Epidemiological Characteristics of Fracture Among Children Aged 6–17 Years: A Large-Scale Cross-Sectional Survey — China, 2019–2021

Lu Cui¹; Qian Gan^2,3; Juan Xu²; Peipei Xu²; Titi Yang²; Wei Cao^2,3; Hongliang Wang²; Haoyan Guo^2,3; Ruihe Luo²; Jianfen Zhang²; Hui Pan²; Wenhua Zhao²; Zhenyu Yang²; Yuxiang Yan^1#; Qian Zhang^2,3#

1. Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China;

2. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China;

3. Key Laboratory of Public Nutrition and Health, National Health Commission of the People's Republic of China, Beijing, China.

# Corresponding authors: Yuxiang Yan, yanyxepi@ccmu.edu.cn; Qian Zhang, zhangqian7208@163.com.

Fractures are frequently occurring injuries in children that have significant repercussions, and most epidemiological studies in which were hospital based. Therefore, in order to investigate the prevalence and distribution of fractures among children and adolescents aged 6-17 years in various regions of China, a descriptive analysis was conducted, using the data from the National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China (2019-2021), in 60,930 aged 6-17 years old children. Results revealed that for children aged 6-17 in China, the overall fracture prevalence was 6.93%, with a higher incidence in males (8.13%) compared to females (5.71%), and in rural areas (7.22%) compared to urban ones (6.62%). The prevalence of fractures increased with age, ranging from 3.18% in males aged 6 years to 13.38% in those aged 17 years, and from 2.86% in females aged 6 years to 8.07% in females aged 17 years. The most common site of fracture was the upper limbs, constituting 63.0% of cases at a prevalence of 4.24%. Clearly, childhood fractures represent a significant public health issue in China, underscoring the need for enhanced fracture prevention awareness, especially among children in rural areas and male children during middle childhood.

6-17岁儿童骨折的流行病学特征 — 中国，2019–2021

崔露¹, 甘倩^2,3,许娟²,徐培培²,杨提提²,曹薇^2,3,王宏亮²,郭浩岩^2,3,罗瑞鹤²,张建芬²,潘慧²,赵文华²,杨振宇²,闫宇翔^1#,张倩^2,3#

1 首都医科大学公共卫生学院, 北京，中国；

2 中国疾病预防控制中心营养与健康研究所，北京，中国；

3 国家卫生健康委公共营养与健康重点实验室，北京，中国。

#通讯作者：闫宇翔，yanyxepi@ccmu.edu.cn；张倩，zhangqian7208@163.com。

骨折作为一种常见的伤害形式，对儿童健康构成了严重的威胁,相关的流行病学研究也是多基于临床数据。因此，为了解和掌握中国不同地区6-17岁儿童和青少年骨折患病率及其分布情况，本研究利用2019-2021年“中国0-17岁儿童营养与健康系统调查与应用”的60,930名6-17岁儿童数据进行了描述性分析。结果显示，我国6–17岁儿童骨折的患病率为6.93%，其中男性儿童骨折患病率高于女性（8.13% vs 5.71%），农村高于城市（7.22% vs 6.62%）。随年龄的增长骨折患病率增加，男性从6岁时的3.18%增长至17岁时的13.38%，女性从2.86%增长至8.07%。在骨折部位方面，上肢（4.24%）为骨折最频发部位，占所有骨折的63.0%。儿童骨折问题在中国已成为一个不容忽视的公共卫生挑战。为了有效应对这一挑战，我们呼吁社会各界加强儿童骨折预防意识，特别是对于农村儿童和中间年龄段男性儿童群体，应给予更多的关注。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.174

Establishing and Validating Refractive Error Reference Values for Myopia Prediction Among Children Aged 6–12 Years — Jiangsu Province, China, 2018–2023

Xiyan Zhang^1,2, Chen-Wei Pan³, Wei Du⁴, Yonglin Zhou², Jie Yang^1,2, Yan Wang², Yiliang Xin², Wei Lu^1,2, Hongxia Ma¹

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

2 Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, Jiangsu Province, China;

3 School of Public Health, Suzhou Medical College of Soochow University, Suzhou City, Jiangsu Province, China;

4 School of Public Health, Southeast University, Nanjing City, Jiangsu Province, China.

*Corresponding author: Hongxia Ma, hongxiama@njmu.edu.cn; Wei Lu, weiluxx@sina.cn.

Previously, it has been proved that a simplified model that refraction error value provides a robust and efficient means of predicting myopia for non-myopic students. The intervention targeting non-myopic children with alert refraction errors (or insufficient hyperopia reserve) holds significant importance in reducing the incidence rate of myopia. This study, comprising two phases (surveillance and cohort studies), was aiming to pinpoint precise refractive error value for onset of myopia prediction among non-myopic children in Jiangsu Province. When conducting myopia screenings using pupil dilation for non-myopic populations: the cycloplegic 50th percentile refractive error emerges as a more precise predictive indicator. When non-myopic students reach the 50th cycloplegic refractive error value, the likelihood of myopia onset in the subsequent year increases 7-fold for boys and 4.7-fold for girls, compared to control group. When conducting myopia screenings without pupil dilation: this study advocates for the incorporation of AL and CC values as supplementary indicators in screenings.

6-12岁儿童非近视儿童屈光度参考值的建立和队列验证 — 中国江苏省，2018-2023年

张锡彦^1,2, 潘臣炜³, 杜伟⁴, 周永林², 杨婕^1,2, 王艳², 信义亮², 陆伟^1,2#, 马红霞^1#

1 南京医科大学公共卫生学院，南京市，江苏省，中国；

2 江苏省疾病预防控中心，南京市，江苏省，中国；

3 苏州大学苏州医学部公共卫生学院，苏州市，江苏省，中国；

4 东南大学公共卫生学院，南京市，江苏省，中国。

#通讯作者：马红霞，hongxiama@njmu.edu.cn；陆伟，weiluxx@sina.cn。

已有研究证明屈光误差值的简化模型为非近视学生预测近视提供了一种稳健有效的方法。针对预警屈光不正（或远视储备不足）的非近视儿童的干预措施在降低近视发病率方面具有重要意义。南京医科大学张锡彦、陆伟、马红霞等人自2018年联合江苏省疾病预防控制中心建立了儿童近视与健康福祉队列研究，收集指标包括了角膜曲率、眼轴长度、行为习惯等指标,利用散瞳验光的金标准进行筛查。自然观察学生从远视储备（足）→预警（近视前）→近视→高度近视全过程，从而制定适合地方的远视储备标准，为尽早发现远视储备不足的儿童提供理论支持和指导。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.175

Hearing Loss and Depressive Symptoms Among community-Dwelling Older Adults — Liaoning, Henan, and Guangdong Provinces, China, 2019–2020

Ran An^1&, Lu Cui^2&, Liyuan Yang³, Han Zhang¹, Shige Qi^1#, Haoyan Guo^4#

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

2. School of Public Health, Capital Medical University, Beijing, China;

3. Chengnan Community Health Service Center of Changping District, Beijing, China;

4. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.

& Joint first authors.

# Corresponding authors: Haoyan Guo, guohy@chinacdc.cn; Shige Qi, qishige@ncncd.chinacdc.cn.

Hearing loss and depressive symptoms are increasingly becoming major health issues among the elderly. Surveys indicated that the prevalence of depression is higher among the elderly compared to other age groups. Numerous studies had demonstrated that hearing loss in older adults leads to an increased risk of depressive symptoms. Therefore, in order to further examine the association between hearing loss and depressive symptoms among elderly individuals in Chinese communities, as well as the differences by age and gender, this study analyzed data from the second round of the project of Prevention and Intervention on Neurodegenerative Disease for Elderly in China (PINDEC) conducted in three provinces of China from 2019 to 2020. A total of 9,865 community-dwelling elderly individuals aged 60 years and above participated in the survey. The results showed that older adults aged 60-74 years with severe or profound hearing loss had a higher risk of depressive symptoms (OR=1.50, 95% CI: 1.04, 2.16). When stratified by gender, severe or profound hearing loss was significantly associated with depressive symptoms among elderly women aged 60-74 years (OR=1.60, 95% CI: 1.01-2.56). This study shows that elderly people with severe or extremely severe hearing loss had a significantly increased risk of depression symptoms. It is necessary to develop a national strategy for preventing and intervening in elderly hearing loss in order to reduce the risk of depression symptoms in the elderly population.

社区老年人听力损失和抑郁症状关系调查分析 — 中国辽宁、河南和广东省，2019-2020年

安然^1&,崔露^2&,杨丽媛³,张晗¹,齐士格^1#,郭浩岩^4#

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；

2． 首都医科大学公共卫生学院，北京，中国；

3． 北京市昌平区城南社区卫生服务中心，北京，中国；

4． 中国疾病预防控制中心营养与健康研究所，北京，中国。

&共同第一作者。

#通讯作者：郭浩岩，guohy@chinacdc.cn；齐士格，qishige@ncncd.chinacdc.cn。

听力受损和抑郁逐渐成为老年人主要健康问题，调查显示与其他年龄组相比，老年人患抑郁症的比例更高。大量研究表明，老年人听力损失会导致抑郁症状风险增加。因此，为进一步探讨中国社区老年人群中听力损失与抑郁症状的关系及其年龄性别差异，本研究利用2019-2020年在中国三省开展的老年期重点疾病预防和干预项目（PINDEC）第二轮调查数据，对参与调查的9,865名60岁及以上的社区老年人进行分析。结果显示，60-74岁存在重度或极重度听力损失的老年人抑郁症状风险较高(OR=1.50, 95% CI: 1.04，2.16)。按照性别分层后，60-74 岁的老年女性重度或极重度听力损失与抑郁症状之间显著相关（OR=1.60, 95% CI: 1.01，2.56）。本研究结果表明，患有重度或极重度听力受损的老年人抑郁症状风险明显升高，并存在年龄和性别差异。为降低老年人群的抑郁症状发生风险，非常有必要制定国家老年听力损失预防和干预策略。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.176

Hearing Loss and Cognitive Impairment Among Community-Dwelling Older Adults — Liaoning, Henan, and Guangdong Provinces, China, 2019–2020

Shige Qi^1&, Yuzhang Huang^2&, Liyuan Yang³, Haoyan Guo⁴, Ran An¹, Lu Cui⁵, Han Zhang¹, Jing Wu^1#

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

2. Department of Health Policy Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA;

3. Chengnan Community Health Service Center of Changping District, Beijing, China;

4. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China;

5. School of Public Health, Capital Medical University, Beijing, China.

& Joint first authors.

# Corresponding author: Jing Wu, wujing@chinacdc.cn.

Hearing loss (HL) and cognitive impairment are both highly prevalent neurological complications for older adults. Many research results have shown that about 59% of elderly people suffer from varying degrees of hearing loss, and about 22% of elderly people have cognitive impairment. A systematic review and meta-analysis showed that age-related hearing loss was a possible biomarker and modifiable risk factor for cognitive impairment. Aimed to explore the association between HL and cognitive among the elderly population in China, this study utilized the data from the second round of the project of Prevention and Intervention on Neurodegenerative Disease for Elderly in China (PINDEC), which was conducted in 3 provincial-level administrative divisions (PLADs) in 2019-2020, a multivariate statistical analysis was used on the data of 10347 community elderly people aged 60 and above who participated in the survey. The result shows that compared with no HL group, the odds ratio for cognitive impairment were 1.23(1.08-1.40) for mild HL, 1.55(1.32-1.82) for moderate HL, and 1.87(1.47-2.39) for severe or profound HL. The association between hearing loss and cognitive impairment highlights the need to integrate the early identification and intervention of these problems into primary care, as both are risk factors for healthy aging and preventable and/or treatable conditions.

社区老年人听力损失和认知障碍关系调查分析 — 中国辽宁、河南和广东省，2019-2020年

齐士格^1&，黄羽张^2&，杨丽媛³，郭浩岩⁴，安然¹，崔路⁵，张晗¹，吴静^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；

2美国约翰斯·霍普金斯大学彭博公共卫生学院卫生政策管理系，巴尔的摩市，马里兰州，美国；

3北京市昌平区城南社区卫生服务中心，北京，中国；

4中国疾病预防控制中心营养与健康研究所，北京，中国；

5首都医科大学公共卫生学院, 北京，中国。

&共同第一作者。

#通讯作者：吴静，wujing@chinacdc.cn。

听力损失和认知障碍是老年人群常见的两种神经系统疾患，很多研究结果显示有59%左右的老年人存在不同程度的听力损失，有22%左右的老年人存在认知障碍。一项系统综述和荟萃分析结果表明，与年龄相关的听力损失可能是认知障碍危险因素或生物标志物。所以，为了进一步探讨在中国社区老年人群中听力损失与认知障碍的关系，本研究利用2019-2020年在中国三省开展的老年期重点疾病预防和干预项目（PINDEC）第二轮调查数据，对参与调查的10,347名60岁及以上的社区老年人数据进行了多因素统计分析。结果显示，与无听力损失人群相比，轻度听力损失的人群认知障碍优势比为1.23（1.08-1.40），中度听力损失人群认知障碍优势比为1.55（1.32-1.82），重度或深度听力损失人群认知障碍优势比为1.87（1.47-2.39）。听力损失和认知障碍之间的关联突出表明，两者都是影响健康老龄化的危险因素，也是可预防和/或可治疗的疾病，有必要将这些疾患的早期识别和干预纳入初级保健。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.177

Handgrip Strength and Low Muscle Strength Rate in Chinese Adults — China, 2020

Jiarong Zhu¹, Jingjing Wang¹, Chaoqun Fan¹, Dongming Wu¹, Qiang Feng^1#

1. Department of National Fitness and Scientific Exercise Research Center, China Institute of Sport Science, Beijing, China.

#Corresponding author: Qiang Feng, fengqiang@ciss.cn.

A national study of handgrip strength (HS) and low muscle strength rate (LMSR) among Chinese adults in 2020 found that HS declined on average by 3.1 kg since 2000, with males having significantly higher HS than females (40.4 kg vs 25.1 kg). Peak HS occurs between ages 30–34, followed by an age-related decline. LMSR markedly increased with age, being 13.7 times higher in those aged 75–79 compared to 20–24. Urban residents showed higher HS and lower LMSR than rural residents. The findings underscore the importance of promoting resistance training and a nutritious diet, especially among women, the elderly, and rural communities, to improve muscle strength and prevent sarcopenia. With musculoskeletal disorders increasingly recognized as major global health challenges, the study highlights the need for policies and interventions to enhance HS and skeletal muscle health in China.

成年人握力和低肌肉力量率 —中国，2020年

朱家荣¹；王晶晶¹；范超群¹；武东明¹；冯强^1#

1. 国民体质与科学健身中心，国家体育总局体育科学研究所，北京，中国。

^#通讯作者：冯强, fengqiang@ciss.cn。

一项关于2020年中国成年人握力和低肌肉力量率的全国性研究发现，自2000年以来，平均手握力下降了3.1公斤，男性手握力显著高于女性（40.4公斤对25.1公斤）。握力峰值出现在30至34岁年龄段，随后随年龄增长而下降。随着年龄的增长，低肌肉力量检出率显著增加，在75至79岁年龄段的人群中比20至24岁年龄段高出13.7倍。城市居民的握力更高且低肌肉力量率更低。这些发现强调了推广抗阻训练和营养饮食的重要性，特别是对于女性、老年人以及农村社区而言，以改善肌肉力量并预防肌肉减少症。随着肌肉骨骼障碍越来越多地被认定为全球主要健康挑战，该研究突出了需要制定政策和干预措施来增强中国人群的手握力和骨骼肌健康的必要性。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.178