BMC Public Health最新文献

{"title":"Burden, trends, projections, and spatial patterns of lip and oral cavity cancer in Iran: a time-series analysis from 1990 to 2040.","authors":"Farhad Noravesh, Seyed Ehsan Beladian Behbahan, Afsaneh Saeediankia, Ayad Bahadorimonfared, Mehdi Azizmohammad Looha, Gohar Mohammadi","doi":"10.1186/s12889-025-22202-8","DOIUrl":"10.1186/s12889-025-22202-8","url":null,"abstract":"<p><strong>Background: </strong>Lip and oral cavity cancer (LOCC) is a significant public health concern worldwide. This study investigated the long-term trends in the LOCC burden in Iran from 1990 to 2021.</p><p><strong>Methods: </strong>We analyzed LOCC burden in Iran from 1990 to 2021 using the Global Burden of Disease (GBD) 2021 dataset, focusing on age-standardized disability-adjusted life years (ASDR), mortality rates (ASMR), and incidence rates (ASIR) stratified by sex and province. Joinpoint regression analysis was used to identify temporal trends, and the annual percent change (APC) and average APC (AAPC) were calculated. Future projections up to 2040 were generated using a hybrid forecasting model (ARIMA, ETS, and neural networks). Spatial analysis detected hotspot and coldspot regions in 1990 and 2021.</p><p><strong>Results: </strong>We observed a significant increase in the LOCC burden across all three indicators (disability-adjusted life years [DALY], ASMR, and ASIR) from 1990 to 2021. Joinpoint analysis revealed significant temporal trends, with an overall upward trajectory in the AAPC for both sexes combined and separately. Specifically, the overall AAPC for the ASDR was 0.34% (95% confidence interval [CI]: 0.26,0.39) for both sexes, 0.40% (95% CI: 0.32,0.45) for females, and 0.35% (95% CI: 0.27,0.42) for males. For the ASMR, the overall AAPC was 0.41% (95% CI: 0.34,0.46), 0.54% (95% CI: 0.48,0.58) for females, and 0.36% (95% CI: 0.29,0.42) for males. Similarly, the overall AAPC for ASIR was 1.33% (95% CI: 1.24,1.40), 1.51% (95% CI: 1.43,1.59) for females, and 1.26% (95% CI: 1.17,1.33) for males. Geographic variations were evident, with most provinces exhibiting increasing ASDR and ASMR, while ASIR displayed a consistent upward trend across all provinces. Notably, females showed a slightly more pronounced increase in ASDR, ASMR, and ASIR compared to males. Projections indicate a declining trend in DALYs, a fluctuating but stable mortality rate, and a continuous rise in incidence by 2040. Spatial analysis indicated no significant spatial autocorrelation at the national level in both 1990 and 2021.</p><p><strong>Conclusion: </strong>Our findings highlight a rising burden of LOCC in Iran, with future projections indicating a growing incidence rate. Targeted public health interventions addressing regional disparities and risk factors are crucial. Sex-specific and region-specific policies, along with early detection strategies, are essential to mitigate the disease burden.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1282"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catastrophic and impoverishing impacts of health expenditures: a focus on non-communicable diseases in Pokhara Metropolitan City, Nepal.","authors":"Simrin Kafle, Shiva Raj Adhikari, Per Kallestrup, Dinesh Neupane, Ulrika Enemark","doi":"10.1186/s12889-025-22418-8","DOIUrl":"10.1186/s12889-025-22418-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ensuring equitable access to Universal Health Coverage (UHC) is crucial, particularly in low-resource settings like Nepal, where high out-of-pocket expenditure (OOPE) poses a significant barrier to the utilization of healthcare services. This study examined the catastrophic and impoverishing impact of household-level healthcare expenditures, focusing on whether households with NCDs have a higher likelihood of incurring CHE and experiencing impoverishment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted this study in Pokhara Metropolitan City, Nepal, involving 1,276 households. Catastrophic Health Expenditure (CHE) was defined when OOPE was 10% or more of the household's total expenditure, while impoverishment was measured using the poverty headcount ratio, poverty gap, and squared poverty gap. We used a poverty line of NPR 7,674 (approximately USD 230 in Purchasing Power Parity) per capita per month, as set by the National Statistics Office for the Gandaki urban area in 2024. Total monthly household consumption was the sum of food and non-food expenditures, including healthcare expenditures. Health expenditure was calculated based on self-reported data validated by pertinent documents. Household weight was used in the data analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 1276 households, 853 (66.8%) reported illness in the past month, and 125 households suffered from CHE. This corresponds to 9.8% of all sampled and 14.6% of households that experienced illness. Out of those 125 households, 82 faced CHE due to NCDs, representing 6.4% of all sampled and 9.6% of households experiencing illness. Most health expenditures were primarily due to medication (60%) and curative care (17.3%) in NCD conditions. The poverty rate increased by 1.17%points, from 9.4% to 10.6%, over the past month due to healthcare costs, leading to a 12.3% increase in people living in poverty, with 1.02%points attributed to NCDs. The poverty gap rose from 1.5% to 1.9%, and the squared poverty gap increased from 0.003 to 0.005. Households with more than two members affected by NCDs had 3 times higher odds of experiencing CHE (AOR 3.02, 95% CI 2.59-3.51). Those with a household member/s suffering from heart disease had twice the odds of facing CHE (AOR 2.41, 95% CI 2.22-2.62). Households with diabetic members had 1.13 times higher odds of experiencing CHE (AOR = 1.13, 95% CI: 1.05-1.21). Households in the lowest quintile had twice the odds of incurring CHE than those in the highest quintile (AOR 1.93, 95% CI 1.75-2.15).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;NCDs and their associated costs are significant contributors to CHE and impoverishment. As Nepal moves towards UHC, policymakers need to accord the highest priority to enhancing financial protection mechanisms by subsidizing healthcare costs, particularly for medicines and curative care related to NCDs. Furthermore, addressing economic inequalities through targeted support for low-income and marginalized","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1283"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equivalence of electronic health record data for measuring hypertension prevalence: a retrospective comparison to BRFSS with data from two Indiana health systems, 2021.","authors":"Katie S Allen, Justin Stiles, Veronica M Daye, Ashley Wiensch, Nimish Valvi, Brian E Dixon","doi":"10.1186/s12889-025-22425-9","DOIUrl":"10.1186/s12889-025-22425-9","url":null,"abstract":"<p><strong>Background: </strong>Public health surveillance requires timely access to actionable data at every level. Current approaches for accessing chronic disease surveillance data are not sufficient, and health departments are increasingly looking to augment surveillance efforts using electronic health records (EHRs). While proven effective for acute syndromic surveillance, the utilization of EHR systems and health data networks for monitoring chronic conditions remains sparse. This study tested the generalizability of a previously validated hypertension computable phenotype.</p><p><strong>Methods: </strong>A previously developed phenotype was used to estimate prevalence of hypertension in a geographically and clinically distinct region from its development. To test validity, the results were compared to available, statewide Behavioral Risk Factor Surveillance System (BRFSS) data using the two one-sided t-test (TOST) of equivalence between BRFSS- and EHR-based prevalence estimates. The TOST was performed at the overall level as well as stratified by age, gender, and race/ethnicity.</p><p><strong>Results: </strong>Compared to statewide hypertension prevalence of 34.5% in the BRFSS, an EHR-based phenotype estimated an overall prevalence of 24.1%. Estimates were not equivalent overall or across most subpopulations. Like BRFSS, we observed higher prevalence among Black men and women as well as increasing prevalence with age.</p><p><strong>Conclusion: </strong>With caveats, this study demonstrates that EHR-derived prevalence estimates may serve as a complement for population-based survey estimates. Utilizing available EHR data should increase timeliness of surveillance as well as enhance the ability of states and local health agencies to more readily address the burden of chronic disease in their respective jurisdictions.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1285"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the hidden effect of multi-morbidities on the severity of Covid-19: a latent class analysis approach.","authors":"Sedigheh Akhavnnezhad, Seyedeh Solmaz Talebi, Ehsan Mosa Farkhani, Marzieh Rohani-Rasaf","doi":"10.1186/s12889-025-22523-8","DOIUrl":"10.1186/s12889-025-22523-8","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological studies showed that Covid-19 patients with underlying diseases had higher rates of severe Covid-19. Previous studies focused on the presence of a single chronic disease but this study investigated the prevalence and patterns of multi-morbidities in patients with Covid-19 and its relationship with the severity of Covid-19.</p><p><strong>Methods: </strong>This retrospective study focused on patients age 30 years and older with positive polymerase chain reaction (PCR) results in 24 hospitals of Mashhad in northeastern Iran from 20-3-2020 to 21-1-2022. The number of studied confirmed patients was 318,502. The underlying diseases were identified according to the International Classification of Diseases, and the severity of Covid-19, including death, need for ventilation, and need for treatment in the intensive care unit (ICU). The pattern of multi-morbidities in these confirmed cases was investigated using latent class analysis (LCA), and the relationship between this pattern and the severity of Covid-19 was determined by multivariate logistic regression.</p><p><strong>Results: </strong>The most common coexisting diseases were hypertension in 30,100 patients (9.5%), metabolic disorders in 23,798 (7.5%) and hyperlipidemia in 22,454 (7%). Different comorbidities were grouped into three classes by the LCA model. Class 1 was patients without multi-morbidities, or 83% people., Class 2, which included 9% patients, was patients with hypertension, diabetes, respiratory diseases, and mental behavioral disorders (HRMD class). Class 3, which included patients with metabolic diseases, for whom the probability of developing hypertension, hyperlipidemia, diabetes, and metabolic disorders was high, included 7% patients. The results of multivariate logistic regression showed that having HRMD and metabolic diseases compared to no multi-morbidity adjusted for some risk factors increased the odds of developing severe Covid-19 by 81% and 55%, respectively.</p><p><strong>Conclusions: </strong>The classes identified in this study provided a clear view of different groups of Covid-19 patients with certain multi-morbidities and underscore the importance of considering these patterns, rather than individual comorbidities, in risk assessment and management of COVID-19 patients. This approach will guide clinical decision-making and resource allocation in the ongoing management of the COVID-19 pandemic.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1272"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children's views on weight measurement and talking about weight.","authors":"Ryan Herbert, Fiona Gillison, Elisabeth Grey, Abigail Hewitt, Alice Woods, Charlotte Jackson, Grace Wisbey, Jack Perks, Maddy Longhurst","doi":"10.1186/s12889-025-22354-7","DOIUrl":"10.1186/s12889-025-22354-7","url":null,"abstract":"<p><strong>Background: </strong>Parents are considered important in promoting children's healthy weight, but express concern about how to talk to children about weight without harming their wellbeing. However, there is little research with children themselves as to what they expect and want in relation to managing their weight. This study aimed to explore children's views about weight measurement, and whether and how information about their weight should be shared with them.</p><p><strong>Methods: </strong>Primary school-aged children were recruited through their school to take part in focus groups. Discussions were focused around two tasks: drawing a shared mind map of sources of information about weight; and exploring responses to a structured story about a child's experience of being weighed and measured. The discussions were recorded, transcribed and analysed using thematic analysis.</p><p><strong>Results: </strong>Forty-eight children took part, across eight focus groups. Theme 1 explored how children considered that most weight discussions were peripheral to them, often overheard conversations related to family members' attempts at weight loss. Theme 2 showed how children empathised with the challenges parents face when deciding whether to disclose weight status, in balancing the desire to avoid upsetting children with the desire to be honest and action focussed. Theme 3 summarised children's expectations about what should happen if children are found to have overweight or obesity, emphasising a whole-family approach.</p><p><strong>Conclusion: </strong>Children's views about how and whether to talk about weight varied, but appeared underpinned by the awareness of stigma and belief in individual responsibility and capability for controlling body weight.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1280"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the link between physical activity and cognitive function: the mediating impact of depressive symptoms.","authors":"Luhan Zhang, Jiacheng Zhang, Qi Chen, Xian Cai, Liping Zu, Lingyan Liu, Xiaomin Wu, Chenyu Li, Fei Ma","doi":"10.1186/s12889-025-22410-2","DOIUrl":"10.1186/s12889-025-22410-2","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the association between physical activity and cognitive function in adults aged 50 and older, with a focus on the mediating role of depressive symptoms.</p><p><strong>Methods: </strong>Data were drawn from Waves 7 to 9 of the English Longitudinal Study of Ageing (ELSA), including 5,499 participants aged 50 years and older. Cognitive function was assessed through measures of episodic memory, numeracy, and orientation. Physical activity was quantified using a composite measure combining the frequency of vigorous, moderate, and light exercise with their respective average metabolic equivalents. Depressive symptoms were evaluated using the CES-D-8 scale. Generalized estimating equations (GEE) were employed to examine the association between physical activity and cognitive function, while the Bootstrap method was utilized to evaluate the mediating role of depressive symptoms.</p><p><strong>Results: </strong>GEE analyses revealed that higher levels of physical activity were significantly associated with improved global cognitive function(β = 0.151, 95%CI: 0.118-0.183), episodic memory(β = 0.074, 95%CI: 0.058-0.090), numeracy(β = 0.033, 95%CI: 0.015-0.051), and orientation(β = 0.039, 95%CI: 0.022-0.057) (all P < 0.001). Physical activity also demonstrated a significant negative association with depressive symptoms(β=-0.402, 95%CI: -0.452 to -0.352) (P < 0.001), which, in turn, were linked to lower cognitive function. Notably, depressive symptoms mediated 8.46% of the association between physical activity and global cognitive function.</p><p><strong>Conclusions: </strong>Greater engagement in physical activity is associated with better cognitive function, and this association is partially mediated by depressive symptoms. These findings underscore the importance of promoting physical activity to support cognitive health in older adults, with particular attention to its potential role in mitigating depressive symptoms.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1265"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal health disparities linked to stressful life events: a cross-sectional study of industrialized Italian cities.","authors":"Esha Bansal, Alessandra Patrono, Stefano Renzetti, Roberto G Lucchini, Yueh-Hsiu Mathilda Chiu, Michele Conversano, Miriana Montemurro, Deborah Bruno, Carmen Franco, Augusto Giorgino, Giuseppa Cagna, Chiara Fedrighi, Maurizio Memo, Donatella Placidi","doi":"10.1186/s12889-024-21092-6","DOIUrl":"10.1186/s12889-024-21092-6","url":null,"abstract":"<p><strong>Background: </strong>Understanding the impact of family life stressors on maternal health is crucial, particularly in highly industrialized areas. This study assessed the validity of an Italian-language version of the Crisis in Family Systems-Revised (CRISYS-R) survey in Northern and Southern Italian cohorts.</p><p><strong>Methods: </strong>Mothers (n = 252) completed an Italian version of CRISYS-R, translated from English using the forward-backward method. At least 14 days after initial survey completion, a random subset of mothers (n = 44) retook CRISYS-R. Information about family demographics, socioeconomic status, and maternal health were collected by self-report on structured surveys. Statistical analyses were performed in R.</p><p><strong>Results: </strong>Test-retest analysis yielded a Pearson coefficient of 0.714 (Brescia: 0.845, Taranto: 0.726). Cronbach's alpha coefficient for internal consistency was 0.765 (Brescia: 0.718, Taranto: 0.784). In multivariable regression, the total number of stressors reported on the initial CRISYS-R test was positively associated with: poor maternal mental health (p < 0.001), poor maternal physical health (p < 0.01), and residence in Southern rather than Northern Italy (p = 0.02). Univariate correlations yielded similar results, plus a negative correlation between annual family income and total life stressors (p < 0.05).</p><p><strong>Conclusions: </strong>Statistical analyses support the validity and reliability of an Italian-language CRISYS-R in industrialized areas, while highlighting relationships between family stress and maternal mental and physical health. This survey instrument has the potential to inform public health policies and interventions serving families in Italian-speaking areas with high burdens of industrial pollution.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1255"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the multilayer perceptron approach to explore the relationship between PUBG gaming, sleep disorder, quality of life, and migraine.","authors":"Ali Hassan, Muhammad Daniyal, Roy Rillera Marzo, Mohammed Aljuaid, Duaa Shahid","doi":"10.1186/s12889-025-21880-8","DOIUrl":"10.1186/s12889-025-21880-8","url":null,"abstract":"<p><strong>Background of the study: </strong>Player Unknown's Battlegrounds (PUBG), a popular and widely played multiplayer online game, has generated interest and concern about its effects on the physical health of its players. This study explores the relationship between factors like cultivation level, gaming disorder, migraine and associated symptoms, sleep quality, and life quality of PUBG players.</p><p><strong>Methods: </strong>This cross-sectional study included 500 PUBG players, categorized into Lower, Medium, and High PUBG Users. Data were collected using a self-administered questionnaire, including the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and a gaming disorder screening tool. The Multilayer Perceptron (MLP) methodology was applied to analyze the factors influencing migraine symptoms, sleep quality, and quality of life.</p><p><strong>Results: </strong>Participants of the study were categorized into lower PUBG users (LPU), medium PUBG users (MPU), and high PUBG users (HPU). Among study participants reporting migraine pain, 259 (51.8%) reported that they were HPU. By examining daytime sleepiness using the ESS, Higher normal Day sleep (DS) was observed in 78 (15.9%) HPU. The cultivation level of PUBG showed a very weak positive correlation with experiencing migraine pain or associated headache symptoms (r = 0.034, p = 0.454). In contrast, the gaming disorder of PUBG showed a weak negative correlation with PSQI (r = -0.092, p = 0.041). The higher levels of gaming disorder are slightly associated with poorer sleep quality. The results of the MLP model suggested that daily PUBG use was the most contributing factor to migraine and related symptoms followed by gaming disorder, gaming addiction, PSQI, and ESS.</p><p><strong>Conclusion: </strong>The study concluded that PUBG playing contributes to migraine and its associated symptoms although is not significant it contributes to less sleep quality and lower quality of life.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1268"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and prediabetes among women universally screened for gestational diabetes: a multi-ethnic, population-based, prospective study with eleven years follow-up.","authors":"Christin W Waage, Anne Karen Jenum, Ibrahimu Mdala, Sindre Lee-Ødegård, Anja Maria Braend, Line Sletner, Jens Petter Berg, Kåre I Birkeland","doi":"10.1186/s12889-025-22493-x","DOIUrl":"10.1186/s12889-025-22493-x","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes (GDM) is a strong risk factor for later development of diabetes. However, data are scarce on the long-term risk for diabetes or prediabetes diagnosed by HbA1c, in non-selected, multi-ethnic populations universally screened for GDM using the WHO₂₀₁₃ criteria. We aimed to investigate the development of diabetes or prediabetes eleven years after the index pregnancy and identify risk factors in pregnancy or shortly after.</p><p><strong>Methods: </strong>A population-based cohort study of 360 women with complete eleven years follow-up data for diabetes (HbA1c ≥ 48 mmol/mol) or prediabetes_ADA (HbA1c 39-47 mmol/mol). Women were enrolled in gestational week 15 and universally screened with an oral glucose tolerance test in week 28. We performed least absolute shrinkage and selection operator (LASSO) regression to identify predictors of future diabetes or prediabetes_ADA and constructed a nomogram to predict individual risks.</p><p><strong>Results: </strong>Diabetes or prediabetes_ADA combined, was found in 26.9%, and the prevalence was slightly higher in previous GDM compared with non-GDM women (35.6% versus 23.5%; p = 0.019). The relative risk (RR) for developing diabetes or prediabetes_ADA was moderately elevated in GDM compared with non-GDM women (1.4 [1.0, 1.9], p = 0.035). Seven women (1.9%) had diabetes and all of these except for one, had previous GDM. Hence, the crude prevalence was 5.8% among GDM women vs. 0.4% among non-GDM women. The RR for developing diabetes was substantially higher in GDM vs. non-GDM women (14.8 [2.6, 277.1], p = 0.012). Prediabetes_ADA was found in 25% and the RR for prediabetes_ADA was not significantly increased for GDM compared to non-GDM women (1.3 [0.9, 1.8], p = 0.143). Among Europeans, 17.0% had diabetes or prediabetes_ADA, compared to 43.0% among South Asians (p < 0.001) and 34.4% among other ethnicities (p = 0.002). The most significant predictors identified from the LASSO were HbA1c measured in early pregnancy, ethnicity, and a family history of diabetes.</p><p><strong>Conclusions: </strong>The risk for developing diabetes was low, overall and among GDM women. Still GDM represented a strong risk for diabetes, but not for prediabetes_ADA. HbA1c early in pregnancy, non-European ethnicity, and a family history of diabetes were the strongest risk factors for developing diabetes or prediabetes_ADA.</p><p><strong>Trial registration: </strong>STORK G2 Women and Risk of Diabetes. NCT03870724 (ClinicalTrials.gov). February 27th, 2019.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1264"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global and national burden of tracheal, bronchus, and lung cancer attributabled to household air pollution from solid fuels in populations aged 55 and above: an integrated study of frontier and joinpoint regression analysis.","authors":"Ke-Jie He, Zhilong Xu, Jianguang Xu, Guoyu Gong","doi":"10.1186/s12889-025-22466-0","DOIUrl":"10.1186/s12889-025-22466-0","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the global, regional, and country-specific burden of tracheal, bronchus, and lung cancer (TBL) in individuals aged 55 and above due to household air pollution from solid fuels (HAPSF) between 1990 and 2021, and to project its incidence and mortality rates for 2044.</p><p><strong>Methods: </strong>This study utilized data from the Global Burden of Disease Study 2021 (GBD 2021) to assess the burden of TBL in individuals aged 55 and above due to HAPSF between 1990 and 2021. The Age-Period-Cohort (APC) model, based on Poisson distribution, was used to analyze the impact of age, period, and cohort on TBL mortality trends. Joinpoint regression and decomposition analysis were applied to identify significant changes in trends and assess the contributions of population growth, aging, and epidemiological transitions. Based on the identified trends, projections of TBL incidence and mortality rates for 2044 were made using the Bayesian Age-Period-Cohort (BAPC) model. The analysis was conducted across 204 countries and regions, considering different socio-demographic index (SDI) levels.</p><p><strong>Results: </strong>In 2021, significant disparities in TBL burden attributable to HAPSF were observed across 204 countries. High-SDI countries like the United Arab Emirates had the lowest TBL-related death and DALY rates, while low-SDI countries, such as North Korea, reported the highest. From 1990 to 2021, global TBL-related DALYs declined by 4.17% annually, with more substantial reductions in high-SDI regions. However, a slight resurgence in DALYs was observed between 2019 and 2021. DALY trends showed variations by age and sex, with more pronounced declines in higher-SDI regions, particularly for older age groups. Projections for 2041 indicate continued substantial decreases in TBL burden across all age groups, with the most significant reductions expected among males. Decomposition analysis revealed that population growth primarily contributed to the increase in TBL burden, while epidemiological transitions led to reductions, especially in middle and high-SDI regions. Frontier analysis identified countries with the greatest potential for improvement in TBL burden, including both low-SDI countries and certain high-SDI regions. Projections using the Bayesian Age-Period-Cohort (BAPC) model suggest that DALYs will decrease substantially by 2044, with the most significant reductions in the 70-74 and 65-69 age groups.</p><p><strong>Conclusions: </strong>Socioeconomic development is negatively correlated with the TBL burden from HAPSF. Lower SDI countries face a heavier burden, while high SDI countries see increased TBL in aging populations. Tailored policies are needed for different SDI regions.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1249"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}