General Population In Shanghai Research Articles

Analysis of perfluorinated compounds in human serum from the general population in Shanghai by liquid chromatography-tandem mass spectrometry (LC-MS/MS)

Perfluorinated compounds (PFCs) have potential health risk to human. In this paper, human serum samples collected from Jiading District, Shanghai aged from 23 to 87 years old (12 male and 33 female) were analyzed for 17 perfluorinated compounds (PFCs). A novel method for the elimination of background contamination of perfluorooctanoic acid (PFOA) generated from instrument by the modification of high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) has also been developed and validated. The limit of detection (LOD) for all monitored PFCs range from 0.02 to 0.18 ng mL−1. The limit of quantitation (LOQ) for PFOS and PFOA was 2.23 and 1.60 ng mL−1, respectively, and for other PFCs it ranged from 0.04 to 0.88 ng mL−1. Of the 17 PFCs analyzed in Shanghai serum, eleven were found. The dominating PFCs in all samples were perfluorooctanesulfonate (PFOS) and PFOA with a fraction of 49.5%, 34.2%, respectively. The median total concentration of each serum samples was 53.43 ng mL−1 with a range from <LOD to 99.37 ng mL−1. The results indicate a high human exposure to PFCs in Shanghai region. Compared with other cities in China and some other countries, PFOA and PFDA concentrations in the serum of general population of Shanghai are highest. For all donors, no significant association between age and PFCs was found (p = 0.125–0.951) and no workplace significant correlation was found (p = 0.247–0.861). Since no signification is founded and PFCs exposure is prevalent, further investigation is needed to explore its source and potential health impact. These results will also provide significant background data of PFCs in Shanghai.

Dietary exposure to aluminium from wheat flour and puffed products of residents in Shanghai, China

A dietary survey of 3431 residents was conducted by a 24-h dietary recall method in Shanghai, China, quarterly from September 2013 to September 2014. A total of 400 food samples were tested for aluminium concentration, including wheat flour and puffed products from 2011 to 2013. Probabilistic analysis was used to estimate the dietary exposure to aluminium from wheat and puffed products. The means of dietary aluminium exposure for children (2–6 years old), juveniles (7–17 years old), adults (18–65 years old) and seniors (over 65 years old) were 1.88, 0.94, 0.44 and 0.42 mg kg−1 body weight (bw) week−1 respectively, with a population average of 0.51 mg kg−1 bw week−1. The proportions of those who had aluminium exposure from wheat and puffed products lower than the provisional tolerable weekly intake (PTWI) were 77%, 90%, 97%, and 97% respectively from children to seniors. We estimated that the proportions of people at risk would decrease by 13%, 6%, 2% and 2% respectively under the new China National Standards – GB 2760–2014 National Food Safety for Standards for using food additives. The results indicated that aluminium from wheat flour and puffed products is unlikely to cause adverse health effects in the general population in Shanghai; however, children were at a higher risk of excess aluminium exposure. Significant improvements in reducing the dietary exposure to aluminium are expected in the population, especially for children after the implementation of GB 2760–2014.

Glutathione S-transferase P1 Ile105Val polymorphism and breast cancer risk: convergence and divergence of the two recent meta-analyses

We read with great interest the recent meta-analysis by Lu et al. [1], which has reached important conclusions about the association between glutathione S-transferase P1 (GSTP1) Ile105Val polymorphism and breast cancer risk. Nevertheless, some methodological issues need to be addressed concerning the meta-analysis by Lu et al. [1]. Importantly, three sizeable eligible studies [2–4] (2,204 cases and 2,530 controls) have not been included in the metaanalysis, even though they satisfied the search criteria. In addition, close inspection of the data provided by the authors (Table 1) revealed some issues that are worth discussing, so as to provide the scientific audience with an accurate presentation of the underlying data. Specifically, the data reported by Lu et al. [1] for the studies by Maugard et al. [5], Krajinovic et al. [6], Unlu et al. [7] and Torresan et al. [8] do not seem in line with the data provided in the original publications. The genotype frequencies for Ile/Ile, Ile/Val, Val/Val in cases and controls should read: 99-101-20-81-90-25 for the study by Maugard et al. [5], 69-55-5-91-73-13 for the study by Krajinovic et al. [6], 2826-11-51-37-20 for the study by Unlu et al. [7] and 54-3513-77-22-3 for the study by Torresan et al. [8] (italics denote the discrepancies between Lu et al. [1] and the original publications). The above may imply that the original odds ratios for the aforementioned studies may significantly differ from those calculated by Lu et al. [1]. It can be also secondarily noted that the selection of controls in the study by Lee et al. [9] is not hospital-based, given that Lee et al. [9] clearly states that ‘‘controls were randomly selected from the general population of Shanghai’’. As a result, the studies by Lee et al. [9] and Egan et al. [10] seem to have been performed on mutually overlapping populations; consequently the smaller study [10] should have been excluded from the analysis. Despite the above, the results reported by Lu et al. [1] confirm our previous meta-analysis [11] and essentially expand them among the subset of hospital-based studies. Discussing methodological issues of meta-analyses [12, 13] may well elaborate and substantiate their original results.

GC-FPD measurement of urinary dialkylphosphate metabolites of organophosphorous pesticides as pentafluorobenzyl derivatives in occupationally exposed workers and in a general population in Shanghai (China)

Measurement of organophosphorus (OP) pesticide metabolites in human biological fluids is an important biomarker of pesticides exposure. We measured the urinary excretion of OP pesticide metabolites to evaluate occupational and non-occupational exposure to OP pesticides in the Chinese population in Shanghai (Eastern China). We collected urine samples from 30 exposed workers in a dimethoate emulsion packing division and from 60 healthy adults without any report of occupational exposure. DMP, DMTP, DMDTP, DEP, DEDP and DEDTP were measured by GC-FPD after derivatization with pentafluorobenzyl bromide. The LOQ values (1 mL urine) were 2.0 μg/L for DMP and DETP, 4.0 μg/L for DEP and DEDTP, 8.0 μg/L for DMDTP, and 10.0 μg/L for DMTP. Dimethyl phosphates were detected in the majority of the urine samples, i.e., 90–100% in the exposed group and 80–87% in the control group. The concentration of the urinary diethyl phosphates DEP and DETP was above the LOQ values in 40 and 20% of samples for the exposed group, and in 50 and 30% of the samples for the control group, respectively. DEDTP was not detectable in the urine samples except for a post-shift exposed worker (detection frequency, 6.7%). Median creatinine-adjusted values (μg/g cr.) for DAP in Chinese with pre-shift, post-shift and without occupational exposure to OP were 316, 584 and 170 for DMP, below LOQ, 115 and 114 for DEP, 840, 1730 and 693 for DMTP, and 255, 756 and 135 for DMDTP, respectively . In all subjects, the highest excretion levels were found for DMTP . Several OP pesticide metabolites were frequently detected in urine samples of both populations studied.

Impact of hypertension on health-related quality of life in a population-based study in Shanghai, China

The purpose of this study was to examine the relationship between hypertension and health-related quality of life (HRQL) in a general representative Chinese population, and to explore the impacts of comorbidity on people with hypertension. Population-based cross-sectional survey. A self-administered questionnaire survey including demographic questions and the Mandarin version of 36-item Short Form (SF-36) was conducted in a general population in Shanghai, China. In total, 1034 subjects participated. The SF-36 dimension scores of hypertensive subjects were compared with those of normotensive subjects. Independent association of hypertension with each quality-of-life domain was analysed using a multiple linear regression model, so were the effects of comorbidity on the HRQL of hypertensive subjects. Nine hundred and nineteen respondents were included in the analysis, and 16.97% reported hypertension. Respondents with hypertension scored lower than those without hypertension in at least five SF-36 dimensions. The dimension of role limitations due to physical problems was the most affected, whereas the mental health dimension was the least affected. Hypertensive subjects with comorbidity experienced lower SF-36 scores than hypertensive subjects without comorbidity. Hypertension markedly impairs quality of life in terms of both physical and mental health. Comorbidity further deteriorates HRQL among people with hypertension. The findings suggest that people with hypertension represent a vulnerable population, and it is important to prevent and treat comorbidity of hypertension.

Alcohol consumption and metabolic syndrome among Shanghai adults: A randomized multistage stratified cluster sampling investigation

To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. We performed a cross-sectional analysis of data from the randomized multistage stratified cluster sampling of Shanghai adults, who were evaluated for alcohol consumption and each component of metabolic syndrome, using the adapted U.S. National Cholesterol Education Program criteria. Current alcohol consumption was defined as more than once of alcohol drinking per month. The study population consisted of 3953 participants (1524 men) with a mean age of 54.3 +/- 12.1 years. Among them, 448 subjects (11.3%) were current alcohol drinkers, including 405 males and 43 females. After adjustment for age and sex, the prevalence of current alcohol drinking and metabolic syndrome in the general population of Shanghai was 13.0% and 15.3%, respectively. Compared with nondrinkers, the prevalence of hypertriglyceridemia and hypertension was higher while the prevalence of abdominal obesity, low serum high-density-lipoprotein cholesterol (HDL-C) and diabetes mellitus was lower in subjects who consumed alcohol twice or more per month, with a trend toward reducing the prevalence of metabolic syndrome. Among the current alcohol drinkers, systolic blood pressure, HDL-C, fasting plasma glucose, and prevalence of hypertriglyceridemia tended to increase with increased alcohol consumption. However, low-density-lipoprotein cholesterol concentration, prevalence of abdominal obesity, low serum HDL-C and metabolic syndrome showed the tendency to decrease. Moreover, these statistically significant differences were independent of gender and age. Current alcohol consumption is associated with a lower prevalence of metabolic syndrome irrespective of alcohol intake (g/d), and has a favorable influence on HDL-C, waist circumference, and possible diabetes mellitus. However, alcohol intake increases the likelihood of hypertension, hypertriglyceridemia and hyperglycemia. The clinical significance of these findings needs further investigation.

Trauma and Dissociation in China

In order to determine whether pathological dissociation occurs in China, the authors conducted a survey among psychiatric inpatients, outpatients, and the general population in Shanghai, China. There is virtually no popular or professional knowledge of dissociative identity disorder in China, and therefore professional and popular contamination cannot exist. Chinese versions of the Dissociative Experiences Scale and the Dissociative Disorders Interview Schedule were administered to 423 inpatients, 304 outpatients, and 618 factory workers in Shanghai by Chinese psychiatrists working at the Shanghai Mental Health Center. Dissociative disorders were diagnosed in 24 respondents by structured interview, and 15 respondents fell into the dissociative taxon on the Dissociative Experiences Scale. The outpatients reported the highest rates of childhood physical and/or sexual abuse and of pathological dissociation. Pathological dissociation can be detected readily among psychiatric outpatients in China but is much less common in the general population. Pathological dissociation is more frequent in more traumatized subsamples of the Chinese population. The findings are not consistent with the sociocognitive, contamination, or iatrogenic models of dissociative identity disorder.

Fatty liver and the metabolic syndrome among Shanghai adults

To explore the relationship between fatty liver and the metabolic syndrome in the adults of Shanghai and evaluate the value of fatty liver as a marker for risk factor clustering. Questionnaires, physical examinations, laboratory tests (blood lipid and glucose) and real-time liver ultrasonographies were performed in Shanghai adults and analyzed using randomized, multistage, stratified cluster sampling. Prevalence of the metabolic syndrome was defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria with the exception of abdominal obesity (waist circumference > 90 cm in men and > 80 cm in women); fatty liver was diagnosed in accordance with the presence of an ultrasonographic pattern consistent with 'bright' liver (brightness and posterior attenuation of liver). The study population consisted of 3175 subjects (1218 men) with a mean (+/- SD) age of 52.4 +/- 15.1 years. Metabolic syndrome and fatty liver were found in 726 (22.87%) and 661 (20.82%) of sampled cases, respectively. After adjustment by age and sex, the prevalence of the metabolic syndrome and fatty liver in the general population of Shanghai were 15.30 and 17.29%, respectively. The risk for fatty liver in subjects with abdominal obesity, diabetes, dyslipidemia and hypertension increased 32.78-fold (95% confidence interval (CI) 14.85-72.35), 31.58-fold (95% CI 14.18-70.35), 22.64-fold (95% CI 10.26-49.99) and 23.25-fold (95% CI 10.54-51.30), respectively, compared with controls, whereas the risk for fatty liver in subjects with metabolic syndrome was increased by 39.33-fold (95% CI 17.77-87.05). After the 661 patients with fatty liver had been stratified by body mass index (BMI), the prevalence of abdominal obesity, hypertension and the metabolic syndrome were increased from 25.0, 47.2 and 36.1%, respectively, in people with normal BMI to 81.0, 73.8 and 55.4%, respectively, in obese persons. However, the prevalence of hypertriglyceridemia, high fasting glucose and low high-density lipoprotein-cholesterol showed no significant changes with increased BMI. Moreover, among fatty liver patients with normal BMI, the detection rate for one or more features of metabolic disorders was as high as 83.3% and that for five features was 2.8%. Compared with obesity (BMI > or = 25 kg/m2) and abdominal obesity, fatty liver had the highest clustering rate, specificity, positive predictive value and attributable risk percentage in detecting risk factor clustering in both sexes. There is a high prevalence of metabolic syndrome and fatty liver among Shanghai adults. Metabolic disorders are closely related to fatty liver; moreover, fatty liver appears to be a good predictor for the clustering of risk factors for metabolic syndrome.

Prevalence of and risk factors for fatty liver in a general population of Shanghai, China

To determine the prevalence and risk factors of fatty liver (FL) among Shanghai adults. A cross-sectional ultrasonographic survey with randomized multistage stratified cluster sampling was used. The study included 3175 subjects (1218 men) with a mean age of 52 years. FL was found in 661 (20.82%) subjects. After adjustment by age and sex, FL prevalence was found to be 17.29%, and the prevalences of alcoholic, suspected alcoholic and nonalcoholic FL were determined to be 0.79, 1.15 and 15.35%, respectively. Generally, age, body mass index (BMI), waist circumference, blood pressure, and the prevalences of obesity, diabetes, hypertension and dyslipidemia were all significantly higher in FL patients than in controls; In contrast, the levels of high-density-lipoprotein cholesterol (HDL-C), education and physical activity were markedly lower. Multiple regression analyses showed that only nine factors (male, educational level, waist circumference, BMI, HDL-C, triglyceride, fasting plasma glucose, diabetes and hypertension) were closely related to FL. In excessive drinkers, obesity increased the risk for FL by 4.8-fold, but excessive drinking was associated with only a 1.5-fold increased risk in obese subjects. FL in Shanghai is highly prevalent and mainly related to multiple metabolic disorders.

Plasma sex steroid hormones and breast cancer risk in Chinese women.

Estrogens regulate the growth and differentiation of mammary cells and play an important role in the development of breast cancer. High circulating levels of estrogens are associated with increased risk of breast cancer in Caucasian women. Because Asian women have low estrogens in the circulation compared with their Caucasian counterparts, the effect of estrogens on breast cancer risk in populations with low circulating estrogens remains to be elucidated. We conducted a population-based case-control study in China to evaluate the association of sex steroid hormones with breast cancer risk in Chinese women. Our study included 300 incident cases with primary breast cancer and 300 age- and menopausal status-matched healthy controls randomly selected from the general population in Shanghai. Fasting blood samples were collected from cases prior to any treatment and from their matched controls. Commercial immunoassays were used to measure plasma concentrations of estradiol, estrone, estrone sulfate, testosterone, progesterone, dehydroepiandrosteindian sulfate (DHEA-S) and steroid hormone-binding globulin (SHBG). Conditional logistic regression analysis was performed to examine the association between steroid hormones and breast cancer risk. The results showed that breast cancer risk was elevated with increasing levels of estrone and testosterone (p for trend < 0.05) but not with DHEA-S, estradiol, estrone sulfate, progesterone or SHBG. The estimated relative risks between upper and lower tertiles were 2.07 (95% confidence interval [CI] 0.97-4.41) for estrone in postmenopausal women, 2.01 (95% CI 0.96-4.21) for testosterone in premenopausal women, and 2.40 (95% CI 1.11-5.21) for testosterone in postmenopausal women, after adjusting for age at first live birth, waist-to-hip ratio, total calorie intake, a history of fibroadenoma, a family history of breast cancer and SHBG. These results, in general, are consistent with the findings in Caucasian women and indicate that high sex steroid hormones in the circulation, both androgen and estrogen, are associated with increased risk of breast cancer even in populations with relatively low sex hormones.

Abortion history and breast cancer risk: results from the Shanghai Breast Cancer Study.

Studies of the association between induced abortion and breast cancer risk have been inconsistent, perhaps due to underreporting of abortions. Induced abortion is a well-accepted family planning procedure in China, and women who have several induced abortions do not feel stigmatized. The authors used data from a population-based case-control study of breast cancer among women age 25-64 conducted between 1996 and 1998 in urban Shanghai to assess whether a history of and the number of induced abortions were related to breast cancer risk. In-person interviews were completed with 1,459 incident breast cancer cases ascertained through a population-based cancer registry, and 1,556 controls randomly selected from the general population in Shanghai (with respective response rates of 91% and 90%). After adjusting for confounding, there was no relation between ever having had an induced abortion and breast cancer (odds ratio [OR] = 0.9, 95% confidence interval [CI] 0.7-1.2). Women who had 3 or more induced abortions were not at increased risk of premenopausal breast cancer (OR = 0.9, 95% CI 0.6-1.4) or postmenopausal breast cancer (OR = 1.3, 95% CI 0.8-2.3). These results suggest that a history of several induced abortions has little influence on breast cancer risk in Chinese women.

Prevalence of TT virus and GBV-C infections among patients with liver diseases and the general population in Shanghai, China.

To determine the prevalence of TT virus (TTV) and GB virus C/hepatitis G virus (GBV-C) infections among patients with liver disease and the general population in Shanghai, China, we studied 90 patients with liver diseases (acute hepatitis, 28; chronic hepatitis, 27; liver cirrhosis, 20; hepatocellular carcinoma, 15) and 90 age, sex matched healthy blood donors as controls. There were no significant differences in the clinical and demographic characteristics between the two groups, except for liver function test values. There was a statistical difference between the patient group and the control group with regard to the prevalence of TTV DNA (23.5% in patient group, 11.1% in control group, P < 0.05), although no differences in clinical features could be found between TTV DNA-positive and negative subjects. Also, no differences in TTV DNA prevalence among various categories of liver diseases were noted (P = NS). The prevalence of HBsAg was significantly different between the patient group (36.7%) and the control group (3.3%) (P0.01), whereas the prevalence of anti-HCV and GBV-C RNA were not significantly different between the two groups. The nucleotide sequences were determined in the TTV DNA-positive samples and evaluated using phylogenetic analysis which suggested that they could be divided into two main genotypes designated as genotype 1 and 2. There were five samples clustered into 3 hitherto unknown subtypes of genotype 2. We concluded that (1) although TTV infection is widespread among both groups and there is a statistical difference of TTV infection between them, no hepatic damaging evidence and correlation with certain liver disease could be found in this study, suggest that TTV may not be major cause of liver disease, (2) GBV-C infection is frequent, but the virus is not the cause of liver diseases, and (3) new subtypes of TTV may exist in Shanghai, China.