096-5087.2023.05.001
Abstract   PDF (887KB)  
Objective To investigate the prevalence of dissociative tendency and its influencing factors among middle school students, so as to provide insights into prevention and early interventions of adolescent dissociative tendency. Methods Students at ages of 13 to 18 years that studied in 9 high schools were sampled using a multistage, stratified, cluster sampling method from 3 counties (districts) of Hangzhou City from January, 2021 and March, 2022. Participants' demographics and social, school, family environment and psychological factors were collected using self-designed questionnaires and standardized scales. The dissociative tendency was initially screened using the Adolescent Dissociative Experience Scale (A-DES), and the diagnosed by three psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Factors affecting ADT were identified using a multivariable logistic regression model. Results Totally 3 240 students were recruited, and 2 841 students were qualified, with a response rate of 87.69%. The respondents included 1 389 men (48.89%) and 1 452 women (51.11%), and had a mean age of (15.69±1.58) years. The prevalence of dissociative tendency was 24.04%, and the detection of dissociative tendency was higher among men than among women (29.23% vs. 19.08%; χ2=24.529, P<0.001). Multivariable logistic regression analysis identified negative teacher-student relationship (OR=1.055, 95%CI: 1.010-1.103), family emotional expressiveness (OR=0.872, 95%CI: 0.777-0.978), family conflict (OR=1.152, 95%CI: 1.045-1.271), family organization (OR=0.880, 95%CI: 0.780-0.992) and family cohesion (OR=0.871, 95%CI: 0.766-0.987) as factors affecting dissociative tendency among men, and somatization (OR=1.041, 95%CI: 1.002-1.082) and paranoid ideation (OR=1.094, 95%CI: 1.006-1.190) as factors affecting dissociative tendency among women. Conclusions The prevalence of dissociative tendency was 24.04% among middle school students. Negative teacher-student relationship, family emotional expressiveness, family conflict, family organization, and family cohesion may affect dissociative tendency among men, while somatization and paranoid ideation may affect dissociative tendency among women.
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Epidemiological characteristics of influenza outbreaks in Zhejiang Province from 2013 to 2022
WANG Xuan, LIU Shelan, CAO Yanli, SUN Wanwan, FENG Yan, LING Feng
Preventive Medicine    2023, 35 (8): 645-648.   DOI: 10.19485/j.cnki.issn2096-5087.2023.08.001
Abstract   PDF (743KB)  
Objective To investigate the epidemiological characteristics of influenza outbreaks in Zhejiang Province from 2013 to 2022, so as to provide insights into influenza prevention and control. Methods Data pertaining to influenza outbreaks reported in Zhejiang Province from 2013 to 2022 were collected from National Influenza Surveillance System in China, including time, region, cases and pathogen types of influenza outbreaks. The temporal, spatial and pathogen distribution of influenza outbreaks were analyzed using a descriptive epidemiological method. Results A total of 577 influenza outbreaks involving 448 698 individuals were reported in Zhejiang Province from 2013 to 2022, and the overall attack rate was 5.34% (23 974 cases), with no death reported. The lowest attack rate of influenza was 0.26%, and the highest was 80.00%, with a median attack rate of 10.89% (interquartile range, 24.26%). The outbreak had the shortest duration of 1.00 day, and the longest duration of 59.00 days, with a median duration of 9.00 (interquartile range, 11.00) days. There were 387 influenza outbreaks that occurred between November and January of the following year (67.07%), and the three highest numbers of outbreaks were reported in Hangzhou City (310 outbreaks), Wenzhou City (51 outbreaks) and Jinhua City (46 outbreaks). There were 395 outbreaks reported in urban regions (68.46%), 93 in counties and townships (16.12%) and 89 in rural regions (15.42%), and influenza outbreaks predominantly occurred in primary schools (487 outbreaks, 84.40%). In addition, the types of pathogens were alternately prevalent, with influenza B virus (241 outbreaks, 41.77%) and A/H3N2 virus (232 outbreaks, 40.21%) as predominant subtypes. Conclusions Influenza outbreaks mainly occurred in winter in Zhejiang Province from 2013 to 2022, and primary schools were main places of influenza outbreaks, while influenza B virus and A/H3N2 virus were predominant subtypes. It is necessary to reinforce the surveillance and report of influenza-like illness in schools and improve the coverage of influenza vaccination to prevent influenza outbreaks.
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Association of long working hours and shift work with occupational stress in level A tertiary hospitals
CI Xiaoyu, ZUO Shurui, LI Tao, HAN Yicheng, HE Ping, YANG Chengxin
Preventive Medicine    2023, 35 (7): 553-557.   DOI: 10.19485/j.cnki.issn2096-5087.2023.07.001
Abstract   PDF (822KB)  
Objective To examine the association of long working hours and shift work with occupational stress among medical staff in level A tertiary hospitals, so as to provide insights into promotion of physical and mental health among medical personnel. Methods One level A tertiary hospital was sampled using a stratified cluster sampling method from southern and northern Xinjiang Uygur Autonomous Region, and all medical personnel were recruited from these two hospitals. Participants' demographics, working duration, and working in shifts were collected using questionnaires, and occupational stress was measured using the Core Scale for Measurement of Occupational Stress proposed by National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention. The associations of long working hours (weekly working duration of >40 hours) and shift work with occupational stress were examined using a multiple linear regression model. Results A total of 2 529 questionnaires were allocated, and 2 262 were valid, with an effective rate of 89.44%. The respondents had a mean age of (35.12±8.71) years, and included 1 696 women (74.98%). Of all respondents, there were 722 doctors (31.92%), 1 033 nurses (45.67%), 361 medical or pharmaceutical technicians (15.96%), 1 808 with long working hours (79.93%) and 1 264 with shift work (55.88%). The score of occupational stress was (44.79±8.49) points, and the prevalence of occupational stress was 28.69% among respondents. Multiple linear regression analysis showed that after adjustment for age, marital status, length of service, position, smoking and physical exercise, long working hours (>40 h, β'=0.124; >48 h, β'=0.175; ≥55 h, β'=0.323) and shift work (β'=0.203) were influencing factors for occupational stress among medical personnel(P<0.05); however, there was no interaction between long working hours and shift work (P>0.05). Conclusion Long working hours and shift work may increase the risk of occupational stress among medical personnel in level A tertiary hospitals.
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Research progress on the epidemiology of chronic kidney disease
ZHU Siyi, HONG Hang, BIAN Xueyan, XU Guozhang
Preventive Medicine    2023, 35 (9): 770-773.   DOI: 10.19485/j.cnki.issn2096-5087.2023.09.008
Abstract   PDF (816KB)  
Chronic kidney disease (CKD) is characterized by long course, poor prognosis, multiple complications and high cost of treatment, thus it has become a major public health problem. Based on review of publications pertaining to the epidemiological study of CKD from February 2002 to March 2023, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of CKD. It is found that China has the largest number of adult patients with CKD in Asia, and the prevalence of CKD is higher among females and elderly people. The influencing factors for CKD include cardiovascular diseases, diabetes, hypertension and coronavirus disease 2019. Henceforth, it is of vital importance to emphasize three levels of prevention and optimize the CKD management, so as to support for prevention and control of CKD.
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Trends in prevalence of depression symptoms among middle-aged and elderly residents in China from 2011 to 2018
DUAN Rui, WANG Hong
Preventive Medicine    2023, 35 (8): 649-654.   DOI: 10.19485/j.cnki.issn2096-5087.2023.08.002
Abstract   PDF (800KB)  
Objective To investigate the trends in prevalence of depression symptoms among middle-aged and elderly residents at ages of 45 years and older in China from 2011 to 2018, so as to provide insights into depression prevention and control among middle-aged and elderly residents. Methods Demographic features and evaluation data of depressive symptoms were collected from middle-aged and elderly residents at ages of 45 years and older recorded during four follow-ups in the China Health and Retirement Longitudinal Study (CHARLS), and the depressive symptoms were screened using the Center for Epidemiological Studies Depression Scale (CES-D). Following sampling weights, non-response weights, and post-stratification weighting, the detection of depressive symptoms was analyzed among the middle-aged and elderly residents with different demographics, and the trends in prevalence of depressive symptoms were identified using annual percent change (APC). Results A total of 48 223 middle-aged and elderly residents were enrolled, including 12 624, 10 427, 12 144, and 13 028 residents in 2011, 2013, 2015 and 2018, with mean ages of (58.8±9.4), (58.9±9.2), (59.0±9.2), and (61.1±9.2) years, respectively. The prevalence of depressive symptoms was 34.5% (95%CI: 33.3%-35.8%), 29.6% (95%CI: 28.5%- 30.8%), 30.6% (95%CI: 29.4%-31.8%), and 35.0% (95%CI: 33.6%-36.4%) among middle-aged and elderly residents in 2011, 2013, 2015 and 2018, respectively, with no remarkable changing trends seen (APC=0.4%, t=0.188, P=0.868). Higher detection was seen among residents at advanced ages, among women than among men, among rural residents than among urban residents, among residents with lower educational levels, among widowed and unmarried residents than among married residents, among unemployed residents than among employees, and among residents that had lower per capita personal consumption expenditures than mean expenditures than among residents that had higher per capita personal consumption expenditures than mean expenditures (all P<0.05). Conclusions There were no obvious trends in prevalence of depressive symptoms among middle-aged and elderly residents in China from 2011 to 2018, and individuals with advanced ages, women, urban residents and those with low educational and economic levels should be given a high priority for depression control.
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