1. Chen SL, Xius DO, Bao CD, Liu QY. COPCORD Study in Shanghai. APLAR Rheumatology. Eds. Nasution AR, Darmawan J. Churchil Livingstone Tokyo. 1992:393-395.
2. Richard D. Wigley, Zhang Nai Zheng, Zeng Qingyu, et al. Rheumatic Diseases in China: ILAR-China Study Comparing the Prevalence of Rheumatic Symptoms in Northern and Southern Rural Populations. The Journal of Rheumatology 1994;21(8):1484~1490.
3. Chen S, Du H, Wang Y, Xu L.The epidemiology study of hyperuricemia and gout in a community population of Huangpu District in Shanghai. Chin Med J (Engl) 1998;111: 228-230.
4. Dai SM, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.. Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study.
J Rheumatol. 2003; 30: 2245-51.
5. Zeng Qing Yu,Wang Qing Wen, Chen Ren, et al. Primary gout in Shantou: a clinical and epidemiological study. Chinese Medical Journal 2003; 116(1): 66~69.
6. Zeng Qing-yu, Chen Ren, Xiao Zheng-Yu, Huang Shao-bi, Liu Yuan, Xu Jing-cai, Chen Shun-le, John Darmawan, RD Wigley, KD Muirden. Low prevalence of knee and back pain in southeast China; the Shantou COPCORD study. J Rheumatol. 2004; 31: 2439-43.
7. Wu ZB, Zhu P, Wang HK, Zheng ZH, Jia Y, Ding J, Leng N, Zhang HQ, Liu L. [Prevalence of seronegative spondyloarthritis in the army force of China.]
Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Sep;25(9):753-5. Chinese.
8. Zeng QY, Darmawan J, Xiao ZY, Chen SB, Chen R, Lin K, Wigley R, Chen SL, Zhang NZ. Risk factors associated with rheumatic complaints: a WHO-ILAR COPCORD study in Shantou, Southeast China. J Rheumatol. 2005; 32: 920-7.
Zeng QY, Darmawan J, Xiao ZY, Chen SB, Chen R, Lin K, Wigley R, Chen SL, Zhang NZ. Risk factors associated with rheumatic complaints: a WHO-ILAR COPCORD study in Shantou, Southeast China. J Rheumatol 2005 May;32(5):920-7.
OBJECTIVE: To validate the differences of the prevalence of rheumatic symptoms between the north and south part of China and to investigate the associated risk factors for rheumatic complaints in Shantou, China. METHODS: Four samples together comprising 10,638 people > or = 16 years of age were surveyed in 1987, 1992, 1995, and 1999. The protocol of the ILAR-China Collaborative Study or the WHO-ILAR COPCORD Core Questionnaire was implemented. Data on rheumatic symptoms that were part of these surveys were collected and analyzed. RESULTS: The prevalence rate of rheumatic complaints was increasing in the Shantou area during the recent decade (in 1987 11.6%, 1992 12.5%, 1995 16.0%, and 1999 19.8%). However, it was still lower than the rate in Beijing, China, in 1987 (40.0%). Rheumatic symptoms were more prevalent in women than in men, and were more frequently seen in the elderly than in young people. The most frequently involved site was the low back followed by the knee and neck. Lumbar pain was more frequent among rural residents, while neck pain was more prevalent in the urban school-age population group. The prevalence of knee pain was significantly higher in people living in multi-story buildings without elevators compared with those living in single-story houses. The peak value of bone mineral density (BMD) in the Shantou population was 0.839 +/- 0.085 g/cm2 in men, and 0.723 +/- 0.064 g/cm2 in women, significantly higher than that reported in 13 other provinces and cities of China including Beijing. The sense of seeking a physician’s care was higher in the population with a higher prevalence of rheumatic symptoms than that in the group with a lower prevalence of complaints. However, no significant difference was found in the rate of disability among the different population samples. CONCLUSION: The prevalence rate of rheumatic complaints was lower in Shantou than in Beijing. Socioeconomic status, environmental differences (e.g., Shantou in the southern and Beijing in the northern part of China), sex, age, occupation, ergonomics, BMD, and awareness of seeking medical care might all be risk factors associated with the prevalence of rheumatic complaints.
Zeng QY, Chen R, Xiao ZY, Huang SB, Liu Y, Xu JC, Chen SL, Darmawan J, Couchman KG, Wigley RD, Muirden KD. Low prevalence of knee and back pain in southeast China; the Shantou COPCORD study. J Rheumatol. 2004 Dec;31(12):2439-43.
OBJECTIVE: To determine whether the previously noted low prevalence of knee pain (KP) and lumbar pain (LP) in rural southern China compared with the high prevalence observed in North China was also true in a southern urban population. METHODS: A population based sample of 2040 adults > or = 16 years of age was studied in Chenghai City, close to the rural area previously studied on the southeast coast of China. Primary healthcare workers administered the COPCORD Phase I and II questionnaires. Those with rheumatic symptoms were recalled for medical examination, with a response rate at examination (phase III) of 98.4%. Those suspected of having arthritis had radiographs and laboratory tests. Prevalences were age and sex adjusted to the total of populations previously reported. RESULTS: (1) The prevalence for all rheumatic symptoms at phase III was 18.1%. Of the 7.5% with KP, 55% had osteoarthritic changes on radiograph (KOA) compared with 29% of a sample with no KP (p < 0.001). Of the 11.5% with LP, 69% had degenerative changes on lumbar spine radiograph (LOA). (2) Of residents in single-level houses the prevalence was 5.6% for KP and 7.9% for LP, whereas in 4 to 6-level apartment buildings these rates were significantly higher, 9.1% and 16.2%, respectively. All these pain rates were significantly lower than noted in rural North China. The prevalence of pain together with radiographic OA changes in the knee (KOA) was half the rate in single-floor residents (2.7%) compared to apartment residents (5.3%), as was lumbar spine degenerative disease (5.3% vs 11.5%). CONCLUSION: The prevalence of knee and lumbar spine pain in this southern urban sample was confirmed to be much lower than in the rural sample in the North, although higher than in the rural sample in the South. Comparing COPCORD studies of Han Chinese in Shanghai and Malaysia there was a decrease in prevalence of knee and back pain with latitude, suggesting an association with climate. Knee and back pain and radiological degenerative changes in the knee and lumbar spine were twice as prevalent in apartment residents than in those living in older single-level houses. Further study is needed to explain these observations.
Wu ZB, Zhu P, Wang HK, Zheng ZH, Jia Y, Ding J, Leng N, Zhang HQ, Liu L.
[Prevalence of seronegative spondyloarthritis in the army force of China.]
[Article in Chinese]. Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Sep;25(9):753-5.
OBJECTIVE: To investigate the prevalence and epidemiologic characteristics of seronegative spondyloarthritis (SpAs) in Chinese army force in different areas. METHODS: 4-phase survey was conducted in 21 750 Chinese army, including: face-to-face interviews with standardized COPCORD questionnaires (Phase I screening); further examination on the suspected cases; identification of inflammatory joint and spinal diseases (Phase II); identification of SpAs (AS and uSpA) by more than two experienced specialists in rheumatology; further examination with X-rays and laboratory detection of HLA-B27 (Phase III); and data analysis (Phase IV). RESULTS: Among 21 750 army men, 21 cases of RA, 106 cases of SpAs were identified, with prevalence rates of 0.966 per thousand, 4.87 per thousand respectively. In 106 cases of SpAs, there were 46 cases of ankylosing spondylitis (AS), 52 cases of undifferentiated SpAs (uSpAs) with the prevalence rates of 2.11 per thousand and 2.39 per thousand respectively. Few cases of reactive arthritis (ReA) and Reiter’s syndrome (RS) were identified (6 and 1 cases respectively). The prevalence of AS, uSpAs were higher in navy than that in the ground force or the air force. Soldiers in cold and damp areas had higher prevalence rates than that in the plain and drought areas. CONCLUSION: The prevalence of SpA (especially AS and uSpA) in Chinese army force was similar to that in the civilians. SpA (AS and uSpA) was more prevalent seen in the Navy. The incidence of SpA (AS and uSpA) was influenced by environmental factors such as coldness and dampness.
Dai SM, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM. Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study. J Rheumatol. 2003 Oct;30(10):2245-51.
OBJECTIVE: To carry out a cross-sectional survey on prevalence of musculoskeletal symptoms, rheumatoid arthritis (RA), ankylosing spondylitis (AS), and gout. METHODS: In Shanghai, 4 communities comprising 7603 inhabitants over 15 years of age in an urban population were randomly selected from 13 communities. Interviews were conducted from September 1997 to March 1998 by trained physicians using the COPCORD Core Questionnaire. Physical and radiographic examinations and serologic tests were carried out when required to classify categories of rheumatic diseases. The diagnoses of RA, systemic lupus erythematosus (SLE), and gout were based on American Rheumatism Association criteria. The diagnosis of AS strictly followed the modified New York criteria of 1984. Crude prevalence rates were standardized according to a standard Chinese population for age and sex structure. RESULTS: A total of 6584 adults (3394 women, 3190 men) were interviewed, and response rate was 86.6%. The age and sex standardized prevalence rate of rheumatic symptoms at any site amounted to 13.3% (95% CI 12.5-14.1%). Symptoms occurred more frequently in the following sites: knee 7.0% (95% CI 6.4-7.6%), lower back 5.6% (95% CI 5.0-6.2%), shoulder 4.7% (95% CI 4.2-5.2%), and neck 2.4% (95% CI 2.0-2.8%). Women complained of rheumatic symptoms more frequently than men. The standardized rates of RA, AS, gout, symptomatic knee osteoarthritis, and soft tissue rheumatism were 0.28% (95% CI 0.15-0.41%), 0.11% (95% CI 0.03-0.19%), 0.22% (95% CI 0.11-0.33%), 4.1% (95% CI 3.6-4.6%), and 3.4% (95% CI 3.0-3.8%), respectively. Two cases of SLE, one case of dermatomyositis, and one case of systemic sclerosis were found. CONCLUSION: Compared with rates in European and Western countries the prevalence rates of RA, AS, and gout are low in Shanghai, China, although the prevalence rates of rheumatic symptoms are high.