Pneumonia in children poses a serious disease burden globally, and pneumococcal conjugate vaccination is the most direct and effective preventive measure against pneumococcal disease, while there is a lack of information on the coverage of 13-valent pneumococcal conjugate vaccine (PCV13) in children.
To analyze the vaccination rate of PCV13 in children born from 2017 to 2022 in Jiangsu Province, find the difference and reasons under different circumstances, and provide reference on improvement of PCV13 vaccination rate for future.
Through the Jiangsu provincial vaccination management information system, the basic information and vaccination information of PCV13 (as of 2023-12-31) were collected, including the date of birth, gender, household registration attributes, date of vaccination, and the number of doses of vaccination and other basic information, and the data were descriptive analyzed.
There were 4 537 123 children registered in the Jiangsu provincial vaccination management information system from 2017 to 2022, of which 784 220 children were vaccinated with 2 406 974 doses of PCV13, with a vaccination rate of 17.28%. In Jiangsu Province, there were 697 698 children given the first dose of vaccination, of which 82 503 (11.83%) were given the first dose at <2 months of age, 511 273 (73.28%) at 2-6 months of age, 26 106 (3.74%) at 7-11 months of age, 38 530 (5.52%) at 12-24 months of age, and 39 286 (5.63%) at 2-5 years of age. The rate of 1, 2, 3, and 4 doses of vaccination was higher among resident children (16.11%, 14.71%, 13.43%, and 11.50%) than among migrant children (13.87%, 12.70%, 11.42%, and 9.52%) (P<0.05). In terms of regional distribution, the vaccination rate of each dose was in the order of South Jiangsu, Central Jiangsu and North Jiangsu from high to low, and the difference was statistically significant (P<0.05). In terms of gender, there was no statistically significant difference in the rates of the first dose and the second doses of vaccination between boys and girls (P>0.05) ; but the rates of the 3rd and 4th doses of vaccination were lower in boys than in girls (P<0.05). Among children born in 2017-2022, the rate of 1, 2, 3, and 4 doses of vaccination increased with the year of birth (P<0.05). The proportion of children aged 2-6 months who received the first dose of PCV13 was the highest among children of different household registration, gender, year of birth and region, and significant differences were also observed in the ages at the first vaccination of the children from various household registration, of both genders, with various regions, and in various years of birth (P<0.05) .
The vaccination rate of PCV13 among children in Jiangsu Province is 17.28%, which is at a relatively low level. The age of the first dose of vaccination is the highest in the age of 2-6 months, and the vaccination rate of each dose increases with the year of birth, so in order to improve the coverage level of PCV13 in the target population, it is recommended that PCV13 be included in the National Immunization Program.
Currently, the number of obese adolescents in China is increasing dramatically, and adolescent obesity is not only closely related to metabolic diseases, but also a risk factor for coronary heart disease mortality in adulthood. Lipid metabolic flexibility is regarded as an important indicator of the metabolic health of an organism. Studies confirm that cardiorespiratory fitness is associated with lipid metabolic flexibility, but are lacking in obese adolescents with different metabolic phenotypes.
To investigate the association of cardiorespiratory fitness with lipid metabolic flexibility in metabolically unhealthy obesity (MUO) adolescents and metabolically healthy obesity (MHO) adolescents.
Ninety-one obese adolescents were selected to participate in the Shenzhen Weight Loss Camp (2022-2023), and were divided into 35 in the MUO group and 56 in the MHO group in accordance with the "Expert Consensus on the Definition and Screening of Metabolically Healthy Obesity in Chinese Children". The gas metabolism data from the resting metabolic test, incremental load treadmill test and heart rate data were collected using a gas metabolism analyzer and a heart rate meter; the maximum oxygen uptake (VO2max) was estimated based on the heart rate-oxygen uptake relationship; and the third-order polynomial fitting curve was used to obtain the maximal fat oxidation rate (MFO) or the corresponding maximal fat oxidation intensity (FATmax) to reflect the flexibility of lipid metabolism. The linear regression analysis was used to explore the correlation between VO2max and MFO and FATmax.
The overall MFO and FATmax of the two groups were (5.54±1.37) mg·min-1·kg-1 and (4.19±0.87) MET. The BMI, systolic blood pressure, diastolic blood pressure, and triacylglycerol levels in the MUO group were higher than those in the MHO group, and the level of high-density lipoprotein cholesterol was lower than that in the MHO group (P<0.05). Before adjustment, the MFO in the MUO group was lower than that in the MHO group (P<0.05) ; after adjustment for VO2max, the difference in MFO between the two groups of obese adolescents was not statistically significant (P>0.05) ; before adjustment and after adjusting VO2max, there was no statistically significant difference between the two groups of obese adolescents when comparing FATmax (P>0.05). VO2max was positively correlated with MFO in obese adolescents in the overall (B=0.077, 95%CI=0.011-0.144, P=0.023) and MHO groups (B=0.105, 95%CI=0.027-0.182, P=0.009) ; VO2max was positively correlated with FATmax in obese adolescents in the MHO group (B=0.057, 95%CI=0.003-0.111, P=0.041) ; VO2max was not linearly related to MFO and FATmax in obese adolescents in the MUO group (P>0.05) .
MUO adolescents have lower MFO than MHO adolescents; during running exercise, obese adolescents with different metabolic phenotypes could reach MFO at (4.19±0.87) MET intensity. Cardiorespiratory fitness is a key factor influencing lipid metabolic flexibility in MHO adolescents, and MUO adolescents may need to be transformed into MHO adolescents to promote lipid metabolic flexibility.
