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Socioeconomic status and self-reported, screen-detected and total diabetes prevalence in Chinese men and women in 2011-2012: a nationwide cross-sectional study.

ABSTRACT: A rapid epidemiological transition is taking place in China and the association between socioeconomic status (SES) and diabetes prevalence is not clear and may vary by population characteristics and geography within the country. We describe the associations between educational level, annual household living expenditure (AHLE) and diabetes prevalence in a large middle-aged and elderly Chinese population using data from a nationwide cross-sectional study.We used data from the China Health and Retirement Longitudinal Study, which collected information from interviews and blood tests from a nationwide sample of people over 44 years of age in 2011-2012. We used multivariable logistic regression to describe the association between highest levels of education (high school or above compared to illiterate) or AHLE (top vs bottom quartile) and self-reported, screen-detected or total diabetes prevalence. We stratified by sex and adjusted for age, education or AHLE (as appropriate), urban, rural or migrant residence status and geographical area.Complete data were available for 10?100 participants of whom 10.5% and 28.9% had the highest and the lowest levels of education respectively. Overall prevalence of self-reported diabetes was 6.0% and of screen-detected diabetes was 9.8%. Higher education level was associated with both self-reported diabetes (odds ratio (OR)?=?2.41, 95% confidence interval CI?=?1.36-4.46) and total diabetes (OR?=?1.53 95%, CI?=?1.10-2.15) only in men. AHLE was associated with self-reported diabetes in men (OR?=?1.87, 95% CI?=?1.26-2.84) and women (OR?=?2.31, 95% CI?=?1.62-3.34). There was no association between SES and screen-detected diabetes for men or women.SES inequalities exist in prevalence of diabetes in China and can be used to inform approaches to prevention. Identification and appropriate intervention for people with undiagnosed diabetes is required for all SES groups.

SUBMITTER: Wu H

PROVIDER: S-EPMC6076585 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Project description:Antimicrobial resistance profiling of pathogens helps to identify the emergence of rare or new resistance threats and prioritize possible actions to be taken against them. The analysis of wastewater (WW) can reveal the circulation of antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARG) among the catchment communities. Here, we analyzed WW influent samples to determine the prevalence of carbapenemase genes-carrying Gram-negative bacteria (Carba-GNB) in Helsinki, Finland. This study set important historical reference points from the very early stage of the carbapenemase era, during the period 2011-2012. A total of 405 bacterial isolates grown on CHROMagarKPC (n = 195) and CHROMagarESBL (n = 210) from WW influent samples were collected between October 2011 and August 2012 and were analyzed. The bacterial DNA from the isolates was extracted, and the prevalence of carbapenemases genes bla KPC, bla NDM, bla GES, bla OXA-48, bla IMP, bla IMI, and bla VIM were screened with multiplexed PCR. All carbapenemase-positive isolates were identified taxonomically to species or genus level with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The nucleic acid extraction was successful for 399 isolates, of which 59 (14.8%) were found to carry carbapenemase genes. A total of 89.8% of the carbapenemase positive isolates (53 out of 59) were obtained from CHROMagarKPC plates and only 10.2% (six out of 59) were obtained from CHROMagar ESBL plates. Among the Carba-GNB isolates, 86.4% were bla GES (51 out of 59), 10.2% were bla KPC (six out of 59), and 3.4% were bla VIM (two out of 59). The most common carba-gene, bla GES, was carried by 10 different bacterial species, including Aeromonas spp., Enterobacter spp., and Kluyvera spp.; the bla KPC gene was carried by Escherichia coli, Klebsiella pneumoniae, and Kluyvera cryocescens; and the bla VIM gene was carried by Aeromonas hydrophila/caviae and Citrobacter amalonaticus. This study emphasizes that wastewater surveillance (WWS) can be an additional tool for monitoring antimicrobial resistance (AMR) at the population level.

Project description:BACKGROUND: Low socioeconomic status is a risk factor for liver cirrhosis, but it is unknown whether it is a prognostic factor after cirrhosis diagnosis. We examined whether marital status, employment, and personal income were associated with the survival of cirrhosis patients. METHODS: Using registry-data we conducted a population-based cohort study of 1,765 Danish cirrhosis patients diagnosed in 1999-2001 at age 45-59 years. Follow-up ended on 31 December 2003. With Cox regression we examined the associations between marital status (never married, divorced, married), employment (employed, disability pensioner, unemployed), personal income (0-49, 50-99, 100+ percent of the national average) and survival, controlling for gender, age, cirrhosis severity, comorbidity, and substance abuse. RESULTS: Five-year survival was higher for married patients (48%) than for patients who never married (40%) or were divorced (34%), but after adjustment only divorced patients had poorer survival than married patients (adjusted hazard ratio for divorced vs. married = 1.22, 95% CI 1.04-1.42). Five-year survival was lower for disability pensioners (31%) than for employed (46%) or unemployed patients (48%), also after adjustment (adjusted hazard ratio for disability pensioners vs. employed = 1.35, 95% CI 1.09-1.66). Personal income was not associated with survival. CONCLUSION: Marital status and employment were associated with the survival of cirrhosis patients. Specifically, divorced cirrhosis patients and cirrhosis patients who never married had a poorer survival than did married cirrhosis patients, and cirrhosis patients who were disability pensioners had a poorer survival than did employed or unemployed cirrhosis patients. The poorer survival for the divorced and for the disability pensioners could not be explained by differences in other socioeconomic factors, gender, age, cirrhosis severity, substance abuse, or comorbidity. Personal income was not associated with survival.

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Socioeconomic status and self-reported, screen-detected and total diabetes prevalence in Chinese men and women in 2011-2012: a nationwide cross-sectional study.

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