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Chen H, Qian Y, Dong Y, Yang Z, Guo L, Liu J, Shen Q, Wang L. Patterns and changes in life expectancy in China, 1990-2016. PLoS One 2020; 15:e0231007. [PMID: 32236129 PMCID: PMC7112202 DOI: 10.1371/journal.pone.0231007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/13/2020] [Indexed: 12/11/2022] Open
Abstract
Objective To achieve the goal of “healthy China 2030”, reasonable health policies must be developed based on the changes of death spectrum. We aim to investigate the temporal patterns of life expectancy (LE) and age/cause-specific contributions from 1990 to 2016. Methods Joinpoint regression model was used with Arriaga’s decomposition method. Results LE in China has reached to 76.3 years in 2016 with an increase of 9.44 years from 1990. From 1990 to 2002, a remarkable reduction in infant mortality accounted for an increase of 1.27 years (35.39%) to LE which mainly resulted from diarrhea, lower respiratory, and other common infectious diseases (1.00 years, 27.79%). After 2002, those aged 65+ years contributed most to increased LE and the most prominent causes included cardiovascular diseases (0.67 years, 23.36%), chronic respiratory diseases (0.54 years, 18.76%) and neoplasms (0.39 years, 13.44%). Moreover, the effects of transport injuries changed from negative to positive. After 2007, contributions of transport and unintentional injuries increased especially for males. And for females contributions of cardiovascular diseases sharply increased LE by 1.17 years (32.26%). Conclusion More attention should be paid to cardiovascular diseases, chronic respiratory diseases and neoplasms which were mainly attributed to the increase of LE, especially for males and elderly population.
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Affiliation(s)
- Hai Chen
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Yun Qian
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Yunqiu Dong
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Zhijie Yang
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Liangliang Guo
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Jia Liu
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Qian Shen
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Lu Wang
- Department of Chronic Disease Control, Center for Disease Control and Prevention, Wuxi, Jiangsu, China
- * E-mail:
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Du H, Li L, Bennett D, Guo Y, Turnbull I, Yang L, Bragg F, Bian Z, Chen Y, Chen J, Millwood IY, Sansome S, Ma L, Huang Y, Zhang N, Zheng X, Sun Q, Key TJ, Collins R, Peto R, Chen Z. Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults. PLoS Med 2017; 14:e1002279. [PMID: 28399126 PMCID: PMC5388466 DOI: 10.1371/journal.pmed.1002279] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 03/01/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Despite the well-recognised health benefits of fresh fruit consumption, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, on risks of death and major vascular complications. METHODS AND FINDINGS Between June 2004 and July 2008, the nationwide China Kadoorie Biobank study recruited 0.5 million adults aged 30-79 (mean 51) y from ten diverse localities across China. During ~7 y of follow-up, 9,504 new diabetes cases were recorded among 482,591 participants without prevalent (previously diagnosed or screen-detected) diabetes at baseline, with an overall incidence rate of 2.8 per 1,000 person-years. Among 30,300 (5.9%) participants who had diabetes at baseline, 3,389 deaths occurred (overall mortality rate 16.5 per 1,000), along with 9,746 cases of macrovascular disease and 1,345 cases of microvascular disease. Cox regression yielded adjusted hazard ratios (HRs) associating each disease outcome with self-reported fresh fruit consumption, adjusting for potential confounders such as age, sex, region, socio-economic status, other lifestyle factors, body mass index, and family history of diabetes. Overall, 18.8% of participants reported consuming fresh fruit daily, and 6.4% never/rarely (non-consumers), with the proportion of non-consumers about three times higher in individuals with previously diagnosed diabetes (18.9%) than in those with screen-detected diabetes (6.7%) or no diabetes (6.0%). Among those without diabetes at baseline, higher fruit consumption was associated with significantly lower risk of developing diabetes (adjusted HR = 0.88 [95% CI 0.83-0.93] for daily versus non-consumers, p < 0.001, corresponding to a 0.2% difference in 5-y absolute risk), with a clear dose-response relationship. Among those with baseline diabetes, higher fruit consumption was associated with lower risks of all-cause mortality (adjusted HR = 0.83 [95% CI 0.74-0.93] per 100 g/d) and microvascular (0.72 [0.61-0.87]) and macrovascular (0.87 [0.82-0.93]) complications (p < 0.001), with similar HRs in individuals with previously diagnosed and screen-detected diabetes; estimated differences in 5-y absolute risk between daily and non-consumers were 1.9%, 1.1%, and 5.4%, respectively. The main limitation of this study was that, owing to its observational nature, we could not fully exclude the effects of residual confounding. CONCLUSION In this large epidemiological study in Chinese adults, higher fresh fruit consumption was associated with significantly lower risk of diabetes and, among diabetic individuals, lower risks of death and development of major vascular complications.
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Affiliation(s)
- Huaidong Du
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Chinese Academy of Medical Sciences, Beijing, China
| | - Derrick Bennett
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Iain Turnbull
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ling Yang
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Fiona Bragg
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Iona Y. Millwood
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sam Sansome
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Liangcai Ma
- Noncommunicable Disease Prevention and Control Department, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Ying Huang
- Noncommunicable Disease Prevention and Control Department, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Ningmei Zhang
- Noncommunicable Disease Prevention and Control Department, Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Xiangyang Zheng
- Noncommunicable Disease Prevention and Control Department, Meilan Center for Disease Control and Prevention, Haikou, China
| | - Qiang Sun
- Pengzhou Center for Disease Control and Prevention, Pengzhou, China
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Richard Peto
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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