Hyperinsulinemia negatively affects the association between insulin resistance and blood pressure

Background and aimsAlthough hyperinsulinemia and insulin resistance (IR) together cause metabolic diseases, the available evidence fails to link hyperinsulinemia with blood pressure (BP) elevation. To further understand the role of hyperinsulinemia in the pathophysiology of hypertension, we conducted this study to investigate the moderating effect of fasting insulin (FINS) on the association between IR and BP.Methods and resultsThe health screening data of 72,076 individuals were analyzed for this moderation analysis. IR was indicated by the homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride-glucose index (TyG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc). In the adjusted model, three IR indicators were considered independent variables; FINS was used as a moderator, and systolic BP (SBP) and diastolic BP (DBP) were used as dependent variables. The regression coefficient of the interaction term between the three IR indicators and FINS was significantly negative in all moderation models. Simple slope tests and the Johnson–Neymann technique also indicated that FINS negatively moderated the association between IR and BP.ConclusionsThis moderation analysis showed that FINS negatively mediated the association between IR and BP, suggesting that hyperinsulinemia may buffer, not reinforce, the effect of IR on hypertension.     

NMR spectroscopy based metabolomics confirms the aggravation of metabolic disorder in metabolic syndrome combined with hyperuricemia

Background and aimsHyperuricemia (HUA) were associated with Metabolic syndrome (MetS) and its components. However, the molecular mechanism of uric acid in the development of MetS was not well elucidated. The aim of this study was developing a systemic metabolic profile by using metabolomics approach to explore the molecular mechanism of uric acid in the development of MetS.Methods and resultsAnthropometric, clinical biochemical data, and serum samples were collected from patients with MetS, MetS combined with HUA (MetS & HUA) and healthy controls. ¹H nuclear magnetic resonance (NMR) spectroscopy was used to detect endogenous small molecule metabolites of serum samples, then multivariate statistical analysis was applied to distinguish samples of different groups. In addition, pathway analysis was performed to contribute to understanding the metabolic change. By serum metabolic profiling, a total of 20 identified metabolites including lipids, amino acids, and organic acids were significantly altered in MetS and MetS & HUA patients. MetS & HUA patients presented a more severe disorder in both identified metabolites and BMI and biochemical indexes. According to pathway analysis, there were 3 and 5 metabolic pathways remarkably perturbed in MetS and MetS & HUA group respectively.ConclusionTaken together, we identified disordered metabolites and related pathways for both MetS and MetS & HUA patients, and found a more severe metabolic disorder in MetS patients who has a higher serum uric acid. Our study provides biochemical insights into the metabolic alteration for the progress of MetS.     

COVID-19疫情防控常态化下某疾病预防控制系统职工心理健康现状及影响因素

  目的  调查COVID-19疫情防控常态化下上海市疾病预防控制系统职工心理健康现状,分析相关影响因素。  方法  采用分层整群抽样的方法,对上海市4所CDC共538名职工开展心理健康状况问卷调查。  结果  调查对象抑郁、焦虑、人际孤独得分分别为10(3, 20)分、7(2, 15)分、4(0, 12)分。不同学历、婚姻状况、职业、有无基础性疾病、不同单位、不同工作班制组的抑郁得分比较,均存在统计学差异(均有P < 0.05),不同学历、职业、有无基础性疾病、不同单位、不同工作班制组的焦虑及人际孤独得分比较,均存在统计学差异(均有P < 0.05)。职工自我判断抑郁、焦虑、人际孤独来源主要是常规工作与疫情工作并存带来的双重压力、疫情进展不明确、不知何时结束等。多因素分析结果显示单位、基础性疾病、轮班制(多班、倒班制)、学历、近两周最长工作时长是职工抑郁得分的主要影响因素;单位、基础性疾病、轮班制(多班、倒班制)、近两周最长工作时长是职工焦虑得分的主要影响因素;单位、轮班制(多班、倒班制)是职工人际孤独得分的主要影响因素。  结论  上海市疾病预防控制系统职工中抑郁、焦虑、人际孤独三个维度的得分及影响因素各不相同,应结合抑郁、焦虑、人际孤独自我判定来源有针对性地进行干预,提高其心理健康水平。     

SLC30A8 rs13266634位点基因多态性、内脏脂肪指数与糖前期和糖尿病的关系

目的 研究SLC30A8 rs13266634位点基因多态性、内脏脂肪指数与糖前期和糖尿病的关系,为其科学防治提供依据。方法 采用1∶2配对病例对照研究的方法,病例组为浦东新区2013—2016年队列人群中随访和新增的677例糖尿病病例,对照组按社区、年龄、性别、是否有血缘关系共匹配1354例,对选取的人群进行流行病学调查及基因型分析。采用卡方检验、多元logistic回归和分层Cox回归模型等方法对糖前期和糖尿病的影响因素进行分析。结果 单因素分析发现C等位基因在对照组、糖前期、糖尿病组中的分布具有明显差异(x2=6.169,P=0.046)。调整后的多元logistic回归分析表明,基因型CC患糖前期和糖尿病的风险分别为TT的1.187倍(P=0.343, 95%CI:0.833~1.693)和1.501倍(P=0.010, 95%CI:1.101~2.045);内脏脂肪指数的OR值在两组中均随数值的增加而增加,差异均有统计学意义(P<0.05)。结论 SLC30A8 rs13266634 C等位基因为2型糖尿病的易感基因,CC基因型为2型糖尿病的潜在危险因素,内脏脂肪指数与糖前期和糖尿病的患病风险有关。     

应用SaTScan与FleXScan识别丙型肝炎发病的高风险区域

目的 探测2015年上海市浦东新区丙型肝炎（简称"丙肝"）发病的空间聚集性,识别丙肝发病的高风险区域;比较SaTScan与FleXScan在疾病空间聚集性探测方面的应用效果。方法 收集2015年浦东新区丙肝的发病数据,以街道和镇为分析单位,分别采用SaTScan 9.4.4与FleXScan 3中的Poisson模型探测丙肝发病空间聚集区域;并通过调整参数比较两个软件在不同参数设置下所探测到的聚集区域的位置和范围的变化情况。结果 上海浦东2015年丙肝发病率为12.72/10万;SaTScan和FleXScan均只扫描到一个具有统计学意义（P<0.05）的空间聚集区域,分别包含10个镇（川沙新镇、大团、合庆、惠南、祝桥、宣桥、周浦、新场、老港和万祥）和4个镇（川沙新镇、张江、曹路和合庆）,两种方法的扫描结果均覆盖了川沙新镇和合庆镇;SaTScan的窗口比例从50%变化到25%,聚集区域范围减少了一个镇,FleXScan设定不同K值所探测到的聚集区域变化范围较大。结论 上海浦东新区2015年丙肝发病存在空间聚集性,结合SaTScan的和FleXScan的扫描结果认为川沙新镇和合庆镇是浦东丙肝发病的高风险区域和重点防控区域。     

上海市浦东新区MSM的规模估计及性行为特征

目的 了解上海市浦东新区男男性行为者（men who have sex with men, MSM）规模,线下交友场所活跃地点的空间分布,行为特征、安全性行为及检测等情况。方法 人群规模估计采用“多中心-捕获再捕获方式”,采用核密度分析法对MSM线下活动场所进行分析及找出热点区域,采用卡方检验对性行为特征进行分析;用Logistic 回归模型分析安全性行为的影响因素。结果 浦东新区MSM规模估计为4 386人（95%CI：1 258~7 514）;浦东新区MSM线下交友地点以西北部为主;活动地点除健身场所外,还有公园、绿地、男厕所和桑拿房等,且活动规模以小型规模为主（≤5人）,占61.17%,大型规模较少（50~100人）,仅占3.72%;不同年龄、婚姻状况、教育情况、性取向、近半年性行为关系类型及对象类型、是否使用助性剂,发生性行为时,是否采取保护措施方面差异有统计学意义（P<0.05）。结论 利用捕获-再捕获的方法,开展活跃MSM规模估计非常重要;MSM行为及安全性行为特征、活动场所及形式较为复杂,且不同年龄段可能交友场所和形式有所不同,需线上与线下调查相结合,精准定位线下活动类型,有针对性的对高危行为及热点场所进行干预,对防控艾滋病有重大意义。     

Assessment of the timely administration of the hepatitis B and BCG birth dose and the primary infant vaccination schedule in 2015–2016 in the Mekong Delta,Viet Nam

IntroductionVietnam is implementing hepatitis B (HBV) birth dose (BD) vaccination since 2003 but coverage remains low, especially in the Mekong River Delta. This study aimed to determine the coverage of the HBV BD vaccination, to identify socio-demographic factors influencing HBV BD, and to assess reasons for non-immunization of neonates.MethodsA cross-sectional survey was conducted in 2015–2016. Mothers from 526 children aged 6–11 months living in 3 provinces in the Mekong River Delta - representing respectively urban, rural and remote area - were interviewed at home and infant vaccination documents were checked. The three-stage sampling method was adapted from WHO 30-cluster sampling. Predictors of HBV BD administration were identified with multiple regression analysis.ResultsThe overall HBV BD coverage (within 24 h) was 46.6% (compared to 44.5% for BCG) and was significantly higher in remote or rural than in urban area (OR 1.87 and 3.36, respectively), and in children whose father had a higher educational level (OR 2.76; 2.29 and 1.86, respectively, for master degree, bachelor and secondary school) as compared to a lower level. Main reasons for not having received HBV BD mentioned by parents were vaccines not offered by health care workers (53.0%), and illness of the infant (27.2%).ConclusionAlthough Vietnam started HBV BD vaccination more than 10 years ago, the coverage and timeliness need to improve to reach WHO targets (95% within 24 h after birth). Better training and information of health care workers, and better protocols ensuring timely HBV BD could address these vaccine administration thresholds.     

大肠杆菌两种检测方法的比较分析

目的比较2种大肠杆菌培养方法的优劣。方法取大肠杆菌标准菌株[ATCC25922]在2012年10-11月内分5次,每次20遍适当倍数的稀释,最终取得10-7、10-8、10-93个合适的稀释度共300分样液后,运用方法 1取上述阳性对照样液上清液各1 ml接种单料乳糖胆盐发酵管3管进行检测;同时运用方法 2测定剩余的上述样液,倒入双料乳糖胆盐发酵培养液中,置(36±1)℃培养24 h,对其进行平行比对实验。结果方法 1阳性数为229件,方法 2阳性数为249件,经χ2检验,2种大肠杆菌培养方法差异有统计学意义(P<0.05)。结论方法 2比方法 1简便、廉价、检出率高。建议将大肠菌群检验标准DB31/8-2004《托幼机构环境、空气、物体表面卫生要求及检测方法》中"按方法 1:取样液上清液接种单料乳糖胆盐发酵管3管"修订为"按方法 2:用测定剩余的检样,倒入双料乳糖胆盐发酵培养液中"。