1
|
Ferrari AJ, Santomauro DF, Aali A, Abate YH, Abbafati C, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdollahi A, Abdullahi A, Abegaz KH, Abeldaño Zuñiga RA, Aboagye RG, Abolhassani H, Abreu LG, Abualruz H, Abu-Gharbieh E, Abu-Rmeileh NME, Ackerman IN, Addo IY, Addolorato G, Adebiyi AO, Adepoju AV, Adewuyi HO, Afyouni S, Afzal S, Afzal S, Agodi A, Ahmad A, Ahmad D, Ahmad F, Ahmad S, Ahmed A, Ahmed LA, Ahmed MB, Ajami M, Akinosoglou K, Akkaif MA, Al Hasan SM, Alalalmeh SO, Al-Aly Z, Albashtawy M, Aldridge RW, Alemu MD, Alemu YM, Alene KA, Al-Gheethi AAS, Alharrasi M, Alhassan RK, Ali MU, Ali R, Ali SSS, Alif SM, Aljunid SM, Al-Marwani S, Almazan JU, Alomari MA, Al-Omari B, Altaany Z, Alvis-Guzman N, Alvis-Zakzuk NJ, Alwafi H, Al-Wardat MS, Al-Worafi YM, Aly S, Alzoubi KH, Amare AT, Amegbor PM, Ameyaw EK, Amin TT, Amindarolzarbi A, Amiri S, Amugsi DA, Ancuceanu R, Anderlini D, Anderson DB, Andrade PP, Andrei CL, Ansari H, Antony CM, Anwar S, Anwar SL, Anwer R, Anyanwu PE, Arab JP, Arabloo J, Arafat M, Araki DT, Aravkin AY, Arkew M, Armocida B, Arndt MB, Arooj M, Artamonov AA, Aruleba RT, Arumugam A, Ashbaugh C, Ashemo MY, Ashraf M, Asika MO, Askari E, Astell-Burt T, Athari SS, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Ausloos M, Avan A, Awotidebe AW, Awuviry-Newton K, Ayala Quintanilla BP, Ayuso-Mateos JL, Azadnajafabad S, Azevedo RMS, Babu AS, Badar M, Badiye AD, Baghdadi S, Bagheri N, Bah S, Bai R, Baker JL, Bakkannavar SM, Bako AT, Balakrishnan S, Bam K, Banik PC, Barchitta M, Bardhan M, Bardideh E, Barker-Collo SL, Barqawi HJ, Barrow A, Barteit S, Barua L, Bashiri Aliabadi S, Basiru A, Basu S, Basu S, Bathini PP, Batra K, Baune BT, Bayileyegn NS, Behnam B, Behnoush AH, Beiranvand M, Bejarano Ramirez DF, Bell ML, Bello OO, Beloukas A, Bensenor IM, Berezvai Z, Bernabe E, Bernstein RS, Bettencourt PJG, Bhagavathula AS, Bhala N, Bhandari D, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Bishai JD, Bisignano C, Bitra VR, Bjørge T, Bodolica V, Bodunrin AO, Bogale EK, Bonakdar Hashemi M, Bonny A, Bora Basara B, Borhany H, Boxe C, Brady OJ, Bragazzi NL, Braithwaite D, Brant LC, Brauer M, Breitner S, Brenner H, Brown J, Brugha T, Bulamu NB, Buonsenso D, Burkart K, Burns RA, Busse R, Bustanji Y, Butt ZA, Byun J, Caetano dos Santos FL, Calina D, Cámera LA, Campos-Nonato IR, Cao C, Capodici A, Carr S, Carreras G, Carugno A, Carvalho M, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catapano AL, Cattaruzza MS, Caye A, Cegolon L, Cembranel F, Cenderadewi M, Cerin E, Chakraborty PA, Chan JSK, Chan RNC, Chandika RM, Chandrasekar EK, Charalampous P, Chattu VK, Chatzimavridou-Grigoriadou V, Chen AW, Chen AT, Chen CS, Chen H, Chen NM, Cheng ETW, Chimed-Ochir O, Chimoriya R, Ching PR, Cho WCS, Choi S, Chong B, Chong YY, Choudhari SG, Chowdhury R, Christensen SWM, Chu DT, Chukwu IS, Chung E, Chung E, Chutiyami M, Claassens MM, Cogen RM, Columbus A, Conde J, Cortesi PA, Cousin E, Criqui MH, Cruz-Martins N, Dadras O, Dai S, Dai X, Dai Z, Dalaba MA, Damiani G, Das JK, Das S, Dashti M, Dávila-Cervantes CA, Davletov K, De Leo D, Debele AT, Debopadhaya S, DeCleene NK, Deeba F, Degenhardt L, Del Bo' C, Delgado-Enciso I, Demetriades AK, Denova-Gutiérrez E, Dervenis N, Desai HD, Desai R, Deuba K, Dhama K, Dharmaratne SD, Dhingra S, Dias da Silva D, Diaz D, Diaz LA, Diaz MJ, Dima A, Ding DD, Dirac MA, Do THP, do Prado CB, Dohare S, Dominguez RMV, Dong W, Dongarwar D, D'Oria M, Dorsey ER, Doshmangir L, Dowou RK, Driscoll TR, Dsouza HL, Dsouza V, Dube J, Dumith SC, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dzianach PA, Dziedzic AM, Eboreime E, Ebrahimi A, Edinur HA, Edvardsson D, Eikemo TA, Eini E, Ekholuenetale M, Ekundayo TC, El Sayed I, El Tantawi M, Elbarazi I, Elemam NM, ElGohary GMT, Elhadi M, Elmeligy OAA, ELNahas G, Elshaer M, Elsohaby I, Engelbert Bain L, Erkhembayar R, Eshrati B, Estep K, Fabin N, Fagbamigbe AF, Falzone L, Fareed M, Farinha CSES, Faris MEM, Faro A, Farrokhi P, Fatehizadeh A, Fauk NK, Feigin VL, Feng X, Fereshtehnejad SM, Feroze AH, Ferreira N, Ferreira PH, Fischer F, Flavel J, Flood D, Flor LS, Foigt NA, Folayan MO, Force LM, Fortuna D, Foschi M, Franklin RC, Freitas A, Fukumoto T, Furtado JM, Gaal PA, Gadanya MA, Gaidhane AM, Gaihre S, Galali Y, Ganbat M, Gandhi AP, Ganesan B, Ganie MA, Ganiyani MA, Gardner WM, Gebi TG, Gebregergis MW, Gebrehiwot M, Gebremariam TBB, Gebremeskel TG, Gela YY, Georgescu SR, Getachew Obsa A, Gething PW, Getie M, Ghadiri K, Ghadirian F, Ghailan KY, Ghajar A, Ghasemi M, Ghasempour Dabaghi G, Ghasemzadeh A, Ghazy RM, Gholamrezanezhad A, Ghorbani M, Ghotbi E, Gibson RM, Gill TK, Ginindza TG, Girmay A, Glasbey JC, Göbölös L, Godinho MA, Goharinezhad S, Goldust M, Golechha M, Goleij P, Gona PN, Gorini G, Goulart AC, Grada A, Grivna M, Guan SY, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Gulati S, Gulisashvili D, Gunawardane DA, Guo C, Gupta AK, Gupta B, Gupta I, Gupta M, Gupta R, Gupta VB, Gupta VK, Gupta VK, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Haddadi R, Hadi NR, Haep N, Hafezi-Nejad N, Hafiz A, Hagins H, Halboub ES, Halimi A, Haller S, Halwani R, Hamilton EB, Hankey GJ, Hannan MA, Haque MN, Harapan H, Haro JM, Hartvigsen J, Hasaballah AI, Hasan I, Hasanian M, Hasnain MS, Hassan A, Haubold J, Havmoeller RJ, Hay SI, Hayat K, Hebert JJ, Hegazi OE, Heidari G, Helfer B, Hemmati M, Hendrie D, Henson CA, Hezam K, Hiraike Y, Hoan NQ, Holla R, Hon J, Hossain MM, Hosseinzadeh H, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hsu JM, Huang J, Hugo FN, Hushmandi K, Hussain J, Hussein NR, Huynh CK, Huynh HH, Hwang BF, Iannucci VC, Ihler AL, Ikiroma AI, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Immurana M, Irham LM, Islam MR, Islam SMS, Islami F, Ismail F, Ismail NE, Isola G, Iwagami M, Iwu CCD, Iyer M, Jaafari J, Jacobsen KH, Jadidi-Niaragh F, Jafarinia M, Jaggi K, Jahankhani K, Jahanmehr N, Jahrami H, Jain A, Jain N, Jairoun AA, Jaiswal A, Jakovljevic M, Jatau AI, Javadov S, Javaheri T, Jayapal SK, Jayaram S, Jee SH, Jeganathan J, Jeyakumar A, Jha AK, Jiang H, Jin Y, Jonas JB, Joo T, Joseph A, Joseph N, Joshua CE, Jozwiak JJ, Jürisson M, K V, Kaambwa B, Kabir A, Kabir Z, Kadashetti V, Kalani R, Kalankesh LR, Kaliyadan F, Kalra S, Kamenov K, Kamyari N, Kanagasabai T, Kandel H, Kanmanthareddy AR, Kanmodi KK, Kantar RS, Karaye IM, Karim A, Karimi SE, Karimi Y, Kasraei H, Kassel MB, Kauppila JH, Kawakami N, Kayode GA, Kazemi F, Kazemian S, Keikavoosi-Arani L, Keller C, Kempen JH, Kerr JA, Keshtkar K, Kesse-Guyot E, Keykhaei M, Khajuria H, Khalaji A, Khalid A, Khalid N, Khalilian A, Khamesipour F, Khan A, Khan I, Khan M, Khan MAB, Khanmohammadi S, Khatab K, Khatami F, Khatatbeh MM, Khater AM, Khayat Kashani HR, Khidri FF, Khodadoust E, Khormali M, Khorrami Z, Kifle ZD, Kim MS, Kimokoti RW, Kisa A, Kisa S, Knudsen AKS, Kocarnik JM, Kochhar S, Koh HY, Kolahi AA, Kompani F, Koren G, Korzh O, Kosen S, Koulmane Laxminarayana SL, Krishan K, Krishna V, Krishnamoorthy V, Kuate Defo B, Kuddus MA, Kuddus M, Kuitunen I, Kulkarni V, Kumar M, Kumar N, Kumar R, Kurmi OP, Kusuma D, Kyu HH, La Vecchia C, Lacey B, Ladan MA, Laflamme L, Lafranconi A, Lahariya C, Lai DTC, Lal DK, Lalloo R, Lallukka T, Lám J, Lan Q, Lan T, Landires I, Lanfranchi F, Langguth B, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Lauriola P, Le HH, Le LKD, Le NHH, Le TDT, Leasher JL, Ledda C, Lee M, Lee PH, Lee SW, Lee SW, Lee WC, Lee YH, LeGrand KE, Lenzi J, Leong E, Leung J, Li MC, Li W, Li X, Li Y, Li Y, Lim LL, Lim SS, Lindstrom M, Linn S, Liu G, Liu R, Liu S, Liu W, Liu X, Liu X, Llanaj E, Lo CH, López-Bueno R, Loreche AM, Lorenzovici L, Lozano R, Lubinda J, Lucchetti G, Lunevicius R, Lusk JB, lv H, Ma ZF, Machairas N, Madureira-Carvalho ÁM, Magaña Gómez JA, Maghazachi AA, Maharjan P, Mahasha PW, Maheri M, Mahjoub S, Mahmoud MA, Mahmoudi E, Majeed A, Makris KC, Malakan Rad E, Malhotra K, Malik AA, Malik I, Malta DC, Manla Y, Mansour A, Mansouri P, Mansournia MA, Mantilla Herrera AM, Mantovani LG, Manu E, Marateb HR, Mardi P, Martinez G, Martinez-Piedra R, Martini D, Martins-Melo FR, Martorell M, Marx W, Maryam S, Marzo RR, Mathangasinghe Y, Mathieson S, Mathioudakis AG, Mattumpuram J, Maugeri A, Mayeli M, Mazidi M, Mazzotti A, McGrath JJ, McKee M, McKowen ALW, McPhail MA, Mehrabani-Zeinabad K, Mehrabi Nasab E, Mekene Meto T, Mendoza W, Menezes RG, Mensah GA, Mentis AFA, Meo SA, Meresa HA, Meretoja A, Meretoja TJ, Mersha AM, Mestrovic T, Mettananda KCD, Mettananda S, Michalek IM, Miller PA, Miller TR, Mills EJ, Minh LHN, Mirijello A, Mirrakhimov EM, Mirutse MK, Mirza-Aghazadeh-Attari M, Mirzaei M, Mirzaei R, Misganaw A, Mishra AK, Mitchell PB, Mittal C, Moazen B, Moberg ME, Mohamed J, Mohamed MFH, Mohamed NS, Mohammadi E, Mohammadi S, Mohammed H, Mohammed S, Mohammed S, Mohr RM, Mokdad AH, Molinaro S, Momtazmanesh S, Monasta L, Mondello S, Moodi Ghalibaf A, Moradi M, Moradi Y, Moradi-Lakeh M, Moraga P, Morawska L, Moreira RS, Morovatdar N, Morrison SD, Morze J, Mosapour A, Mosser JF, Mossialos E, Motappa R, Mougin V, Mouodi S, Mrejen M, Msherghi A, Mubarik S, Mueller UO, Mulita F, Munjal K, Murillo-Zamora E, Murlimanju BV, Mustafa G, Muthu S, Muzaffar M, Myung W, Nagarajan AJ, Naghavi P, Naik GR, Nainu F, Nair S, Najmuldeen HHR, Nangia V, Naqvi AA, Narayana AI, Nargus S, Nascimento GG, Nashwan AJ, Nasrollahizadeh A, Nasrollahizadeh A, Natto ZS, Nayak BP, Nayak VC, Nduaguba SO, Negash H, Negoi I, Negoi RI, Nejadghaderi SA, Nesbit OD, Netsere HB, Ng M, Nguefack-Tsague G, Ngunjiri JW, Nguyen DH, Nguyen HQ, Niazi RK, Nikolouzakis TK, Nikoobar A, Nikoomanesh F, Nikpoor AR, Nnaji CA, Nnyanzi LA, Noman EA, Nomura S, Norrving B, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nurrika D, Nzoputam CI, Nzoputam OJ, Oancea B, Odetokun IA, O'Donnell MJ, Oguntade AS, Oguta JO, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Olagunju AT, Olasupo OO, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Olusanya JO, Omar HA, Omer GL, Omonisi AEE, Onie S, Onwujekwe OE, Ordak M, Orish VN, Ortega-Altamirano DV, Ortiz A, Ortiz-Brizuela E, Osman WMS, Ostroff SM, Osuagwu UL, Otoiu A, Otstavnov N, Otstavnov SS, Ouyahia A, Ouyang G, Owolabi MO, P A MP, Padron-Monedero A, Padubidri JR, Palicz T, Palladino C, Pan F, Pandi-Perumal SR, Pangaribuan HU, Panos GD, Panos LD, Pantea Stoian AM, Pardhan S, Parikh RR, Pashaei A, Pasovic M, Passera R, Patel J, Patel SK, Patil S, Patoulias D, Patthipati VS, Pawar S, Pazoki Toroudi H, Pease SA, Peden AE, Pedersini P, Peng M, Pensato U, Pepito VCF, Peprah EK, Peprah P, Perdigão J, Pereira MO, Perianayagam A, Perico N, Pesudovs K, Petermann-Rocha FE, Petri WA, Pham HT, Philip AK, Phillips MR, Pigeolet M, Pigott DM, Pillay JD, Piracha ZZ, Pirouzpanah S, Plass D, Plotnikov E, Poddighe D, Polinder S, Postma MJ, Pourtaheri N, Prada SI, Pradhan PMS, Prakash V, Prasad M, Prates EJS, Priscilla T, Pritchett N, Puri P, Puvvula J, Qasim NH, Qattea I, Qazi AS, Qian G, Rabiee Rad M, Radhakrishnan RA, Radhakrishnan V, Raeisi Shahraki H, Rafferty Q, Raggi A, Raghav PR, Rahim MJ, Rahman MM, Rahman MHU, Rahman M, Rahman MA, Rahmani S, Rahmanian M, Rahmawaty S, Rajaa S, Ramadan MM, Ramasamy SK, Ramasubramani P, Ramazanu S, Rana K, Ranabhat CL, Rancic N, Rane A, Rao CR, Rao K, Rao M, Rao SJ, Rashidi MM, Rathnaiah Babu G, Rauniyar SK, Rawaf DL, Rawaf S, Razo C, Reddy MMRK, Redwan EMM, Reifels L, Reiner Jr RC, Remuzzi G, Renzaho AMN, Reshmi B, Reyes LF, Rezaei N, Rezaei N, Rezaei N, Rezaei Hachesu P, Rezaeian M, Rickard J, Rodrigues CF, Rodriguez JAB, Roever L, Ronfani L, Roshandel G, Rotimi K, Rout HS, Roy B, Roy N, Roy P, Rubagotti E, S N C, Saad AMA, Saber-Ayad MM, Sabour S, Sacco S, Sachdev PS, Saddik B, Saddler A, Sadee BA, Sadeghi E, Sadeghi M, Saeb MR, Saeed U, Safi SZ, Sagar R, Sagoe D, Saif Z, Sajid MR, Sakshaug JW, Salam N, Salami AA, Salaroli LB, Saleh MA, Salem MR, Salem MZY, Sallam M, Samadzadeh S, Samargandy S, Samodra YL, Samy AM, Sanabria J, Sanna F, Santos IS, Santric-Milicevic MM, Sarasmita MA, Sarikhani Y, Sarmiento-Suárez R, Sarode GS, Sarode SC, Sarveazad A, Sathian B, Sathyanarayan A, Satpathy M, Sawhney M, Scarmeas N, Schaarschmidt BM, Schmidt MI, Schneider IJC, Schumacher AE, Schwebel DC, Schwendicke F, Sedighi M, Senapati S, Senthilkumaran S, Sepanlou SG, Sethi Y, Setoguchi S, Seylani A, Shadid J, Shafie M, Shah H, Shah NS, Shah PA, Shahbandi A, Shahid S, Shahid W, Shahwan MJ, Shaikh MA, Shakeri A, Shalash AS, Sham S, Shamim MA, Shamshirgaran MA, Shamsi MA, Shanawaz M, Shankar A, Shannawaz M, Sharath M, Sharifan A, Sharifi-Rad J, Sharma M, Sharma R, Sharma S, Sharma U, Sharma V, Shastry RP, Shavandi A, Shayan AM, Shayan M, Shehabeldine AME, Shetty PH, Shibuya K, Shifa JE, Shiferaw D, Shiferaw WS, Shigematsu M, Shiri R, Shitaye NA, Shittu A, Shivakumar KM, Shivarov V, Shokati Eshkiki Z, Shool S, Shrestha S, Shuval K, Sibhat MM, Siddig EE, Sigfusdottir ID, Silva DAS, Silva JP, Silva LMLR, Silva S, Simpson CR, Singal A, Singh A, Singh BB, Singh H, Singh JA, Singh M, Singh P, Skou ST, Sleet DA, Slepak ELN, Solanki R, Soliman SSM, Song S, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Sreeramareddy CT, Stark BA, Starodubova AV, Stein C, Stein DJ, Steiner C, Steiner TJ, Steinmetz JD, Steiropoulos P, Stockfelt L, Stokes MA, Subedi NS, Subramaniyan V, Suemoto CK, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sundström J, Swain CK, Szarpak L, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabche C, Tabish M, Tadakamadla SK, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Talaat IM, Talukder A, Tampa M, Tamuzi JL, Tan KK, Tandukar S, Tang H, Tavakoli Oliaee R, Tavangar SM, Teimoori M, Temsah MH, Teramoto M, Thangaraju P, Thankappan KR, Thapar R, Thayakaran R, Thirunavukkarasu S, Thomas N, Thomas NK, Thum CCC, Tichopad A, Ticoalu JHV, Tillawi T, Tiruye TY, Tobe-Gai R, Tonelli M, Topor-Madry R, Torre AE, Touvier M, Tovani-Palone MR, Tran JT, Tran MTN, Tran NM, Tran NH, Trico D, Tromans SJ, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tumurkhuu M, Tyrovolas S, Udoh A, Umair M, Umakanthan S, Umar TP, Undurraga EA, Unim B, Unnikrishnan B, Unsworth CA, Upadhyay E, Urso D, Usman JS, Vahabi SM, Vaithinathan AG, Van den Eynde J, Varga O, Varma RP, Vart P, Vasankari TJ, Vasic M, Vaziri S, Vellingiri B, Venketasubramanian N, Veroux M, Verras GI, Vervoort D, Villafañe JH, Violante FS, Vlassov V, Vollset SE, Volovat SR, Vongpradith A, Waheed Y, Wang C, Wang F, Wang N, Wang S, Wang Y, Wang YP, Ward P, Wassie EG, Weaver MR, Weerakoon KG, Weintraub RG, Weiss DJ, Weldemariam AH, Wells KM, Wen YF, Whisnant JL, Whiteford HA, Wiangkham T, Wickramasinghe DP, Wickramasinghe ND, Wilandika A, Wilkerson C, Willeit P, Wimo A, Woldegebreal DH, Wolf AW, Wong YJ, Woolf AD, Wu C, Wu F, Wu X, Wu Z, Wulf Hanson S, Xia Y, Xiao H, Xu X, Xu YY, Yadav L, Yadollahpour A, Yaghoubi S, Yamagishi K, Yang L, Yano Y, Yao Y, Yaribeygi H, Yazdanpanah MH, Ye P, Yehualashet SS, Yesuf SA, Yezli S, Yiğit A, Yiğit V, Yigzaw ZA, Yismaw Y, Yon DK, Yonemoto N, Younis MZ, Yu C, Yu Y, Yusuf H, Zahid MH, Zakham F, Zaki L, Zaki N, Zaman BA, Zamora N, Zand R, Zandieh GGZ, Zar HJ, Zarrintan A, Zastrozhin MS, Zhang H, Zhang N, Zhang Y, Zhao H, Zhong C, Zhong P, Zhou J, Zhu Z, Ziafati M, Zielińska M, Zimsen SRM, Zoladl M, Zumla A, Zyoud SH, Vos T, Murray CJL. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00757-8. [PMID: 38642570 DOI: 10.1016/s0140-6736(24)00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
2
|
Naghavi M, Ong KL, Aali A, Ababneh HS, Abate YH, Abbafati C, Abbasgholizadeh R, Abbasian M, Abbasi-Kangevari M, Abbastabar H, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdollahifar MA, Abdoun M, Abdulah DM, Abdullahi A, Abebe M, Abebe SS, Abedi A, Abegaz KH, Abhilash ES, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Abolmaali M, Abouzid M, Aboye GB, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualruz H, Abubakar B, Abu-Gharbieh E, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Accrombessi MMK, Adal TG, Adamu AA, Addo IY, Addolorato G, Adebiyi AO, Adekanmbi V, Adepoju AV, Adetunji CO, Adetunji JB, Adeyeoluwa TE, Adeyinka DA, Adeyomoye OI, Admass BAA, Adnani QES, Adra S, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Agasthi P, Aggarwal M, Aghamiri S, Agide FD, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed MB, Ahmed SA, Ajami M, Aji B, Akara EM, Akbarialiabad H, Akinosoglou K, Akinyemiju T, Akkaif MA, Akyirem S, Al Hamad H, Al Hasan SM, Alahdab F, Alalalmeh SO, Alalwan TA, Al-Aly Z, Alam K, Alam M, Alam N, Al-amer RM, Alanezi FM, Alanzi TM, Al-Azzam S, Albakri A, Albashtawy M, AlBataineh MT, Alcalde-Rabanal JE, Aldawsari KA, Aldhaleei WA, Aldridge RW, Alema HB, Alemayohu MA, Alemi S, Alemu YM, Al-Gheethi AAS, Alhabib KF, Alhalaiqa FAN, Al-Hanawi MK, Ali A, Ali A, Ali L, Ali MU, Ali R, Ali S, Ali SSS, Alicandro G, Alif SM, Alikhani R, Alimohamadi Y, Aliyi AA, Aljasir MAM, Aljunid SM, Alla F, Allebeck P, Al-Marwani S, Al-Maweri SAA, Almazan JU, Al-Mekhlafi HM, Almidani L, Almidani O, Alomari MA, Al-Omari B, Alonso J, Alqahtani JS, Alqalyoobi S, Alqutaibi AY, Al-Sabah SK, Altaany Z, Altaf A, Al-Tawfiq JA, Altirkawi KA, Aluh DO, Alvis-Guzman N, Alwafi H, Al-Worafi YM, Aly H, Aly S, Alzoubi KH, Amani R, Amare AT, Amegbor PM, Ameyaw EK, Amin TT, Amindarolzarbi A, Amiri S, Amirzade-Iranaq MH, Amu H, Amugsi DA, Amusa GA, Ancuceanu R, Anderlini D, Anderson DB, Andrade PP, Andrei CL, Andrei T, Angus C, Anil A, Anil S, Anoushiravani A, Ansari H, Ansariadi A, Ansari-Moghaddam A, Antony CM, Antriyandarti E, Anvari D, Anvari S, Anwar S, Anwar SL, Anwer R, Anyasodor AE, Aqeel M, Arab JP, Arabloo J, Arafat M, Aravkin AY, Areda D, Aremu A, Aremu O, Ariffin H, Arkew M, Armocida B, Arndt MB, Ärnlöv J, Arooj M, Artamonov AA, Arulappan J, Aruleba RT, Arumugam A, Asaad M, Asadi-Lari M, Asgedom AA, Asghariahmadabad M, Asghari-Jafarabadi M, Ashraf M, Aslani A, Astell-Burt T, Athar M, Athari SS, Atinafu BTT, Atlaw HW, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Ausloos M, Avan A, Awedew AF, Aweke AM, Ayala Quintanilla BP, Ayatollahi H, Ayuso-Mateos JL, Ayyoubzadeh SM, Azadnajafabad S, Azevedo RMS, Azzam AY, B DB, Babu AS, Badar M, Badiye AD, Baghdadi S, Bagheri N, Bagherieh S, Bah S, Bahadorikhalili S, Bahmanziari N, Bai R, Baig AA, Baker JL, Bako AT, Bakshi RK, Balakrishnan S, Balasubramanian M, Baltatu OC, Bam K, Banach M, Bandyopadhyay S, Banik PC, Bansal H, Bansal K, Barbic F, Barchitta M, Bardhan M, Bardideh E, Barker-Collo SL, Bärnighausen TW, Barone-Adesi F, Barqawi HJ, Barrero LH, Barrow A, Barteit S, Barua L, Basharat Z, Bashiri A, Basiru A, Baskaran P, Basnyat B, Bassat Q, Basso JD, Basting AVL, Basu S, Batra K, Baune BT, Bayati M, Bayileyegn NS, Beaney T, Bedi N, Beghi M, Behboudi E, Behera P, Behnoush AH, Behzadifar M, Beiranvand M, Bejarano Ramirez DF, Béjot Y, Belay SA, Belete CM, Bell ML, Bello MB, Bello OO, Belo L, Beloukas A, Bender RG, Bensenor IM, Beran A, Berezvai Z, Berhie AY, Berice BN, Bernstein RS, Bertolacci GJ, Bettencourt PJG, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhandari D, Bhangdia K, Bhardwaj N, Bhardwaj P, Bhardwaj PV, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Bishai JD, Bisignano C, Bisulli F, Biswas A, Biswas B, Bitaraf S, Bitew BD, Bitra VR, Bjørge T, Boachie MK, Boampong MS, Bobirca AV, Bodolica V, Bodunrin AO, Bogale EK, Bogale KA, Bohlouli S, Bolarinwa OA, Boloor A, Bonakdar Hashemi M, Bonny A, Bora K, Bora Basara B, Borhany H, Borzutzky A, Bouaoud S, Boustany A, Boxe C, Boyko EJ, Brady OJ, Braithwaite D, Brant LC, Brauer M, Brazinova A, Brazo-Sayavera J, Breitborde NJK, Breitner S, Brenner H, Briko AN, Briko NI, Britton G, Brown J, Brugha T, Bulamu NB, Bulto LN, Buonsenso D, Burns RA, Busse R, Bustanji Y, Butt NS, Butt ZA, Caetano dos Santos FL, Calina D, Cámera LA, Campos LA, Campos-Nonato IR, Cao C, Cao Y, Capodici A, Cárdenas R, Carr S, Carreras G, Carrero JJ, Carugno A, Carvalheiro CG, Carvalho F, Carvalho M, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Catapano AL, Cattaruzza MS, Cederroth CR, Cegolon L, Cembranel F, Cenderadewi M, Cercy KM, Cerin E, Cevik M, Chadwick J, Chahine Y, Chakraborty C, Chakraborty PA, Chan JSK, Chan RNC, Chandika RM, Chandrasekar EK, Chang CK, Chang JC, Chanie GS, Charalampous P, Chattu VK, Chaturvedi P, Chatzimavridou-Grigoriadou V, Chaurasia A, Chen AW, Chen AT, Chen CS, Chen H, Chen MX, Chen S, Cheng CY, Cheng ETW, Cherbuin N, Cheru WA, Chien JH, Chimed-Ochir O, Chimoriya R, Ching PR, Chirinos-Caceres JL, Chitheer A, Cho WCS, Chong B, Chopra H, Choudhari SG, Chowdhury R, Christopher DJ, Chukwu IS, Chung E, Chung E, Chung E, Chung SC, Chutiyami M, Cindi Z, Cioffi I, Claassens MM, Claro RM, Coberly K, Cogen RM, Columbus A, Comfort H, Conde J, Cortese S, Cortesi PA, Costa VM, Costanzo S, Cousin E, Couto RAS, Cowden RG, Cramer KM, Criqui MH, Cruz-Martins N, Cuadra-Hernández SM, Culbreth GT, Cullen P, Cunningham M, Curado MP, Dadana S, Dadras O, Dai S, Dai X, Dai Z, Dalli LL, Damiani G, Darega Gela J, Das JK, Das S, Das S, Dascalu AM, Dash NR, Dashti M, Dastiridou A, Davey G, Dávila-Cervantes CA, Davis Weaver N, Davletov K, De Leo D, de Luca K, Debele AT, Debopadhaya S, Degenhardt L, Dehghan A, Deitesfeld L, Del Bo' C, Delgado-Enciso I, Demessa BH, Demetriades AK, Deng K, Deng X, Denova-Gutiérrez E, Deravi N, Dereje N, Dervenis N, Dervišević E, Des Jarlais DC, Desai HD, Desai R, Devanbu VGC, Dewan SMR, Dhali A, Dhama K, Dhimal M, Dhingra S, Dhulipala VR, Dias da Silva D, Diaz D, Diaz MJ, Dima A, Ding DD, Ding H, Dinis-Oliveira RJ, Dirac MA, Djalalinia S, Do THP, do Prado CB, Doaei S, Dodangeh M, Dodangeh M, Dohare S, Dokova KG, Dolecek C, Dominguez RMV, Dong W, Dongarwar D, D'Oria M, Dorostkar F, Dorsey ER, dos Santos WM, Doshi R, Doshmangir L, Dowou RK, Driscoll TR, Dsouza HL, Dsouza V, Du M, Dube J, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dwyer-Lindgren L, Dzianach PA, Dziedzic AM, E'mar AR, Eboreime E, Ebrahimi A, Echieh CP, Edinur HA, Edvardsson D, Edvardsson K, Efendi D, Efendi F, Effendi DE, Eikemo TA, Eini E, Ekholuenetale M, Ekundayo TC, El Sayed I, Elbarazi I, Elema TB, Elemam NM, Elgar FJ, Elgendy IY, ElGohary GMT, Elhabashy HR, Elhadi M, El-Huneidi W, Elilo LT, Elmeligy OAA, Elmonem MA, Elshaer M, Elsohaby I, Emeto TI, Engelbert Bain L, Erkhembayar R, Esezobor CI, Eshrati B, Eskandarieh S, Espinosa-Montero J, Esubalew H, Etaee F, Fabin N, Fadaka AO, Fagbamigbe AF, Fahim A, Fahimi S, Fakhri-Demeshghieh A, Falzone L, Fareed M, Farinha CSES, Faris MEM, Faris PS, Faro A, Fasanmi AO, Fatehizadeh A, Fattahi H, Fauk NK, Fazeli P, Feigin VL, Feizkhah A, Fekadu G, Feng X, Fereshtehnejad SM, Feroze AH, Ferrante D, Ferrari AJ, Ferreira N, Fetensa G, Feyisa BR, Filip I, Fischer F, Flavel J, Flood D, Florin BT, Foigt NA, Folayan MO, Fomenkov AA, Foroutan B, Foroutan M, Forthun I, Fortuna D, Foschi M, Fowobaje KR, Francis KL, Franklin RC, Freitas A, Friedman J, Friedman SD, Fukumoto T, Fuller JE, Fux B, Gaal PA, Gadanya MA, Gaidhane AM, Gaihre S, Gakidou E, Galali Y, Galles NC, Gallus S, Ganbat M, Gandhi AP, Ganesan B, Ganiyani MA, Garcia-Gordillo MA, Gardner WM, Garg J, Garg N, Gautam RK, Gbadamosi SO, Gebi TG, Gebregergis MW, Gebrehiwot M, Gebremeskel TG, Georgescu SR, Getachew T, Gething PW, Getie M, Ghadiri K, Ghahramani S, Ghailan KY, Ghasemi MR, Ghasempour Dabaghi G, Ghasemzadeh A, Ghashghaee A, Ghassemi F, Ghazy RM, Ghimire A, Ghoba S, Gholamalizadeh M, Gholamian A, Gholamrezanezhad A, Gholizadeh N, Ghorbani M, Ghorbani Vajargah P, Ghoshal AG, Gill PS, Gill TK, Gillum RF, Ginindza TG, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Godinho MA, Goel A, Golchin A, Goldust M, Golechha M, Goleij P, Gomes NGM, Gona PN, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Goulart BNG, Goyal A, Grada A, Graham SM, Grivna M, Grosso G, Guan SY, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Guimarães RA, Gulati S, Gunawardane DA, Gunturu S, Guo C, Gupta AK, Gupta B, Gupta MK, Gupta M, Gupta RD, Gupta R, Gupta S, Gupta VB, Gupta VK, Gupta VK, Gurmessa L, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Haddadi R, Hadei M, Hadi NR, Haep N, Hafezi-Nejad N, Hailu A, Haj-Mirzaian A, Halboub ES, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hamilton EB, Han C, Han Q, Hanif A, Hanifi N, Hankey GJ, Hanna F, Hannan MA, Haque MN, Harapan H, Hargono A, Haro JM, Hasaballah AI, Hasan I, Hasan MT, Hasani H, Hasanian M, Hashi A, Hasnain MS, Hassan I, Hassanipour S, Hassankhani H, Haubold J, Havmoeller RJ, Hay SI, He J, Hebert JJ, Hegazi OE, Heidari G, Heidari M, Heidari-Foroozan M, Helfer B, Hendrie D, Herrera-Serna BY, Herteliu C, Hesami H, Hezam K, Hill CL, Hiraike Y, Holla R, Horita N, Hossain MM, Hossain S, Hosseini MS, Hosseinzadeh H, Hosseinzadeh M, Hosseinzadeh Adli A, Hostiuc M, Hostiuc S, Hsairi M, Hsieh VCR, Hsu RL, Hu C, Huang J, Hultström M, Humayun A, Hundie TG, Hussain J, Hussain MA, Hussein NR, Hussien FM, Huynh HH, Hwang BF, Ibitoye SE, Ibrahim KS, Iftikhar PM, Ijo D, Ikiroma AI, Ikuta KS, Ikwegbue PC, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Immurana M, Inamdar S, Indriasih E, Iqhrammullah M, Iradukunda A, Iregbu KC, Islam MR, Islam SMS, Islami F, Ismail F, Ismail NE, Iso H, Isola G, Iwagami M, Iwu CCD, Iyamu IO, Iyer M, J LM, Jaafari J, Jacob L, Jacobsen KH, Jadidi-Niaragh F, Jafarinia M, Jafarzadeh A, Jaggi K, Jahankhani K, Jahanmehr N, Jahrami H, Jain N, Jairoun AA, Jaiswal A, Jamshidi E, Janko MM, Jatau AI, Javadov S, Javaheri T, Jayapal SK, Jayaram S, Jebai R, Jee SH, Jeganathan J, Jha AK, Jha RP, Jiang H, Jin Y, Johnson O, Jokar M, Jonas JB, Joo T, Joseph A, Joseph N, Joshua CE, Joshy G, Jozwiak JJ, Jürisson M, K V, Kaambwa B, Kabir A, Kabir Z, Kadashetti V, Kadir DH, Kalani R, Kalankesh LR, Kalankesh LR, Kaliyadan F, Kalra S, Kamal VK, Kamarajah SK, Kamath R, Kamiab Z, Kamyari N, Kanagasabai T, Kanchan T, Kandel H, Kanmanthareddy AR, Kanmiki EW, Kanmodi KK, Kannan S S, Kansal SK, Kantar RS, Kapoor N, Karajizadeh M, Karanth SD, Karasneh RA, Karaye IM, Karch A, Karim A, Karimi SE, Karimi Behnagh A, Kashoo FZ, Kasnazani QHA, Kasraei H, Kassebaum NJ, Kassel MB, Kauppila JH, Kaur N, Kawakami N, Kayode GA, Kazemi F, Kazemian S, Kazmi TH, Kebebew GM, Kebede AD, Kebede F, Keflie TS, Keiyoro PN, Keller C, Kelly JT, Kempen JH, Kerr JA, Kesse-Guyot E, Khajuria H, Khalaji A, Khalid N, Khalil AA, Khalilian A, Khamesipour F, Khan A, Khan A, Khan G, Khan I, Khan IA, Khan MN, Khan M, Khan MJ, Khan MAB, Khan ZA, Khan suheb MZ, Khanmohammadi S, Khatab K, Khatami F, Khatatbeh H, Khatatbeh MM, Khavandegar A, Khayat Kashani HR, Khidri FF, Khodadoust E, Khorgamphar M, Khormali M, Khorrami Z, Khosravi A, Khosravi MA, Kifle ZD, Kim G, Kim J, Kim K, Kim MS, Kim YJ, Kimokoti RW, Kinzel KE, Kisa A, Kisa S, Klu D, Knudsen AKS, Kocarnik JM, Kochhar S, Kocsis T, Koh DSQ, Kolahi AA, Kolves K, Kompani F, Koren G, Kosen S, Kostev K, Koul PA, Koulmane Laxminarayana SL, Krishan K, Krishna H, Krishna V, Krishnamoorthy V, Krishnamoorthy Y, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kuddus MA, Kuddus M, Kuitunen I, Kulimbet M, Kulkarni V, Kumar A, Kumar A, Kumar H, Kumar M, Kumar R, Kumari M, Kumie FT, Kundu S, Kurmi OP, Kusnali A, Kusuma D, Kwarteng A, Kyriopoulos I, Kyu HH, La Vecchia C, Lacey B, Ladan MA, Laflamme L, Lagat AK, Lager ACJ, Lahmar A, Lai DTC, Lal DK, Lalloo R, Lallukka T, Lam H, Lám J, Landrum KR, Lanfranchi F, Lang JJ, Langguth B, Lansingh VC, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Lassi ZS, Latief K, Latifinaibin K, Lauriola P, Le NHH, Le TTT, Le TDT, Ledda C, Ledesma JR, Lee M, Lee PH, Lee SW, Lee SWH, Lee WC, Lee YH, LeGrand KE, Leigh J, Leong E, Lerango TL, Li MC, Li W, Li X, Li Y, Li Z, Ligade VS, Likaka ATM, Lim LL, Lim SS, Lindstrom M, Linehan C, Liu C, Liu G, Liu J, Liu R, Liu S, Liu X, Liu X, Llanaj E, Loftus MJ, López-Bueno R, Lopukhov PD, Loreche AM, Lorkowski S, Lotufo PA, Lozano R, Lubinda J, Lucchetti G, Lugo A, Lunevicius R, Ma ZF, Maass KL, Machairas N, Machoy M, Madadizadeh F, Madsen C, Madureira-Carvalho ÁM, Maghazachi AA, Maharaj SB, Mahjoub S, Mahmoud MA, Mahmoudi A, Mahmoudi E, Mahmoudi R, Majeed A, Makhdoom IF, Malakan Rad E, Maled V, Malekzadeh R, Malhotra AK, Malhotra K, Malik AA, Malik I, Malta DC, Mamun AA, Mansouri P, Mansournia MA, Mantovani LG, Maqsood S, Marasini BP, Marateb HR, Maravilla JC, Marconi AM, Mardi P, Marino M, Marjani A, Martinez G, Martinez-Guerra BA, Martinez-Piedra R, Martini D, Martini S, Martins-Melo FR, Martorell M, Marx W, Maryam S, Marzo RR, Masaka A, Masrie A, Mathieson S, Mathioudakis AG, Mathur MR, Mattumpuram J, Matzopoulos R, Maude RJ, Maugeri A, Maulik PK, Mayeli M, Mazaheri M, Mazidi M, McGrath JJ, McKee M, McKowen ALW, McLaughlin SA, McPhail SM, Mechili EA, Medina JRC, Mediratta RP, Meena JK, Mehra R, Mehrabani-Zeinabad K, Mehrabi Nasab E, Mekene Meto T, Meles GG, Mendez-Lopez MAM, Mendoza W, Menezes RG, Mengist B, Mentis AFA, Meo SA, Meresa HA, Meretoja A, Meretoja TJ, Mersha AM, Mesfin BA, Mestrovic T, Mettananda KCD, Mettananda S, Meylakhs P, Mhlanga A, Mhlanga L, Mi T, Miazgowski T, Micha G, Michalek IM, Miller TR, Mills EJ, Minh LHN, Mini GK, Mir Mohammad Sadeghi P, Mirica A, Mirijello A, Mirrakhimov EM, Mirutse MK, Mirzaei M, Misganaw A, Mishra A, Misra S, Mitchell PB, Mithra P, Mittal C, Mobayen M, Moberg ME, Mohamadkhani A, Mohamed J, Mohamed MFH, Mohamed NS, Mohammad-Alizadeh-Charandabi S, Mohammadi S, Mohammadian-Hafshejani A, Mohammadifard N, Mohammed H, Mohammed H, Mohammed M, Mohammed S, Mohammed S, Mohan V, Mojiri-Forushani H, Mokari A, Mokdad AH, Molinaro S, Molokhia M, Momtazmanesh S, Monasta L, Mondello S, Moni MA, Moodi Ghalibaf A, Moradi M, Moradi Y, Moradi-Lakeh M, Moradzadeh M, Moraga P, Morawska L, Moreira RS, Morovatdar N, Morrison SD, Morze J, Mosser JF, Motappa R, Mougin V, Mouodi S, Mousavi P, Mousavi SE, Mousavi Khaneghah A, Mpolya EA, Mrejen M, Mubarik S, Muccioli L, Mueller UO, Mughal F, Mukherjee S, Mulita F, Munjal K, Murillo-Zamora E, Musaigwa F, Musallam KM, Mustafa A, Mustafa G, Muthupandian S, Muthusamy R, Muzaffar M, Myung W, Nagarajan AJ, Nagel G, Naghavi P, Naheed A, Naik GR, Naik G, Nainu F, Nair S, Najmuldeen HHR, Nakhostin Ansari N, Nangia V, Naqvi AA, Narasimha Swamy S, Narayana AI, Nargus S, Nascimento BR, Nascimento GG, Nasehi S, Nashwan AJ, Natto ZS, Nauman J, Naveed M, Nayak BP, Nayak VC, Nazri-Panjaki A, Ndejjo R, Nduaguba SO, Negash H, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nejjari C, Nena E, Nepal S, Ng M, Nggada HA, Nguefack-Tsague G, Ngunjiri JW, Nguyen AH, Nguyen DH, Nguyen HTH, Nguyen PT, Nguyen VT, Niazi RK, Nielsen KR, Nigatu YT, Nikolouzakis TK, Nikoobar A, Nikoomanesh F, Nikpoor AR, Ningrum DNA, Nnaji CA, Nnyanzi LA, Noman EA, Nomura S, Noreen M, Noroozi N, Norrving B, Noubiap JJ, Novotney A, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nuñez-Samudio V, Nurrika D, Nutor JJ, Oancea B, Obamiro KO, Oboh MA, Odetokun IA, Odogwu NM, O'Donnell MJ, Oduro MS, Ofakunrin AOD, Ogunkoya A, Oguntade AS, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Olagunju AT, Olaiya MT, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Olusanya JO, Oluwafemi YD, Omar HA, Omar Bali A, Omer GL, Ondayo MA, Ong S, Onwujekwe OE, Onyedibe KI, Ordak M, Orisakwe OE, Orish VN, Ortega-Altamirano DV, Ortiz A, Osman WMS, Ostroff SM, Osuagwu UL, Otoiu A, Otstavnov N, Otstavnov SS, Ouyahia A, Ouyang G, Owolabi MO, Ozten Y, P A MP, Padron-Monedero A, Padubidri JR, Pal PK, Palicz T, Palladino C, Palladino R, Palma-Alvarez RF, Pan F, Pan HF, Pana A, Panda P, Panda-Jonas S, Pandi-Perumal SR, Pangaribuan HU, Panos GD, Panos LD, Pantazopoulos I, Pantea Stoian AM, Papadopoulou P, Parikh RR, Park S, Parthasarathi A, Pashaei A, Pasovic M, Passera R, Pasupula DK, Patel HM, Patel J, Patel SK, Patil S, Patoulias D, Patthipati VS, Paudel U, Pazoki Toroudi H, Pease SA, Peden AE, Pedersini P, Pensato U, Pepito VCF, Peprah EK, Peprah P, Perdigão J, Pereira M, Peres MFP, Perianayagam A, Perico N, Pestell RG, Pesudovs K, Petermann-Rocha FE, Petri WA, Pham HT, Philip AK, Phillips MR, Pierannunzio D, Pigeolet M, Pigott DM, Pilgrim T, Piracha ZZ, Piradov MA, Pirouzpanah S, Plakkal N, Plotnikov E, Podder V, Poddighe D, Polinder S, Polkinghorne KR, Poluru R, Ponkilainen VT, Porru F, Postma MJ, Poudel GR, Pourshams A, Pourtaheri N, Prada SI, Pradhan PMS, Prakasham TN, Prasad M, Prashant A, Prates EJS, Prieto Alhambra D, PRISCILLA TINA, Pritchett N, Purohit BM, Puvvula J, Qasim NH, Qattea I, Qazi AS, Qian G, Qiu S, Qureshi MF, Rabiee Rad M, Radfar A, Radhakrishnan RA, Radhakrishnan V, Raeisi Shahraki H, Rafferty Q, Raggi A, Raghav PR, Raheem N, Rahim F, Rahim MJ, Rahimi-Movaghar V, Rahman MM, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmanian V, Rajaa S, Rajput P, Rakovac I, Ramasamy SK, Ramazanu S, Rana K, Ranabhat CL, Rancic N, Rane A, Rao CR, Rao IR, Rao M, Rao SJ, Rasali DP, Rasella D, Rashedi S, Rashedi V, Rashidi MM, Rasouli-Saravani A, Rasul A, Rathnaiah Babu G, Rauniyar SK, Ravangard R, Ravikumar N, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Rawlley B, Raza RZ, Razo C, Redwan EMM, Rehman FU, Reifels L, Reiner Jr RC, Remuzzi G, Reyes LF, Rezaei M, Rezaei N, Rezaei N, Rezaeian M, Rhee TG, Riaz MA, Ribeiro ALP, Rickard J, Riva HR, Robinson-Oden HE, Rodrigues CF, Rodrigues M, Roever L, Rogowski ELB, Rohloff P, Romadlon DS, Romero-Rodríguez E, Romoli M, Ronfani L, Roshandel G, Roth GA, Rout HS, Roy N, Roy P, Rubagotti E, Ruela GDA, Rumisha SF, Runghien T, Rwegerera GM, Rynkiewicz A, S N C, Saad AMA, Saadatian Z, Saber K, Saber-Ayad MM, SaberiKamarposhti M, Sabour S, Sacco S, Sachdev PS, Sachdeva R, Saddik B, Saddler A, Sadee BA, Sadeghi E, Sadeghi E, Sadeghian F, Saeb MR, Saeed U, Safaeinejad F, Safi SZ, Sagar R, Saghazadeh A, Sagoe D, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahoo U, Sahu M, Saif Z, Sajid MR, Sakshaug JW, Salam N, Salamati P, Salami AA, Salaroli LB, Saleh MA, Salehi S, Salem MR, Salem MZY, Salimi S, Samadi Kafil H, Samadzadeh S, Samargandy S, Samodra YL, Samy AM, Sanabria J, Sanna F, Santomauro DF, Santos IS, Santric-Milicevic MM, Sao Jose BP, Sarasmita MA, Saraswathy SYI, Saravanan A, Saravi B, Sarikhani Y, Sarkar T, Sarmiento-Suárez R, Sarode GS, Sarode SC, Sarveazad A, Sathian B, Sathish T, Satpathy M, Sayeed A, Sayeed MA, Saylan M, Sayyah M, Scarmeas N, Schaarschmidt BM, Schlaich MP, Schlee W, Schmidt MI, Schneider IJC, Schuermans A, Schumacher AE, Schutte AE, Schwarzinger M, Schwebel DC, Schwendicke F, Šekerija M, Selvaraj S, Senapati S, Senthilkumaran S, Sepanlou SG, Serban D, Sethi Y, Sha F, Shabany M, Shafaat A, Shafie M, Shah NS, Shah PA, Shah SM, Shahabi S, Shahbandi A, Shahid I, Shahid S, Shahid W, Shahsavari HR, Shahwan MJ, Shaikh A, Shaikh MA, Shakeri A, Shalash AS, Sham S, Shamim MA, Shams-Beyranvand M, Shamshad H, Shamsi MA, Shanawaz M, Shankar A, Sharfaei S, Sharifan A, Sharifi-Rad J, Sharma R, Sharma S, Sharma U, Sharma V, Shastry RP, Shavandi A, Shayan M, Shehabeldine AME, Sheikh A, Sheikhi RA, Shen J, Shetty A, Shetty BSK, Shetty PH, Shi P, Shibuya K, Shiferaw D, Shigematsu M, Shin MJ, Shin YH, Shiri R, Shirkoohi R, Shitaye NA, Shittu A, Shiue I, Shivakumar KM, Shivarov V, Shokraneh F, Shokri A, Shool S, Shorofi SA, Shrestha S, Shuval K, Siddig EE, Silva JP, Silva LMLR, Silva S, Simpson CR, Singal A, Singh A, Singh BB, Singh G, Singh J, Singh NP, Singh P, Singh S, Sinha DN, Sinto R, Siraj MS, Sirota SB, Sitas F, Sivakumar S, Skryabin VY, Skryabina AA, Sleet DA, Socea B, Sokhan A, Solanki R, Solanki S, Soleimani H, Soliman SSM, Song S, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Spearman S, Sreeramareddy CT, Srivastava VK, Stanaway JD, Stanikzai MH, Stark BA, Starnes JR, Starodubova AV, Stein C, Stein DJ, Steinbeis F, Steiner C, Steinmetz JD, Steiropoulos P, Stevanović A, Stockfelt L, Stokes MA, Stortecky S, Subramaniyan V, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun HZ, Sun J, Sundström J, Sunkersing D, Sunnerhagen KS, Swain CK, Szarpak L, Szeto MD, Szócska M, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabish M, TADAKAMADLA JYOTHI, Tadakamadla SK, Taheri Abkenar Y, Taheri Soodejani M, Taiba J, Takahashi K, Talaat IM, Talukder A, Tampa M, Tamuzi JL, Tan KK, Tandukar S, Tang H, Tang HK, Tarigan IU, Tariku MK, Tariqujjaman M, Tarkang EE, Tavakoli Oliaee R, Tavangar SM, Taveira N, Tefera YM, Temsah MH, Temsah RMH, Teramoto M, Tesler R, Teye-Kwadjo E, Thakur R, Thangaraju P, Thankappan KR, Tharwat S, Thayakaran R, Thomas N, Thomas NK, Thomson AM, Thrift AG, Thum CCC, Thygesen LC, Tian J, Tichopad A, Ticoalu JHV, Tillawi T, Tiruye TY, Titova MV, Tonelli M, Topor-Madry R, Toriola AT, Torre AE, Touvier M, Tovani-Palone MR, Tran JT, Tran NM, Trico D, Tromans SJ, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tumurkhuu M, Tung K, Tyrovolas S, Uddin SMN, Udoakang AJ, Udoh A, Ullah A, Ullah I, Ullah S, Ullah S, Umakanthan S, Umeokonkwo CD, Unim B, Unnikrishnan B, Unsworth CA, Upadhyay E, Urso D, Usman JS, Vahabi SM, Vaithinathan AG, Valizadeh R, Van de Velde SM, Van den Eynde J, Varga O, Vart P, Varthya SB, Vasankari TJ, Vasic M, Vaziri S, Vellingiri B, Venketasubramanian N, Verghese NA, Verma M, Veroux M, Verras GI, Vervoort D, Villafañe JH, Villanueva GI, Vinayak M, Violante FS, Viskadourou M, Vladimirov SK, Vlassov V, Vo B, Vollset SE, Vongpradith A, Vos T, Vujcic IS, Vukovic R, Wafa HA, Waheed Y, Wamai RG, Wang C, Wang N, Wang S, Wang S, Wang Y, Wang YP, Waqas M, Ward P, Wassie EG, Watson S, Watson SLW, Weerakoon KG, Wei MY, Weintraub RG, Weiss DJ, Westerman R, Whisnant JL, Wiangkham T, Wickramasinghe DP, Wickramasinghe ND, Wilandika A, Wilkerson C, Willeit P, Wilson S, Wojewodzic MW, Woldegebreal DH, Wolf AW, Wolfe CDA, Wondimagegene YA, Wong YJ, Wongsin U, Wu AM, Wu C, Wu F, Wu X, Wu Z, Xia J, Xiao H, Xie Y, Xu S, Xu WD, Xu X, Xu YY, Yadollahpour A, Yamagishi K, Yang D, Yang L, Yano Y, Yao Y, Yaribeygi H, Ye P, Yehualashet SS, Yesiltepe M, Yesuf SA, Yezli S, Yi S, Yigezu A, Yiğit A, Yiğit V, Yip P, Yismaw MB, Yismaw Y, Yon DK, Yonemoto N, Yoon SJ, You Y, Younis MZ, Yousefi Z, Yu C, Yu Y, Yuh FH, Zadey S, Zadnik V, Zafari N, Zakham F, Zaki N, Zaman SB, Zamora N, Zand R, Zangiabadian M, Zar HJ, Zare I, Zarrintan A, Zeariya MGM, Zeinali Z, Zhang H, Zhang J, Zhang J, Zhang L, Zhang Y, Zhang ZJ, Zhao H, Zhong C, Zhou J, Zhu B, Zhu L, Ziafati M, Zielińska M, Zitoun OA, Zoladl M, Zou Z, Zuhlke LJ, Zumla A, Zweck E, Zyoud SH, Wool EE, Murray CJL. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00367-2. [PMID: 38582094 DOI: 10.1016/s0140-6736(24)00367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
3
|
Steinmetz JD, Seeher KM, Schiess N, Nichols E, Cao B, Servili C, Cavallera V, Cousin E, Hagins H, Moberg ME, Mehlman ML, Abate YH, Abbas J, Abbasi MA, Abbasian M, Abbastabar H, Abdelmasseh M, Abdollahi M, Abdollahi M, Abdollahifar MA, Abd-Rabu R, Abdulah DM, Abdullahi A, Abedi A, Abedi V, Abeldaño Zuñiga RA, Abidi H, Abiodun O, Aboagye RG, Abolhassani H, Aboyans V, Abrha WA, Abualhasan A, Abu-Gharbieh E, Aburuz S, Adamu LH, Addo IY, Adebayo OM, Adekanmbi V, Adekiya TA, Adikusuma W, Adnani QES, Adra S, Afework T, Afolabi AA, Afraz A, Afzal S, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad S, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed JQ, Ahmed LA, Ahmed MB, Ahmed SA, Ajami M, Aji B, Ajumobi O, Akade SE, Akbari M, Akbarialiabad H, Akhlaghi S, Akinosoglou K, Akinyemi RO, Akonde M, Al Hasan SM, Alahdab F, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Aldawsari KA, Alemi H, Alemi S, Algammal AM, Al-Gheethi AAS, Alhalaiqa FAN, Alhassan RK, Ali A, Ali EA, Ali L, Ali MU, Ali MM, Ali R, Ali S, Ali SSS, Ali Z, Alif SM, Alimohamadi Y, Aliyi AA, Aljofan M, Aljunid SM, Alladi S, Almazan JU, Almustanyir S, Al-Omari B, Alqahtani JS, Alqasmi I, Alqutaibi AY, Al-Shahi Salman R, Altaany Z, Al-Tawfiq JA, Altirkawi KA, Alvis-Guzman N, Al-Worafi YM, Aly H, Aly S, Alzoubi KH, Amani R, Amindarolzarbi A, Amiri S, Amirzade-Iranaq MH, Amu H, Amugsi DA, Amusa GA, Amzat J, Ancuceanu R, Anderlini D, Anderson DB, Andrei CL, Androudi S, Angappan D, Angesom TW, Anil A, Ansari-Moghaddam A, Anwer R, Arafat M, Aravkin AY, Areda D, Ariffin H, Arifin H, Arkew M, Ärnlöv J, Arooj M, Artamonov AA, Artanti KD, Aruleba RT, Asadi-Pooya AA, Asena TF, Asghari-Jafarabadi M, Ashraf M, Ashraf T, Atalell KA, Athari SS, Atinafu BTT, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Avan A, Ayala Quintanilla BP, Ayatollahi H, Ayinde OO, Ayyoubzadeh SM, Azadnajafabad S, Azizi Z, Azizian K, Azzam AY, Babaei M, Badar M, Badiye AD, Baghdadi S, Bagherieh S, Bai R, Baig AA, Balakrishnan S, Balalla S, Baltatu OC, Banach M, Bandyopadhyay S, Banerjee I, Baran MF, Barboza MA, Barchitta M, Bardhan M, Barker-Collo SL, Bärnighausen TW, Barrow A, Bashash D, Bashiri H, Bashiru HA, Basiru A, Basso JD, Basu S, Batiha AMM, Batra K, Baune BT, Bedi N, Begde A, Begum T, Behnam B, Behnoush AH, Beiranvand M, Béjot Y, Bekele A, Belete MA, Belgaumi UI, Bemanalizadeh M, Bender RG, Benfor B, Bennett DA, Bensenor IM, Berice B, Bettencourt PJG, Beyene KA, Bhadra A, Bhagat DS, Bhangdia K, Bhardwaj N, Bhardwaj P, Bhargava A, Bhaskar S, Bhat AN, Bhat V, Bhatti GK, Bhatti JS, Bhatti R, Bijani A, Bikbov B, Bilalaga MM, Biswas A, Bitaraf S, Bitra VR, Bjørge T, Bodolica V, Bodunrin AO, Boloor A, Braithwaite D, Brayne C, Brenner H, Briko A, Bringas Vega ML, Brown J, Budke CM, Buonsenso D, Burkart K, Burns RA, Bustanji Y, Butt MH, Butt NS, Butt ZA, Cabral LS, Caetano dos Santos FL, Calina D, Campos-Nonato IR, Cao C, Carabin H, Cárdenas R, Carreras G, Carvalho AF, Castañeda-Orjuela CA, Casulli A, Catalá-López F, Catapano AL, Caye A, Cegolon L, Cenderadewi M, Cerin E, Chacón-Uscamaita PRU, Chan JSK, Chanie GS, Charan J, Chattu VK, Chekol Abebe E, Chen H, Chen J, Chi G, Chichagi F, Chidambaram SB, Chimoriya R, Ching PR, Chitheer A, Chong YY, Chopra H, Choudhari SG, Chowdhury EK, Chowdhury R, Christensen H, Chu DT, Chukwu IS, Chung E, Coberly K, Columbus A, Comachio J, Conde J, Cortesi PA, Costa VM, Couto RAS, Criqui MH, Cruz-Martins N, Dabbagh Ohadi MA, Dadana S, Dadras O, Dai X, Dai Z, D'Amico E, Danawi HA, Dandona L, Dandona R, Darwish AH, Das S, Das S, Dascalu AM, Dash NR, Dashti M, De la Hoz FP, de la Torre-Luque A, De Leo D, Dean FE, Dehghan A, Dehghan A, Dejene H, Demant D, Demetriades AK, Demissie S, Deng X, Desai HD, Devanbu VGC, Dhama K, Dharmaratne SD, Dhimal M, Dias da Silva D, Diaz D, Dibas M, Ding DD, Dinu M, Dirac MA, Diress M, Do TC, Do THP, Doan KDK, Dodangeh M, Doheim MF, Dokova KG, Dongarwar D, Dsouza HL, Dube J, Duraisamy S, Durojaiye OC, Dutta S, Dziedzic AM, Edinur HA, Eissazade N, Ekholuenetale M, Ekundayo TC, El Nahas N, El Sayed I, Elahi Najafi MA, Elbarazi I, Elemam NM, Elgar FJ, Elgendy IY, Elhabashy HR, Elhadi M, Elilo LT, Ellenbogen RG, Elmeligy OAA, Elmonem MA, Elshaer M, Elsohaby I, Emamverdi M, Emeto TI, Endres M, Esezobor CI, Eskandarieh S, Fadaei A, Fagbamigbe AF, Fahim A, Faramarzi A, Fares J, Farjoud Kouhanjani M, Faro A, Farzadfar F, Fatehizadeh A, Fathi M, Fathi S, Fatima SAF, Feizkhah A, Fereshtehnejad SM, Ferrari AJ, Ferreira N, Fetensa G, Firouraghi N, Fischer F, Fonseca AC, Force LM, Fornari A, Foroutan B, Fukumoto T, Gadanya MA, Gaidhane AM, Galali Y, Galehdar N, Gan Q, Gandhi AP, Ganesan B, Gardner WM, Garg N, Gau SY, Gautam RK, Gebre T, Gebrehiwot M, Gebremeskel GG, Gebreslassie HG, Getacher L, Ghaderi Yazdi B, Ghadirian F, Ghaffarpasand F, Ghanbari R, Ghasemi M, Ghazy RM, Ghimire S, Gholami A, Gholamrezanezhad A, Ghotbi E, Ghozy S, Gialluisi A, Gill PS, Glasstetter LM, Gnedovskaya EV, Golchin A, Golechha M, Goleij P, Golinelli D, Gomes-Neto M, Goulart AC, Goyal A, Gray RJ, Grivna M, Guadie HA, Guan B, Guarducci G, Guicciardi S, Gunawardane DA, Guo H, Gupta B, Gupta R, Gupta S, Gupta VB, Gupta VK, Gutiérrez RA, Habibzadeh F, Hachinski V, Haddadi R, Hadei M, Hadi NR, Haep N, Haile TG, Haj-Mirzaian A, Hall BJ, Halwani R, Hameed S, Hamiduzzaman M, Hammoud A, Han H, Hanifi N, Hankey GJ, Hannan MA, Hao J, Harapan H, Hareru HE, Hargono A, Harlianto NI, Haro JM, Hartman NN, Hasaballah AI, Hasan F, Hasani H, Hasanian M, Hassan A, Hassan S, Hassanipour S, Hassankhani H, Hassen MB, Haubold J, Hay SI, Hayat K, Hegazy MI, Heidari G, Heidari M, Heidari-Soureshjani R, Hesami H, Hezam K, Hiraike Y, Hoffman HJ, Holla R, Hopf KP, Horita N, Hossain MM, Hossain MB, Hossain S, Hosseinzadeh H, Hosseinzadeh M, Hostiuc S, Hu C, Huang J, Huda MN, Hussain J, Hussein NR, Huynh HH, Hwang BF, Ibitoye SE, Ilaghi M, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Iravanpour F, Islam SMS, Ismail F, Iso H, Isola G, Iwagami M, Iwu CCD, Iyer M, Jaan A, Jacob L, Jadidi-Niaragh F, Jafari M, Jafarinia M, Jafarzadeh A, Jahankhani K, Jahanmehr N, Jahrami H, Jaiswal A, Jakovljevic M, Jamora RDG, Jana S, Javadi N, Javed S, Javeed S, Jayapal SK, Jayaram S, Jiang H, Johnson CO, Johnson WD, Jokar M, Jonas JB, Joseph A, Joseph N, Joshua CE, Jürisson M, Kabir A, Kabir Z, Kabito GG, Kadashetti V, Kafi F, Kalani R, Kalantar F, Kaliyadan F, Kamath A, Kamath S, Kanchan T, Kandel A, Kandel H, Kanmodi KK, Karajizadeh M, Karami J, Karanth SD, Karaye IM, Karch A, Karimi A, Karimi H, Karimi Behnagh A, Kasraei H, Kassebaum NJ, Kauppila JH, Kaur H, Kaur N, Kayode GA, Kazemi F, Keikavoosi-Arani L, Keller C, Keykhaei M, Khadembashiri MA, Khader YS, Khafaie MA, Khajuria H, Khalaji A, Khamesipour F, Khammarnia M, Khan M, Khan MAB, Khan YH, Khan Suheb MZ, Khanmohammadi S, Khanna T, Khatab K, Khatatbeh H, Khatatbeh MM, Khateri S, Khatib MN, Khayat Kashani HR, Khonji MS, khorashadizadeh F, Khormali M, Khubchandani J, Kian S, Kim G, Kim J, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Kochhar S, Kolahi AA, Koly KN, Kompani F, Koroshetz WJ, Kosen S, Kourosh Arami M, Koyanagi A, Kravchenko MA, Krishan K, Krishnamoorthy V, Kuate Defo B, Kuddus MA, Kumar A, Kumar GA, Kumar M, Kumar N, Kumsa NB, Kundu S, Kurniasari MD, Kusuma D, Kuttikkattu A, Kyu HH, La Vecchia C, Ladan MA, Lahariya C, Laksono T, Lal DK, Lallukka T, Lám J, Lami FH, Landires I, Langguth B, Lasrado S, Latief K, Latifinaibin K, Lau KMM, Laurens MB, Lawal BK, Le LKD, Le TTT, Ledda C, Lee M, Lee SW, Lee SW, Lee WC, Lee YH, Leonardi M, Lerango TL, Li MC, Li W, Ligade VS, Lim SS, Linehan C, Liu C, Liu J, Liu W, Lo CH, Lo WD, Lobo SW, Logroscino G, Lopes G, Lopukhov PD, Lorenzovici L, Lorkowski S, Loureiro JA, Lubinda J, Lucchetti G, Lutzky Saute R, Ma ZF, Mabrok M, Machoy M, Madadizadeh F, Magdy Abd El Razek M, Maghazachi AA, Maghbouli N, Mahjoub S, Mahmoudi M, Majeed A, Malagón-Rojas JN, Malakan Rad E, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Manilal A, Mansouri V, Mansournia MA, Marasini BP, Marateb HR, Maroufi SF, Martinez-Raga J, Martini S, Martins-Melo FR, Martorell M, März W, Marzo RR, Massano J, Mathangasinghe Y, Mathews E, Maude RJ, Maugeri A, Maulik PK, Mayeli M, Mazaheri M, McAlinden C, McGrath JJ, Meena JK, Mehndiratta MM, Mendez-Lopez MAM, Mendoza W, Mendoza-Cano O, Menezes RG, Merati M, Meretoja A, Merkin A, Mersha AM, Mestrovic T, Mi T, Miazgowski T, Michalek IM, Mihretie ET, Minh LHN, Mirfakhraie R, Mirica A, Mirrakhimov EM, Mirzaei M, Misganaw A, Misra S, Mithra P, Mizana BA, Mohamadkhani A, Mohamed NS, Mohammadi E, Mohammadi H, Mohammadi S, Mohammadi S, Mohammadshahi M, Mohammed M, Mohammed S, Mohammed S, Mohan S, Mojiri-forushani H, Moka N, Mokdad AH, Molinaro S, Möller H, Monasta L, Moniruzzaman M, Montazeri F, Moradi M, Moradi Y, Moradi-Lakeh M, Moraga P, Morovatdar N, Morrison SD, Mosapour A, Mosser JF, Mossialos E, Motaghinejad M, Mousavi P, Mousavi SE, Mubarik S, Muccioli L, Mughal F, Mukoro GD, Mulita A, Mulita F, Musaigwa F, Mustafa A, Mustafa G, Muthu S, Nagarajan AJ, Naghavi P, Naik GR, Nainu F, Nair TS, Najmuldeen HHR, Nakhostin Ansari N, Nambi G, Namdar Areshtanab H, Nargus S, Nascimento BR, Naser AY, Nashwan AJJ, Nasoori H, Nasreldein A, Natto ZS, Nauman J, Nayak BP, Nazri-Panjaki A, Negaresh M, Negash H, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nematollahi MH, Nesbit OD, Newton CRJ, Nguyen DH, Nguyen HTH, Nguyen HQ, Nguyen NTT, Nguyen PT, Nguyen VT, Niazi RK, Nikolouzakis TK, Niranjan V, Nnyanzi LA, Noman EA, Noroozi N, Norrving B, Noubiap JJ, Nri-Ezedi CA, Ntaios G, Nuñez-Samudio V, Nurrika D, Oancea B, Odetokun IA, O'Donnell MJ, Ogunsakin RE, Oguta JO, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Okwute PG, Olagunju AT, Olaiya MT, Olana MD, Olatubi MI, Oliveira GMM, Olufadewa II, Olusanya BO, Omar Bali A, Ong S, Onwujekwe OE, Ordak M, Orji AU, Ortega-Altamirano DV, Osuagwu UL, Otstavnov N, Otstavnov SS, Ouyahia A, Owolabi MO, P A MP, Pacheco-Barrios K, Padubidri JR, Pal PK, Palange PN, Palladino C, Palladino R, Palma-Alvarez RF, Pan F, Panagiotakos D, Panda-Jonas S, Pandey A, Pandey A, Pandian JD, Pangaribuan HU, Pantazopoulos I, Pardhan S, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Patel J, Patil S, Patoulias D, Pawar S, Pedersini P, Pensato U, Pereira DM, Pereira J, Pereira MO, Peres MFP, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Pham HT, Phillips MR, Pinilla-Monsalve GD, Piradov MA, Plotnikov E, Poddighe D, Polat B, Poluru R, Pond CD, Poudel GR, Pouramini A, Pourbagher-Shahri AM, Pourfridoni M, Pourtaheri N, Prakash PY, Prakash S, Prakash V, Prates EJS, Pritchett N, Purnobasuki H, Qasim NH, Qattea I, Qian G, Radhakrishnan V, Raee P, Raeisi Shahraki H, Rafique I, Raggi A, Raghav PR, Rahati MM, Rahim F, Rahimi Z, Rahimifard M, Rahman MO, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmani S, Rahmani Youshanlouei H, Rahmati M, Raj Moolambally S, Rajabpour-Sanati A, Ramadan H, Ramasamy SK, Ramasubramani P, Ramazanu S, Rancic N, Rao IR, Rao SJ, Rapaka D, Rashedi V, Rashid AM, Rashidi MM, Rashidi Alavijeh M, Rasouli-Saravani A, Rawaf S, Razo C, Redwan EMM, Rekabi Bana A, Remuzzi G, Rezaei N, Rezaei N, Rezaei N, Rezaeian M, Rhee TG, Riad A, Robinson SR, Rodrigues M, Rodriguez JAB, Roever L, Rogowski ELB, Romoli M, Ronfani L, Roy P, Roy Pramanik K, Rubagotti E, Ruiz MA, Russ TC, S Sunnerhagen K, Saad AMA, Saadatian Z, Saber K, SaberiKamarposhti M, Sacco S, Saddik B, Sadeghi E, Sadeghian S, Saeed U, Saeed U, Safdarian M, Safi SZ, Sagar R, Sagoe D, Saheb Sharif-Askari F, Saheb Sharif-Askari N, Sahebkar A, Sahoo SS, Sahraian MA, Sajedi SA, Sakshaug JW, Saleh MA, Salehi Omran H, Salem MR, Salimi S, Samadi Kafil H, Samadzadeh S, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanadgol N, Sanjeev RK, Sanmarchi F, Santomauro DF, Santri IN, Santric-Milicevic MM, Saravanan A, Sarveazad A, Satpathy M, Saylan M, Sayyah M, Scarmeas N, Schlaich MP, Schuermans A, Schwarzinger M, Schwebel DC, Selvaraj S, Sendekie AK, Sengupta P, Senthilkumaran S, Serban D, Sergindo MT, Sethi Y, SeyedAlinaghi S, Seylani A, Shabani M, Shabany M, Shafie M, Shahabi S, Shahbandi A, Shahid S, Shahraki-Sanavi F, Shahsavari HR, Shahwan MJ, Shaikh MA, Shaji KS, Sham S, Shama ATT, Shamim MA, Shams-Beyranvand M, Shamsi MA, Shanawaz M, Sharath M, Sharfaei S, Sharifan A, Sharma M, Sharma R, Shashamo BB, Shayan M, Sheikhi RA, Shekhar S, Shen J, Shenoy SM, Shetty PH, Shiferaw DS, Shigematsu M, Shiri R, Shittu A, Shivakumar KM, Shokri F, Shool S, Shorofi SA, Shrestha S, Siankam Tankwanchi AB, Siddig EE, Sigfusdottir ID, Silva JP, Silva LMLR, Sinaei E, Singh BB, Singh G, Singh P, Singh S, Sirota SB, Sivakumar S, Sohag AAM, Solanki R, Soleimani H, Solikhah S, Solomon Y, Solomon Y, Song S, Song Y, Sotoudeh H, Spartalis M, Stark BA, Starnes JR, Starodubova AV, Stein DJ, Steiner TJ, Stovner LJ, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun J, Sunkersing D, Sunny A, Susianti H, Swain CK, Szeto MD, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabai S, Tabish M, Taheri M, Tahvildari A, Tajbakhsh A, Tampa M, Tamuzi JJLL, Tan KK, Tang H, Tareke M, Tarigan IU, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Tavasol A, Tefera YM, Tehrani-Banihashemi A, Temesgen WA, Temsah MH, Teramoto M, Tesfaye AH, Tesfaye EG, Tesler R, Thakali O, Thangaraju P, Thapa R, Thapar R, Thomas NK, Thrift AG, Ticoalu JHV, Tillawi T, Toghroli R, Tonelli M, Tovani-Palone MR, Traini E, Tran NM, Tran NH, Tran PV, Tromans SJ, Truelsen TC, Truyen TTTT, Tsatsakis A, Tsegay GM, Tsermpini EE, Tualeka AR, Tufa DG, Ubah CS, Udoakang AJ, Ulhaq I, Umair M, Umakanthan S, Umapathi KK, Unim B, Unnikrishnan B, Vaithinathan AG, Vakilian A, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Vart P, Varthya SB, Vasankari TJ, Vaziri S, Vellingiri B, Venketasubramanian N, Verras GI, Vervoort D, Villafañe JH, Villani L, Vinueza Veloz AF, Viskadourou M, Vladimirov SK, Vlassov V, Volovat SR, Vu LT, Vujcic IS, Wagaye B, Waheed Y, Wahood W, Walde MT, Wang F, Wang S, Wang Y, Wang YP, Waqas M, Waris A, Weerakoon KG, Weintraub RG, Weldemariam AH, Westerman R, Whisnant JL, Wickramasinghe DP, Wickramasinghe ND, Willekens B, Wilner LB, Winkler AS, Wolfe CDA, Wu AM, Wulf Hanson S, Xu S, Xu X, Yadollahpour A, Yaghoubi S, Yahya G, Yamagishi K, Yang L, Yano Y, Yao Y, Yehualashet SS, Yeshaneh A, Yesiltepe M, Yi S, Yiğit A, Yiğit V, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Yusuf H, Zadey S, Zahedi M, Zakham F, Zaki N, Zali A, Zamagni G, Zand R, Zandieh GGZ, Zangiabadian M, Zarghami A, Zastrozhin MS, Zeariya MGM, Zegeye ZB, Zeukeng F, Zhai C, Zhang C, Zhang H, Zhang Y, Zhang ZJ, Zhao H, Zhao Y, Zheng P, Zhou H, Zhu B, Zhumagaliuly A, Zielińska M, Zikarg YT, Zoladl M, Murray CJL, Ong KL, Feigin VL, Vos T, Dua T. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:344-381. [PMID: 38493795 PMCID: PMC10949203 DOI: 10.1016/s1474-4422(24)00038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
4
|
Schumacher AE, Kyu HH, Aali A, Abbafati C, Abbas J, Abbasgholizadeh R, Abbasi MA, Abbasian M, Abd ElHafeez S, Abdelmasseh M, Abd-Elsalam S, Abdelwahab A, Abdollahi M, Abdoun M, Abdullahi A, Abdurehman AM, Abebe M, Abedi A, Abedi A, Abegaz TM, Abeldaño Zuñiga RA, Abhilash ES, Abiodun OO, Aboagye RG, Abolhassani H, Abouzid M, Abreu LG, Abrha WA, Abrigo MRM, Abtahi D, Abu Rumeileh S, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Acuna JM, Adair T, Addo IY, Adebayo OM, Adegboye OA, Adekanmbi V, Aden B, Adepoju AV, Adetunji CO, Adeyeoluwa TE, Adeyomoye OI, Adha R, Adibi A, Adikusuma W, Adnani QES, Adra S, Afework A, Afolabi AA, Afraz A, Afyouni S, Afzal S, Agasthi P, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad T, Ahmadi K, Ahmadzade AM, Ahmadzade M, Ahmed A, Ahmed H, Ahmed LA, Ahmed MB, Ahmed SA, Ajami M, Aji B, Ajumobi O, Akalu GT, Akara EM, Akinosoglou K, Akkala S, Akyirem S, Al Hamad H, Al Hasan SM, Al Homsi A, Al Qadire M, Ala M, Aladelusi TO, AL-Ahdal TMA, Alalalmeh SO, Al-Aly Z, Alam K, Alam M, Alam Z, Al-amer RM, Alanezi FM, Alanzi TM, Albashtawy M, AlBataineh MT, Aldridge RW, Alemi S, Al-Eyadhy A, Al-Gheethi AAS, Alhabib KF, Alhalaiqa FAN, Al-Hanawi MK, Ali A, Ali A, Ali BA, Ali H, Ali MU, Ali R, Ali SSS, Ali Z, Alian Samakkhah S, Alicandro G, Alif SM, Aligol M, Alimi R, Aliyi AA, Al-Jumaily A, Aljunid SM, Almahmeed W, Al-Marwani S, Al-Maweri SAA, Almazan JU, Al-Mekhlafi HM, Almidani O, Alomari MA, Alonso N, Alqahtani JS, Alqutaibi AY, Al-Sabah SK, Altaf A, Al-Tawfiq JA, Altirkawi KA, Alvi FJ, Alwafi H, Al-Worafi YM, Aly H, Alzoubi KH, Amare AT, Ameyaw EK, Amhare AF, Amin TT, Amindarolzarbi A, Aminian Dehkordi J, Amiri S, Amu H, Amugsi DA, Amzat J, Ancuceanu R, Anderlini D, Andrade PP, Andrei CL, Andrei T, Angappan D, Anil A, Anjum A, Antony CM, Antriyandarti E, Anuoluwa IA, Anwar SL, Anyasodor AE, Appiah SCY, Aqeel M, Arabloo J, Arabzadeh Bahri R, Arab-Zozani M, Arafat M, Araújo AM, Aravkin AY, Aremu A, Ariffin H, Aripov T, Armocida B, Arooj M, Artamonov AA, Artanti KD, Arulappan J, Aruleba IT, Aruleba RT, Arumugam A, Asaad M, Asgary S, Ashemo MY, Ashraf M, Asika MO, Athari SS, Atout MMW, Atreya A, Attia S, Aujayeb A, Avan A, Awotidebe AW, Ayala Quintanilla BP, Ayanore MA, Ayele GM, Ayuso-Mateos JL, Ayyoubzadeh SM, Azadnajafabad S, Azhar GS, Aziz S, Azzam AY, Babashahi M, Babu AS, Badar M, Badawi A, Badiye AD, Baghdadi S, Bagheri N, Bagherieh S, Bah S, Bahadorikhalili S, Bai J, Bai R, Baker JL, Bakkannavar SM, Bako AT, Balakrishnan S, Balogun SA, Baltatu OC, Bam K, Banach M, Bandyopadhyay S, Banik B, Banik PC, Bansal H, Barati S, Barchitta M, Bardhan M, Barker-Collo SL, Barone-Adesi F, Barqawi HJ, Barr RD, Barrero LH, Basharat Z, Bashir AIJ, Bashiru HA, Baskaran P, Basnyat B, Bassat Q, Basso JD, Basu S, Batra K, Batra R, Baune BT, Bayati M, Bayileyegn NS, Beaney T, Bedi N, Begum T, Behboudi E, Behnoush AH, Beiranvand M, Bejarano Ramirez DF, Belgaumi UI, Bell ML, Bello AK, Bello MB, Bello OO, Belo L, Beloukas A, Bendak S, Bennett DA, Bensenor IM, Benzian H, Berezvai Z, Berman AE, Bermudez ANC, Bettencourt PJG, Beyene HB, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhandari D, Bhardwaj N, Bhardwaj P, Bhardwaj PV, Bhargava A, Bhaskar S, Bhat V, Bhatti GK, Bhatti JS, Bhatti MS, Bhatti R, Bhutta ZA, Bikbov B, Binmadi N, Bintoro BS, Biondi A, Bisignano C, Bisulli F, Biswas A, Biswas RK, Bitaraf S, Bjørge T, Bleyer A, Boampong MS, Bodolica V, Bodunrin AO, Bolarinwa OA, Bonakdar Hashemi M, Bonny A, Bora K, Bora Basara B, Borodo SB, Borschmann R, Botero Carvajal A, Bouaoud S, Boudalia S, Boyko EJ, Bragazzi NL, Braithwaite D, Brenner H, Britton G, Browne AJ, Brunoni AR, Bulamu NB, Bulto LN, Buonsenso D, Burkart K, Burns RA, Burugina Nagaraja S, Busse R, Bustanji Y, Butt ZA, Caetano dos Santos FL, Cai T, Calina D, Cámera LA, Campos LA, Campos-Nonato IR, Cao C, Cardenas CA, Cárdenas R, Carr S, Carreras G, Carrero JJ, Carugno A, Carvalho F, Carvalho M, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Catapano AL, Cattaruzza MS, Caye A, Cederroth CR, Cembranel F, Cenderadewi M, Cercy KM, Cerin E, Cevik M, Chacón-Uscamaita PRU, Chahine Y, Chakraborty C, Chan JSK, Chang CK, Charalampous P, Charan J, Chattu VK, Chatzimavridou-Grigoriadou V, Chavula MP, Cheema HA, Chen AT, Chen H, Chen L, Chen MX, Chen S, Cherbuin N, Chew DS, Chi G, Chirinos-Caceres JL, Chitheer A, Cho SMJ, Cho WCS, Chong B, Chopra H, Choudhary R, Chowdhury R, Chu DT, Chukwu IS, Chung E, Chung E, Chung SC, Cini KI, Clark CCT, Coberly K, Columbus A, Comfort H, Conde J, Conti S, Cortesi PA, Costa VM, Cousin E, Cowden RG, Criqui MH, Cruz-Martins N, Culbreth GT, Cullen P, Cunningham M, da Silva e Silva D, Dadana S, Dadras O, Dai Z, Dalal K, Dalli LL, Damiani G, D'Amico E, Daneshvar S, Darwesh AM, Das JK, Das S, Dash NR, Dashti M, Dávila-Cervantes CA, Davis Weaver N, Davletov K, De Leo D, Debele AT, Degenhardt L, Dehbandi R, Deitesfeld L, Delgado-Enciso I, Delgado-Ortiz L, Demant D, Demessa BH, Demetriades AK, Deng X, Denova-Gutiérrez E, Deribe K, Dervenis N, Des Jarlais DC, Desai HD, Desai R, Deuba K, Devanbu VGC, Dey S, Dhali A, Dhama K, Dhimal ML, Dhimal M, Dhingra S, Dias da Silva D, Diaz D, Dima A, Ding DD, Dirac MA, Dixit A, Dixit SG, Do TC, Do THP, do Prado CB, Dodangeh M, Dokova KG, Dolecek C, Dorsey ER, dos Santos WM, Doshi R, Doshmangir L, Douiri A, Dowou RK, Driscoll TR, Dsouza HL, Dube J, Dumith SC, Dunachie SJ, Duncan BB, Duraes AR, Duraisamy S, Durojaiye OC, Dutta S, Dzianach PA, Dziedzic AM, Ebenezer O, Eboreime E, Ebrahimi A, Echieh CP, Ed-Dra A, Edinur HA, Edvardsson D, Edvardsson K, Efendi D, Efendi F, Eghdami S, Eikemo TA, Eini E, Ekholuenetale M, Ekpor E, Ekundayo TC, El Arab RA, El Morsi DAW, El Sayed Zaki M, El Tantawi M, Elbarazi I, Elemam NM, Elgar FJ, Elgendy IY, ElGohary GMT, Elhabashy HR, Elhadi M, Elmeligy OAA, Elshaer M, Elsohaby I, Emami Zeydi A, Emamverdi M, Emeto TI, Engelbert Bain L, Erkhembayar R, Eshetie TC, Eskandarieh S, Espinosa-Montero J, Estep K, Etaee F, Eze UA, Fabin N, Fadaka AO, Fagbamigbe AF, Fahimi S, Falzone L, Farinha CSES, Faris MEM, Farjoud Kouhanjani M, Faro A, Farrokhpour H, Fatehizadeh A, Fattahi H, Fauk NK, Fazeli P, Feigin VL, Fekadu G, Fereshtehnejad SM, Feroze AH, Ferrante D, Ferrara P, Ferreira N, Fetensa G, Filip I, Fischer F, Flavel J, Flaxman AD, Flor LS, Florin BT, Folayan MO, Foley KM, Fomenkov AA, Force LM, Fornari C, Foroutan B, Foschi M, Francis KL, Franklin RC, Freitas A, Friedman J, Friedman SD, Fukumoto T, Fuller JE, Gaal PA, Gadanya MA, Gaihre S, Gaipov A, Gakidou E, Galali Y, Galehdar N, Gallus S, Gan Q, Gandhi AP, Ganesan B, Garg J, Gau SY, Gautam P, Gautam RK, Gazzelloni F, Gebregergis MW, Gebrehiwot M, Gebremariam TB, Gerema U, Getachew ME, Getachew T, Gething PW, Ghafourifard M, Ghahramani S, Ghailan KY, Ghajar A, Ghanbarnia MJ, Ghasemi M, Ghasemzadeh A, Ghassemi F, Ghazy RM, Ghimire S, Gholamian A, Gholamrezanezhad A, Ghorbani Vajargah P, Ghozali G, Ghozy S, Ghuge AD, Gialluisi A, Gibson RM, Gil AU, Gill PS, Gill TK, Gillum RF, Ginindza TG, Girmay A, Glasbey JC, Gnedovskaya EV, Göbölös L, Goel A, Goldust M, Golechha M, Goleij P, Golestanfar A, Golinelli D, Gona PN, Goudarzi H, Goudarzian AH, Goyal A, Greenhalgh S, Grivna M, Guarducci G, Gubari MIM, Gudeta MD, Guha A, Guicciardi S, Gunawardane DA, Gunturu S, Guo C, Gupta AK, Gupta B, Gupta IR, Gupta RD, Gupta S, Gupta VB, Gupta VK, Gupta VK, Gutiérrez RA, Habibzadeh F, Habibzadeh P, Hachinski V, Haddadi M, Haddadi R, Haep N, Hajj Ali A, Halboub ES, Halim SA, Hall BJ, Haller S, Halwani R, Hamadeh RR, Hamagharib Abdullah K, Hamidi S, Hamiduzzaman M, Hammoud A, Hanifi N, Hankey GJ, Hannan MA, Haque MN, Harapan H, Haro JM, Hasaballah AI, Hasan F, Hasan I, Hasan MT, Hasani H, Hasanian M, Hasanpour- Dehkordi A, Hassan AM, Hassan A, Hassanian-Moghaddam H, Hassanipour S, Haubold J, Havmoeller RJ, Hay SI, Hbid Y, Hebert JJ, Hegazi OE, Heidari G, Heidari M, Heidari-Foroozan M, Heidari-Soureshjani R, Helfer B, Herteliu C, Hesami H, Hettiarachchi D, Heyi DZ, Hezam K, Hiraike Y, Hoffman HJ, Holla R, Horita N, Hossain MB, Hossain MM, Hossain S, Hosseini MS, Hosseinzadeh H, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hsairi M, Hsieh VCR, Hu C, Huang J, Huda MN, Hugo FN, Hultström M, Hussain J, Hussain S, Hussein NR, Huy LD, Huynh HH, Hwang BF, Ibitoye SE, Idowu OO, Ijo D, Ikuta KS, Ilaghi M, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Inbaraj LR, Iradukunda A, Iravanpour F, Iregbu KC, Islam MR, Islam MM, Islam SMS, Islami F, Ismail NE, Isola G, Iwagami M, Iwu CCD, Iwu-Jaja CJ, Iyer M, J LM, Jaafari J, Jacob L, Jacobsen KH, Jadidi-Niaragh F, Jafarinia M, Jaggi K, Jahankhani K, Jahanmehr N, Jahrami H, Jain A, Jain N, Jairoun AA, Jakovljevic M, Jalilzadeh Yengejeh R, Jamshidi E, Jani CT, Janko MM, Jatau AI, Jayapal SK, Jayaram S, Jeganathan J, Jema AT, Jemere DM, Jeong W, Jha AK, Jha RP, Ji JS, Jiang H, Jin Y, Jin Y, Johnson O, Jomehzadeh N, Jones DP, Joo T, Joseph A, Joseph N, Joshua CE, Jozwiak JJ, Jürisson M, Kaambwa B, Kabir A, Kabir H, Kabir Z, Kadashetti V, Kahe F, Kakodkar PV, Kalani R, Kalankesh LR, Kaliyadan F, Kalra S, Kamath A, Kamireddy A, Kanagasabai T, Kandel H, Kanmiki EW, Kanmodi KK, Kantar RS, Kapoor N, Karajizadeh M, Karami Matin B, Karanth SD, Karaye IM, Karim A, Karimi H, Karimi SE, Karimi Behnagh A, Karkhah S, Karna AK, Kashoo FZ, Kasraei H, Kassaw NA, Kassebaum NJ, Kassel MB, Katamreddy A, Katikireddi SV, Katoto PDMC, Kauppila JH, Kaur N, Kaydi N, Kayibanda JF, Kayode GA, Kazemi F, Kazemian S, Kazeminia S, Keikavoosi-Arani L, Keller C, Kempen JH, Kerr JA, Kesse-Guyot E, Keykhaei M, Khadembashiri MM, Khadembashiri MA, Khafaie MA, Khajuria H, Khalafi M, Khalaji A, Khalid N, Khalil IA, Khamesipour F, Khan A, Khan G, Khan I, Khan IA, Khan M, Khan MAB, Khan T, Khan suheb MZ, Khanmohammadi S, Khatab K, Khatami F, Khavandegar A, Khayat Kashani HR, Kheirallah KA, Khidri FF, Khodadoust E, Khormali M, Khosrowjerdi M, Khubchandani J, Khusun H, Kifle ZD, Kim G, Kim J, Kimokoti RW, Kinzel KE, Kiross GT, Kisa A, Kisa S, Kiss JB, Kivimäki M, Klu D, Knudsen AKS, Kolahi AA, Kompani F, Koren G, Kosen S, Kostev K, Kotnis AL, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Kravchenko MA, Krishan K, Krishna H, Krishnamoorthy V, Krishnamoorthy Y, Krohn KJ, Kuate Defo B, Kubeisy CM, Kucuk Bicer B, Kuddus MA, Kuddus M, Kuitunen I, Kujan O, Kulimbet M, Kulkarni V, Kumar A, Kumar H, Kumar N, Kumar R, Kumar S, Kumari M, Kurmanova A, Kurmi OP, Kusnali A, Kusuma D, Kutluk T, Kuttikkattu A, Kyei EF, Kyriopoulos I, La Vecchia C, Ladan MA, Laflamme L, Lahariya C, Lahmar A, Lai DTC, Laksono T, Lal DK, Lalloo R, Lallukka T, Lám J, Lamnisos D, Lan T, Lanfranchi F, Langguth B, Lansingh VC, Laplante-Lévesque A, Larijani B, Larsson AO, Lasrado S, Latief K, Latif M, Latifinaibin K, Lauriola P, Le LKD, Le NHH, Le TTT, Le TDT, Lee M, Lee PH, Lee SW, Lee SW, Lee WC, Lee YH, Legesse SM, Leigh J, Lenzi J, Leong E, Lerango TL, Li MC, Li W, Li X, Li Y, Li Z, Libra M, Ligade VS, Likaka ATM, Lim LL, Lin RT, Lin S, Lioutas VA, Listl S, Liu J, Liu S, Liu X, Livingstone KM, Llanaj E, Lo CH, Loreche AM, Lorenzovici L, Lotfi M, Lotfizadeh M, Lozano R, Lubinda J, Lucchetti G, Lugo A, Lunevicius R, Ma J, Ma S, Ma ZF, Mabrok M, Machairas N, Machoy M, Madsen C, Magaña Gómez JA, Maghazachi AA, Maharaj SB, Maharjan P, Mahjoub S, Mahmoud MA, Mahmoudi E, Mahmoudi M, Makram OM, Malagón-Rojas JN, Malakan Rad E, Malekzadeh R, Malhotra AK, Malhotra K, Malik AA, Malik I, Malinga LA, Malta DC, Mamun AA, Manla Y, Mannan F, Mansoori Y, Mansour A, Mansouri V, Mansournia MA, Mantovani LG, Marasini BP, Marateb HR, Maravilla JC, Marconi AM, Mardi P, Marino M, Marjani A, Marrugo Arnedo CA, Martinez-Guerra BA, Martinez-Piedra R, Martins CA, Martins-Melo FR, Martorell M, Marx W, Maryam S, Marzo RR, Mate KKV, Matei CN, Mathioudakis AG, Maude RJ, Maugeri A, May EA, Mayeli M, Mazaheri M, Mazidi M, Mazzotti A, McAlinden C, McGrath JJ, McKee M, McKowen ALW, McLaughlin SA, McPhail MA, McPhail SM, Mechili EA, Mediratta RP, Meena JK, Mehari M, Mehlman ML, Mehra R, Mehrabani-Zeinabad K, Mehrabi Nasab E, Mehrotra R, Mekonnen MM, Mendoza W, Menezes RG, Mengesha EW, Mensah GA, Mensah LG, Mentis AFA, Meo SA, Meretoja A, Meretoja TJ, Mersha AM, Mesfin BA, Mestrovic T, Mhlanga A, Mhlanga L, Mi T, Micha G, Michalek IM, Miller TR, Mindlin SN, Minelli G, Minh LHN, Mini GK, Minja NW, Mirdamadi N, Mirghafourvand M, Mirica A, Mirinezhad SK, Mirmosayyeb O, Mirutse MK, Mirza-Aghazadeh-Attari M, Mirzaei M, Misgana T, Misra S, Mitchell PB, Mithra P, Mittal C, Mittal M, Moazen B, Mohamed AI, Mohamed J, Mohamed MFH, Mohamed NS, Mohammad-Alizadeh-Charandabi S, Mohammadi S, Mohammadian-Hafshejani A, Mohammad-pour S, Mohammadshahi M, Mohammed M, Mohammed S, Mohammed S, Mojiri-forushani H, Mokdad AH, Mokhtarzadehazar P, Momenzadeh K, Momtazmanesh S, Monasta L, Moni MA, Montazeri F, Moodi Ghalibaf A, Moradi M, Moradi Y, Moradi-Lakeh M, Moradinazar M, Moradpour F, Moraga P, Morawska L, Moreira RS, Morovatdar N, Morrison SD, Morze J, Mosaddeghi Heris R, Mosser JF, Mossialos E, Mostafavi H, Mostofinejad A, Mougin V, Mouodi S, Mousavi P, Mousavi SE, Mousavi Khaneghah A, Mpundu-Kaambwa C, Mrejen M, Mubarik S, Muccioli L, Mueller UO, Mughal F, Mukherjee S, Mukoro GD, Mulita A, Mulita F, Muniyandi M, Munjal K, Musaigwa F, Musallam KM, Mustafa G, Muthu S, Muthupandian S, Myung W, Nabhan AF, Nafukho FM, Nagarajan AJ, Naghavi M, Naghavi P, Naik GR, Naik G, Naimzada MD, Nair S, Nair TS, Najmuldeen HHR, Naldi L, Nangia V, Nargus S, Nascimento BR, Nascimento GG, Naser AY, Nasiri MJ, Natto ZS, Nauman J, Naveed M, Nayak BP, Nayak VC, Nayyar AK, Nazri-Panjaki A, Negash H, Negero AK, Negoi I, Negoi RI, Negru SM, Nejadghaderi SA, Nejjari C, Nematollahi MH, Nena E, Nepal S, Nesbit OD, Newton CRJ, Ngunjiri JW, Nguyen DH, Nguyen PT, Nguyen PT, Nguyen TT, Nguyen VT, Nigatu YT, Nikolouzakis TK, Nikoobar A, Nikpoor AR, Nizam MA, Nomura S, Noreen M, Noroozi N, Norouzian Baghani A, Norrving B, Noubiap JJ, Novotney A, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nuñez-Samudio V, Nurrika D, Oancea B, Obamiro KO, Odetokun IA, Ofakunrin AOD, Ogunsakin RE, Oguta JO, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okidi L, Okonji OC, Okwute PG, Olagunju AT, Olaiya MT, Olanipekun TO, Olatubi MI, Olivas-Martinez A, Oliveira GMM, Oliver S, Olorukooba AA, Olufadewa II, Olusanya BO, Olusanya JO, Oluwafemi YD, Oluwatunase GO, Omar HA, Omer GL, Ong S, Onwujekwe OE, Onyedibe KI, Opio JN, Ordak M, Orellana ER, Orisakwe OE, Orish VN, Orru H, Ortega-Altamirano DV, Ortiz A, Ortiz-Brizuela E, Ortiz-Prado E, Osuagwu UL, Otoiu A, Otstavnov N, Ouyahia A, Ouyang G, Owolabi MO, Oyeyemi IT, Oyeyemi OT, Ozten Y, P A MP, Padubidri JR, Pahlavikhah Varnosfaderani M, Pal PK, Palicz T, Palladino C, Palladino R, Palma-Alvarez RF, Pana A, Panahi P, Pandey A, Pandi-Perumal SR, Pando-Robles V, Pangaribuan HU, Panos GD, Pantazopoulos I, Papadopoulou P, Pardhan S, Parikh RR, Park S, Parthasarathi A, Pashaei A, Pasupula DK, Patel JR, Patel SK, Pathan AR, Patil A, Patil S, Patoulias D, Patthipati VS, Paudel U, Pawar S, Pazoki Toroudi H, Pease SA, Peden AE, Pedersini P, Peng M, Pensato U, Pepito VCF, Peprah EK, Pereira G, Pereira J, Pereira M, Peres MFP, Perianayagam A, Perico N, Petcu IR, Petermann-Rocha FE, Pezzani R, Pham HT, Phillips MR, Pierannunzio D, Pigeolet M, Pigott DM, Pilgrim T, Pinheiro M, Piradov MA, Plakkal N, Plotnikov E, Poddighe D, Pollner P, Poluru R, Pond CD, Postma MJ, Poudel GR, Poudel L, Pourali G, Pourtaheri N, Prada SI, Pradhan PMS, Prajapati VK, Prakash V, Prasad CP, Prasad M, Prashant A, Prates EJS, Purnobasuki H, Purohit BM, Puvvula J, Qaisar R, Qasim NH, Qattea I, Qian G, Quan NK, Radfar A, Radhakrishnan V, Raee P, Raeisi Shahraki H, Rafiei Alavi SN, Rafique I, Raggi A, Rahim F, Rahman MM, Rahman M, Rahman MA, Rahman T, Rahmani AM, Rahmani S, Rahnavard N, Rai P, Rajaa S, Rajabpour-Sanati A, Rajput P, Ram P, Ramadan H, Ramasamy SK, Ramazanu S, Rana J, Rana K, Ranabhat CL, Rancic N, Rani S, Ranjan S, Rao CR, Rao IR, Rao M, Rao SJ, Rasali DP, Rasella D, Rashedi S, Rashedi V, Rashid AM, Rasouli-Saravani A, Rastogi P, Rasul A, Ravangard R, Ravikumar N, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghian-Jahromi I, Reddy MMRK, Redwan EMM, Rehman FU, Reiner Jr RC, Remuzzi G, Reshmi B, Resnikoff S, Reyes LF, Rezaee M, Rezaei N, Rezaei N, Rezaeian M, Riaz MA, Ribeiro AI, Ribeiro DC, Rickard J, Rios-Blancas MJ, Robinson-Oden HE, Rodrigues M, Rodriguez JAB, Roever L, Rohilla R, Rohloff P, Romadlon DS, Ronfani L, Roshandel G, Roshanzamir S, Rostamian M, Roy B, Roy P, Rubagotti E, Rumisha SF, Rwegerera GM, Rynkiewicz A, S M, S N C, S Sunnerhagen K, Saad AMA, Sabbatucci M, Saber K, Saber-Ayad MM, Sacco S, Saddik B, Saddler A, Sadee BA, Sadeghi E, Sadeghi M, Sadeghian S, Saeed U, Saeedi M, Safi S, Sagar R, Saghazadeh A, Saheb Sharif-Askari N, Sahoo SS, Sahraian MA, Sajedi SA, Sajid MR, Sakshaug JW, Salahi S, Salahi S, Salamati P, Salami AA, Salaroli LB, Saleh MA, Salehi S, Salem MR, Salem MZY, Salimi S, Samadi Kafil H, Samadzadeh S, Samara KA, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanabria J, Sanadgol N, Sanganyado E, Sanjeev RK, Sanmarchi F, Sanna F, Santri IN, Santric-Milicevic MM, Sarasmita MA, Saravanan A, Saravi B, Sarikhani Y, Sarkar C, Sarmiento-Suárez R, Sarode GS, Sarode SC, Sarveazad A, Sathian B, Sathish T, Sattin D, Saulam J, Sawyer SM, Saxena S, Saya GK, Sayadi Y, Sayeed A, Sayeed MA, Saylan M, Scarmeas N, Schaarschmidt BM, Schlee W, Schmidt MI, Schuermans A, Schwebel DC, Schwendicke F, Šekerija M, Selvaraj S, Semreen MH, Senapati S, Sengupta P, Senthilkumaran S, Sepanlou SG, Serban D, Sertsu A, Sethi Y, SeyedAlinaghi S, Seyedi SA, Shafaat A, Shafaat O, Shafie M, Shafiee A, Shah NS, Shah PA, Shahabi S, Shahbandi A, Shahid I, Shahid S, Shahid W, Shahwan MJ, Shaikh MA, Shakeri A, Shakil H, Sham S, Shamim MA, Shams-Beyranvand M, Shamshad H, Shamshirgaran MA, Shamsi MA, Shanawaz M, Shankar A, Sharfaei S, Sharifan A, Shariff M, Sharifi-Rad J, Sharma M, Sharma R, Sharma S, Sharma V, Shastry RP, Shavandi A, Shaw DH, Shayan AM, Shehabeldine AME, Sheikh A, Sheikhi RA, Shen J, Shenoy MM, Shetty BSK, Shetty RS, Shey RA, Shiani A, Shibuya K, Shiferaw D, Shigematsu M, Shin JI, Shin MJ, Shiri R, Shirkoohi R, Shittu A, Shiue I, Shivakumar KM, Shivarov V, Shool S, Shrestha S, Shuja KH, Shuval K, Si Y, Sibhat MM, Siddig EE, Sigfusdottir ID, Silva JP, Silva LMLR, Silva S, Simões JP, Simpson CR, Singal A, Singh A, Singh A, Singh A, Singh BB, Singh B, Singh M, Singh M, Singh NP, Singh P, Singh S, Siraj MS, Sitas F, Sivakumar S, Skryabin VY, Skryabina AA, Sleet DA, Slepak ELN, Sohrabi H, Soleimani H, Soliman SSM, Solmi M, Solomon Y, Song Y, Sorensen RJD, Soriano JB, Soyiri IN, Spartalis M, Sreeramareddy CT, Starnes JR, Starodubov VI, Starodubova AV, Stefan SC, Stein DJ, Steinbeis F, Steiropoulos P, Stockfelt L, Stokes MA, Stortecky S, Stranges S, Stroumpoulis K, Suleman M, Suliankatchi Abdulkader R, Sultana A, Sun J, Sunkersing D, Susanty S, Swain CK, Sykes BL, Szarpak L, Szeto MD, Szócska M, Tabaee Damavandi P, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabb KM, Tabish M, Taborda-Barata LM, Tabuchi T, Tadesse BT, Taheri A, Taheri Abkenar Y, Taheri Soodejani M, Taherkhani A, Taiba J, Tajbakhsh A, Talaat IM, Talukder A, Tamuzi JL, Tan KK, Tang H, Tang HK, Tat NY, Tat VY, Tavakoli Oliaee R, Tavangar SM, Taveira N, Tebeje TM, Tefera YM, Teimoori M, Temsah MH, Temsah RMH, Teramoto M, Tesfaye SH, Thangaraju P, Thankappan KR, Thapa R, Thapar R, Thomas N, Thrift AG, Thum CCC, Tian J, Tichopad A, Ticoalu JHV, Tiruye TY, Tohidast SA, Tonelli M, Touvier M, Tovani-Palone MR, Tram KH, Tran NM, Trico D, Trihandini I, Tromans SJ, Truong VT, Truyen TTTT, Tsermpini EE, Tumurkhuu M, Tung K, Tyrovolas S, Ubah CS, Udoakang AJ, Udoh A, Ulhaq I, Ullah S, Ullah S, Umair M, Umar TP, Umeokonkwo CD, Umesh A, Unim B, Unnikrishnan B, Upadhyay E, Urso D, Vacante M, Vahdani AM, Vaithinathan AG, Valadan Tahbaz S, Valizadeh R, Van den Eynde J, Varavikova E, Varga O, Varma SA, Vart P, Varthya SB, Vasankari TJ, Veerman LJ, Venketasubramanian N, Venugopal D, Verghese NA, Verma M, Verma P, Veroux M, Verras GI, Vervoort D, Vieira RJ, Villafañe JH, Villani L, Villanueva GI, Villeneuve PJ, Violante FS, Visontay R, Vlassov V, Vo B, Vollset SE, Volovat SR, Volovici V, Vongpradith A, Vos T, Vujcic IS, Vukovic R, Wado YD, Wafa HA, Waheed Y, Wamai RG, Wang C, Wang D, Wang F, Wang S, Wang S, Wang Y, Wang YP, Ward P, Watson S, Weaver MR, Weerakoon KG, Weiss DJ, Weldemariam AH, Wells KM, Wen YF, Werdecker A, Westerman R, Wickramasinghe DP, Wickramasinghe ND, Wijeratne T, Wilson S, Wojewodzic MW, Wool EE, Woolf AD, Wu D, Wulandari RD, Xiao H, Xu B, Xu X, Yadav L, Yaghoubi S, Yang L, Yano Y, Yao Y, Ye P, Yesera GE, Yesodharan R, Yesuf SA, Yiğit A, Yiğit V, Yip P, Yon DK, Yonemoto N, You Y, Younis MZ, Yu C, Zadey S, Zadnik V, Zafari N, Zahedi M, Zahid MN, Zahir M, Zakham F, Zaki N, Zakzuk J, Zamagni G, Zaman BA, Zaman SB, Zamora N, Zand R, Zandi M, Zandieh GGZ, Zanghì A, Zare I, Zastrozhin MS, Zeariya MGM, Zeng Y, Zhai C, Zhang C, Zhang H, Zhang H, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao Y, Zhao Y, Zheng P, Zhong C, Zhou J, Zhu B, Zhu Z, Ziaeefar P, Zielińska M, Zou Z, Zumla A, Zweck E, Zyoud SH, Lim SS, Murray CJL. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024:S0140-6736(24)00476-8. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
Collapse
|
5
|
Liu S, Sharp A, Lane S, Villanueva EV, Lu Z, Ma ZF. Low Iodine Nutrition Knowledge in Chinese Breastfeeding Women despite Adequate Iodine Status. Nutrients 2024; 16:491. [PMID: 38398815 PMCID: PMC10891795 DOI: 10.3390/nu16040491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
There has been a scarcity of evidence about iodine nutrition knowledge among women during pregnancy and lactation. The aim of this study was to determine women's iodine knowledge and the relationship between knowledge and iodine status during pregnancy and lactation. Women were recruited from a hospital in the western part of China in the third trimester of pregnancy and followed until the end of the first week of lactation. The women's iodine status was measured by their urinary iodine concentration (UIC) and an iodine-specific, validated food frequency questionnaire (FFQ). Iodine nutrition knowledge was assessed using an iodine nutrition knowledge questionnaire. A total of 200 women (mean age of 29.0 ± 4.2 years) completed the whole study. The majority of the women did not consume enough iodine during both pregnancy and lactation (231.89 vs. 237.26 µg/day). The overall mean iodine knowledge scores in our sample of women during pregnancy and lactation were 4.77 and 4.87, indicating low iodine knowledge. The use of iodized salt and a higher education level were significantly associated with an increased iodine knowledge score. In conclusion, this study reported poor iodine nutrition knowledge in women, highlighting a public health concern. Therefore, the iodine knowledge of women should be improved, possibly via maternal health campaigns to avoid the consequences of iodine deficiency disorders in newborns.
Collapse
Affiliation(s)
- Shuchang Liu
- Department of Biological Sciences, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China
- Harris-Wellbeing Research Centre, Faculty of Health & Life Sciences, University of Liverpool, Liverpool L8 7SS, UK
- School of Health and Sport Sciences, Liverpool Hope University, Liverpool L16 9JD, UK
| | - Andrew Sharp
- Harris-Wellbeing Research Centre, Faculty of Health & Life Sciences, University of Liverpool, Liverpool L8 7SS, UK
| | - Steven Lane
- Health Data Science, University of Liverpool, Liverpool L69 3BX, UK
| | - Elmer V. Villanueva
- School of Science, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China
- First Year College, Victoria University, Footscray, VIC 3011, Australia
| | - Zhiliang Lu
- Department of Biological Sciences, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China
| | - Zheng Feei Ma
- School of Science, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, University of the West of England, Bristol BS16 1QY, UK
| |
Collapse
|
6
|
Liu S, Sharp A, Luo X, Lane S, Villanueva EV, Lu Z, Ma ZF. The use of breast milk iodine concentration in the first week of lactation as a biomarker of iodine status in breast-feeding women. Br J Nutr 2024; 131:286-295. [PMID: 37642155 DOI: 10.1017/s0007114523001897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Breast milk iodine concentration (BMIC) is a promising indicator of iodine status in lactating women. However, there are limited data on its usefulness to reflect maternal iodine deficiency. Therefore, the aim of our study was to assess iodine concentration in breast milk and urine samples in exclusively breast-feeding women. Eligible pregnant women undergoing routine antenatal care in a large hospital in Shaanxi Province, China, were followed up from the third trimester of pregnancy until the first week of lactation. Urine samples (20 ml) were collected during pregnancy and lactation. Iodine concentration in samples was measured based on Sandell-Kolthoff reaction. Breast milk samples (5 ml) were provided during lactation. A receiver operating curve (ROC) was constructed to determine the diagnostic performance of BMIC. An iodine-specific FFQ was completed twice during pregnancy and lactation. A total of 200 women completed the study. The overall median BMIC was 89 μg/l, indicating iodine sufficiency (i.e. BMIC reference range between 60 and 465 μg/l). Women reported similar median urinary iodine concentration (UIC) during pregnancy and lactation (112 and 113 μg/l, respectively), but their iodine status differed - mild-to-moderate iodine deficiency during pregnancy and iodine sufficiency during lactation. The ROC for BMIC using UIC as a reference standard was 0·755 (95 % CI: 0·644, 0·866). In conclusion, this study demonstrated that women were iodine sufficient in the first week of lactation as assessed by UIC, which was consistent with BMIC. These findings suggested that BMIC is a useful biomarker to assess iodine status in lactating women.
Collapse
Affiliation(s)
- Shuchang Liu
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou215123, People's Republic of China
- Harris-Wellbeing Research Centre, Faculty of Health & Life Sciences, University of Liverpool, LiverpoolL8 7SS, UK
| | - Andrew Sharp
- Harris-Wellbeing Research Centre, Faculty of Health & Life Sciences, University of Liverpool, LiverpoolL8 7SS, UK
| | - Xiaoqin Luo
- School of Public Health, Xi'an Jiaotong University, Xi'an710006, People's Republic of China
| | - Steven Lane
- Health Data Science, University of Liverpool, Liverpool, UK
| | - Elmer V Villanueva
- School of Science, Xi'an Jiaotong-Liverpool University, Suzhou215123, People's Republic of China
- Victoria University, Footscray Victoria Melbourne3011, Australia
| | - Zhiliang Lu
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou215123, People's Republic of China
| | - Zheng Feei Ma
- School of Science, Xi'an Jiaotong-Liverpool University, Suzhou215123, People's Republic of China
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, University of the West of England, BristolBS16 1QY, UK
| |
Collapse
|
7
|
Ma ZF. Relationship of household cooking salt and eating out on iodine status of Chinese pregnant women in environmental iodine-deficient coastal areas. Br J Nutr 2023; 130:2206. [PMID: 37475619 DOI: 10.1017/s0007114523001654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Affiliation(s)
- Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| |
Collapse
|
8
|
Liu S, Sharp A, Lu Z, Ma ZF. Maternal iodine intake and adherence to iodine supplement recommendations in a group of Chinese women: the results from the WIN cohort study - CORRIGENDUM. Proc Nutr Soc 2023; 82:492. [PMID: 37078399 DOI: 10.1017/s0029665123002768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Affiliation(s)
- S Liu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
- Harris-Wellbeing Research Centre, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - A Sharp
- Harris-Wellbeing Research Centre, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - Z Lu
- Department of Biological Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Z F Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| |
Collapse
|
9
|
Zhang J, Li Q, Zhang J, Zhao X, Jiang M, Huang X, Liu D, Yan Y, Li X, Chen J, Ma ZF, Zhang X, Ming WK, Wong TH, Yan G, Wu Y. Chinese university students' preferences for physical activity incentive programs: a discrete choice experiment. Front Public Health 2023; 11:1281740. [PMID: 38026342 PMCID: PMC10646335 DOI: 10.3389/fpubh.2023.1281740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This study aims to explore and compare Chinese university students' preferences for various physical activity motivation programs. Patients and methods A cross-sectional study was conducted in China from February 25 to March 25, 2022. Participants anonymously completed an online questionnaire based on a DCE. A total of 1,358 university students participated in the survey. The conditional logit model (CLM), willingness to accept (WTA), and propensity score matching (PSM) were used to assess college students' preferences for different attributes and levels of physical activity incentive programs. Results Respondents identified the number of bonus, exercise time, and academic rewards as the three most significant attributes of the athletic incentive program. The importance of each attribute varied based on individual characteristics such as gender and BMI. In CLM, college students displayed a preference for a "¥4" bonus amount (OR: 2.04, 95% CI 1.95-2.13), "20 min" of exercise time (OR: 1.85, 95% CI 1.79-1.92), and "bonus points for comprehensive test scores" as academic rewards (OR: 1.33, 95% CI 1.28-1.37). According to the WTA results, college students were willing to accept the highest cost to obtain academic rewards tied to composite test scores. Conclusion The number of bonus, exercise time, and academic rewards emerge as the three most crucial attributes of physical activity incentive programs. Furthermore, college students with different characteristics exhibit heterogeneity in their preferences for such programs. These findings can guide the development of programs and policies aimed at motivating college students to engage in physical activities.
Collapse
Affiliation(s)
- Jingbo Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Qing Li
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Jinzi Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Xianqi Zhao
- School of Public Health, Shandong University, Jinan, China
| | - Maomin Jiang
- School of Public Affairs, Xiamen University, Xiamen, China
| | - Xincheng Huang
- School of Economics and Management, Beijing Institute of Graphic Communication, Beijing, China
| | - Diyue Liu
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Yupei Yan
- Department of Humanities, Arts and Media, Changzhi Medical College, Changzhi, China
| | - Xialei Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
| | - Xiyue Zhang
- Alliance Manchester Business School, University of Manchester, Manchester, United Kingdom
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Tak-hap Wong
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Guanyun Yan
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| |
Collapse
|
10
|
Ma ZF. Editorial: Nutrient requirements and diabetes during pregnancy. Front Nutr 2023; 10:1270576. [PMID: 37955020 PMCID: PMC10634607 DOI: 10.3389/fnut.2023.1270576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/25/2023] [Indexed: 11/14/2023] Open
Affiliation(s)
- Zheng Feei Ma
- College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
| |
Collapse
|
11
|
He MJ, Ji LD, Lian L, Ma ZF, Luo YT, Lai JL, Wang KJ. [Epidemiological trend of early-onset gastric cancer and late-onset gastric cancer in China from 2000 to 2019]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1198-1202. [PMID: 37661609 DOI: 10.3760/cma.j.cn112338-20230302-00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Objective: In order to understand the changing trends of gastric cancer incidence and mortality in early-onset and late-onset in China from 2000 to 2019. Methods: The Global Burden of Disease research data was collected, and Excel and R 4.2.1 softwares were used to examine the incidence rate, mortality rate, and disability-adjusted life years (DALY) of Chinese people from 2000 to 2019, with a focus on gender, age, and year. Results: In 2019, the crude incidence rates were 7.06/100 000 (95%UI: 6.63/100 000-7.59/100 000) and 114.52/100 000 (95%UI: 108.79/100 000-121.63/100 000) for early- and late-onset gastric cancer, respectively. The crude mortality rate for early-onset gastric cancer was 3.29/100 000 (95%UI: 3.11/100 000- 3.50/100 000), while the crude mortality rate for late-onset gastric cancer was 81.88/100 000 (95%UI: 78.15/100 000-86.04/100 000). Additionally, the crude DALY rates for these two types of gastric cancer were 156.48/100 000 (95%UI: 148.82/100 000-165.84/100 000) and 1 750.13/100 000 (95%UI: 1 661.21/100 000-1 852.99/100 000). The standardized incidence of early-onset gastric cancer decreased from 5.49/100 000 in 2000 to 4.76/100 000 in 2019, and that of late-onset gastric cancer decreased from 143.45/100 000 in 2000 to 123.02/100 000 in 2019.The standardized mortality rate of early-onset gastric cancer decreased from 4.16/100 000 in 2000 to 2.18/100 000 in 2019, and that of late-onset gastric cancer decreased from 140.82/100 000 in 2000 to 91.49/100 000 in 2019. The standardized DALY rate for early-onset gastric cancer in 2019 was 105.87/100 000 (95%UI: 87.98/100 000 -125.60/100 000), lower than 198.84/100 000 (95%UI: 179.47/100 000- 219.83/100 000) in 2000. The standardized DALY rate for late onset gastric cancer in 2019 was 1 821.11/100 000 (95%UI: 1 509.42/100 000-2 158.53/100 000), lower than 2 932.52/100 000 (95%UI: 2 665.92/100 000-3 252.60/100 000) in 2000. Conclusions: The standardized mortality rate of early-onset gastric cancer in China showed a decreasing trend from 2000 to 2019. The standardized mortality rate of late onset gastric cancer showed a trend of first increasing and then decreasing. Notably, the incidence, mortality, and DALY of late-onset gastric cancer were significantly higher than those of early-onset gastric cancer during this period. Additionally, male incidence, mortality, and crude DALY rates were higher than female.
Collapse
Affiliation(s)
- M J He
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - L D Ji
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - L Lian
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Z F Ma
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y T Luo
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - J L Lai
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - K J Wang
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China Key Laboratory of Tumor Epidemiology of Henan Province/State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou 450001, China
| |
Collapse
|
12
|
Ma Y, Zhou M, Yu W, Zou Z, Ge P, Ma ZF, Tong Y, Li W, Li Q, Li Y, Zhu S, Sun X, Wu Y. Using the Unified Theory of Acceptance and Use of Technology (UTAUT) and e-health literacy(e-HL) to investigate the tobacco control intentions and behaviors of non-smoking college students in China: a cross-sectional investigation. BMC Public Health 2023; 23:765. [PMID: 37098499 PMCID: PMC10127360 DOI: 10.1186/s12889-023-15644-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/10/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Non-smoking college students are starting to smoke in increasing numbers, which shows that their tobacco control situation seems not optimistic. The UTAUT and e-HL are commonly used models and theories to predict health behaviors, while there are few studies on tobacco control. This paper aims to study the influencing factors of tobacco control intention and behavior of non-smoking college students in China by combining the UTAUT and e-HL. METHODS Based on the stratified sampling method, 625 college students from 12 universities were selected. Data were collected using a self-made questionnaire designed based on the UTAUT and e-health literacy scales. Data were analyzed by SPSS 22 and AMOS 26, including descriptive statistics, one-way variance analysis and structural equation model analysis. RESULTS The results of one-way variance analysis showed that there were significant differences in the score of non-smoking college students' tobacco control intention or behavior by hometowns, monthly living expenses, and parents' smoking history. Performance expectancy, effort expectancy, social influence had direct positive effects on behavioral intention. Facilitating condition, behavioral intention had direct positive impacts on use behavior and e-HL had an indirect positive impact on use behavior. CONCLUSIONS The combination of the UTAUT and e-HL can be used as an appropriate framework to predict the influencing factors of non-smoking college students' intention and behavior of tobacco control. Improving performance expectancy, effort expectancy, and e-HL among non-smoking college students, creating positive social environments, and providing facilitating condition are key aspects of increasing their tobacco control intention and behavior. It is also beneficial to promote the implementation of smoke-free campus and smoke-free family projects.
Collapse
Affiliation(s)
- Yuanyuan Ma
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Mengxia Zhou
- School of Media and Communication, Shanghai Jiaotong University, Shanghai, 201100, China
| | - Wenli Yu
- School of Foreign Languages, Weifang University of Science and Technology, Shouguang, 262700, China
| | - Ziyue Zou
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Pu Ge
- School of Management, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, BS16 1QY, UK
| | - Yuting Tong
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Wei Li
- Department of Second Clinical Medical School, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Qiyu Li
- School of Humanities and Health Management, Jinzhou Medical University, Jinzhou, 121000, China
| | - Yunshan Li
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Siya Zhu
- School of Foreign Languages, Anhui University of Technology, Anhui, 243000, China
| | - Xinying Sun
- School of Public Health, Peking University, Haidian District, 38 Xueyuan Road, Beijing, 100191, China.
| | - Yibo Wu
- School of Public Health, Peking University, Haidian District, 38 Xueyuan Road, Beijing, 100191, China.
| |
Collapse
|
13
|
He J, Liu X, Lu X, Zhong M, Jia C, Lucero-Prisno DE, Ma ZF, Li H. The impact of COVID-19 on global health journals: an analysis of impact factor and publication trends. BMJ Glob Health 2023; 8:bmjgh-2022-011514. [PMID: 37012001 PMCID: PMC10083532 DOI: 10.1136/bmjgh-2022-011514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/09/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND COVID-19 has affected research productivity across all areas of knowledge. Current evidence suggests that COVID-19 has had a blockbuster effect on journal impact factors (JIFs) and publication trends, while little is known on global health journals. METHODS Twenty global health journals were included to analyse the impact of COVID-19 on their JIFs and publication trends. Indicator data, including numbers of publications, citations, articles with different types, etc, were extracted from journal websites and Web of Science Core Collection database. The JIFs from 2019 to 2021 were simulated for longitudinal and cross-sectional analyses. Interrupted time-series analysis and non-parametric tests were applied to assess whether COVID-19 had decreased non-COVID-19 publications from January 2018 to June 2022. RESULTS In 2020, 615 out of 3223 publications were COVID-19 related, accounting for 19.08%. The simulated JIFs of 17 out of 20 journals in 2021 were higher than those in 2019 and 2020. Notably, 18 out of 20 journals had a decrease in their simulated JIFs after excluding COVID-19-related publications. Moreover, 10 out of 20 journals decreased their monthly numbers of non-COVID-19 publications after the COVID-19 outbreak. For all the 20 journals as a whole, after the COVID-19 outbreak in February 2020, the total number of non-COVID-19 publications significantly decreased by 14.2 compared with the previous month (p=0.013), and since then, on average, the publications had decreased by 0.6 per month until June 2022 (p<0.001). CONCLUSIONS COVID-19 has impacted the structure of COVID-19-related publications, the JIFs of global health journals and their numbers of non-COVID-19 publications. Although journals may benefit from increased JIFs, global health journals should avoid relying on a single metric. More follow-up studies including more years of data with a combination of metrics should be conducted to generate more robust evidence.
Collapse
Affiliation(s)
- Jiaxin He
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Xinliang Liu
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Xinyang Lu
- Department of Mathematical Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Meiling Zhong
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Changli Jia
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Don Eliseo Lucero-Prisno
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Hao Li
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| |
Collapse
|
14
|
Wang G, Zheng C, Lu M, Luo L, Wan Z, Ma ZF. Assessment of knowledge, attitudes, practices, and risk perceptions regarding COVID-19: a cross-sectional study from China. Z Gesundh Wiss 2023:1-11. [PMID: 37361275 PMCID: PMC10020754 DOI: 10.1007/s10389-023-01877-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
Aim To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices.
Collapse
Affiliation(s)
- Guiping Wang
- Laboratory Animal Center, Medical College of Soochow University, 199 Ren’ai Road, Suzhou, China
| | - Canjie Zheng
- Quzhou Center for Disease Control and Prevention, Quzhou, 324000 Zhejiang province China
| | - Mingxia Lu
- Henan Provincial Center for Disease Control and Prevention, No.105 Nongye South Road, Zhengzhou, 450016 Henan China
| | - Lan Luo
- School of Public Health, Soochow University, 199 Ren’ai Road, Suzhou, 215123 China
| | - Zhongxiao Wan
- School of Public Health, Soochow University, 199 Ren’ai Road, Suzhou, 215123 China
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Ren’ai Road, Suzhou, 215123 China
| | - Zheng Feei Ma
- Center for Public Health, School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
- Center for Public Health, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| |
Collapse
|
15
|
Ma ZF. Micronutrients as a Possible and Modifiable Risk Factor for COVID-19 During Pregnancy. Biol Trace Elem Res 2023; 201:1063-1064. [PMID: 35391600 PMCID: PMC8989252 DOI: 10.1007/s12011-022-03230-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/01/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China.
| |
Collapse
|
16
|
Qu B, Wu S, Zhao P, Ma ZF, Goodacre R, Yuan L, Chen Y. Geographical pattern of minerals and its association with health disparities in the USA. Environ Geochem Health 2023:10.1007/s10653-023-01510-1. [PMID: 36805365 DOI: 10.1007/s10653-023-01510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to determine the common latent patterns of geographical distribution of health-related minerals across the USA and to evaluate the real-world cumulative effects of these patterns on overall population health. It was an ecological study using county-level data (3080 contiguous counties) on the concentrations of 14 minerals (i.e., aluminum, arsenic, calcium, copper, iron, lead, magnesium, manganese, mercury, phosphorus, selenium, sodium, titanium, zinc) in stream sediments (or surface soils), and the measurements of overall health including life expectancy at birth, age-specific mortality risks and cause-specific (summarized by 21 mutually exclusive groups) mortality rates. Latent class analysis (LCA) was employed to identify the common clusters of life expectancy-related minerals based on their concentration characteristics. Multivariate linear regression analyses were then conducted to examine the relationship between the LCA-derived clusters and the health measurements, with adjustment for potential confounding factors. Five minerals (i.e., arsenic, calcium, selenium, sodium and zinc) were associated with life expectancy and were analyzed in LCA. Three clusters were determined across the USA, the 'common' (n = 2056, 66.8%), 'infertile' (n = 739, 24.0%) and 'plentiful' (n = 285, 9.3%) clusters. Residents in counties with the 'infertile' profile were associated with the shortest life expectancy, highest mortality risks at all ages, and highest mortality rates for many reasons including the top five leading causes of death: cardiovascular diseases, neoplasms, neurological disorders, chronic respiratory conditions, and diabetes, urogenital, blood and endocrine diseases. Results remained statistically significant after confounding adjustment. Our study brings novel perspectives regarding environmental geochemistry to explain health disparities in the USA.
Collapse
Affiliation(s)
- Bingjie Qu
- Xi'an Jiaotong-Liverpool University, Wisdom Lake Academy of Pharmacy, Suzhou, China
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Shiqiang Wu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Peng Zhao
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Royston Goodacre
- Department of Biochemistry and Systems Biology, Centre for Metabolomics Research, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Linxi Yuan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Ying Chen
- Xi'an Jiaotong-Liverpool University, Wisdom Lake Academy of Pharmacy, Suzhou, China.
| |
Collapse
|
17
|
Gong F, Yi P, Yu L, Fan S, Gao G, Jin Y, Zeng L, Li Y, Ma ZF. Media use degree and depression: A latent profile analysis from Chinese residents. Front Psychol 2023; 13:1070774. [PMID: 36733883 PMCID: PMC9887043 DOI: 10.3389/fpsyg.2022.1070774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Background Previous studies have emphasized the media as an essential channel for understanding information about depression. However, they have not divided groups according to the degree of media use to study their differences in depression. Therefore, this study aims to explore the influence of media use on depression and the influencing factors of depression in people with different media use degrees. Methods Based on seven items related to media use, a total of 11, 031 respondents were categorized by the frequency of media use using latent profile analysis (LPA). Secondly, multiple linear regression analyzes were conducted to analyze the effects of depression in people with different degrees of media use. Finally, factors influencing depression among people with different degrees of media use were explored separately. Results All respondents were classified into three groups: media use low-frequency (9.7%), media use general (67.1%), and media use high-frequency (23.2%). Compared with media use general group, media use low-frequency (β = 0.019, p = 0.044) and media use high-frequency (β = 0.238, p < 0.001) groups are significantly associated with depression. The factors influencing depression in the population differed between media use low-frequency, media use general, and media use high-frequency groups. Conclusion The government and the appropriate departments should develop targeted strategies for improving the overall health status of people with different media use degrees.
Collapse
Affiliation(s)
- Fangmin Gong
- College of Literature and Journalism Communication, Jishou University, Jishou, China
| | - Pei Yi
- College of Literature and Journalism Communication, Jishou University, Jishou, China,Pei Yi,
| | - Lian Yu
- College of Public Health, Xi’an Jiaotong University Health Science Center, Xi'an, China,*Correspondence: Lian Yu,
| | - Siyuan Fan
- Department of Preventive Medicine, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Guangze Gao
- Tongliao Clinical College, Inner Mongolia Medical University, Tongliao, China
| | - Yile Jin
- Baotou Clinical College, Inner Mongolia Medical University, Baotou, China
| | - Leixiao Zeng
- College of Journalism and Communication, Renmin University of China, Beijing, China
| | - Yang Li
- College of Communication and Art Design, University of Shanghai for Science and Technology, Shanghai, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
| |
Collapse
|
18
|
Chen Y, Ma ZF, Yu D, Jiang Z, Wang B, Yuan L. Geographical distribution of trace elements (selenium, zinc, iron, copper) and case fatality rate of COVID-19: a national analysis across conterminous USA. Environ Geochem Health 2022; 44:4423-4436. [PMID: 35098416 PMCID: PMC8801196 DOI: 10.1007/s10653-022-01204-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/09/2022] [Indexed: 06/01/2023]
Abstract
Severe outcome particularly death is the largest burden of COVID-19. Clinical observations showed preliminary data that deficiency in certain trace elements, essential for the normal activity of immune system, may be associated with worse COVID-19 outcome. Relevant study of environmental epidemiology has yet to be explored. We investigated the geographical association between concentrations of Se, Zn, Fe and Cu in surface soils and case fatality rate of COVID-19 in USA. Two sets of database, including epidemiological data of COVID-19 (including case fatality rate, from the University of John Hopkinson) and geochemical concentration data of Se, Zn, Fe and Cu in surface soils (from the National Geochemical Survey), were mapped according to geographical location at the county level across conterminous USA. Characteristics of population, socio-demographics and residential environment by county were also collected. Seven cross-sectional sampling dates, with a 4-week interval between adjacent dates, constructed an observational investigation over 24 weeks from October 8, 2020, to March 25, 2021. Multivariable fractional (logit) outcome regression analyses were used to assess the association with adjustment for potential confounding factors. In USA counties with the lowest concentration of Zn, the case fatality rate of COVID-19 was the highest, after adjustment for other influencing factors. Associations of Se, Fe and Cu with case fatality rate of COVID-19 were either inconsistent over time or disappeared after adjustment for Zn. Our large study provides epidemiological evidence suggesting an association of Zn with COVID-19 severity, suggesting Zn deficiency should be avoided.
Collapse
Affiliation(s)
- Ying Chen
- Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Dahai Yu
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, ST5 5BG, UK
| | - Zifei Jiang
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Bo Wang
- Suzhou Centre for Disease Control and Prevention, Suzhou, 215004, China
| | - Linxi Yuan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China.
| |
Collapse
|
19
|
Wen C, Wei J, Ma ZF, He M, Zhao S, Ji J, He D. Heterogeneous epidemic modelling within an enclosed space and corresponding Bayesian estimation. Infect Dis Model 2022; 7:1-24. [PMID: 35287302 PMCID: PMC8906904 DOI: 10.1016/j.idm.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/19/2022] Open
Abstract
Since March 11th, 2020, COVID-19 has been a global pandemic for more than one years due to a long and infectious incubation period. This paper establishes a heterogeneous epidemic model that divides the incubation period into infectious and non-infectious and employs the Bayesian framework to model the ‘Diamond Princess’ enclosed space incident. The heterogeneity includes two different identities, two transmission methods, two different-size rooms, and six transmission stages. This model is also applicable to similar mixed structures, including closed schools, hospitals, and communities. As the COVID-19 pandemic continues, our mathematical modeling can provide management insights to the governments and policymakers on how the COVID-19 disease has spread and what prevention strategies still need to be taken. A completely data-driven linear heterogeneous epidemic model for a relatively enclosed space composed of subspaces up to three people is developed. The heterogeneity of the model includes the following five aspects: two different identities, two infection sources, two transmission methods, two different-size rooms, and six transmission stages. A probabilistic algorithm to calculate the change in the subspace distribution of people is constructed. A simple method is introduced to calculate the basic reproduction number R0 for different infection sources. An improved approximate Bayesian updating computation method based on entirely non-informative priors that simultaneously infers any number of unknown parameters is proposed.
Collapse
Affiliation(s)
- Conghua Wen
- Department of Financial and Actuarial Mathematics, School of Science, Xi'an Jiaotong-Liverpool University, China
| | - Junwei Wei
- Department of Financial and Actuarial Mathematics, School of Science, Xi'an Jiaotong-Liverpool University, China
| | - Zheng Feei Ma
- Department of Health and Environmental Science, School of Science, Xi'an Jiaotong-Liverpool University, China
| | - Mu He
- Department of Foundational Mathematics, School of Science, Xi'an Jiaotong-Liverpool University, China
- Corresponding author.
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- CUHK Shenzhen Research Institute, Shenzhen, China
| | - Jiayu Ji
- Department of Kinesiology & Physical Education, University of Toronto, CA, Canada
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
- Corresponding author.
| |
Collapse
|
20
|
Cao Y, Ma ZF, Zhang Y, Zhang Y. Evaluation of lifestyle, attitude and stressful impact amid COVID-19 among adults in Shanghai, China. Int J Environ Health Res 2022; 32:1137-1146. [PMID: 33164565 DOI: 10.1080/09603123.2020.1841887] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/21/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to evaluate the impact of the COVID-19 pandemic on the psychological health and mental health-related lifestyles in Shanghai, China. In the cross-sectional study conducted in May 2020, participants were asked to complete a validated questionnaire including the impact of event scale (IES), social and family support, lifestyle changes, and indicators of negative mental health impact. A total of 430 participants (303 females and 127 males) completed the questionnaire. The overall mean of IES score was 32.3 ± 12.2, indicating a moderate-to-severe mental stress impact. Moreover, there were 68.4% of participant who had IES score ≥26. Females were more likely to get increased support from family and friends, share feeling with them and others, and care for family member's feeling (all P < 0.05). In conclusion, although the COVID-19 pandemic was correlated with high stressful impact, it had associated with some positive mental-health related changes in an urban environment.
Collapse
Affiliation(s)
- Yang Cao
- Department of Health Promotion, Pudong Maternal and Child Health Care Institution, Shanghai, 201399, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Yutong Zhang
- Jinzhou Medical University, Jinzhou, 121001, China
| | - Yingfei Zhang
- Mathematics Teaching and Research Office, Public Basic College, Jinzhou Medical University, Jinzhou, 121001, China
| |
Collapse
|
21
|
Liu S, Ma ZF. Reference Intervals of the Ratio of Urine Iodine to Creatinine in Pregnant Women in an Iodine-Replete Area of China : Reference Intervals of the Ratio of Urine Iodine to Creatinine in Pregnant Women in an Iodine-Replete Area of China. Biol Trace Elem Res 2022; 200:2053-2054. [PMID: 34279843 DOI: 10.1007/s12011-021-02831-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Shuchang Liu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
- Faculty of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China.
| |
Collapse
|
22
|
Liu X, Ren N, Ma ZF, Zhong M, Li H. Risk factors on healthcare-associated infections among tuberculosis hospitalized patients in China from 2001 to 2020: a systematic review and meta-analysis. BMC Infect Dis 2022; 22:392. [PMID: 35443620 PMCID: PMC9019792 DOI: 10.1186/s12879-022-07364-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background China has been still suffering from high burden attributable to tuberculosis (TB) and healthcare-associated infections (HAIs). TB patients are at high risk to get HAIs. Evidence-based guidelines or regulations to constrain the rising HAIs among TB hospitalized patients are needed in China. The aim of this systematic review and meta-analysis is to investigate the risk factors associated with HAIs among TB hospitalized patients in Chinese hospitals. Methods Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 to December 31st 2020. Meta-analyses of ORs of the risk factors between patients with HAIs and patients without HAIs among TB hospitalized patients were estimated. Heterogeneity among studies was assessed based on the \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\widehat{{\uptau }}$$\end{document}τ^2 and I2 statistics to select the meta-analysis model. Review Manager 5.3 was employed and P < 0.05 was considered as statistical significance. Results 851 records were filtered from the databases, of which 11 studies were included in the quantitative meta-analysis. A total of 11,922 TB patients were included in the systematic review and meta-analysis, of which 1133 were diagnosed as having HAIs. Age older than 60 years (OR: 2.89 [2.01–4.15]), complications (OR: 3.28 [2.10–5.13]), diabetes mellitus (OR: 1.63 [1.22–2.19]), invasive procedure (OR: 3.80 [2.25–6.42]), longer than 15 hospitalization days (OR: 2.09 [1.64–2.64]), secondary tuberculosis (OR: 2.25 [1.48–3.42]), smoking (OR: 1.40[1.02–1.93]), underlying disease (OR: 2.66 [1.53–4.62]), and use of antibiotics (OR: 2.77 [2.35–3.27]) were the main risk factors associated with HAIs among TB hospitalized patients with a statistical significance (P < 0.05). Conclusions Age older than 60 years, presence of complications, presence of diabetes mellitus, invasive procedure, longer than 15 hospitalization days, secondary tuberculosis, smoking, presence of underlying disease, and use of antibiotics were the main risk factors which had a negative impact on HAIs among TB hospitalized patients in Chinese hospitals. These findings provided evidence for policy makers and hospital managers to make effective infection prevention and control measures to constrain the rising HAIs. It is also required that more cost-effective infection prevention and control measures should be widely applied in routinely medical treatment and clinical management to reduce the occurrence of HAIs among TB hospitalized patients. Supplementary information The online version contains supplementary material available at 10.1186/s12879-022-07364-9.
Collapse
Affiliation(s)
- Xinliang Liu
- School of Public Health/Global Health Institute, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, China.,Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, M13 9PL, UK
| | - Nili Ren
- Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, 430030, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, Jiangsu, China
| | - Meiling Zhong
- School of Public Health/Global Health Institute, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, China
| | - Hao Li
- School of Public Health/Global Health Institute, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, China.
| |
Collapse
|
23
|
Yuan L, Ma ZF, Zhang M, Qin L, Yin X, Han F. Hair Se Is a Sensitive Biomarker to Monitor the Effects of Se Supplementation in Elderly. Biol Trace Elem Res 2022; 200:488-496. [PMID: 33738684 DOI: 10.1007/s12011-021-02674-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/14/2021] [Indexed: 11/24/2022]
Abstract
It is rapidly increasing to have selenium (Se) supplementation for urban elderly population in China since they are facing a widespread deficiency daily Se intake. However, until now, there is no low-cost, non-invasive, rapid, and reliable method to monitor the health improvement or risk for elderly Se-supplemented population in China. The present cross-sectional study (229 participants with older than 55 years old) performed in Beijing, China, revealed that the Se concentrations of non-supplementer users (n = 27) were 55 ± 23 μg/L in urine, 139.9 ± 102.3 μg/L in serum, and 487.6 ± 158.7 μg/kg in hair. But a significant increase on hair Se concentrations (615.4 ± 238.8 μg/kg) was observed for Se supplementer users (n = 202) (p < 0.05); there were no significant statistical differences in serum and urine between the Se-supplemented (n = 202) and Se non-supplemented groups (n = 27). This indicated the hair Se levels could be a more sensitive biomarker for Se-supplemented elderly population. Participants who consumed Se supplements for 7-12 months had the highest Se status based on hair and serum Se concentrations (p < 0.05). The present study also revealed that most elderly adults in Beijing just need to supplement 50 μg Se per day to achieve Se plateau status. Furthermore, hair Se levels were positively related with triglycerides/TG levels (p < 0.05) but not body mass index/BMI, total cholesterol/TC, and low-density lipoprotein cholesterol/LDL, implicating Se supplementation for Se sufficiency baseline in elderly population in Beijing likely posed health risk, especially on TG because of excessive Se oxidation stress. An ongoing monitoring of Se status via hair is still warranted to prevent future Se deficiency or excess in China.
Collapse
Affiliation(s)
- Linxi Yuan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Jiangsu, 215123, Suzhou, China.
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Jiangsu, 215123, Suzhou, China
| | - Minming Zhang
- Key Laboratory of Functional Agriculture, Suzhou Research Institute, University of Science and Technology of China, Suzhou, 215123, Jiangsu, China
| | - Liqiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Xuebin Yin
- Key Laboratory of Functional Agriculture, Suzhou Research Institute, University of Science and Technology of China, Suzhou, 215123, Jiangsu, China
| | - Feng Han
- Research Centre, Soochow Setek Biotechnology Co., Ltd., Suzhou, 215123, Jiangsu, China
| |
Collapse
|
24
|
Luo X, Zhang W, He Z, Yang H, Gao J, Wu P, Ma ZF. Dietary Vitamin C Intake Is Associated With Improved Liver Function and Glucose Metabolism in Chinese Adults. Front Nutr 2022; 8:779912. [PMID: 35174195 PMCID: PMC8841761 DOI: 10.3389/fnut.2021.779912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases worldwide. Dietary vitamin C intake might play an important role in reducing the risk of NAFLD. This study assesses the relationship between dietary vitamin C intake and diagnostic biomarkers of NAFLD. Methods The data from the 2009 China Health and Nutrition Survey (CHNS), nine provinces across four diverse regions (Northeast, East Coast, Central, and West) were included in the study. The dietary vitamin C intake of participants was calculated based on 3-day 24-h diet questionnaires at the individual level. The associations of dietary vitamin C intake and the biochemical indicators of liver function and glucose/lipid metabolism were determined. Results A total of 8,307 participants were included in the final analysis. The mean dietary vitamin C intake for the overall, male and female subjects was 79.8 ± 58.6, 81.6 ± 55.3, and 78.2 ± 61.2 mg/day, respectively. The prevalence of inadequate dietary vitamin C intake for the overall, male and female subjects was 24.4, 26.5, and 22.6%, respectively. Intake of vitamin C was associated with both lower concentrations of plasma ferritin and hemoglobin A1c (HbA1c). Higher dietary vitamin C intake was associated with higher albumin, even further adjusted for body mass index (BMI), residence, and smoking status. No improvement in lipid metabolism was found. Conclusion This study demonstrated that higher dietary vitamin C intake is a benefit for improving glucose metabolism and liver function in which reducing ferritin, a biomarker of iron accumulation, may be involved.
Collapse
Affiliation(s)
- Xiaoqin Luo
- Department of Nutrition and Food Safety of School of Public Health, Xi'an Jiaotong University, Xi'an, China
- *Correspondence: Xiaoqin Luo
| | - Wanyu Zhang
- Department of Nutrition and Food Safety of School of Public Health, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Health Supervision Center, Xi'an, China
| | - Zhangya He
- Department of Nutrition and Food Safety of School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Hexiang Yang
- Department of Nutrition and Food Safety of School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Jiayi Gao
- Department of Nutrition and Food Safety of School of Public Health, Xi'an Jiaotong University, Xi'an, China
- Emergency Medical Center, Xi'an Public Health Center, Xi'an, China
| | - Pei Wu
- Department of Nutrition and Food Safety of School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
- Zheng Feei Ma
| |
Collapse
|
25
|
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Chee Woon Wang
- Department of Biochemistry, Faculty of Medicine, MAHSA University, Jenjarom, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| |
Collapse
|
26
|
Zulkifli KK, Tan PO, Mustaffa N, Chuah YY, Muthukaruppan R, Ma ZF, Lee YY. Is Gut Involvement a Cause or Effect of COVID-19? Malays J Med Sci 2021; 28:186-193. [PMID: 35002498 PMCID: PMC8715874 DOI: 10.21315/mjms2021.28.6.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 06/24/2021] [Indexed: 01/08/2023] Open
Abstract
Digestive disorder symptoms in COVID-19 may be similar in form to post-infectious functional gastrointestinal disorder (PI-FGID). To cause clinical effects, SARS-CoV-2 must reach the bowels and gastric hypochlorhydria may facilitate such transit. Asian elderly are predisposed to greater infection rate and severity of COVID-19, and the high prevalence of gastric atrophy and intake of proton-pump inhibitor in this aged group might explain the risk. Persistence shedding of SARS-CoV-2 in stools indicates that faecal transmission should not be disregarded. Gut involvement in COVID-19 is mediated by angiotensin-converting enzyme 2 (ACE2) receptor, which serves as the entry point for SARS-CoV-2 in the small bowel. ACE2 dysregulation has an impact on the homeostasis of gut microbiota and altered inflammatory response. Liver injury is variable in COVID-19 and is likely a result of by-stander effects rather than actual viropathic process. Further research is needed to understand if gut involvement is a cause or effect of SARS-CoV-2.
Collapse
Affiliation(s)
| | - Phei Oon Tan
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nazri Mustaffa
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Yoen Young Chuah
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ping Tung Christian Hospital, Ping Tung, Taiwan
| | - Raman Muthukaruppan
- Department of Medicine and Gastroenterology Unit, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
| | - Zheng Feei Ma
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
27
|
Liu D, Luo L, Xie F, Yu Z, Ma ZF, Wang Y, Wan Z. Factors associated with the willingness and acceptance of SARS-CoV-2 vaccine from adult subjects in China. Hum Vaccin Immunother 2021; 17:2405-2414. [PMID: 33759691 PMCID: PMC8475565 DOI: 10.1080/21645515.2021.1899732] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/01/2021] [Indexed: 12/22/2022] Open
Abstract
Aim: We aimed to investigate factors affecting the willingness and acceptance of the SARS-CoV-2 vaccination among adults in China and sources of knowledge about the vaccine.Methods: A cross-sectional, web-based survey was conducted from September 8th to 15th, 2020, comprising of 23 questions. Binary logistic regression analysis was performed to examine factors associated with vaccination willingness and acceptance.Results: A total of 983 questionnaires were included and 81.3% of the participants were willing to receive the SARS-CoV-2 vaccine. With a "bachelor degree or above" (OR = 0.56, p = 0.020) and believing that the vaccine would not cause SARS-CoV-2 infection (OR = 0.50, p = 0.003) were associated with an increased willingness. Aged :30 years (OR = 0.38, p = 0.001), and believing that the vaccine would not cause SARS-CoV-2 infection (OR = 0.52, p = 0.004) were associated with higher acceptance; while from Henan province (OR = 2.49, p < 0.001), not willing to vaccinate (OR = 3.86, p < 0.001), not suffering from chronic diseases (OR = 2.25, p = 0.013), and thinking it was not safe and effective in preventing COVID-19 (OR = 1.94, p = 0.001) were correlated with a lower acceptance.Conclusions: In conclusion, age, education, and vaccine perception might be key factors affecting the vaccine willingness and acceptance. Triggering positive perception of vaccine, especially by targeting those aged <30 years, or those with below bachelor degree, or without chronic diseases might be key approaches for improving the willingness and acceptance of vaccine in China.
Collapse
Affiliation(s)
- Di Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Lan Luo
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Fangfei Xie
- Physical Examination Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Yun Wang
- Physical Examination Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Zhongxiao Wan
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
- College of Public Health, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
28
|
Pan B, Zhang Q, Zhou H, Ma ZF. Prevalence of Components of Metabolic Syndrome Among Adults with the Presence of Autoimmune Thyroid Condition in an Iodine-Sufficient Region. Biol Trace Elem Res 2021; 199:2837-2843. [PMID: 33006706 DOI: 10.1007/s12011-020-02413-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/28/2020] [Indexed: 12/14/2022]
Abstract
The presence of autoimmune thyroid condition could lead to thyroid dysfunction in adults. In addition, thyroid antibody positivity has been suggested to be associated with hyperuricemia, diabetes and obesity in individuals with thyroid autoimmune diseases. Currently, there are limited studies that assessed the relationship of thyroid antibody with the components of metabolic syndrome in adults, especially from iodine-sufficient regions. Therefore, the aim of this study was to determine the prevalence of components of metabolic syndrome in Chinese adults with autoimmune thyroid condition. Medical records of adult inpatients in the Suzhou Ninth People's Hospital, Suzhou, Jiangsu, China, from January 2016 to September 2019 were reviewed and included after screening for eligibility. A total of 1105 participants were included in our final analysis, and of these, 77.5% (n = 856) were females. There was a higher prevalence of thyroid antibodies in females than males (30.6% vs. 23.7%) (p = 0.034). Although there were significant differences in mean TSH, FT3 and FT4 values between participants positive and negative for thyroid antibodies, these values were still within the normal reference range. No differences in the mean BMI, prevalence of diabetes, hyperuricemia, hypertriglyceridemia and hypercholesterolemia between participants positive and negative for thyroid antibodies were reported (p > 0.05). In conclusion, our study reported that participants positive for thyroid antibodies did not appear to be accompanied by abnormal thyroid function, lipid profile, uric acid and glucose concentrations.
Collapse
Affiliation(s)
- Binyu Pan
- Department of Clinical Nutrition, Suzhou Ninth People's Hospital, Suzhou, 215200, Jiangsu Province, China
| | - Qin Zhang
- Department of Clinical Nutrition, Suzhou Ninth People's Hospital, Suzhou, 215200, Jiangsu Province, China
| | - Hang Zhou
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu Province, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, Jiangsu Province, China.
| |
Collapse
|
29
|
Ma ZF. Maternal Urinary Iodine Concentration and Pregnancy Outcomes: Tehran Thyroid and Pregnancy Study. Biol Trace Elem Res 2021; 199:2438-2439. [PMID: 32856249 DOI: 10.1007/s12011-020-02361-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China.
| |
Collapse
|
30
|
Abstract
OBJECTIVES The COVID-19 pandemic has caused a profound impact on health and well-being of populations. However, there are limited studies that have investigated the psychological aspects of vulnerable groups including pregnant women amid the COVID-19 pandemic. Therefore, we aimed to assess the psychological impact of the COVID-19 pandemic among Chinese pregnant women from February 2020 until March 2020. METHODS Our study was conducted using a modified validated online questionnaire comprising of sociodemographic, the Impact of Event Scale (IES), attitude and mental health-related questions towards COVID-19. RESULTS A total of 560 women were included. The overall mean age and IES of women was 25.8 ± 2.7 years and 31.4 ± 13.7. Moreover, 67.1% of them had IES ⩾26. Psychological impact seemed to be more severe in women in second trimester of pregnancy (the highest IES) (p = .016). There was a significant association between trimesters of pregnancy and some indicators of negative health impacts (including increased stress from work, increased stress from home, feeling apprehensive and helpless during the early stages of the COVID-19 pandemic) (all p < .05). CONCLUSIONS Our results reported moderate-to-severe stressful impact among Chinese pregnant women. We recommend that appropriate measures should be taken to address the maternal mental health issues.
Collapse
Affiliation(s)
- Yingfei Zhang
- Mathematics Teaching and Research Office, Public Basic College, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, China
| |
Collapse
|
31
|
Hamid N, Muhamad R, Kueh YC, Zahari Z, Mohamad Nor N, Abdullah N, Wong MS, Meor Zul Kefli'Auni SA, Ma ZF, Lee YY. Translation of the Revised Dyadic Adjustment Scale (RDAS) into the Malay Language and Its Psychometric Qualities among Healthy Married Malay Women. J Pharm Bioallied Sci 2021; 12:444-448. [PMID: 33679091 PMCID: PMC7909054 DOI: 10.4103/jpbs.jpbs_265_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/26/2020] [Accepted: 05/29/2020] [Indexed: 11/04/2022] Open
Abstract
Background: In Malaysia, the problem of marital distress is fast becoming an important public health concern. A major shortcoming is inadequate marital evaluation. There are, however, very few localized instruments for married women in Malaysia. The objective of this study was to translate the original version of the Revised Dyadic Adjustment Scale (RDAS) and to evaluate for its psychometric properties. Multiple aspects of validity and reliability were also assessed. Materials and Methods: The questionnaire was first translated into the Malay language (RDAS-M). In this cross-sectional study, healthy married Malay women in Kota Bharu, Kelantan, were recruited from January to April 2018. Participants were asked to complete the RDAS-M that consists of three domains, that is, dyadic consensus, dyadic satisfaction, and dyadic cohesion with a total of 14 items. The concept, content, and construct validity using exploratory factor analysis (EFA) and reliability of the RDAS-M were assessed. Results: Of the 164 recruited participants, 150 consented to participate. The mean age of the participants was 34.1 years (standard deviation [SD], 9.5 years), ranging from 20 to 57 years. All 14 items were considered comprehensible by more than 95% of the subjects. Based on EFA, total variance extracted was 69.08%, and the original three factors were retained. The Malay version of the RDAS was valid based on factor loadings for dyadic consensus, dyadic satisfaction, and dyadic cohesion, which ranged from 0.64 to 0.80, 0.79 to 0.98, and 0.37 to 0.78, respectively. The internal consistency was good with coefficient α of 0.87 for dyadic consensus, 0.93 for dyadic satisfaction, and 0.78 for dyadic cohesion. Conclusions: The Malay version of the RDAS is easy to understand, and is a reliable and valid instrument for married women. It is also comparable with the original version of the RDAS in terms of structure and psychometric properties.
Collapse
Affiliation(s)
- Nurhazwani Hamid
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Rosediani Muhamad
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Yee Cheng Kueh
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Zalina Zahari
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA), Besut, Terengganu, Malaysia
| | - Nurhayati Mohamad Nor
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Nurzulaikha Abdullah
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Mung Seong Wong
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | | | - Zheng Feei Ma
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| |
Collapse
|
32
|
Zhang Y, Luo X, Ma ZF. Willingness of the general population to accept and pay for COVID-19 vaccination during the early stages of COVID-19 pandemic: a nationally representative survey in mainland China. Hum Vaccin Immunother 2021; 17:1622-1627. [PMID: 33606600 DOI: 10.1080/21645515.2020.1847585] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has caused negative impacts both on populations' health worldwide. COVID-19 vaccines are currently developed and tested in clinical trials. However, limited studies have investigated the willingness to get COVID-19 vaccines in populations. Therefore, the study aimed to determine the individual's willingness to accept and pay for COVID-19 vaccines, and knowledge, attitude, and perceptions (KAP) of COVID-19 vaccines, which hopefully will be available soon. Non-pregnant Chinese adults aged ≥18 years were asked to complete a self-administered KAP COVID-19 vaccine questionnaire distributed between March and May 2020. A total of 1179 participants (574 males and 605 females) were included and the mean age was 36.0 ± 11.5 years. Both the willingness to be vaccinated against COVID-19 and pay for COVID-19 vaccines were high (77.4% and 81.1%), respectively. Also, the most acceptable price range of COVID-19 vaccine was ¥501-1000 (US $ 75-149). Education and willingness to be vaccinated were significantly associated with some of the responses in KAP (P < .05). In conclusion, our study reported high willingness to be vaccinated against COVID-19 and pay for COVID-19 vaccines in Chinese population. Our findings also provided some important contributions for public health policy makers to formulate appropriate vaccination programs.
Collapse
Affiliation(s)
| | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| |
Collapse
|
33
|
Abdul Kadir NP, Ma ZF, Abdul Hafidz MI, Annamalai C, Jayaraman T, Hamid N, Norhasliza S, Abd Aziz A, Yusof Z, Lee H, Lee YY. Comparing Efficacy and Safety of Empirical vs. Guided Therapy for Non-cardiac Chest Pain: A Pragmatic Randomized Trial. Front Med (Lausanne) 2021; 8:605647. [PMID: 33659261 PMCID: PMC7917139 DOI: 10.3389/fmed.2021.605647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 01/13/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Non-cardiac chest pain is common with two-thirds due to gastroesophageal reflux disease (GERD). Objective: To evaluate the effectiveness and safety of guided vs. empirical therapy in non-cardiac chest pain. Methods: Adults with normal angiogram or stress test were randomized into either a guided or empirical group. In the guided group, after the ambulatory pH-impedance test, if GERD then dexlansoprazole 30 mg/day for 8 weeks, but if functional or hypersensitive chest pain, then theophylline SR 250 mg/day for 4 weeks. In the empirical group, dexlansoprazole 60 mg/day was given for 2 weeks. The primary outcome was global chest pain visual analog score (VAS) and secondary outcomes were Quality of Life in Reflux and Dyspepsia (QOLRAD), GERD questionnaire (GERDQ), and pH parameters, all determined at baseline, 2nd and 8th weeks. Results: Of 200 screened patients, 132 were excluded, and of 68 randomized per-protocol, 33 were in the guided group and 35 in the empirical group. For between-group analysis, mean global pain scores were better with guided vs. empirical group at 8th week (P = 0.005) but not GERDQ or QOLRAD or any of pH measures (all P > 0.05). For within-group analysis, mean QOLRAD improved earliest at 8th week vs. baseline (P = 0.006) in the guided group and 2nd week vs. baseline (P = 0.011) in the empirical group but no differences were seen in other secondary outcomes (P > 0.05). No serious adverse events were reported. Conclusions: Guided approach may be preferred over short-term empirical therapy in symptom response, however QOLRAD, acid-related symptoms, or pH measures are not significantly different (trial registration ID no. NCT03319121).
Collapse
Affiliation(s)
| | - Zheng Feei Ma
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | | | - Chandramouli Annamalai
- Gastroenterology Unit, Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Thevaraajan Jayaraman
- Gastroenterology Unit, Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Nurhazwani Hamid
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Siti Norhasliza
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Azliani Abd Aziz
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Zurkurnai Yusof
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Hady Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.,Gut Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
34
|
Ji J, He Z, Qu P, Gao J, Zhang W, Wu P, Wei J, Zhang T, Ma ZF, Luo X, Mi Y. The Xi'an longitudinal mother-child cohort study: design, study population and methods. Eur J Epidemiol 2021; 36:223-232. [PMID: 33420871 DOI: 10.1007/s10654-020-00704-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 12/03/2020] [Indexed: 12/13/2022]
Abstract
The large-scale Xi'an longitudinal mother-child cohort study has started to enroll pregnant women who attended Northwest Women's and Children's Hospital (NWCH) for antenatal care in early pregnancy (less than 20 weeks' gestation) from January 2013 and the enrollment will be ended in January 2023. We aimed to investigate the role of external factors (i.e., diet and environment) and internal (i.e., biological, genetic and epigenetic) on the short- and long-term outcomes of mothers and children up to at least 12 years. Mothers completed all routine prenatal care during pregnancy and four times of follow-up at 42 days, 3, 6 and 12 years after delivery, respectively. For children, birth information were obtained from routine medical records and the follow-up information were obtained from child health care clinics of NWCH at age 42 days, 6, 12 and 24 months, then by interviewing mothers every two years until 12 years old. A range of data (including biological, demographic, birth outcomes/birth defects and nutritional factors from both maternal and off-spring) were collected by both interviews and laboratory tests. By June 30th 2019, a total of 114,946 mothers and 124,454 live births had been recruited.
Collapse
Affiliation(s)
- Jing Ji
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, 710061, China
| | - Zhangya He
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Pengfei Qu
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, 710061, China
| | - Jiayi Gao
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Wanyu Zhang
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Pei Wu
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Junxiang Wei
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, 710061, China
| | - Tianxiao Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Yang Mi
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, 710061, China.
| |
Collapse
|
35
|
Zhou H, Lu Y, Pan B, Zhao Q, Ma ZF. Iodine Deficiency as Assessed by Neonatal TSH in a Sample of Mother-and-Newborn Pairs in Jiangsu Province, China. Biol Trace Elem Res 2021; 199:70-75. [PMID: 32253700 DOI: 10.1007/s12011-020-02135-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022]
Abstract
China has eliminated iodine deficiency disorders since 2011 via the implementation of universal salt iodisation. Following this, a new revised salt iodisation policy was introduced to reduce iodine content in table salt. Since maternal iodine deficiency can lead to cognitive impairment and cretinism in infants, the aim of our study was to assess if the iodine status of pregnant women and neonates was affected by the introduction of new salt iodisation policy. The medical records of the pregnant women and their neonates in the Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China, between January 2018 and May 2018 were reviewed and obtained. Our study included 374 mother-and-newborn pairs. Mean age of the participants was 28 ± 4 years. TSH, FT3 and FT4 of the participants remained within the reference range. The prevalence of thyroid dysfunction was 4.3%. The overall mean neonatal TSH, birth weight and prevalence of low birth weight (LBW) was 2.56 ± 1.59 mIU/L, 3348 ± 465 g and 2.4%, respectively. The prevalence of neonatal TSH values > 5 mIU/L was 8.3%, which suggested the emergence of mild iodine deficiency (i.e. 3.0-19.9%) in our province. In conclusion, although our study reported an improvement of iodine status to mild iodine deficiency in 2017, our pregnant women remained to be iodine deficient. We recommended an ongoing monitoring of iodine status and advocate for the routine iodine supplementation together with iodised salt in Chinese pregnant women.
Collapse
Affiliation(s)
- Hang Zhou
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu Province, China
| | - Yiming Lu
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu Province, China
- Department of Orthopedics, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu Province, China
| | - Binyu Pan
- Department of Clinical Nutrition, Suzhou Ninth People's Hospital, Suzhou, 215200, Jiangsu Province, China
| | - Qihua Zhao
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu Province, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, Jiangsu Province, China.
| |
Collapse
|
36
|
Ma ZF, Zhang Y, Luo X, Li X, Li Y, Liu S, Zhang Y. Increased stressful impact among general population in mainland China amid the COVID-19 pandemic: A nationwide cross-sectional study conducted after Wuhan city's travel ban was lifted. Int J Soc Psychiatry 2020; 66:770-779. [PMID: 32564637 PMCID: PMC7443962 DOI: 10.1177/0020764020935489] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Our study aimed to determine the impact of the COVID-19 pandemic on psychological responses and lifestyle changes among the general population in mainland China following the re-opening of the Wuhan city. METHODS A cross-sectional survey was conducted in April 2020. Participants of Chinese nationality aged ⩾ 18 years were asked to complete a modified validated Chinese version of a questionnaire regarding the impact of event scale (IES), family and social support, mental health-related lifestyle changes, and indicators of negative mental health impacts. RESULTS A total of 728 participants (i.e., 217 males and 511 females) completed the questionnaire. The mean age of the participants was 32.9 ± 10.4 years, with a majority of them (92.2%) having a higher educational qualification level. The overall mean IES in participants was 21.5 ± 7.0, reflecting mild stressful impact (i.e., following the re-opening of the Wuhan city); 25.5% of the participants had an IES score ⩾ 26. Being females and married were significantly associated with a higher mean IES score. The overall mean scores for intrusion and avoidance score scales in participants were 9.4 ± 3.7 and 12.1 ± 4.2, respectively. CONCLUSIONS The COVID-19 pandemic was associated with increased stressful impact in our participants following the re-opening of the Wuhan city when compared with our previous study, which should not be taken lightly.
Collapse
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | | | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Xinli Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yeshan Li
- Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Wuhu, Wuhu, China
| | - Shuchang Liu
- School of Biosciences, University of Nottingham, Loughborough, UK
| | - Yingfei Zhang
- Mathematics Teaching and Research Office, Public Basic College, Jinzhou Medical University, Jinzhou, China
| |
Collapse
|
37
|
Huang J, Ma ZF, Zhang Y, Wan Z, Li Y, Zhou H, Chu A, Lee YY. Geographical distribution of hyperuricemia in mainland China: a comprehensive systematic review and meta-analysis. Glob Health Res Policy 2020; 5:52. [PMID: 33292806 PMCID: PMC7708223 DOI: 10.1186/s41256-020-00178-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/28/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Fructose plays an important role in the complex metabolism of uric acid in the human body. However, high blood uric acid concentration, known as hyperuricemia, is the main risk factor for development of gout. Therefore, we conducted an updated meta-analysis on the prevalence and geographical distribution of hyperuricemia among the general population in mainland China using systematic literature search. METHODS Five electronic databases were used to search for relevant articles published until 2019. All calculations were conducted using the Comprehensive Meta-Analysis (CMA) software. We included 108 eligible articles (172 studies by sex, 95 studies by regions, and 107 studies by study type) and an overall sample size of > 808,505 participants. RESULTS The pooled prevalence of hyperuricemia among the general population in mainland China was 17.4% (95% CI: 15.8-19.1%). Our subgroup analysis indicated that the pooled prevalence by regions ranged from 15.5 to 24.6%. Those living Northeast region and being males had the highest prevalence (P < 0.001). In addition, some provinces in South Central, East and Northeast regions reported a high prevalence (> 20%), particularly in males. An increasing prevalence was reported since 2005-2009 until 2015-2019. No publication of bias was observed as indicated by a symmetrical funnel plot and Begg and Mazumdar rank correlation (P = 0.392). CONCLUSION Prevalence of hyperuricemia is increasing in China, and future studies should investigate the association between the prevalence of hyperuricemia and its risk factors in order to tackle the issue, particularly among the vulnerable groups. Also, our study was the first comprehensive study to investigate the overall prevalence of hyperuricemia in mainland China covering the six different regions.
Collapse
Affiliation(s)
- Jiayun Huang
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, Jiangsu, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, Jiangsu, China.
- School of Medical Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
| | - Yutong Zhang
- Jinzhou Medical University, Jinzhou, 121001, Liaoning, China
| | - Zhongxiao Wan
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Ren'ai Road, Suzhou, 215123, China
| | - Yeshan Li
- Department of Respiratory and Critical Care Medicine, The Second People's Hospital of Wuhu, Wuhu, 241000, Anhui, China
| | - Hang Zhou
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu, China
| | - Anna Chu
- Department of Human Nutrition, University of Otago, Dunedin, 9016, New Zealand
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
- Gut Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, 2217, Australia
| |
Collapse
|
38
|
Ibrahim YS, Tuan Anuar S, Azmi AA, Wan Mohd Khalik WMA, Lehata S, Hamzah SR, Ismail D, Ma ZF, Dzulkarnaen A, Zakaria Z, Mustaffa N, Tuan Sharif SE, Lee YY. Detection of microplastics in human colectomy specimens. JGH Open 2020; 5:116-121. [PMID: 33490620 PMCID: PMC7812470 DOI: 10.1002/jgh3.12457] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 01/18/2023]
Abstract
Background and Aim While dietary exposure to microplastics is increasingly recognized, it is unknown if ingested plastics remain within the digestive tract. We aimed to examine human colectomy specimens for microplastics and to report the characteristics as well as polymer composition of the particles. Methods Colectomy samples were obtained from 11 adults (mean age 45.7, six males) who were residents of Northeastern Peninsular Malaysia. Microplastics were identified following chemical digestion of specimens and subsequent filtration. The samples were then examined for characteristics (abundance, length, shape, and color) and composition of three common polymer types using stereo‐ and Fourier Transform InfraRed (FTIR) microscopes. Results Microplastics were detected in all 11 specimens with an average of 331 particles/individual specimen or 28.1 ± 15.4 particles/g tissue. Filaments or fibers accounted for 96.1% of particles, and 73.1% of all filaments were transparent. Out of 40 random filaments from 10 specimens (one had indeterminate spectra patterns), 90% were polycarbonate, 50% were polyamide, and 40% were polypropylene. Conclusion Our study suggests that microplastics are ubiquitously present in the human colon.
Collapse
Affiliation(s)
- Yusof Shuaib Ibrahim
- Microplastic Research Interest Group, Faculty of Science and Marine Environment Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Sabiqah Tuan Anuar
- Microplastic Research Interest Group, Faculty of Science and Marine Environment Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Alyza A Azmi
- Microplastic Research Interest Group, Faculty of Science and Marine Environment Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Wan Mohd Afiq Wan Mohd Khalik
- Microplastic Research Interest Group, Faculty of Science and Marine Environment Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Shumpei Lehata
- Microplastic Research Interest Group, Faculty of Science and Marine Environment Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Siti Rabaah Hamzah
- Microplastic Research Interest Group, Faculty of Science and Marine Environment Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Dzulkiflee Ismail
- School of Health Sciences Universiti Sains Malaysia Kota Bharu Malaysia
| | - Zheng Feei Ma
- School of Medical Sciences Universiti Sains Malaysia Kota Bharu Malaysia.,Department of Health and Environmental Sciences Xi'an Jiaotong-Liverpool University Suzhou China
| | - Andee Dzulkarnaen
- School of Medical Sciences Universiti Sains Malaysia Kota Bharu Malaysia
| | - Zaidi Zakaria
- School of Medical Sciences Universiti Sains Malaysia Kota Bharu Malaysia
| | - Nazri Mustaffa
- School of Medical Sciences Universiti Sains Malaysia Kota Bharu Malaysia
| | | | - Yeong Yeh Lee
- School of Medical Sciences Universiti Sains Malaysia Kota Bharu Malaysia.,Gut Research Group, Faculty of Medicine National University of Malaysia Kuala Lumpur Malaysia.,St George and Sutherland Clinical School University of New South Wales Sydney Australia
| |
Collapse
|
39
|
Liu S, Ma ZF, Zhang Y, Zhang Y. Attitudes towards Wildlife Consumption inside and outside Hubei Province, China, in Relation to the SARS and COVID-19 Outbreaks. Hum Ecol Interdiscip J 2020; 48:749-756. [PMID: 33199934 PMCID: PMC7657065 DOI: 10.1007/s10745-020-00199-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 05/28/2023]
Abstract
We designed a self-administered 20-item questionnaire to determine changes in attitudes towards wildlife consumption in Chinese adults during the SARS epidemic in 2002-2003 and on-going COVID-19 pandemic that was first identified in December 2019. A total of 348 adults (177 males and 171 females) with a mean age of 29.4 ± 8.5 years participated, the majority (66.7%) from Hubei. The percentages of participants who had eaten wildlife significantly decreased from 27.0% during SARS to 17.8% during COVID-19 (P = 0.032). The most common reason participants provided for consuming wildlife was to try something novel (64.9% during SARS and 54.8% during COVID-19). More than half of participants (≥53.5%) reported that they had stopped eating wildlife meat because most species of wildlife are legally protected. Our study results indicate over the period between the SARS epidemic to the outbreak of the COVID-19 pandemic, attitudes towards the consumption of wildlife in China have changed significantly.
Collapse
Affiliation(s)
- Shuchang Liu
- School of Biosciences, University of Nottingham, Loughborough, LE12 5RD UK
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, 215123 Jiangsu China
| | - Yutong Zhang
- Jinzhou Medical University, Jinzhou, 121001 Liaoning China
| | - Yingfei Zhang
- Mathematics Teaching and Research Office, Public Basic College, Jinzhou Medical University, Jinzhou, 121001 Liaoning China
| |
Collapse
|
40
|
Yu Z, Zheng C, Zheng W, Wan Z, Bu Y, Zhang G, Ding S, Wang E, Zhai D, Ma ZF. Mild-to-moderate iodine deficiency in a sample of pregnant women and salt iodine concentration from Zhejiang province, China. Environ Geochem Health 2020; 42:3811-3818. [PMID: 32596780 DOI: 10.1007/s10653-020-00640-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
Since 2011, Zhejiang province has eliminated iodine deficiency disorders (IDD) in its populations. Following this achievement, a new revised iodine concentration in iodised salt was implemented in Zhejiang in 2012. However, the re-emergence of iodine deficiency has been reported in pregnant women. Therefore, the aim of this study was to assess household salt iodine concentration and iodine status of pregnant women in Zhejiang province, China. We conducted a cross-sectional study between April 2018 and August 2018 in Quzhou, Zhejiang province. Pregnant women aged ≥ 18 years who did not have a history of thyroid disease were recruited into the study. They were asked to complete socio-demographic questionnaires including a food frequency questionnaire (FFQ). In addition, a spot urine sample and a household table salt sample were also provided by each participant. A total of 625 pregnant women agreed to participate. The overall median urinary iodine concentration (UIC) was 130 µg/L, indicating mild-to-moderate iodine deficiency in pregnant women. The coverage of iodised salt was 85.2%, and of these, the rate of adequately iodised salt was 98.1%. In conclusion, our results confirmed the re-emergence of iodine deficiency in pregnant women as reported by other studies conducted in Zhejiang province. Therefore, urgent public health actions are needed to improve iodine status of pregnant women in order to prevent the adverse consequences of IDD on the neurodevelopment of foetus.
Collapse
Affiliation(s)
- Zengli Yu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
| | - Canjie Zheng
- Quzhou Center for Disease Control and Prevention, 154 Xi'an Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Wangfeng Zheng
- Quzhou Hospital of Traditional Chinese Medicine, 117 Quhua Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
- School of Public Health, Soochow University, Suzhou, 215123, People's Republic of China
| | - Yongjun Bu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Guofu Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Shibin Ding
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Erhui Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Desheng Zhai
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, People's Republic of China.
| |
Collapse
|
41
|
Ma ZF. The Results of 16 Years Iodization: Assessment of Iodine Deficiency Among School-age Children in Antalya, Turkey. J Clin Res Pediatr Endocrinol 2020; 12:329-330. [PMID: 32157851 PMCID: PMC7499134 DOI: 10.4274/jcrpe.galenos.2019.2019.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, China; School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia,* Address for Correspondence: Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, China; School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia E-mail:
| |
Collapse
|
42
|
Ma ZF, Deraman MA, Coyle C, Lee YY. Editorial: simultaneous, prolonged monitoring of the acid pocket and oesophageal reflux. Authors' reply. Aliment Pharmacol Ther 2020; 52:398-399. [PMID: 32592257 DOI: 10.1111/apt.15835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Zheng Feei Ma
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bahru, Malaysia.,Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Mohd Adli Deraman
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bahru, Malaysia
| | | | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bahru, Malaysia.,Gut Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
43
|
Ma ZF, Ibrahim YS, Lee YY. Microplastic Pollution and Health and Relevance to the Malaysia's Roadmap to Zero Single-Use Plastics 2018-2030. Malays J Med Sci 2020; 27:1-6. [PMID: 32684801 PMCID: PMC7337955 DOI: 10.21315/mjms2020.27.3.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/03/2022] Open
Abstract
Microplastic pollution is an emerging environmental and public health threat worldwide including Malaysia. Microplastics are widespread in drinking water, but also food products especially seafood, an important dietary source for the Malaysians. Potential health hazards may be a result of chemicals, physical properties and microbial disturbance associated with microplastic exposure. However, most studies were performed in animals rather than in human. Nevertheless, in recognition of rising threat from microplastics, in 2018, the Malaysia’s Roadmap to Zero Single-use Plastics 2018–2030 has been released. In this editorial, we firstly discussed the potential impact of microplastics on human health, followed by the strategies or limitations highlighted in the Malaysia’s Roadmap.
Collapse
Affiliation(s)
- Zheng Feei Ma
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Yusof Shuaib Ibrahim
- Microplastic Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Gut Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
44
|
Deraman MA, Abdul Hafidz MI, Lawenko RM, Ma ZF, Wong MS, Coyle C, Lee YY. Randomised clinical trial: the effectiveness of Gaviscon Advance vs non-alginate antacid in suppression of acid pocket and post-prandial reflux in obese individuals after late-night supper. Aliment Pharmacol Ther 2020; 51:1014-1021. [PMID: 32343001 PMCID: PMC7318318 DOI: 10.1111/apt.15746] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/10/2020] [Accepted: 04/02/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Late-night supper increases the risk of postprandial reflux from the acid pocket especially in obesity. An alginate-based, raft-forming medication may be useful for obese patients with GERD. AIMS To compare the efficacy of Gaviscon Advance (Reckitt Benckiser, UK) and a non-alginate antacid in post-supper suppression of the acid pocket and post-prandial reflux among obese participants. METHODS Participants underwent 48 h wireless and probe-based pH-metry recording of the acid pocket and lower oesophagus, respectively, and were randomised to single post-supper (10 pm) dose of either Gaviscon Advance or a non-alginate antacid on the second night. Primary outcomes were suppression of median pH of acid pocket and lower oesophagus, measured every 10-minutes post-supper for 1 h. Secondary outcomes were suppression of % time pH < 4 at lower oesophagus and improvement in frequency and visual analogue score (VAS) of regurgitation. RESULTS Of the 81 screened participants, 55 were excluded and 26 (mean age 33.5 years, males 77.8% and BMI 32.8 kg/m2 ) were randomised to Gaviscon Advance (n = 13) or antacid (n = 13). Median pH of the acid pocket but not the lower oesophagus was suppressed with Gaviscon Advance vs antacid (all P < 0.04) Gaviscon Advance but not antacid significantly reduced in % time pH < 4, symptom frequency and VAS on day 2 vs day 1 (all P < 0.05). CONCLUSIONS Among obese individuals, Gaviscon Advance was superior to a non-alginate antacid in post-supper suppression of the acid pocket. (Clinical trial registration unique identifier: NCT03516188).
Collapse
Affiliation(s)
- Mohd Adli Deraman
- School of Medical SciencesUniversiti Sains MalaysiaKota BahruMalaysia
| | | | | | - Zheng Feei Ma
- School of Medical SciencesUniversiti Sains MalaysiaKota BahruMalaysia,Department of Health and Environmental SciencesXi'an Jiaotong‐Liverpool UniversitySuzhouChina
| | - Mung Seong Wong
- School of Medical SciencesUniversiti Sains MalaysiaKota BahruMalaysia
| | | | - Yeong Yeh Lee
- School of Medical SciencesUniversiti Sains MalaysiaKota BahruMalaysia,Gut Research GroupFaculty of MedicineUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia,St George and Sutherland Clinical SchoolUniversity of New South WalesSydneyNSWAustralia
| |
Collapse
|
45
|
Ma ZF. Association between Serum Free Thyroxine and Anemia in Euthyroid Adults: A Nationwide Study (Endocrinol Metab 2020;35:106-14, Mijin Kim et al.). Endocrinol Metab (Seoul) 2020; 35:484-485. [PMID: 32615733 PMCID: PMC7386125 DOI: 10.3803/enm.2020.35.2.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou,
China
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu,
Malaysia
| |
Collapse
|
46
|
Li X, Yang Y, Ma ZF, Gao S, Ning Y, Zhao L, He Z, Luo X. Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury. Nutr Neurosci 2020; 25:530-536. [PMID: 32431234 DOI: 10.1080/1028415x.2020.1765114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective: To investigate the effect of nutritional support on nutritional status and clinical outcomes of patients with traumatic brain injury (TBI).Methods: Sixty-one patients with TBI from the intensive care unit and neurosurgery of Xianyang Central Hospital from 2017 to 2019 were retrospectively included. General and clinical data of the study subjects were collected. The control group (n = 28) received parenteral nutrition alone, and the observation group (n = 33) received parenteral nutrition combined with enteral nutrition. The general conditions and biochemical indicators of both groups of patients were divided into two groups of ≤8 and ≥9 for stratified analysis to compare the nutritional support status and infection complications during hospitalization Occurrence, ICU length of stay, total length of stay, total cost of stay, and prognostic indicators of the patients were analyzed and compared.Results: There were no significant differences in biochemical indicators between both groups of patients when they were discharged. Among patients with GCS ≤8 points, the incidence of lung infection in the observer was significantly higher than that in the control group (P < 0.001), but the incidence of intracranial infection, stress ulcers, and diarrhea was not statistically different from that in the control group (P = 0.739). No significant differences were observed in hospitalization time and hospitalization costs between both groups (P = 0.306 and P = 0.079, respectively). The observation group was significantly better than the control group in GSC score and long-term quality of life score (P = 0.042 and P = 0.025, respectively). When GCS was ≥ 9 points, there was no statistical difference in the incidence of lung infections and intracranial infections between both groups of patients (P = 0.800 and P = 0.127, respectively). The observation group was significantly higher than the control group in terms of length of hospital stay, nasal feeding time and hospitalization costs (P < 0.001, P < 0.001 and P = 0.006, respectively). The observation group was significantly better than the control group in GSC score and long-term quality of life score (P = 0.001 and P = 0.015, respectively). There was no significant difference in the incidence of pulmonary infection and intracranial infection between both groups of patients (P = 0.800 and P = 0.127, respectively).Conclusion: Enteral nutrition combined with parenteral nutrition intervention has a positive effect on the clinical prognosis of TBI patients.
Collapse
Affiliation(s)
- Xiaomin Li
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, People's Republic of China.,Department of Clinical Nutrition, Xianyang Central Hospital, Xianyang, People's Republic of China
| | - Yafeng Yang
- Department of Clinical Nutrition, Xianyang Central Hospital, Xianyang, People's Republic of China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, People's Republic of China
| | - Shan Gao
- Department of Clinical Nutrition, Xianyang Central Hospital, Xianyang, People's Republic of China
| | - Yuan Ning
- Department of Clinical Nutrition, Xianyang Central Hospital, Xianyang, People's Republic of China
| | - Ling Zhao
- Department of Clinical Nutrition, Xianyang Central Hospital, Xianyang, People's Republic of China
| | - Zhangya He
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, People's Republic of China
| |
Collapse
|
47
|
Zhou H, Ma ZF, Lu Y, Du Y, Shao J, Wang L, Wu Q, Pan B, Zhu W, Zhao Q, Wei H. Elevated serum uric acid, hyperuricaemia and dietary patterns among adolescents in mainland China. J Pediatr Endocrinol Metab 2020; 33:487-493. [PMID: 32069235 DOI: 10.1515/jpem-2019-0265] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 01/13/2020] [Indexed: 12/20/2022]
Abstract
Background Elevated serum uric acid concentrations have been associated with metabolic syndrome. However, only limited information is available on the prevalence of hyperuricaemia in adolescents. Therefore, the aim of our cross-sectional study was to study the prevalence of hyperuricaemia and dietary patterns in adolescents aged 13-16 years living in Yangzhou, China. Methods Adolescents were asked to complete a 20-item food frequency questionnaire (FFQ) and provide an overnight fasting finger-prick sample. Principal component analysis (PCA) with varimax rotation was used to derive the dietary patterns that might be associated with high uric acid concentrations. Results A total of 1070 adolescents were recruited. Of these, 53.6% (n = 574) were females, and 58.5% (n = 625) were within the normal body mass index (BMI) range. The males had a significantly higher serving size and frequency in their weekly food consumption, including meat, poultry, Chinese cereal staple foods and Western-style fast foods, than the females (all p < 0.02). The overall mean serum uric acid concentration and prevalence of hyperuricaemia were 368.6 ± 114.5 μmol/L and 37.9%, respectively. The prevalence of hyperuricaemia was 4.633 times greater among the participants who were overweight and obese than among those who were underweight. On the other hand, the prevalence of hyperuricaemia was 0.694 times lower among the participants who had normal weight than those who were underweight. Conclusions The prevalence of hyperuricaemia was relatively high in Chinese adolescents. The prevention of hyperuricaemia measures should be strengthened in adolescents to effectively control for obesity and gout, which tend to persist into adulthood.
Collapse
Affiliation(s)
- Hang Zhou
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, Jiangsu Province, China
| | - Yiming Lu
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Orthopedics, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| | - Yanyan Du
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| | - Jian Shao
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| | - Liya Wang
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| | - Qin Wu
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Rheumatology and Immunology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| | - Binyu Pan
- Department of Clinical Nutrition, The First People's Hospital of Wujiang District, Suzhou, Jiangsu Province, China
| | - Wenxi Zhu
- Yangzhou Emergency Medical Center, Yangzhou, Jiangsu Province, China
| | - Qihua Zhao
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| | - Hua Wei
- Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.,Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
| |
Collapse
|
48
|
Singh L, Joshi T, Tewari D, Echeverría J, Mocan A, Sah AN, Parvanov E, Tzvetkov NT, Ma ZF, Lee YY, Poznański P, Huminiecki L, Sacharczuk M, Jóźwik A, Horbańczuk JO, Feder-Kubis J, Atanasov AG. Ethnopharmacological Applications Targeting Alcohol Abuse: Overview and Outlook. Front Pharmacol 2020; 10:1593. [PMID: 32116660 PMCID: PMC7034411 DOI: 10.3389/fphar.2019.01593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022] Open
Abstract
Excessive alcohol consumption is the cause of several diseases and thus is of a major concern for society. Worldwide alcohol consumption has increased by many folds over the past decades. This urgently calls for intervention and relapse counteract measures. Modern pharmacological solutions induce complete alcohol self-restraint and prevent relapse, but they have many side effects. Natural products are most promising as they cause fewer adverse effects. Here we discuss in detail the medicinal plants used in various traditional/folklore medicine systems for targeting alcohol abuse. We also comprehensively describe preclinical and clinical studies done on some of these plants along with the possible mechanisms of action.
Collapse
Affiliation(s)
- Laxman Singh
- Centre for Biodiversity Conservation & Management, G.B. Pant National Institute of Himalayan Environment & Sustainable Development, Almora, India
| | - Tanuj Joshi
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University Bhimtal Campus, Nainital, India
| | - Devesh Tewari
- Department of Pharmacognosy, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Javier Echeverría
- Department of Environmental Sciences, Faculty of Chemistry and Biology, Universidad de Santiago de Chile, Santiago, Chile
| | - Andrei Mocan
- Department of Pharmaceutical Botany, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Archana N. Sah
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University Bhimtal Campus, Nainital, India
| | - Emil Parvanov
- Institute of Molecular Genetics, Academy of Sciences of the Czech Republic, Division BIOCEV, Prague, Czechia
| | - Nikolay T. Tzvetkov
- Institute of Molecular Biology “Roumen Tsanev”, Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Department Global R&D, NTZ Lab Ltd., Sofia, Bulgaria
| | - Zheng Feei Ma
- Department of Public Health, Xi’an Jiaotong-Liverpool University, Suzhou, China
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Piotr Poznański
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Lukasz Huminiecki
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Mariusz Sacharczuk
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Artur Jóźwik
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Jarosław O. Horbańczuk
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Joanna Feder-Kubis
- Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego, Wrocław, Poland
| | - Atanas G. Atanasov
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
- Department of Pharmacognosy, University of Vienna, Vienna, Austria
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
49
|
Affiliation(s)
- Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China.
| |
Collapse
|
50
|
Yang S, Wang G, Ma ZF, Qin LQ, Zhai YJ, Yu ZL, Xue M, Zhang YH, Wan Z. DietaryAdvancedGlycationEnd Products-InducedCognitive Impairment in Aged ICR Mice: Protective Role of Quercetin. Mol Nutr Food Res 2020; 64:e1901019. [PMID: 31860939 DOI: 10.1002/mnfr.201901019] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/02/2019] [Indexed: 01/05/2023]
Abstract
SCOPE Dietary advanced glycation products (dAGEs) have been reported to induce cognitive impairment while quercetin possesses potential neuroprotective effects. The aim is to explore whether dAGEs would induce similar cognitive impairment from both young and aged ICR mice, and the protective effects of quercetin. METHODS AND RESULTS A total of 32 aged ICR mice (15-month-old) and 16 young ICR mice (3-month-old) are randomly assigned into the following six groups: Young mice control group, young mice fed with AGEs diet group, old mice control group, old mice fed with AGEs diet group, old mice with quercetin supplemented diet group, old mice fed with AGE diet supplemented with quercetin group. Dietary AGEs induced cognitive impairment only in aged, but not in young, ICR mice, while quercetin intervention is capable of reversing dAGEs-induced cognitive dysfunction. This may be since quercetin 1) increased miR-219, miR-15a, and miR-132 expression, inhibited p-ERK1/2, and tau phosphorylation; and 2) improved gut microbiota richness and diversity, inhibited phylum Tenericutes and Proteobacteria, and elevated butyric acid from cecum. CONCLUSION Prolonged application of quercetin may be beneficial in the elderly, especially for those with high consumption of dAGEs.
Collapse
Affiliation(s)
- Shengyi Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Ren'ai Road, Suzhou, 215123, China
| | - Guiping Wang
- School of Physical Education, Soochow University, No. 50, Donghuan road, Suzhou, 215006, China
| | - Zheng Feei Ma
- School of Public Health, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Ren'ai Road, Suzhou, 215123, China
| | - Yu-Jia Zhai
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Ren'ai Road, Suzhou, 215123, China
| | - Zeng-Li Yu
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Man Xue
- Suzhou Institute for Food Control, No.1336 Wuzhong Avenue, Wuzhong District, Suzhou, 215104, China
| | - Ya-Han Zhang
- Suzhou Institute for Food Control, No.1336 Wuzhong Avenue, Wuzhong District, Suzhou, 215104, China
| | - Zhongxiao Wan
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, 199 Ren'ai Road, Suzhou, 215123, China
| |
Collapse
|