目的:基于前瞻性队列比较不同方法确定的儿童早期体重指数(body mass index,BMI)轨迹与超重风险的关联,识别在儿童早期生长发育重要窗口期具有较高肥胖风险的人群。方法:共纳入北大通州出生队列的1330名儿童,分别在儿童刚出生,1、3、6、...目的:基于前瞻性队列比较不同方法确定的儿童早期体重指数(body mass index,BMI)轨迹与超重风险的关联,识别在儿童早期生长发育重要窗口期具有较高肥胖风险的人群。方法:共纳入北大通州出生队列的1330名儿童,分别在儿童刚出生,1、3、6、9、12、18、24月龄和3岁进行随访,根据其身长/身高和体质量计算BMI Z评分。应用潜类别增长混合模型(growth mixture modelling,GMM)和基于纵向数据的k-means聚类方法(k-means for longitudinal data,KML)分析儿童早期(从出生至24月龄)BMI轨迹分组,采用线性回归比较不同方法确定的儿童早期BMI轨迹和儿童3岁时BMI Z评分的关联,通过五折交叉验证的平均受试者工作特征曲线下面积,比较Logistic回归模型中不同方法确定的儿童早期BMI轨迹分组对儿童3岁超重风险(BMI Z评分>1)的预测性能。结果:在纳入的研究对象中,用GMM确定的三分类轨迹分为低、中、高轨迹,分别占39.7%、54.1%、6.2%;用KML方法确定的二分类轨迹分为低轨迹和高轨迹,分别占50.3%和49.7%;用KML方法确定的三分类轨迹分为低、中、高轨迹,分别占31.1%、47.4%、21.5%。用不同方法确定的儿童早期BMI轨迹反映的生长模式存在一定差异。线性回归分析发现,在调整母亲民族、受教育水平、分娩方式、产次、分娩时年龄、分娩孕周、胎儿性别和1月龄母乳喂养等协变量后,用KML方法确定的三分类轨迹中的高轨迹组(表现为出生时BMI Z评分略高、婴儿期快速生长后持续稳定在高水平的生长模式)和儿童3岁BMI Z评分的关联最强。Logistic回归分析发现,KML三分类轨迹分组对儿童3岁超重风险具有最佳的预测效果。在额外调整儿童平衡膳食指数正端分、平均每天身体活动时间和视屏时间后,结果基本一致。结论:采用不同方法识别具有不同变化特征的儿童早期BMI轨迹,发现KML方法确定的高轨迹组能更好地发现儿童早期具有较高超重风险的人群,为选择适宜方法开展儿童早期BMI轨迹相关研究提供了依据。展开更多
Objective To analyze the global epidemic status of the Ebola virus disease(EVD) and assess the importation risk into China.Methods Data from World Health Organization reports were used. We described the global epidemi...Objective To analyze the global epidemic status of the Ebola virus disease(EVD) and assess the importation risk into China.Methods Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976–2021, and assessed and ranked the importation risk of EVD from the diseaseoutbreaking countries into China using the risk matrix and Borda count methods, respectively.Results From 1976–2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases(14,124 cases) in Sierra Leone, and the highest cumulative fatality rate(85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease.The Democratic Republic of the Congo had an extremely high risk(23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone,Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co te d’Ivoire.Conclusion China is under the risk of EVD importation with the globalization and severe epidemic status of EVD. Key attention need to be paid to the Democratic Republic of the Congo, Guinea, and Liberia. Therefore, it is necessary to prevent and prepare in advance for importation risk in China.展开更多
基金funded by the National Natural Science Foundation of China[Grant No.71934002,Grant No.72122001]。
文摘Objective To analyze the global epidemic status of the Ebola virus disease(EVD) and assess the importation risk into China.Methods Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976–2021, and assessed and ranked the importation risk of EVD from the diseaseoutbreaking countries into China using the risk matrix and Borda count methods, respectively.Results From 1976–2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases(14,124 cases) in Sierra Leone, and the highest cumulative fatality rate(85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease.The Democratic Republic of the Congo had an extremely high risk(23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone,Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co te d’Ivoire.Conclusion China is under the risk of EVD importation with the globalization and severe epidemic status of EVD. Key attention need to be paid to the Democratic Republic of the Congo, Guinea, and Liberia. Therefore, it is necessary to prevent and prepare in advance for importation risk in China.
