孕育史对孕期抑郁影响的前瞻性队列研究

  目的   探究孕育史对妊娠各期抑郁发生的影响。   方法   使用中国孕产妇队列研究·协和项目中孕育史与妊娠各期抑郁数据完整的3 792名孕妇进行研究。采用爱丁堡产后抑郁量表测量孕妇的抑郁状况。采用χ2检验进行单因素分析, 采用Log-binomial回归模型进行多因素分析, 计算调整相对危险度(relative risk, RR)值及其95%可信区间(confidence interval, CI), 并用森林图进行展示。   结果   Log-binomial回归结果显示, 分娩史增加孕妇孕中期抑郁(RR:1.04, 95% CI:1.01~1.08, P=0.042)和孕晚期抑郁(RR:1.05, 95% CI:1.01~1.10, P=0.020)的发生风险; 与无剖宫产史的孕妇相比, 有剖宫产史的孕妇孕晚期抑郁风险增加了6%(RR:1.06, 95% CI:1.01~1.11, P=0.041)。   结论   孕育史对妊娠抑郁的发生有重要影响, 妇幼保健人员应重点关注此类孕妇, 并开展针对性的健康宣教和心理护理, 加强对孕妇情绪变化的观察并及时给予心理调整。     

孕早期血红蛋白水平与妊娠期糖尿病的关系研究:基于出生人口队列

  目的  探究中国西北地区孕妇孕早期血红蛋白水平与妊娠期糖尿病(gestational diabetes mellitus, GDM)的关系。  方法  连续纳入2018年7月-2019年7月加入西北妇女儿童医院出生人口队列的孕早期孕妇,调查其基本人口学特征、生活行为方式等资料,并对研究对象的孕早期血红蛋白水平、口服葡萄糖耐量试验(oral glucose tolerance test, OGTT)结果进行随访。首先使用logistic回归分析模型分析孕早期血红蛋白水平对GDM的影响,进一步采用限制性三次立方样条来呈现血红蛋白水平与GDM的非线性关系。  结果  在调整了混杂因素后,孕早期高血红蛋白水平(血红蛋白≥135 g/L)增加了GDM的发生风险(OR=1.44,95% CI:1.13~1.83);孕早期血红蛋白水平每升高10 g/L,FPG、OGTT 1h血糖、OGTT 2h血糖水平分别升高0.03 mmol/L(95% CI:0.01~0.05)、0.14 mmol/L(95% CI:0.07~0.21)、0.13 mmol/L(95% CI:0.08~0.19);限制性立方样条结果显示,随着孕早期血红蛋白水平升高,GDM的发生风险逐渐升高。  结论  孕早期血红蛋白水平升高将增加GDM的发病风险,应积极对孕妇孕早期血红蛋白水平进行监测,促进母婴健康。     

孕中期身体活动与剖宫产关系的队列研究

  目的   探究孕中期妇女不同类型和强度的身体活动对剖宫产的影响。   方法   以中国孕产妇队列研究协和项目中的672名孕妇为研究对象, 采用孕期身体活动问卷(pregnancy physical activity questionnaire, PPAQ)调查孕中期妇女身体活动情况, 随访获得研究对象的分娩方式。采用多因素非条件Logistic回归分析模型对数据进行统计分析。   结果   273名孕妇(40.63%)的分娩方式为剖宫产。调整年龄、孕前体重指数(body mass index, BMI)、产史等因素后, 相比于不参加运动锻炼的孕妇, 运动锻炼较高水平的孕妇剖宫产发生风险较低(OR=0.564, 95% CI:0.338~0.941);相对于参加低水平中重度身体活动的孕妇, 参与较高水平中重度身体活动的孕妇剖宫产发生风险较低(OR=0.652, 95% CI:0.437~0.972)。   结论   运动锻炼和中重度身体活动是剖宫产的保护因素, 应进一步加强孕期运动的健康教育, 鼓励孕妇在孕期进行适宜的身体活动。     

孕前体质指数及孕期增重对新生儿出生体重影响的前瞻性队列研究

  目的   分析孕妇孕前体质指数(body mass index, BMI)及孕期增重(gestational weight gain, GWG)与新生儿出生体重的关联性, 并探究孕妇孕前及孕中体重动态变化对新生儿低出生体重(low birth weight, LBW)及巨大儿的影响。   方法   收集中国孕产妇队列·协和纳入的孕早期孕妇孕前体重, 并随访至分娩后, 收集分娩前体重及新生儿出生结局。将孕妇孕前BMI分为低体重组、正常体重组及超重/肥胖组, 将GWG分为适宜、不足及过多组。采用多因素多分类(多项)Logistic回归分析模型探讨孕前BMI及GWG与新生儿出生体重的关系。   结果   孕前BMI及GWG与子代出生体重相关(均有P < 0.05)。孕前超重/肥胖(OR=2.339, 95% CI:1.674~2.282, P < 0.001)、GWG过多(OR=1.398, 95% CI:1.188~1.978, P=0.048)显示为巨大儿的危险因素, GWG不足(OR=1.479, 95% CI:1.461~1.679, P=0.035)显示为LBW的危险因素, GWG过多会降低LBW的发生风险(OR=0.428, 95% CI:0.225~0.817, P=0.010)。低BMI-GWG不足(OR=1.335, 95% CI:1.048~2.319, P=0.048)是LBW的危险因素; 正常BMI-GWG过多(OR=1.088, 95% CI:1.016~1.675, P=0.038)和超重/肥胖-GWG过多(OR=1.498, 95% CI:1.244~2.017, P=0.046)是巨大儿的危险因素。   结论   孕前BMI及GWG是影响新生儿出生体重的重要因素, 提示女性应合理控制孕前及孕中体重变化。     

KCNQ1基因单核苷酸多态性与妊娠期糖尿病的相关性

  目的  探讨电压依赖性钾离子通道(potassium voltage-gated channel, subfamily Q, member 1, KCNQ1)基因多态性与妊娠期糖尿病(gestational diabetes mellitus, GDM)发病风险的关系,为GDM的机制研究提供线索与依据。  方法  采用匹配的病例对照研究设计,病例组来自2012年3月1日—2014年7月30日在山西医科大学第一医院分娩的334名GDM孕妇,按年龄和居住地1∶1匹配334名健康对照,对研究对象进行DNA基因分型。在共显性、显性、隐性、相加等遗传模式下,通过Logistic回归分析模型分析KCNQ1基因的13个候选单核苷酸多态性(single nucleotide polymorphism, SNP)和GDM发病风险的关系,并采用HaploView软件分析单倍体与GDM之间的关系。  结果  在调整糖尿病家族史、孕前BMI且调整多重比较后,在共显性遗传模式下,rs4930000位点携带GG基因型的孕妇与携带AA基因型相比是发生GDM的危险因素(OR=3.37, 95% CI: 1.30~8.73, P=0.013)。rs163171位点携带GA基因型与AA基因型孕妇相比(OR=0.70, 95% CI: 0.50~0.98, P=0.037),rs2074196位点携带CA基因型与携带CC基因型孕妇相比(OR=0.65, 95% CI: 0.46~0.91, P=0.012),rs2237888位点携带GA基因型与GG基因型孕妇相比(OR=0.69, 95% CI: 0.49~0.98, P=0.037),rs72847583位点携带CG基因型与携带CC基因型的孕妇相比(OR=0.63, 95% CI: 0.43~0.92, P=0.017),发生GDM风险低,均是GDM的保护因素。在KCNQ1基因内由rs11023996、rs7924946组成的单倍体Block1 AA表型和由rs233446、rs2237893、rs151293、rs16318、rs163183与rs234852组成的单倍体Block2 CGACG表型与GDM的发病风险相关。  结论  KCNQ1基因位点多态性(rs4930000、rs163171、rs2074196、rs2237888、rs72847583)、单倍体Block1 AA表型与Block2 CGACG表型均与GDM的发病风险相关。     

重庆市区23 896名孕妇妊娠期糖尿病发病现况及危险因素分析

  目的  分析重庆市区2018-2021年孕妇妊娠期糖尿病(gestational diabetes mellitus, GDM)的发病现况及其相关危险因素,为GDM的防控提供依据。  方法  收集2018年1月-2021年6月在重庆医科大学附属妇女儿童医院进行产前检查的孕妇临床资料,并采用logistic回归分析模型分析不同危险因素对GDM的影响。  结果  本研究共纳入来自重庆市区23 896名孕妇为研究对象,确诊为GDM的患者有6 269例,占26.2%。2018-2021年GDM的发病率分别为27.3%、25.0%、26.4%和26.4%。多因素logistic回归分析模型分析结果表明,在调整相关变量之后,年龄(OR=1.47, 95% CI: 1.41~1.54, P < 0.001)、BMI (OR=1.74, 95% CI: 1.65~1.83, P < 0.001)和内分泌疾病史(OR=9.32, 95% CI: 8.68~10.01, P < 0.001)是导致GDM患病风险增加的危险因素。  结论  本研究发现重庆市区GDM的发病率较高,且高龄孕妇、孕前超重或肥胖和内分泌疾病史是GDM的高危因素。重庆市区应加强系统性的产科护理,关注孕期这些危险因素的变化,以减少GDM的发生。     

循环vaspin水平与妊娠糖尿病的关联:系统综述与Meta分析

  目的   评价循环vaspin水平与妊娠糖尿病(gestational diabetes mellitus, GDM)的关联。   方法   系统检索PubMed、EMBASE、Web of Science、中国知网和万方数据库。检索时间截至2019年6月。使用随机效应模型或固定效应模型, 计算合并标准化均数差(standardized mean differences, SMD)及其95%置信区间(confidence interval, CI)。通过亚组分析、Meta回归分析、敏感性分析和发表偏倚分析评价结果的异质性与稳定性。所有统计分析均使用STATA 12.0软件。   结果   共纳入2013年至2019年期间发表的9篇文献(11个研究), 涵盖738例GDM患者和661例健康孕妇。GDM患者和健康孕妇之间总体循环vaspin水平差异有统计学意义(SMD=0.613, 95% CI:0.044~1.182, P=0.035)。根据vaspin水平所处的孕期和体重指数(body mass index, BMI)是否匹配进行亚组分析, 其相关方向与总结果相似; 按照种族进行亚组分析, 发现在“欧洲人”亚组中vaspin水平与GDM可能无关; 通过敏感性分析, 在排除了质量中等的研究和BMI没有匹配的研究后, 循环vaspin水平与GDM的关系依然存在。   结论   在亚洲人群中, 孕产妇循环vaspin水平可能与GDM的风险呈正相关。     

社会经济地位、健康生活方式与高血压发病的前瞻性队列研究

  目的  探讨社会经济地位(socioeconomic status, SES)、健康生活方式与高血压发病的关系,为高血压的防控提供参考依据。  方法  采用分层整群随机抽样于2010年对抽取的贵州省12个县(市、区)≥18岁常住居民共9 280人进行基线调查,于2016—2020年对该队列所有人群进行随访;采用t检验、χ2检验进行单因素分析,使用Cox比例风险回归模型分析SES、健康生活方式对高血压发病的影响。  结果  研究有效样本量为3 401人,高血压发病765人,人群高血压发病密度为32.53/1 000人年。多因素Cox回归结果显示:与低SES(＜9分)人群相比,高SES(≥9分)人群高血压发病风险下降29.9%(HR=0.701, 95% CI: 0.584~0.842);与≤2种健康生活方式的人群相比,4种、≥5种健康生活方式人群发病风险分别降低25.7%(HR=0.743, 95% CI: 0.581~0.950)、39.2%(HR=0.608, 95% CI: 0.455~0.812)。与SES低且健康生活方式≤2种的人群相比,SES低且具有3种、4种、≥5种健康生活方式人群高血压发病风险的差异均无统计学意义(均有P＞0.05);SES高且具有3种、4种、≥5种健康生活方式的人群高血压发病风险分别降低36.3%(HR=0.637, 95% CI: 0.446~0.909)、44.0%(HR=0.560, 95% CI: 0.391~0.802)、55.8%(HR=0.442, 95% CI: 0.295~0.662)。  结论  SES较低人群是贵州省高血压防控的重点人群,应采取措施提高其SES,并有针对性地开展健康教育与健康促进工作。     

天津市宝坻区老年人体质指数、腰围以及腰围身高比与高血压患病率的关联

  目的   探讨天津市宝坻区60岁及以上老年居民的体质指数(body mass index, BMI)、腰围(waist circumference, WC)以及腰围身高比(waist-to-height ratio, WHtR)与高血压患病率的关联。   方法   本研究对2018年4-5月参加天津市宝坻区口东卫生院体检的老年人(≥60岁)进行问卷调查和体格检查。采用分层分析和logistic回归分析BMI与WC(或WHtR)对高血压的联合作用和交互作用。   结果   共邀请1 692人, 1 417人(83.75%)参与本研究。老年人群的高血压患病率为46.36%、BMI超重和肥胖者占66.50%、WC中心型肥胖者占74.66%、WHtR超重和肥胖者占75.38%。与BMI或WC正常相比, BMI超重(OR=1.65, 95% CI:1.19~2.30)和肥胖(OR=3.41, 95% CI:2.23~5.20)及WC中心型肥胖(OR=1.49, 95% CI:1.00~2.23)均增加高血压的患病风险。BMI联合WC超重/肥胖(OR=2.49, 95% CI:1.78~3.46), 或BMI联合WHtR超重/肥胖(WHtR超重: OR=2.05, 95% CI:1.41~2.99;WHtR肥胖: OR=2.37, 95% CI:1.50~3.76)的患病风险高于后者单独作用的风险(WC超重/肥胖: OR=1.39, 95% CI:0.90~2.15;WHtR超重: OR=1.02, 95% CI:0.62~1.66;WHtR肥胖: OR=1.44, 95% CI:0.55~3.81)。   结论   三项指标中, BMI与高血压患病的关联性最强, 且BMI超重/肥胖增强WC(或WHtR)与高血压的关联, 提示控制BMI相关体重指标在正常范围内有助于预防和控制高血压。     

孕早期不良饮食因素与抑郁的关联性

  目的  探究孕早期妇女不良饮食因素与抑郁的关系。  方法  对7 976名参与中国孕产妇队列研究协和项目并在2017年7月25日-2018年7月24日纳入的孕早期妇女进行研究;采用χ2检验描述两组的基线分布差异;在孕早期分别采用定性食物频率测量法和爱丁堡产后抑郁量表测量妇女的饮食摄入频率和抑郁状况;采用Log-binomial回归分析饮食与抑郁的关联性,计算现患比（prevalence ratio,PR）及其95%可信区间（95% confidence interval,95% CI）。  结果  Log-binomial回归结果显示,孕早期饮食规律（PR=0.45,95% CI:0.38~0.54,P < 0.001）、经常吃早餐（PR=0.80,95% CI:0.72~0.90,P < 0.001）的孕妇有较低的抑郁发生风险;而妊娠早期经常食用油炸食品（PR=1.25,95% CI:1.03~1.53,P=0.027）、西式快餐（PR=1.36,95% CI:1.06~1.74,P=0.015）、膨化食品（PR=1.37,95% CI:1.11~1.70,P=0.003）,经常饮用含糖饮料（PR=1.37,95% CI:1.17~1.61,P < 0.001）和葡萄酒（PR=1.60,95% CI:1.26~2.01,P < 0.001）、饮用白酒（PR=1.26,95% CI:1.00~1.59,P=0.047）的孕妇则有较高的抑郁发生风险。  结论  孕早期不良饮食因素与抑郁存在关联性,孕妇应主动了解健康饮食方式,减少不健康饮食的摄入频率,以减少妊娠期间抑郁的发生。     

SH2B接头蛋白1基因多态性及生活行为方式与儿童肥胖的关系

  目的  研究中国儿童人群中SH2B接头蛋白1基因(SH2B adaptor protein 1 gene, SH2B1)rs7498665多态性与肥胖及相关表型的关联, 为探讨生活方式对该多态性与肥胖关系的影响提供依据。  方法  选取北京市3 305名7~18岁儿童青少年进行身体测量和生活方式问卷调查。利用基质支持的激光释放/电离飞行时间质谱分析法对rs7498665多态性进行分型。采用多元Logistic回归和线性回归方法分析全部人群及不同饮食、运动水平下该基因多态性与肥胖及相关表型的相关性。  结果  在非健康膳食摄入、不是每天吃早餐、经常摄入含糖饮料、不是每天进行中高强度体育锻炼情况下, rs7498665多态性G等位基因与肥胖存在相关性, 肥胖风险分别升高37%, 101%, 45%和64%(P值均 < 0.05)。对不同生活方式进行综合评价, rs7498665多态性只在非健康生活方式组的人群中与肥胖发生有关(OR=1.63, 95%CI=1.23~2.17, P < 0.01)。分析肥胖相关表型发现相同趋势的结果, 该位点与综合生活方式存在交互作用(P_{基因×生活方式} < 0.05)。  结论  SH2B1基因rs7498665多态性与肥胖易感的非健康生活方式对儿童肥胖及相关表型存在相互作用。     

眉山市洪雅县老年人不良行为生活方式现状及其影响因素分析

目的了解眉山市洪雅县老年人不良行为生活方式的流行现状并探索相关影响因素。方法2018-08/10,采用多阶段整群随机抽样,对洪雅县15个乡镇60岁及以上常住居民进行调查,包括问卷调查和体格检查,共计纳入5079名60岁及以上老年人,并计算现在吸烟率、经常饮酒率、身体活动不足率和肥胖率,采用非条件Logistic回归进行多因素分析。结果洪雅县老年人现在吸烟率、经常饮酒率、身体活动不足率和肥胖率分别为27.1%、7.5%、38.6%和6.9%。经多因素分析显示,初中文化(文盲为参照,OR=1.620,95%CI:1.237~2.120)是现在吸烟的危险因素,农民职业(非农民为参照,OR=1.683,95%CI:1.342~2.112)是现在吸烟的危险因素;初中文化(文盲为参照,OR=1.863,95%CI:1.280~2.712)是经常饮酒的危险因素;高龄(70~79岁:OR=1.216,95%CI:1.074~1.378;≥80岁:OR=1.811,95%CI:1.508~2.176)是身体活动不足的危险因素,农民(OR=2.348,95%CI:1.937~2.848)是身体活动不足的危险因素;女性是发生肥胖的危险因素(OR=1.654,95%CI:1.321~2.072)。结论洪雅县老年人不良行为生活方式普遍存在,应加强老年人健康危险行为干预。     

Physical activity, hormone replacement therapy, and the presence of coronary calcium in midlife women

Background: Atherosclerotic calcification is a risk factor for cardiovascular events, independent of other traditional risk factors. Studies of the relation of menopausal hormone therapy to cardiovascular events have had inconsistent results, and often have been confounded by lifestyle behaviors and the "healthy user" effect. The authors evaluated the cross-sectional association of hormone therapy use with the presence and severity of atherosclerosis in postmenopausal women, independent of lifestyle factors, including diet and physical activity levels. Methods: The authors consecutively enrolled postmenopausal asymptomatic women who were referred for coronary artery calcium scanning to measure cardiovascular risk. After consent was obtained, women were interviewed prior to their cardiac scan about cardiac risk factors, hormone therapy use, menopausal status, diet, and physical activity. Coronary artery calcium prevalence was defined as any calcification present (score >0). Results: Of the 544 enrolled women aged 50-80 years, 252 (46.3%) were hormone therapy users. Hormone therapy users had a significantly lower prevalence of any coronary artery calcium (defined as coronary artery calcium score >0; 37%), than non-users (50%, p = 0.04), as well as significantly lower mean calcium scores (p = 0.02). Multiple logistic regression models demonstrated a significantly reduced odds of coronary artery calcium in hormone therapy users compared to non-users with an adjusted odds ratio of 0.58 (p = 0.04), adjusting for traditional cardiac risk factors and body mass index. Women who reported consuming a vegetarian or a high-protein diet had almost two-fold odds of coronary artery calcium compared with women who reported regular, mixed, or low-fat, low-salt diets (OR = 1.78, p = 0.02). Severity of coronary artery calcium was less with increasing levels of physical activity, and a significant association was observed between physical activity and hormone therapy use (adjusted OR = 4.05, p = 0.03), independent of coronary artery calcium severity. Conclusion: This cross-sectional study demonstrated a protective association of hormone therapy with the presence and severity of coronary artery calcium. Although a strong relationship was observed between hormone therapy and physical activity, their complex interplay may affect mechanistic biochemical and physiological processes that have yet to be clearly delineated. Thus, physical activity and diet should be taken into account in prospective studies of the relation of hormone therapy use to coronary artery calcium.     

A cross-national comparison of lifestyle between China and the United States, using a comprehensive cross-national measurement tool of the healthfulness of lifestyles: the Lifestyle Index

BACKGROUND: Extensive studies have revealed the importance of a healthy lifestyle and the role of each lifestyle factor in health. However, lifestyle factors have rarely been studied simultaneously. The authors propose an integrated approach to summarize total healthfulness of lifestyles and to enhance understanding of lifestyle patterns across countries. METHODS: The authors created an overall measure of lifestyle called the Lifestyle Index (LI), integrating diet, physical activity, smoking, and alcohol use to provide a global tool of monitoring healthfulness and patterns of lifestyles. Using the LI, the authors conducted a cross-national comparison between China (n = 8352) and the United States (n = 9750). RESULTS: The LI effectively reflected the healthfulness of lifestyle components in both countries. The mean of the LI scores was slightly higher in China than the US. Scores of diet quality, physical activity, and smoking were higher in China, but scores of alcohol behavior were higher in the US. Similar lifestyle patterns but different unhealthy behaviors were identified in these countries. CONCLUSIONS: An assessment of total healthfulness of lifestyles and a better understanding of lifestyle patterns across countries using the LI can provide practical guidance to developing and targeting public health promotion activities to improve global public health.     

Social Media Use,Unhealthy Lifestyles,and the Risk of Miscarriage Among Pregnant Women During the COVID-19 Pandemic: Prospective Observational Study

BackgroundThe COVID-19 pandemic has resulted in changes to normal life and disrupted social and economic function worldwide. However, little is known about the impact of social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women during the COVID-19 pandemic.ObjectiveThis study aims to assess the association between social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women in the early stage of the COVID-19 pandemic in China.MethodsIn this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February 2020. Sociodemographic characteristics, history of previous health, social media use, and current lifestyles were collected at baseline, and we followed up about the occurrence of miscarriage. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposures to COVID-19–specific information.ResultsAmong all the 456 pregnant women, there were 82 (18.0%) who did no physical activities, 82 (18.0%) with inadequate dietary diversity, 174 (38.2%) with poor sleep quality, and 54 (11.8%) spending >3 hours on reading COVID-19 news per day. Women with excessive media use (>3 hours) were more likely to be previously pregnant (P=.03), have no physical activity (P=.003), have inadequate dietary diversity (P=.03), and have poor sleep quality (P<.001). The prevalence of miscarriage was 16.0% (n=73; 95% CI 12.6%-19.4%). Compared with women who spent 0.5-2 hours (25/247, 10.1%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5 hours (5/23, 21.7%), 2-3 hours (26/132, 19.7%), and >3 hours (17/54, 31.5%) was higher (P<.001). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (39/174, 22.4% vs 34/282, 12.1%; P=.003) and a high education level (66/368, 17.9% vs 7/88, 8.0%; P=.02). In the multivariable model, poor sleep quality (adjusted RR 2.06, 95% CI 1.24-3.44; P=.006), 2-3 hours of media use daily (adjusted RR 1.74, 95% CI 1.02-2.97; P=.04), and >3 hours of media use daily (adjusted RR 2.56, 95% CI 1.43-4.59; P=.002) were associated with miscarriage. In the sensitivity analysis, results were still stable.ConclusionsPregnant women with excessive media use were more likely to have no physical activity, inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality were associated with a higher risk of miscarriage. Our findings highlight the importance of healthy lifestyles during the COVID-19 pandemic.     

Latent Class Analysis of Lifestyle Characteristics and Health Risk Behaviors among College Youth

Few studies have examined the context of a wide range of risk behaviors among emerging adults (ages 18–25 years), approximately half of whom in the USA enroll in post-secondary educational institutions. The objective of this research was to examine behavioral patterning in weight behaviors (diet and physical activity), substance use, sexual behavior, stress, and sleep among undergraduate students. Health survey data were collected among undergraduates attending a large, public US university (n = 2,026). Latent class analysis was used to identify homogeneous, mutually exclusive “classes” (patterns) of ten leading risk behaviors. Resulting classes differed for males and females. Female classes were defined as: (1) poor lifestyle (diet, physical activity, sleep), yet low-risk behaviors (e.g., smoking, binge drinking, sexual risk, drunk driving; 40.0% of females), (2) high risk (high substance use, intoxicated sex, drunk driving, poor diet, inadequate sleep) (24.3%), (3) moderate lifestyle, few risk behaviors (20.4%), (4) “health conscious” (favorable diet/physical activity with some unhealthy weight control; 15.4%). Male classes were: (1) poor lifestyle, low risk (with notably high stress, insufficient sleep, 9.2% of males), (2) high risk (33.6% of males, similar to class 2 in females), (3) moderate lifestyle, low risk (51.0%), and (4) “classic jocks” (high physical activity, binge drinking, 6.2%). To our knowledge, this is among the first research to examine complex lifestyle patterning among college youth, particularly with emphasis on the role of weight-related behaviors. These findings have important implications for targeting much needed health promotion strategies among emerging adults and college youth.     

遵义市中老年人群的胃食管反流病与生活方式的关联研究

目的 调查遵义地区中老年人胃食管反流病（gastroesophageal reflux disease,GERD）患者的生活方式和饮食习惯现状,探讨该地区中老年人GERD的危险因素。方法 以2018年1月- 2019年4月期间于遵义市第一人民医院住院的130例患者为病例组,同期在本院体检的130例正常人为对照组,收集并比较研究对象的一般资料、生活方式和饮食习惯,采用多因素非条件logistic回归分析遵义地区中老年人群GERD的危险因素。结果 多因素非条件logistic回归分析结果表明,遵义地区中老年人群GERD的危险因素有BMI（OR = 4.628,95%CI = 2.344～9.134）、饮酒（OR = 3.424,95%CI = 1.401～8.373）、睡眠不足（OR = 1.847,95%CI = 1.344～2.540）、不吃早餐（OR = 3.102,95%CI = 1.770～5.436）、高脂饮食（OR = 2.694,95%CI = 1.667～4.354）、高糖饮食（OR = 2.236,95%CI = 1.3002～3.842）以及常饮浓茶（OR = 4.296,95%CI = 2.328～7.933）（P＜0.05）。结论 遵义地区中老年GERD发病的危险因素众多,可针对高脂、高糖饮食等不良饮食习惯加大对GERD的宣传力度,从清淡饮食、规律作息开始,逐步改善中老年人的生活方式,以达到有效预防中老年GERD的目的。     

妊娠早期睡眠质量对妊娠期糖尿病发病风险影响的前瞻性队列研究

目的 分析孕妇妊娠早期睡眠质量对妊娠期糖尿病(gestational diabetes mellitus,GDM)发病风险的影响.方法 于2018年8—12月选取武汉市妇幼保健院产科门诊903例孕妇作为研究对象,采用结构问卷和匹兹堡睡眠质量指数量表(Pittsburg sleep quality index,PSQI)...     

青春期前生活方式对儿童血压偏高影响的累积效应分析

目的 分析青春期前生活方式对儿童血压偏高检出率和新发率影响的累积作用,为儿童血压偏高的早期干预提供依据.方法 2017年在福建省厦门市4所九年一贯制学校建立青春期发育研究队列,对所有符合纳入标准的二、三年级女生和三、四年级男生进行体格检查和问卷调查.随访2年,选择2017和2019年数据完整的1 316名学生为研究对象...