Prevalence of Helicobacter pylori infection in China from 2014-2023: A systematic review and meta-analysis

Table 1 Characteristics of the included studies

Ref.	Year	Type of study	Region	Data collection time	Detection methods	Age (range/mean ± SD)	Simple size	Male	Positive (male/female)	Prevalence	95%CI
North East
Zhang et al[11]	2016	Cross-sectional	Jilin (Jilin Province)	2014.11-2024.12	2	21-60	1932	44.77	293/395	35.6	33.5-37.8
Wang et al[12]	2014	Cross-sectional	Changchun (Jilin Province)	2012.05-2012.12	1	22-83	1059	65.06	324/138	43.6	40.6-46.7
Zhang et al[13]	2014	Cross-sectional	Shenyang (Liaoning Province)	2012.04-2012.06	2	3-6	1150	52.00	79/72	13.1	11.2-15.2
Zhu et al[14]	2020	Cross-sectional	Jinzhou (Liaoning Province)	2019.02-2019.04	1	21-61	2859	77.86	792/166	33.5	31.8-35.3
Jiang et al[15]	2015	Cross-sectional	Dalian (Liaoning Province)	2012.12-2013.11	2	1-100	4127	53.62	664/591	30.4	29.0-31.8
Ji and Gu[16]	2016	Cross-sectional	Dalian (Liaoning Province)	2013.09-2015.09	2	18-88	4214	47.51	480/437	21.8	20.5-23.0
North China
Zheng et al[17]	2022	Cross-sectional	Tangshan (Hebei Province)	2019.07-2020.09	1	21-78	9944	67.09	3115/1395	45.4	44.4-46.3
Yang et al[18]	2020	Cross-sectional	Beijing	2013.09-2019.06	1	NA	7260	36.54	1106/1726	39.0	37.9-40.1
Zhao et al[19]	2017	Cross-sectional	Beijing	2009.09-2010.02	4	1 month–18 years	1196	50.67	65/62	10.6	8.9-12.5
Xi et al[20]	2018	Cross-sectional	Beijing	NA	4	6-13	291	55.33	47/20	23.0	18.3-28.3
Chen et al[21]	2016	Cross-sectional	Beijing	2012.01-2016.12	1	14-80	11000	51.65	2826/2313	46.7	45.8-47.7
Wu et al[22]	2014	Cross-sectional	Beijing	2010.01-2013.12	1	16-88	10331	69.29	3236/1353	44.4	43.5-45.4
Cui et al[23]	2020	Cross-sectional	Beijing	2018.06-2019.05	1	18-81	1058	52.65	175/163	31.9	29.1-34.9
Zhang et al[24]	2014	Cross-sectional	Beijing	2010	1	70.9	2006	50.10	851/822	83.4	81.7-85.0
Zhang et al[25]	2015	Cross-sectional	Baoding (Hebei Province)	2015	2	20-61	379	49.34	86/89	46.2	41.1-51.3
Chen et al[26]	2019	Cross-sectional	Hohhot (Inner Mongolia Autonomous Region)	2016-2019	1	18-81	13568	56.60	2480/1677	30.6	29.9-31.4
Wang et al[27]	2019	Cross-sectional	Hailar District (Inner Mongolia Autonomous Region)	2017.01-2017.12	1	7-88	15293	56.14	4232/3031	47.5	46.7-48.3
Kan et al[28]	2015	Cross-sectional	Chifeng (Inner Mongolia Autonomous Region)	2013.1.4-2013.5.31	2	17-91	3282	60.18	457/230	20.9	19.6-22.4
Yan et al[29]	2020	Cross-sectional	Chengzhi (Shanxi Province)	2019.01-2019.12	2	16-96	1224	69.61	536/259	65.0	62.2-67.6
Li et al[30]	2022	Cross-sectional	Shanxi Province	2019.01-2021.12	1	20-86	3365	75.99	474/197	19.9	18.6-21.3
Zhang et al[31]	2021	Cross-sectional	Tianjin	2017.08-2018.08	1	16-90	10000	54.09	1978/1626	36.0	35.1-37.0
East China
Zhang et al[32]	2020	Cross-sectional	She County Tongcheng (Anhui Province)	NA	1	20-90	1536	39.84	389/581	63.2	60.7-65.6
Wang et al[33]	2022	Cross-sectional	Suzhou (Anhui Province)	2017.01-2020.07	1	21-85	33634	57.73	7603/5647	39.4	38.9-39.9
Peng et al[34]	2021	Cross-sectional	Anqing (Anhui Province)	2019.04-2019.08	2	18-92	2725	60.51	816/610	52.3	50.4-54.2
Han et al[35]	2021	Cohort study	Anhui Province	2017.07-2020.11	1	≥ 18	1094	67.92	329/153	44.1	41.1-47.1
Guo et al[36]	2019	Cross-sectional	Jieshou (Anhui Province)	2017.1-2018.12	1	18-97	9684	45.34	1356/1676	31.3	30.4-32.2
Hu et al[37]	2015	Cross-sectional	Fujian Province	2013.02-2013.11	2	18-76	2770	NA	1435	51.8	49.9-53.7
Xie et al[38]	2020	Cross-sectional	Ningde (Fujian Province)	2019.10-2020.01	3	11-83	417	55.64	135/112	59.2	54.3-64.0
Li et al[39]	2016	Cross-sectional	Jinjiang (Fujian Province)	2015.01-2015.12	1	17-86	8751	66.67	2640/1440	46.6	45.6-47.7
Liu et al[40]	2016	Cross-sectional	Xiamen (Fujian Province)	2012-2014	1	44.8 ± 12.3	1444	66.90	475/216	47.9	45.2-50.5
Chen et al[41]	2022	Cross-sectional	Zhangzhou (Fujian Province)	2019.09-2020.08	1	20-89	2608	54.79	655/594	47.9	46.0-49.8
Mao et al[42]	2017	Cross-sectional	Suzhou (Jiangsu Province)	2015.01-2015.12	1	20-80	963	77.15	333/92	44.1	41.0-47.3
Zhang et al[43]	2019	Cross-sectional	Nanjing (Jiangsu Province)	2017.05-2017.08	1	64.34 ± 8.32	935	34.33	126/239	35.9	32.9-39.1
Xie et al[44]	2017	Cross-sectional	Suzhou (Jiangsu Province)	2015.10-2016.07	1	12-93	2664	52.74	769/753	57.1	55.2-59.0
Jiang et al[45]	2015	Cross-sectional	Jiangsu Province	2013.01-2014.10	1	17-95	3480	62.44	949/615	44.9	43.3-46.6
Li et al[46]	2019	Cross-sectional	Nanjing (Jiangsu Province)	2019	1	48.75 ± 5.97	700	57.14	132/124	36.6	33.0-40.3
Wang et al[47]	2023	Cross-sectional	Nanjing (Jiangsu Province)	2022	1	NA	15160	54.47	2721/1906	30.5	29.8-31.3
Meng et al[48]	2015	Cross-sectional	Dongtai (Jiangsu Province)	2012.06-2013.6	1	29-75	1598	52.00	403/307	44.4	42.0-46.9
Ji et al[49]	2023	Cross-sectional	Suzhou (Jiangsu Province)	2018.1-2018.12	2	18-89	6588	64.31	2370/1339	56.3	55.1-57.5
Zhang et al[50]	2018	Cross-sectional	Jiuzhou (Jiangxi Province)	2015.07-2016.10	1	18-90	1200	54.92	580	48.3	45.5-51.2
Ren et al[51]	2020	Cross-sectional	Pingxiang (Jiangxi Province)	2016.01-2019.06	2	9-92	10487	58.81	3011/2010	47.9	46.9-48.8
Wang et al[52]	2017	Cross-sectional	Jiuzhou (Jiangxi Province)	2016.01-2017.03	1	43.89	6165	74.16	1689/636	37.7	36.5-38.9
Fang et al[53]	2021	Cross-sectional	Jingdezhen (Jiangxi Province)	2008.7-2019.12	1	6-95	48353	50.08	10462/10301	42.9	42.5-43.4
Xu et al[54]	2019	Cross-sectional	Cao County (Shandong Province)	2018.04-2018.07	1	18-90	1182	49.49	198/175	31.6	28.9-34.3
Shi et al[55]	2022	Cross-sectional	Xintai (Shandong Province)	2021.04-2022.04	1	18-84	400	52.50	106/46	38.0	33.2-43.0
Li et al[56]	2015	Cross-sectional	Jining (Shandong Province)	2012.05-2013.05	1, 2	16-72	580	56.03	156/106	45.2	41.1-49.3
Liang et al[57]	2014	Cross-sectional	Jining (Shandong Province)	2012.02-2012.12	1	16-74	4366	68.60	1690/750	55.9	54.4-57.4
Han et al[58]	2020	Cross-sectional	Jining (Shandong Province)	2017.01-2017.12	2	19-91	2557	69.42	782/466	57.4	55.4-59.3
Kong et al[59]	2022	Cohort study	Shandong Province	2021.07-2022.01	1	NA	1173	47.06	204/226	36.7	33.9-39.5
Zhang et al[60]	2019	Cross-sectional	Shanghai	2017.01-2018.01	1	18-90	5164	52.05	1008/869	36.3	35.0-37.7
Sun et al[61]	2018	Cross-sectional	Shanghai	2016.09-2016.12	2	40-93	3258	43.92	451/461	28.0	26.5-29.6
Jia et al[62]	2020	Cross-sectional	Shanghai	2018.10-2019.9	1	25-70	29986	59.79	11547/6033	58.6	58.1-59.2
Qiu et al[63]	2022	Cross-sectional	Hanghzou (Zhejiang Province)	2019.09-2019.11	1	21-69	225	54.67	31/39	31.1	25.1-37.6
Yu et al[64]	2018	Cross-sectional	Jiaxing (Zhejiang Province)	2016.01-2017.06	1, 3	18-80	4220	47.44	900/709	38.1	36.7-39.6
Zhou et al[65]	2023	Cross-sectional	Wenzhou (Zhejiang Province)	2020.01.1-2022.08.1	2	18-71	568	85.56	197/38	41.4	37.3-45.5
Zheng et al[66]	2015	Cross-sectional	Hanghzou (Zhejiang Province)	2013.06-2014.05	1	12-76	2220	63.96	658/309	43.6	41.5-45.7
Yang et al[67]	2015	Cross-sectional	Wenzhou (Zhejiang Province)	2013.10-2014.4	1	≥ 20	15817	60.79	5078/3525	56.9	56.1-57.7
Lin et al[68]	2014	Cross-sectional	Cangnan County (Zhejiang Province)	2007.06-2012.12	3	18-70	11986	58.06	3351	28.0	27.2-28.8
Yang et al[69]	2015	Cross-sectional	Taizhou (Zhejiang Province)	2011.01-2013.12	1	20-70	2072	53.28	376/336	34.4	32.3-36.5
Wang et al[70]	2015	Cross-sectional	Wenzhou (Zhejiang Province)	2010.04-2015.02	2	0-14	4520	NA	2118	46.9	45.4-48.3
Li et al[71]	2017	Cross-sectional	Anji County (Zhejiang Province)	2015.01-2016.01	4	18-80	943	51.22	242/259	53.1	49.9-56.4
Shen et al[72]	2014	Cross-sectional	Hanghzou (Zhejiang Province)	2012.1-2012.12	2	20-91	7911	54.25	2180/1850	50.9	49.8-52.0
He et al[73]	2016	Cross-sectional	Jiangshan (Zhejiang Province)	2014.05-2015.08	2	3-5	3143	50.56	390/358	23.8	22.3-25.3
Fang et al[74]	2022	Cross-sectional	Jinhua (Zhejiang Province)	2019.1-2021.12	2	NA	2060	50.58	542/523	51.7	49.5-53.9
Northwest China
Yu et al[75]	2016	Cross-sectional	Lanzhou (Gansu Province)	2014.05-2015.07	1	16-96	3239	70.36	1197/482	51.8	50.1-53.6
Xie[76]	2021	Cross-sectional	Yuan County (Gansu Province)	2016.01-2020.01	1	12-84	2369	43.31	694/927	68.4	66.5-70.3
Zou et al[77]	2018	Cross-sectional	Gansu Province	2015.1-2015.12	2	27-87	1338	44.84	99/77	13.2	11.4-15.1
Qin et al[78]	2018	Cross-sectional	Jingtai County (Gansu Province)	2013.05-2017.06	1	≥ 14	7182	49.71	1667/1890	49.6	48.5-50.8
Wu et al[79]	2016	Cross-sectional	Lanzhou (Gansu Province)	2013.07-2015.06	2	18-81	442	57.24	137/89	51.1	46.4-55.9
Li[80]	2016	Cross-sectional	Zhangye County (Gansu Province)	2014.01-2015.12	1	18-83	1000	52.10	297/263	56.0	52.9-59.1
Ma et al[81]	2018	Cross-sectional	Baiyin (Gansu Province)	2018	1	20-70	16722	52.76	4290/2802	42.4	41.7-43.2
Hou et al[82]	2020	Cross-sectional	Qingyang (Gansu Province)	2016.1-2019.12	2	8-92	8321	60.06	2894/2206	61.3	60.2-62.3
Zhang et al[83]	2020	Cross-sectional	Yinchuan (Ningxia Hui Autonomous Region)	2018.06-2018.09	1	≥ 18	800	50.00	243/211	56.8	53.2-60.2
Hu et al[84]	2019	Cross-sectional	Ningxia Hui Autonomous Region	2018.12-2019.12	1	14-88	710	33.10	146/257	56.8	53.0-60.4
Li et al[85]	2024	Cross-sectional	Qinghai Province	2021-2022	1	3-85	1131	42.44	241/356	52.8	49.8-55.7
Li et al[86]	2022	Cross-sectional	Qinghai Province	2021.05-2012.12	1	4-90	4724	42.65	1047/1484	53.6	52.1-55.0
Wang et al[87]	2019	Cross-sectional	Qinghai Province	2017.08-2018.11	1	14-85	2103	48.64	775/784	74.1	72.2-76.0
Zhang et al[88]	2014	Cross-sectional	Xian (Shaanxi Province)	2014.01-2014.02	1	21-82	548	74.09	191/72	48.0	43.7-52.3
Zhang et al[89]	2015	Cross-sectional	Xian (Shaanxi Province)	2009-2013	2	18-70	16506	59.95	2983/1671	27.7	27.0-28.3
Tang et al[90]	2017	Cross-sectional	Xian (Shaanxi Province)	2016	1	18-78	6085	46.05	1463/1585	50.1	48.8-51.4
Xiao et al[91]	2021	Cross-sectional	Xian (Shaanxi Province)	2019.5-2020.05	1	NA	2100	60.81	600/383	46.8	44.7-49.0
Di et al[92]	2022	Cross-sectional	Xian (Shaanxi Province)	2016.09-2020.12	1	5-96	10016	45.06	1753/1502	32.5	31.6-33.4
Zhu et al[93]	2017	Cross-sectional	Hoboksar (Xinjiang Uygur Autonomous Region)	NA	1, 2	20-78	1200	43.58	362/480	70.2	67.5-72.7
Yao and Wang[94]	2017	Cross-sectional	Urumqi (Xinjiang Uygur Autonomous Region)	2016.05.10-2016.11.24	1	NA	2301	43.29	455/585	45.2	43.1-47.3
Li et al[95]	2023	Cross-sectional	Tarbagatay Prefecture (Xinjiang Uygur Autonomous Region)	2019.01-2022.06	2	NA	2840	50.56	846/771	56.9	55.1-58.8
Wang et al[96]	2016	Cross-sectional	Xinjiang Uygur Autonomous Region	2013.06-2014.06	1	17-87	4780	56.19	1264/1045	48.3	46.9-49.7
Fan et al[97]	2016	Cross-sectional	Xinjiang Uygur Autonomous Region	2014.09-2015.09	1	16-75	4774	41.10	1243/1890	65.6	64.3-67.0
Southwest region
Shu[98]	2021	Cross-sectional	Tongren County (Guizhou Province)	2018.04-2019.04	1	20-60	800	56.38	252/201	56.6	53.1-60.1
Yang et al[99]	2019	Cross-sectional	Aba Tibetan and Qiang Autonomous Prefecture (Sichuan Province)	2015.05-2016.12	1	2-92	544	46.51	73/93	30.5	26.7-34.6
Zhou et al[100]	2022	Cross-sectional	Guangyuan (Sichuan Province)	2020.3-2021.03	1	18-81	4296	44.41	1140/1128	52.8	51.3-54.3
Xu et al[101]	2019	Cross-sectional	Luzhou (Sichuan Province)	2017.05-2018.05	1, 2	14-87	18684	63.35	3788/2086	31.4	30.8-32.1
Xiao et al[102]	2020	Cross-sectional	Yibin (Sichuan Province)	2017.01-2018.12	4	2-6	622	54.98	71/60	21.1	17.9-24.5
Luo et al[103]	2022	Cross-sectional	Nanchong (Sichuan Province)	2021.8-2022.5	1	≥ 18	1478	50.47	375/327	47.5	44.9-50.1
Zou et al[10]	2023	Cross-sectional	Chengdu (Sichuan Province)	2013-2014	1	NA	16914	52.49	3640/3341	41.3	40.5-42.0
Zou et al[10]	2023	Cross-sectional	Chengdu (Sichuan Province)	2019-2021	1	NA	18281	46.74	2570/3035	30.7	30.0-31.3
Wu et al[104]	2017	Cross-sectional	The Tibet Autonomous Region	NA	1, 3	2-85	4332	53.46	1475/1208	61.9	60.5-63.4
Cai et al[105]	2018	Cross-sectional	Lhasa (The Tibet Autonomous Region)	2015.11-2016.7	1	5-85	1000	44.30	245/331	57.6	54.5-60.7
Dawa et al[106]	2021	Cross-sectional	The Tibet Autonomous Region	2018-2019	1	NA	717	52.44	196/192	54.1	50.4-57.8
Zhang et al[107]	2021	Cross-sectional	Baishe (Yunnan Province)	2020.04-2020.08	4	3-6	321	50.47	159/40	25.9	21.2-31.0
Xie[108]	2017	Cross-sectional	Qujing (Yunnang Province)	2016.1-2016.12	1	20-79	8790	58.07	1712/1172	32.8	31.8-33.8
Wang et al[109]	2015	Cross-sectional	Yunang Province	2013.01-2014.08	1	≥ 20	6680	72.54	1988/688	40.1	38.9-41.2
Li et al[110]	2018	Cross-sectional	Kunming (Yunnan Province)	2015.01-2017.12	1	20-75	606	36.63	115/75	31.4	27.7-35.2
Jia et al[111]	2018	Cross-sectional	Yunnan Province	2013.01-2015.02	1	21-85	1680	77.74	433/191	37.1	34.8-39.5
Fu et al[112]	2018	Cross-sectional	Kunming (Yunnan Province)	2013.1-2016.12	1	3-18	12932	53.15	1706/1408	24.1	23.3-24.8
Ding et al[113]	2017	Cross-sectional	Dali (Yunnan Province)	2014.06-2016.06	4	0-14	1127	51.46	75/53	11.4	9.6-13.4
Chen and Sun[114]	2019	Cross-sectional	Puer (Yunnan Province)	2018.5.1-2019.4.30	1	18-92	15328	56.36	3793/2502	41.1	40.3-41.9
Liu et al[115]	2017	Cross-sectional	Chongqing	2014.1-2014.12	1	44.1 ± 10.8	10912	52.91	1949/1801	34.4	33.5-35.3
Liu and Lei[116]	2020	Cross-sectional	Chongqing	2017.01-2018.06	1	7-18	1982	50.15	109/121	11.6	10.2-13.1
Zhou[117]	2018	Cross-sectional	Chongqing	2012.01-2016.08	1, 3	38.7	1000	54.60	324/203	52.7	49.6-55.8
Meng and Sun[118]	2018	Cross-sectional	Chongqing	2017.1-2017.12	2	15-85	27662	59.16	4222/2576	24.6	24.1-25.1
Liu and Fan[119]	2016	Cross-sectional	Chongqing	2014.01-2014.12	1	20-90	5788	65.74	1074/513	27.4	26.3-28.6
South China
Zhu et al[120]	2021	Cross-sectional	Shenzhen (Guangdong Province)	2019.1-2019.12	1	20-69	985	55.53	222/164	39.2	36.1-42.3
Zhang et al[121]	2015	Cross-sectional	Guangzhou (Guangdong Province)	2013.07-2014.06	1	8-68	440	45.45	120/132	57.3	52.5-61.9
Liang and Yang[122]	2018	Cross-sectional	Yangjiang (Guangdong Province)	2017.09-2019.08	2	NA	6703	54.20	1741/1564	49.3	48.1-50.5
Yang[123]	2021	Cross-sectional	Jiangmen (Guangdong Province)	2018.01-2019.12	2	28-88	100	52.00	17/7	24.0	16.0-33.6
Xie et al[124]	2014	Cross-sectional	Zhuhai (Guangdong Province)	2013.01-2013.09	2	21-70	2963	63.75	1156/473	55.0	53.2-56.8
Xie et al[125]	2021	Cross-sectional	Chaoshan (Guangdong Province)	2018.03-2020.06	1	16-88	3160	51.27	892/726	51.2	49.4-53.0
Tang and Zhang[126]	2021	Cross-sectional	Shenzhen (Guangdong Province)	2018.06-2020.11	2	NA	3605	53.09	1154/996	59.6	58.0-61.2
Guan et al[127]	2022	Cross-sectional	Guangzhou (Guangdong Province)	2020.1-2020.12	1	22-88	6436	54.93	1110/855	30.5	29.4-31.7
Dai et al[128]	2020	Cross-sectional	Foshan (Guangdong Province)	2018.1-2018.12	1	28-78	15730	52.45	3855/3157	44.6	43.8-45.4
Li et al[129]	2022	Cross-sectional	Shenzhen (Guangdong Province)	2020.09-2021.09	1	≥ 20	5007	59.18	1052/700	35.0	33.7-36.3
Xu and Yan[130]	2018	Cohort study	Nanning (Guangxi Zhuang Autonomous Region)	2014.03-2017.06	1	20-65	2956	58.93	787/552	45.3	43.5-47.1
Weng[131]	2017	Cross-sectional	Laibin (Guangxi Zhuang Autonomous Region)	2014.01-2012.03	1	10-89	6328	59.07	2308/1054	53.1	51.9-54.4
Lin and Cheng[132]	2016	Cross-sectional	Hechi (Guangxi Zhuang Autonomous Region)	2016.01-2016.03	1	20-75	1500	54.47	486/226	47.5	44.9-50.0
Wang[133]	2021	Cross-sectional	Nanning (Guangxi Zhuang Autonomous Region)	2017.01-2019.12	1	21-75	1175	67.83	268/114	32.5	29.8-35.3
Chen et al[134]	2017	Cross-sectional	Hezhou (Guangxi Zhuang Autonomous Region)	2015.05-2015.12	1	18-80	600	58.67	162/130	48.7	44.6-52.7
Chen[135]	2022	Cross-sectional	Nanning (Guangxi Zhuang Autonomous Region)	2021.01-2021.12.31	2	19-89	1485	75.82	251/99	23.6	21.4-25.8
Cao et al[136]	2017	Cross-sectional	Baise (Guangxi Zhuang Autonomous Region)	2012.1-2015.12	2	≥ 7	3363	52.75	930/659	47.2	45.6-49.0
Zhang et al[137]	2023	Cross-sectional	Qionghai (Hainan Province)	NA	1	14-85	535	36.64	77/152	42.8	38.6-47.1
Qiu and Xu[138]	2017	Cross-sectional	Chengmai County (Hainan Province)	2015.01-2016.12	2	22-85	1977	68.03	483/225	35.8	33.7-38.0
Ma et al[139]	2015	Cross-sectional	Haikou (Hainan Province)	2013.07-2013.10	Interdental tartar	21-81	4122	51.55	550/507	25.6	24.3-27.0
Zeng et al[140]	2023	Cross-sectional	Wuzhishan (Hainan Province)	2023.03	1	≥ 18	528	26.70	61/162	42.2	38.0-46.6
Liu et al[141]	2023	Cross-sectional	Hainan Province	2021.07-2022.04	1	NA	1355	44.72	269/360	46.4	43.7-49.1
Central China
Zhao et al[142]	2022	Cross-sectional	Zhengzhou (Henan Province)	2020.01-2020.12	1	18-80	8312	61.81	2009/1217	38.8	37.8-39.9
Chai et al[143]	2021	Cross-sectional	Zhengzhou (Henan Province)	2018-2019	1	18-87	2589	55.66	391/303	26.8	25.1-28.6
Wang et al[144]	2018	Cross-sectional	Henan Province	2017.01-2017.06	1	18-67	2974	56.93	599/418	34.2	32.5-35.9
Liu et al[145]	2021	Cross-sectional	Nanyang (Henan Province)	2019.05-2021.02	2	18-78	856	59.00	324/206	61.9	58.6-65.2
Gu et al[146]	2014	Cross-sectional	Luohe (Henan Province)	NA	2	13-77	1874	49.73	559/524	57.8	55.5-60.0
Fan et al[147]	2015	Cross-sectional	Pingdingshan (Henan Province)	2012.04-2012.06	2	20-83	449	61.02	153/65	48.6	43.8-53.3
Yu et al[148]	2022	Cross-sectional	Zhengzhou (Henan Province)	2020.09-2021.4	2	45.36 ± 19.38	772	42.75	173/246	54.3	50.7-57.8
Lei et al[149]	2023	Cross-sectional	Zhengzhou (Henan Province)	2020.09-2021.03	2	3-90	731	54.31	164/233	54.3	50.6-58.0
Zhang et al[150]	2019	Cross-sectional	Wuhan (Hubei Province)	2017.05-2017.10	1	20-60	11365	72.59	3449/1242	41.3	40.4-42.2
Yang[151]	2020	Cross-sectional	Jingmen (Hubei Province)	2018.01-2018.12	1	15-81	984	57.62	243/125	37.4	34.4-40.5
Li[152]	2022	Cross-sectional	Xianyang (Hubei Province)	2016.10-2017.07	1	15-87	1756	56.09	598/445	59.4	57.1-61.7
Xi[153]	2014	Cross-sectional	Wuhan (Hubei Province)	2012.03-2013.02	1	16-80	3012	48.51	684/733	46.7	45.0-48.5
Liu et al[154]	2017	Cross-sectional	Wuhan (Hubei Province)	2015.07-2015.08	1	20-91	2366	55.83	376/315	29.2	27.4-31.1
Zhou and Lin[155]	2018	Cross-sectional	Huangshi (Hubei Province)	2013.10-2016.6	1	3-13	1240	51.94	596/284	46.0	43.2-48.9
Li et al[156]	2014	Cross-sectional	Xiaogan (Hubei Province)	2012.6-2013.2	2	12-81	2005	55.16	899/486	50.7	48.5-52.9
Jia et al[157]	2016	Cross-sectional	Wuhan (Hubei Province)	2015.03-2015.08	1	51.2	2180	52.02	549/446	47.0	44.9-49.1
Deng et al[158]	2020	Cohort study	Wuhan (Hubei Province)	2018.1-2019.12	1	20-70	2619	63.54	778/331	42.3	40.4-44.3
Li et al[159]	2015	Cross-sectional	Chenzhou (Hunan Province)	2013.08-2014.12	2	> 20	7015	34.23	663/1230	27.0	25.9-28.0
Peng et al[160]	2019	Cross-sectional	Chenzhou (Hunan Province)	2016.01-2017.01	2	22-70	3123	63.24	680/382	34.0	32.3-35.7

NA: Not available.