National Center for Chronic and Noncommunicable Disease Control and Prevention

BackgroundOxidative stress, as quantified by the Oxidative Balance Score (OBS) reflecting the balance between antioxidant and pro-oxidant exposures, plays a pivotal role in kidney function. This study aims to investigate the association between OBS and kidney function, examining gender, diabetes, and hypertension as potential effect modifiers.MethodsCross-sectional data from 9,343 participants in Fujian Province (2020–2021) were analyzed. OBS was calculated using 10 dietary and lifestyle components. Logistic regression assessed associations between OBS and kidney function, stratified by gender, diabetes, and hypertension, with interaction terms. Mediation analysis evaluated the role of neutrophil-to-high-density lipoprotein ratio (NHR) and platelet-to-high-density lipoprotein ratio (PHR).ResultsOBS was inversely associated with low estimated glomerular filtration rate (eGFR) in hypertensive women without diabetes (odds ratio (OR) = 0.58, 95% confidence interval (CI) [0.39–0.86]). A similar inverse association was observed in normotensive (OR = 0.47, 95% CI [0.25–0.86]) men and prehypertensive men (OR = 0.52, 95% CI [0.33–0.81]), independent of diabetes status. Additionally, a significant interaction between OBS and hypertension in men suggested a hypertension-dependent effect. Mediation analysis further indicated that the NHR and PHR accounted for 19.37% and 13.04% of the OBS effects on albuminuria, respectively. NHR also accounted for 9.41% of the association between OBS and low eGFR among normotensive and prehypertensive men.ConclusionOur findings highlight the importance of considering gender and hypertension status when evaluating the association between OBS and kidney function, particularly in normotensive and prehypertensive men.

The "Healthy China 2030" initiative, which aims to achieve a 30% reduction in premature mortality by 2030, recognizes leukemia as the primary cause of cancer-related deaths. Given the limited previous research, providing comprehensive national and subnational estimates and temporal trends of the premature leukemia mortality burden from 2005 to 2020 is crucial. Using data from various sources acquired through the national surveillance mortality system, estimates were derived and compared across 31 provincial-level administrative regions in the Chinese mainland, revealing the magnitude of mortality rates and years of life lost (YLL) due to leukemia in the Chinese population between 2005 and 2020. In 2020, the estimated number of leukemia-related deaths decreased from 61.93 thousand in 2005 to 54.86 thousand, accompanied by a decline in age-standardized mortality rate (ASMR) from 4.97 per 100,000 population in 2005 to 3.49 per 100,000 population. The burden of premature mortality caused by leukemia exhibited a significant reduction, as indicated by a nationwide decline of -39.37% (from 239.46 to 145.18 per 100,000 population) in the age-standardized YLL rate. Despite a notable decrease (-11.41%) in leukemia mortality, China has the highest burden of leukemia-related deaths due to its large population, primarily driven by population aging (12.76%), which has contributed to an upsurge in leukemia fatalities, followed by population growth (7.67%). Leukemia mortality exhibited distinct variations among different provinces and demonstrated a positive correlation with economic activity, particularly in coastal provinces characterized by higher levels of economic development. Xizang is currently the only province experiencing a significant increase in mortality rate, necessitating urgent government support. Significant disparities in premature mortality attributed to leukemia were observed across diverse regions of China, underscoring the need for targeted interventions aimed at promoting a health-protective lifestyles and expanding timely access to basic medical insurance for diagnosis and cost-effective therapy, particularly among high-risk populations and regions with limited healthcare resources.

ABSTRACT Background Diabetes is a leading global public health challenge with 537 million cases worldwide in 2021 and significant economic and societal burdens. Despite global initiatives, feasibility constraints limit widespread implementation of diabetes prevention/control measures. The key to facilitating the implementation of diabetes prevention and control measures lies in prioritise them. Objectives This study aimed to determine the priority of diabetes prevention and control measures in China from the feasibility perspective. Methods From January to February 2021, an online survey was administered to professionals specifically responsible for implementing chronic disease prevention and control programs in 488 national demonstration areas in China. The survey assessed the importance and feasibility of 44 diabetes prevention and control measures across 10 dimensions. The Importance-Performance Analysis (IPA) model categorized these indicators into four quadrants: Highest Priority (high importance and feasibility), Priority Improvement (high importance, low feasibility), Lowest Priority (low importance and feasibility), and Secondary Improvement (low importance, high feasibility). Results Quadrant 1 (‘Highest Priority’) included health education, community action, high-risk discovery and intervention, and medical insurance and family doctors, which should be maintained and strengthened. Quadrant 2 (‘Priority Improvement’) included patient management and complication screening, necessitating targeted efforts to enhance implementation. Quadrant 3 (‘Lowest Priority’) included personal health services assessment follow-up, environmental support, sugar reduction policy, and diabetes co-infection prevention, indicating a risk of overinvestment. No indicators were categorized into Quadrant 4 (‘Secondary Priority’). Conclusions Prioritizing diabetes prevention and control measures based on feasibility maximizes the utilization of limited resources, providing implementable recommendations for policymakers.

Rabies is a nearly 100% fatal, vaccine-preventable disease. This study provides a comprehensive global analysis of rabies burden from 1990 to 2021, highlighting health inequality, and aims to inform resource allocation and reduce the overall burden. The study systematically evaluated the global, regional, and national burden of rabies and its trends from 1990 to 2021 using data from the GBD 2021 database. The Bayesian age-period-cohort (BAPC) model was applied to project future disease burden trends, including age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life-years rate (ASDR). Frontier analysis was conducted to estimate achievable outcomes across different development levels, and decomposition analysis was employed to identify the driving factors behind changes in disease burden. From 1990 to 2021, the global burden of rabies showed a significant decline across multiple indicators. Specifically, the ASIR decreased from 0.42 per 100,000 population [95% uncertainty interval (UI): 0.30, 0.55] in 1990 to 0.13 per 100,000 population (95% UI: 0.08, 0.18) in 2021, reflecting a 69.38% reduction [95% UI: −77.61, −61.03; estimated annual percentage change (EAPC): −4.06% (95% confidence interval, CI: −4.32, −3.80)]. Similar reductions were observed in the ASMR, and ASDR, which declined by 69.35% (95% UI: −77.62, −61.02), and 69.39% (95% UI: −79.35, −59.48), respectively. Frontier analysis showed that significant room for improvement in rabies prevention and control remains in several high-SDI countries and regions, such as the United Arab Emirates, Norway, the United States, Latvia, and Greenland, and many low SDI countries. Despite progress in reducing rabies burden, low-SDI regions remain a priority. Key strategies include enhancing canine vaccination, post-exposure prophylaxis, stray dog control, and international collaboration. Future research should improve data quality and adapt interventions to local contexts to achieve the 2030 goal of eliminating dog-mediated human rabies. Not applicable.

Intracerebral hemorrhage (ICH) incidence is poorly documented in Asia, where it is highest globally. We examined ICH incidence in Shandong Province, East China, using a population-based stroke surveillance system established in 2012, aiming to inform ICH prevention in East China. We obtained the ICH data from Shandong Province in eastern China, covering a period of ten years from 2012 to 2021. Crude, age-standardized, age-specific, gender-specific, and region-specific incidence were calculated.Seasonal trend was assessed and Joinpoint regression was used to compute the Annual Percent Change (APC) in incidence.The life table method was used to estimate ICH early onset probability among residents aged 30-54 years. Spatial autocorrelation analysis was used to identify ICH hot spots. A total of 96,978 cases of ICH were reported. Crude ICH incidence rose from 57.96 to 76.54 per 100,000 (2012 - 2018; APC=4.48%[95%CI:2.66-6.32], P < 0.001), then dropped nonsignificantly to 69.14 (2018 - 2021; APC=- 2.61%[-7.53-2.57], P = 0.250). Males, rural areas, and those ≥45 years old had higher incidence. The probability of early onset (aged30 - 54 years) increased from 0.75% to 1.11% (2012 - 2018; APC=6.36%[2.24-10.65], P=0.010), then decreased nonsignificantly. Significant seasonal variation was confirmed (P<0.001), with peak observed in January (accounting for 10.86% of all cases) and trough in July (accounting for6.62%of all cases). We also found ICH hot spots in northern (Liaocheng, Dezhou, Binzhou), western (Heze), and southern (Linyi) regions of Shandong Province in 2021. Over 10 years, ICH incidence in Shandong Province shifted from increasing to stable and was more higher in males, rural areas, and those ≥45 years old, with seasonal peaks in winter. The identification of spatial clusters in specific regions underscored the need of targeted prevention strategies.

The behavioral and health issues of children and adolescents have become one of the most significant public health challenges with global concern. A cohort study is an ideal approach for exploring the relevant factors associated with these issues and evaluating the possible effectiveness of interventions among children and adolescents. Thus, from September 2024 to January 2025, we selected 6 counties in Zhejiang Province to establish the Zhejiang Childhood Behavior and Health Cohort, aiming to explore the changing patterns, relevant factors, and long-term health effects of behavior and health issues among children and adolescents. This study will introduce the cohort design and conduct descriptive analyses on the main characteristics of participants in the baseline survey. Overall, 21 698 participants aged 6-19 years (mean age, 11.6 years) were recruited, comprising 53.2% males and 68.4% from rural areas. The proportion of ever smoking was 3.6% in males and 2.0% in females. 75.9% of males and 73.3% of females were trying to control their weight. The mean height, weight, and waist circumference of males was (152.8±18.7) cm, (47.0±18.2) kg and (66.6±12.0) cm, respectively, and of females was (148.8±15.7) cm, (42.2±14.2) kg and (62.3±9.4) cm, respectively. The result for the 50-meter dash was 8.8 s in males and 9.4 s in females.

Abstract This study assessed the reliability of equations for estimating 24-hour urinary sodium excretion using first-time morning urine samples. In this study, a total of 2078 residents of Shandong Province in 2019 and 2024 were randomised, and three equations for estimating 24-HUNa were fitted using morning urine samples and 24-hour urine samples from 1454 participants (46.6 ± 13.4 years old), and the three equations as well as equations developed by other researchers were were validated. In the validation group, estimated 24-HUNa was significantly correlated with measured 24-HUNa values. There was no significant difference between the estimated 24-HUNa and the measured 24-HUNa for the three equations fitted in this study, whereas there was a significant difference between the estimated 24-HUNa and the measured 24-HUNa values using Kawasaki and Tanaka et al. In the Bland-Altman analyses, the agreement between measured and estimated 24-HUNa values for the six equations was more than 2500 mg / 24 hours. All equations showed a tendency to underestimate or overestimate 24-HUNa between different levels of actual 24-HUNa values, hypertension status, and age groups. None of the equations tested in this study could estimate an individual's 24-HUNa from a single SU. The SMASH equation fitted in this study was superior to those of other researchers in assessing population-level 24-HUNa excretion in Shandong Province.

BackgroundGestational diabetes mellitus (GDM) is a significant pregnancy complication, and its relationship with serum levels of B vitamins and homocysteine (Hcy) remains unclear. This study aims to investigate the causal associations between genetically predicted serum levels of B vitamins (vitamin B6, B12, and folate) and Hcy with GDM risk.MethodsIndependent single nucleotide polymorphisms (SNPs) associated with Hcy (n = 14), Hcy (independent of BMI) (n = 11), vitamin B6 (n = 16), vitamin B12 (n = 8), folate (n = 14), and folate (independent of BMI) (n = 13) were selected as instrumental variables (IVs) based on genome-wide significance. Summary-level data for GDM were sourced from the FinnGen consortium.ResultsThe MR analysis demonstrated a significant association between serum Hcy levels and GDM risk [OR (95% CI) = 1.28 (1.09, 1.51), p = 0.003] using the inverse variance weighting (IVW) method. Following the exclusion of BMI-related IVs, a suggestive association was observed between serum Hcy levels and GDM risk [OR (95% CI) = 1.26 (1.04, 1.54), p = 0.019].ConclusionsOur study indicates a suggestive association between Hcy levels and GDM, emphasizing the necessity for additional research to explore the role of Hcy in GDM management.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12937-025-01234-1.