Trends in the Mortality Rate of Major Kidney Diseases — China, 2014–2021

Xinhui Yu¹, Jinlei Qi¹, Peng Yin¹, Limin Wang¹, Yunning Liu¹, Maigeng Zhou¹, Lijun Wang^1,#

1. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

# Corresponding author: Lijun Wang, wanglijun@ncncd.chinacdc.cn.

This study evaluated the distribution and trends in mortality rates from major kidney diseases in various populations and regions in China from 2014 to 2021. Mortality data for kidney diseases, including kidney cancer, glomerular disease, tubulointerstitial nephritis, and kidney failure, were sourced from the National Death Cause Surveillance System. The study calculated crude mortality rates, age-standardized mortality rates (ASMR), and average annual percent changes (AAPC) to assess trends and disparities among different genders, age groups, and urban versus rural areas. The results revealed a decrease in ASMR for females from 6.9/100,000 to 5.7/100,000 (AAPC=-3.0%) from 2014 to 2021, while ASMR for males remained stable. Mortality rates increased with age, notably after 60 years. There was a pronounced downward trend in ASMR all kidney diseases combined in rural areas and for each kidney disease type in urban settings. Regionally, ASMR for tubulointerstitial nephritis in the eastern region decreased significantly (AAPC=-7.9%), and ASMR for kidney failure in the western region also fell (AAPC=-2.3%). In contrast, ASMR for kidney cancer in the central region increased (AAPC=2.1%). Excluding kidney cancer, ASMR was higher among men, rural residents, and those in western regions. It is recommended that targeted prevention and control measures be implemented for these populations, along with appropriate health resource allocation, to reduce the burden of kidney diseases.

主要肾脏疾病死亡率变化趋势 — 中国，2014–2021年

于昕辉¹；齐金蕾¹；殷鹏¹；王丽敏¹；刘韫宁¹；周脉耕¹；王黎君^1,#

1.中国疾病预防控制中心慢性非传染性疾病预防控制中心，北京，中国。

^# 通信作者：王黎君，wanglijun@ncncd.chinacdc.cn。

本文分析了2014-2021年中国居民不同人群和地区的主要肾脏疾病死亡水平及其变化趋势。研究通过中国死因监测系统提取根本死因为肾脏肿瘤、肾小球疾病、肾小管疾病和肾衰竭的主要肾脏疾病数据，采用粗死亡率、标化死亡率（ASMR）以及年均变化百分比（AAPC）等指标，展示不同性别、年龄组、城乡及地区的趋势和差异。结果显示2014-2021年间女性的ASMR从6.9/10万下降到5.7/10万（AAPC=-3.0%）；男性的ASMR稳定不变；各亚组的粗死亡率随着年龄增长都出现上升，60岁后上升最为迅速；农村地区总肾脏疾病及城市地区各病种的ASMR均有显著下降趋势；东部地区肾小管疾病（AAPC=-7.9%）和西部地区肾衰竭（AAPC=-2.3%）的ASMR明显降低，而中部地区肾脏肿瘤的ASMR显著升高（AAPC=2.1%）。除肾脏肿瘤外，其他病种ASMR均在男性、农村以及西部地区呈现较高水平。这表明未来应针对这些高危人群开展有针对性的肾脏疾病预防和控制工作，合理分配卫生资源以减轻肾脏疾病的负担。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.236

Emerging Sialylated Class R Lipooligosaccharides in Campylobacter jejuni from Seagulls Has the Potential to Trigger Guillain-Barré Syndrome — Yunnan Province, China, 2018

Xiaoli Chen¹, Yixin Gu¹, Hairui Wang¹, Guilan Zhou¹, Xin Zhang¹, Chang Liu¹, Zhujun Shao¹, Jianzhong Zhang¹, Maojun Zhang^1#

1. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

^# Corresponding authors: Maojun Zhang, zhangmaojun@icdc.cn.

.

Lipooligosaccharide from Campylobacter jejuni has a mimicry antigen structure with gangliosides, which explains the mechanism by which C. jejuni caused Guillain-Barré syndrome (GBS). All 12 C. jejuni strains with class R Sialylated lipooligosaccharides (LOSs) and specific serotypes were isolated from seagulls in south China. These emerging C. jejuni strains had ganglioside-mimicry antigen structures and possessed high potential for triggering GBS. Sialylated LOS class R with GBS-associated serotypes isolated from seagulls highlight the risk of induced GBS around coastal or lakeside areas.

新发的携带唾液酸化R型脂寡糖的海鸥来源空肠弯曲菌具有诱发格林-巴利综合征风险 — 云南省，中国，2018年

陈晓丽¹，顾一心¹，王海瑞¹，周贵兰¹，张鑫¹，刘畅¹，邵祝军¹，张建中¹，张茂俊^1#

1传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心，北京，中国。

^# 通信作者：张茂俊，zhangmaojun@icdc.cn。

空肠弯曲菌感染诱导格林-巴利综合征的机制是空肠弯曲菌脂寡糖与人的神经节苷脂具有“分子模拟”特征。研究发现从我国南方地区的海鸥中分离到的12株空肠弯曲菌具有特异的血清型、菌株的脂寡糖为R型，具有类神经节苷脂结构特征。这部分新发的具有R型脂寡糖的菌株有诱发格林-巴利综合征的高风险。从海鸥中分离到的与格林-巴利综合征相关的，具有特定血清型及唾液酸化R型脂寡糖的空肠弯曲菌的出现，提醒我们应密切关注沿海和环湖地区空肠弯曲菌感染导致的格林-巴利综合征的发病风险。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.237.

Longitudinal Study on Puberty Onset and Adolescent Obesity — Suzhou City, Jiangsu Province, China, 2012–2022

Huiling Lyu¹; Ziyao Ding²; Bowen Chen³; Di Han²; Xi Wang¹; Xiao Jiang²; Jiale Hu¹; Hui Shen^1,2,4#; Jia Hu^1,2,4#

¹ School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

² Department of School Health, Suzhou Center for Disease Prevention and Control, Suzhou City, Jiangsu Province, China;

³ Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, USA; 

⁴ Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou City, Jiangsu Province, China

^# Corresponding author: Hui Shen, 18962168733@163.com;  Jia Hu, hujia200606@163.com.

This study aimed to describe the age at puberty onset in children and adolescents in Suzhou and to explore the relationship between pubertal timing and obesity in late adolescence. Based on the Health Promotion Program for Children and Adolescents (HPPCA) in Suzhou, 9,269 adolescents aged 15–17 years from 20 schools were enrolled, including 67,383 historical physical examination data from 2012 to 2020. The Preece & Baines growth model 1 was used to fit the age at take-off (ATO) and age at peak height velocity (APHV) of each subject. Pubertal timing was judged as early or non-early according to the 25th percentile (P25) of ATO and APHV, respectively. Linear regression and binary logistic regression models were used to analyze the relationship of ATO, APHV, and pubertal timing with body mass index (BMI) levels and obesity risks in late adolescence. The ATO for girls was 7.93±2.19 years, occurring 1.24 years earlier than for boys (P<0.05). The APHV for girls was 10.75±1.22 years, which was 1.67 years earlier than for boys (P<0.05). After adjusting for potential confounders, both ATO and APHV exhibited negative associations with endpoint BMI in late adolescence (β=-0.04, 95% CI: -0.07, -0.02; β=-0.17, 95% CI: -0.22, -0.12). ATO was negatively associated with obesity risk in late adolescence (OR=0.96, 95% CI: 0.93, 1.00). When stratified by gender, these significant associations were found among boys but not girls. Compared to participants in the non-early group, those in the early group with earlier ATO and APHV exhibited higher BMI levels, with β of 0.13 (95% CI: 0, 0.25) for ATO and 0.28 (95% CI: 0.16, 0.41) for APHV. For boys specifically, these associations appeared stronger; no analogous patterns were observed among girls. Boys, but not girls, in the early-onset group identified by ATO and APHV had increased obesity risks than their counterparts in the non-early group, with ORs of 1.25 (95% CI: 1.00, 1.56) for ATO and 1.26 (95% CI: 1.02, 1.55) for APHV. This study's findings indicate that ATO and APHV can serve as early risk indicators of adiposity in adolescents. Therefore, effective monitoring and management of pubertal development are essential, and preventive interventions should prioritize reducing childhood adiposity.

纵向研究青春发动时相与青少年肥胖 — 中国江苏省苏州市，2012–2020年

吕慧玲¹，丁子尧²，陈博文³，韩迪²，王希¹，姜潇²，胡佳乐¹，沈蕙^1,2,4#，胡佳^1,2,4#

¹ 南京医科大学公共卫生学院，南京市，江苏省，中国；

² 苏州市疾病预防控制中心学校卫生科，苏州市，江苏省，中国；

³ 宾夕法尼亚大学工程与应用科学学院，宾夕法尼亚州，美国；

⁴ 南京医科大学姑苏学院苏州市公共卫生高等研究院，苏州市，江苏省，中国。

^# 通讯作者: 沈蕙：18962168733@163.com，胡佳：hujia200606@163.com。

本文描述分析苏州市儿童青少年青春期发动年龄现况，探讨青春发动时相与青春期晚期肥胖的关联。依托苏州市儿童青少年健康监测项目，纳入20所学校9,269名15–17岁青少年及67,383人次的体检数据（2012-2020）。Preece & Baines生长模型1拟合每名研究对象的身高突增开始年龄（Age at Take-off，ATO）和身高速度高峰年龄（Age at Peak Height Velocity，APHV），根据ATO和APHV的P25将青春发动时相判定为提前和非提前。采用线性回归模型及二元Logistic回归，分析不同身高突增年龄及其发动时相与青春期晚期BMI水平和肥胖发生风险之间的关联。结果可见女生的ATO为（7.93±2.19）岁，比男生早1.24年（P<0.05）；女生的APHV为（10.75±1.22）岁，比男孩早1.67岁（P<0.05）。在调整了潜在的混杂因素后，ATO和APHV均与青春期晚期时BMI呈负相关（β=-0.04，95% CI：0.07，-0.02；β=-0.17，95% CI：-0.22，-0.12）；ATO与青春期晚期的肥胖风险呈负相关（OR=0.96，95% CI：0.93，1.00）。当按性别分层时，这些显著的关联仅在男孩中发现。与非提前组的青少年比，ATO和APHV提前组的青少年表现出更高的BMI水平[ATO：β=0.13（95% CI：0，0.25）；APHV：β=0.28（95% CI：0.16，0.41）]，对于男孩，这些关联似乎更强，在女孩中没有观察到类似的关联效应。与非提前相比，基于ATO和APHV确定的提前组的男生具有增加的肥胖风险[ATO：OR=1.25（95% CI：1.00，1.56），APHV：OR=1.26（95% CI：1.02，1.55）]。根据本文研究结果，ATO和APHV可以作为青少年肥胖的早期风险指标。因此，有效监测和管理青春期发育至关重要，预防性干预措施应优先考虑减少儿童肥胖。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.239

AI-Based Hematological Age Predictors and the Association Between Biological Age Acceleration and Type 2 Diabetes Mellitus — Chongqing Municipality, China, 2015–2021

Zhe Yin^1,2†; Yingnan Song^3†; Junhui Zhang^4†; Qiaoyun Dai^1,2; Xinyuan Zhang^1,2; Xueying Yang^1,2; Na Nie⁴; Cuixia Chen^1,2; Zongfu Cao^1#; Xu Ma^2,3#

Author affiliations:

1 National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China;

2 National Human Genetic Resources Sharing Service Platform, National Research Institute for Family Planning, Beijing, China;

3 Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China;

4 The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

†Joint first authors.

*Corresponding author: Zongfu Cao, caozongfu@egene.org.cn; Xu Ma, maxu_ky@nrifp.org.cn.

Biological age (BA) can represent the actual state of human aging more accurately than chronological age (CA). Using hematological data from 112,925 participants in southwestern China, collected between 2015 and 2021, this study constructed BA predictors using 7 machine learning (ML) methods (tailored separately for male and female populations). This study then analyzed the association between BA acceleration and type 2 diabetes mellitus (T2DM) within this data using logistic regression. Additionally, it examined the impact of glycemic control on BA in individuals with diabetes. Among all ML models, deep neural networks (DNN) delivered the best performance in male (MAE=6.89, r=0.75) and female subsets (MAE=6.86, r=0.74). BA acceleration showed positive correlations with T2DM in both male (OR: 2.22, 95% CI: 1.77–2.77) and female subsets (OR: 3.10, 95% CI: 2.16–4.46), while BA deceleration showed negative correlations in both male (OR: 0.32, 95% CI: 0.27–0.39) and female subsets (OR: 0.42, 95% CI: 0.33–0.53). Diabetics with normal fasting glucose had significantly lower BAs than those with impaired fasting glucose in all CA groups except for patients older than 80. Artificial intelligence (AI)-based hematological BA predictors show promise as advanced tools for assessing aging in epidemiological studies. Implementing AI-based BA predictors in public health initiatives could facilitate proactive aging management and disease prevention.

血液学生物年龄人工智能预测器及生物年龄加速与2型糖尿病的关联 — 中国重庆直辖市，2015–2021年

殷哲^1,2*; 宋迎楠^3*; 张俊辉^4*; 代巧云^1,2; 张鑫媛^1,2; 杨雪莹^1,2; 聂娜⁴; 陈翠霞^1,2; 曹宗富^1#; 马旭^2,3#

作者单位

1 国家人类遗传资源中心，国家卫生健康委科学技术研究所，北京，中国；

2 国家人类遗传资源共享服务平台，国家卫生健康委科学技术研究所，北京，中国；

3 中国医学科学院北京协和医学院，北京，中国；

4 重庆医科大学第一附属医院，重庆，中国。

*共同第一作者

*通信作者：曹宗富, caozongfu@egene.org.cn；马旭, maxu_ky@nrifp.org.cn。

生物年龄比实际年龄更能准确地表征人体衰老的实际状态。本研究利用2015年至2021年间在中国西南地区收集的112,925名参与者的数据，采用7种机器学习方法分别构建了性别特异性生物年龄预测模型。随后，本研究通过逻辑回归分析了生物年龄加速与2型糖尿病之间的关联，并进一步考察了血糖控制对糖尿病患者生物年龄的影响。在所有机器学习模型中，深度神经网络在男性（MAE=6.89，r=0.75）和女性（MAE=6.86，r=0.74）中预测性能表现最佳。生物年龄加速均与2型糖尿病的发生呈正相关（男性:OR=2.22，95% CI：1.77，2.77；女性：OR=3.10，95% CI：2.16，4.46）。相反，生物年龄减速则与2型糖尿病的发生呈负相关（男性：OR=0.32，95% CI：0.27，0.39）；女性：OR=0.42，95% CI：0.33，0.53）。除80岁以上的糖尿病患者之外，在所有其他年龄段中，空腹血糖正常的糖尿病患者其生物年龄显著低于空腹血糖受损的糖尿病患者。血液学生物年龄预测人工智能模型在衰老评估流行病学研究中面展现出巨大潜力。将生物年龄预测人工智能模型融入公共卫生举措中，能够有效推动主动老龄化管理和疾病预防。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.240