Association of Creatinine-to-Cystatin C Ratio with Myosteatosis and Physical Performance in Older Adults: The Japan Shimanami Health Promoting Program

ObjectiveSarcopenia is a risk factor for poor outcomes in older adults. Identification of plasma markers may facilitate screening of sarcopenia. We previously reported that creatinine-to-cystatin C ratio is a simple marker of muscle mass. To further assess the clinical relevance of the creatinine-to-cystatin C ratio, we investigated its association with myosteatosis and physical performance.DesignObservational study.Setting and ParticipantsCross-sectional analysis of the dataset obtained from a Japanese population consisting of 1468 older (≥60 years of age) community residents.MethodsThe mean attenuation values of the skeletal muscle calculated from computed tomography images of the midthigh were used as an index of myosteatosis, while the cross-sectional area of the muscle was used as a proxy for muscle mass. Physical performance was assessed by 1-leg standing time.ResultsCreatinine-to-cystatin C ratio was positively associated with the cross-sectional area of muscle fiber-rich muscles, while it showed an inverse association with fat-rich muscle areas, resulting in the positive association between creatinine-to-cystatin C ratio and the mean attenuation value of the skeletal muscle [creatinine-to-cystatin C ratio quartiles (Q), Q1: 47.4 ± 4.8, Q2: 48.9 ± 4.4, Q3: 49.8 ± 4.1, Q4: 50.9 ± 3.7, P < .001]. The results of the linear regression analysis adjusted for major covariates (including muscle cross-sectional area) identified creatinine-to-cystatin C ratio as an independent determinant of the mean attenuation value (Q1: reference, Q2: β = 0.07, P = .019, Q3: β = 0.11, P < .001, Q4: β = 0.16, P < .001). Low creatinine-to-cystatin C ratio was independently associated with 1-leg standing time, although the association was attenuated substantially by adjusting for skeletal muscle cross-sectional area and mean attenuation value.Conclusion and ImplicationsCreatinine-to-cystatin C ratio was associated with myosteatosis in older adults, independent of the muscle mass. Creatinine-to-cystatin C ratio may serve as a convenient marker of sarcopenia.     

SARS-CoV-2 Serial Interval Variation,Montana, USA,March 1–July 31, 2020

We report mean severe acute respiratory syndrome coronavirus 2 serial intervals for Montana, USA, from 583 transmission pairs; infectors’ symptom onset dates occurred during March 1–July 31, 2020. Our estimate was 5.68 (95% CI 5.27–6.08) days, SD 4.77 (95% CI 4.33–5.19) days. Subperiod estimates varied temporally by nonpharmaceutical intervention type and fluctuating incidence.     

Novel predictive risk factor for Erectile Dysfunction: Serum folic acid

The purpose of this study was to compare the serum Folic Acid (FA) levels in patients with Erectile Dysfunction (ED) and healthy controls and whether levels vary with its severity. The study was carried out on 77 sexually active individuals, out of which 41 complained of ED and 36 were apparently normal. Patients were excluded if they had any diseases known to cause ED. The severity was further categorised based on IIEF-5 scores. Blood serum levels of testosterone, lipid profile, random blood sugar, liver function test, renal function test and FA levels were obtained in each patient. Independent-samples t test of significance was used when comparing between two means. Pearson's correlation coefficient (r) test was used for correlating data. All clinical and biochemical parameters except FA were comparable in both the groups. FA levels were significantly decreased in ED group (5.29 vs. 10.8; p value = .004). Smoking habits were comparable between the groups, and FA levels did not vary among smokers and nonsmokers (p value = .46). Serum FA levels significantly declined with increasing severity of ED (8.28 vs. 5.56 vs. 4.37 vs. 3.5; p value < .001). Thus, decreased FA might possibly be one of the novel risk factors for ED.     

2004-2018年中国老年居民慢性非传染性疾病死亡水平与变化趋势

目的分析2004-2018年中国≥65岁老年居民慢性非传染性疾病(慢性病)死亡水平及变化趋势,预测2019-2023年慢性病年龄标化死亡率。方法利用2004-2018年中国死因监测数据集中老年居民死亡数据,分析不同性别、城乡、地区的慢性病粗死亡率、年龄标化死亡率、构成比及变化趋势。采用2010年第六次全国人口普查的人口构成计算年龄标化死亡率;采用加权最小二乘法拟合Joinpoint回归模型,计算全时间段内平均年度变化百分比(AAPC)及95%可信区间;采用对数线性模型预测年龄标化死亡率。结果2004-2018年我国老年居民慢性病年龄标化死亡率从4697.05/10万降至3555.35/10万,平均每年下降2.0%(95%CI:-2.7%~-1.3%)。不同性别、城乡、地区间年龄标化死亡率呈下降趋势。东部地区(AAPC=-2.1%,95%CI:-2.8%~-1.3%)、中部地区(AAPC=-2.8%,95%CI:-3.4%~-2.1%)下降速度均快于西部地区(AAPC=-0.8%,95%CI:-1.8%~0.2%)。慢性病死亡构成比从89.82%上升至91.41%,平均每年上升0.1%(95%CI:0.1%~0.2%)。预计至2023年,男性年龄标化死亡率(3906.23/10万)仍高于女性(2708.43/10万);农村年龄标化死亡率(3283.20/10万)与城市(3250.01/10万)相接近;西部地区(3782.48/10万)与东部地区(3037.01/10万)、中部地区(3249.24/10万)的年龄标化死亡率的差距将进一步拉大。结论2004-2018年我国老年居民慢性病年龄标化死亡率呈下降趋势,死亡构成比呈上升趋势,建议以老年人群中男性居民和西部地区居民作为今后慢病防控关注的重点人群。     

Exposure to psychosocial work strain and changes in smoking behavior during pregnancy – a longitudinal study within the Danish National Birth Cohort

Objective:Knowledge of the relationship between psychosocial strain in the work environment and smoking during pregnancy is scarce. This study aimed to examine the association between psychosocial job strain and change in smoking behavior during pregnancy.Methods:The cohort included 65 645 pregnancies from the Danish National Birth Cohort (1996–2002), where pregnant women were interviewed on job factors and lifestyle during the first and third trimesters. Smoking was categorized into non-, non-daily, and daily smoking at each interview. Psychosocial job strain was categorized into four groups based on the concept of Karasek’s demand–control model: low strain (reference), passive, active and high strain. Associations between psychosocial strain and change in smoking status between the first and second interviews were analyzed by multinomial logistic regression, separately for each smoking category at first interview.Results:Non-smoking women exposed to high strain work were more likely to become daily smokers [adjusted odds ratio (OR_adj) 1.41, (95% confidence interval (CI) 1.08–1.83)] compared to non-smoking women exposed to low strain work. Non-smoking women exposed to passive work were more likely to become both non-daily and daily smokers [OR_adj 1.59 (95% CI 1.21–2.08) and OR_adj 1.32 (95% CI 1.03–1.70), respectively]. Daily smoking women exposed to high strain work were less likely to decrease their smoking [OR_adj 0.57 (95% CI 0.32–0.99)] compared to daily smoking women exposed to low strain work.Conclusions:Psychosocial strain influenced the women’s smoking behavior during pregnancy, especially in job types with low control.     

北京市平谷区65例布鲁氏菌病患者临床特征分析

目的　通过对北京市平谷区65例布鲁氏菌病患者流行病学调查,了解本区布鲁氏菌病疫情动态及患者临床特征,为疫情防控提供参考依据。方法　选取2015 年1月—2019年12月北京市平谷区医院收治的65例布鲁氏菌病患者作为研究对象,对发病时间、发病区域、年龄与性别构成、初步诊断、临床表现、病原学检查及诊治等情况进行统计与分析。结果　患者年龄主要集中在18～59岁,性别比为4.42∶1;以畜牧饲养者居多,约占64.62%,有明确动物或动物制品接触史63例,占96.92%,均为散发,无明显聚集性;全年中以4—6月发病率最高,占发病总数的53.85%;临床症状以发热（52例,80.00%）、乏力（34例,52.31%）、腰痛（26例,40.00%）为主;其中并发症发生率为47.69%,排名较高的前3位分别是脊柱炎、关节炎、腰椎病变。65例患者首诊确诊49例,误诊16例,误诊率为24.62%。病原学检查结果显示,试管凝集试验阳性35例,虎红平板凝集试验阳性30例。结论　布鲁氏菌病高发季节为4—6月,男性患病率明显高于女性,且从事畜牧业及相关产业人员为主要发病人群,以散发为主;布鲁氏菌病首诊误诊率较高,临床医师应提高对该传染病的关注,不断加强疫情防控。     

我国七省流动人口健康素养及其影响因素研究

目的 了解我国七省流动人口的健康素养情况及其影响因素,为开展有针对性的健康素养干预措施提供科学依据。方法 采用2016年全国流动人口卫生计生动态监测调查问卷数据,共纳入2 335名流动人口进行分析。t检验和SymbolcA@²检验用于组间比较。二元logistic回归模型用于分析流动人口健康素养的影响因素。结果 2016年七省流动人口总体健康素养水平为36.7％,其中健康生活方式与行为素养水平较低（36.5%）,传染病防治（33.0%）、基本医疗（27.8%）、慢性病防治素养（22.8%）水平较低。受教育程度更高（初中OR=1.625,P=0.001,高中OR=1.621,P=0.004,大专及以上OR=2.066,P<0.001）、流动次数较少（OR=0.919,P=0.049）、城市地区（OR=1.677,P<0.001）的流动人口健康素养水平更高。结论 流动人口健康素养水平有待提升。应针对受教育程度低、流动次数多的重点人群以及农村重点地区开展干预措施,加强传染病、慢性病防治等健康知识的宣传力度。     

苏州市流动人口吸烟行为及烟草危害认知现况调查

目的 了解苏州市流动人口吸烟行为及对烟草危害认知现况,为苏州市制定控烟措施提供科学依据。方法 在苏州市全域,采用PPS抽样方法共抽取1 800名流动人口进行调查。调查问卷采用《江苏省成人烟草流行调查》,采取面对面PAD调查。应用SPSS 22.0软件进行数据分析。结果 2019年苏州市流动人口现在吸烟率为23.07%,每日吸烟率为19.44%,日平均吸烟量为（11.71±9.41）支。其中男性现在吸烟率为40.00%,每日吸烟率不同分组中农民最高（χ2 = 13.624, P = 0.003）,跨省流动高于省内流动（χ2 = 9.448, P = 0.002）,集中居住人群均高于其余人群（χ2 = 22.814, P＜0.001）,差异均有统计学意义（P＜0.05）。戒烟率为24.23%,戒烟意愿比较低。对吸烟引起的中风、心脏病和阳痿的知晓率分别为68.09%,66.45%和49.18%。对二手烟引起的成人心脏疾病、儿童肺部疾病和成人肺癌的知晓率分别为74.82%,90.81%,90.46%。仅有17.86%的人群正确认识低焦油卷烟危害。结论 苏州市流动人口吸烟率较高,戒烟意愿比较低,对吸烟危害认知不足,需针对男性、中老年及集中居住等重点人群采取控烟宣传干预措施。