Aging biomarkers: Potential mediators of association between long-term ozone exposure and risk of atherosclerosis.

BACKGROUND: Long-term exposure to ambient ozone links to aging biomarkers and increased risk for atherosclerotic cardiovascular diseases (ASCVD). However, the roles of aging biomarkers in the association of long-term exposure to ambient ozone with ASCVD are unclear. METHODS: A total of 5298 participants completed the questionnaire and physical examination and provided biological specimens. Aging biomarkers (telomere length [TL] and mitochondrial copy number [mtDNA-CN]) were measured by using a real-time polymerase chain reaction method. The concentration of ambient ozone was assessed using a random forest model. Associations of ambient ozone or aging biomarkers with 10-year ASCVD risk were analyzed using logistic regression models. The roles of aging biomarkers in the association of ambient ozone exposure with 10-year ASCVD risk were explored by mediation analysis. RESULTS: The adjusted odds ratios and 95% confidence interval of high 10-year ASCVD risk were 1.16 (1.08, 1.25), 0.71 (0.60, 0.85), and 0.78 (0.64, 0.96) in association with each 1-unit increment in ambient ozone (1 µg/m3 ) concentration, relative TL, and mtDNA-CN, respectively. The mediated proportion of the association between ambient ozone exposure and high 10-year ASCVD risk by TL or mtDNA-CN was 21.13% or 7.75%, respectively. The total proportion of association between ambient ozone exposure and high 10-year ASCVD risk mediated by TL plus mtDNA-CN was 21.02%. CONCLUSIONS: Long-term exposure to ambient ozone was associated with increased 10-year ASCVD risk, and the association was partially mediated by aging biomarkers (shortened TL and decreased mtDNA-CN). This study indicated that ambient ozone pollution-related ASCVD risk might be partially explained by the telomere-mitochondrial axis of aging.

Association of eating out frequency and other factors with serum uric acid levels and hyperuricemia in Chinese population.

PURPOSE: A significant shift in meal pattern with frequent eating out was closely associated with multiple chronic outcomes, but with limited evidence on hyperuricemia. We aimed to explore the associations between eating out and serum uric acid (SUA) as well as hyperuricemia. METHODS: A total of 29,597 participants were recruited from the Henan Rural Cohort Study. A validated food frequency questionnaire (FFQ) was used to collect dietary data, including the frequency of eating out. Linear regression models were used to examine the association of eating-out frequency with SUA and BMI. Logistic regression and restricted cubic spline were performed to assess the association and dose-response relationship between eating-out frequency and hyperuricemia. The mediation effect of BMI between eating out and the risk of hyperuricemia was evaluated. RESULTS: Eating out was significantly associated with higher SUA levels in the total population and males (P < 0.001). Multivariate-adjusted odds ratios (ORs) with 95% confidence interval (CIs) of hyperuricemia were 1.26 (1.09, 1.46) for the total population and 1.18 (1.00, 1.40) for males (≥ 7 times/week vs 0 time/week). A non-linear positive dose-response relationship between eating-out frequency and hyperuricemia was observed. Furthermore, BMI played a partial mediating role in the relationship between eating out frequency and hyperuricemia, which explained 30.7% in the total population and 44.8% in males. CONCLUSION: Our findings indicated that eating out was associated with increased SUA levels and elevated hyperuricemia risk in rural China, especially in males. Moreover, the relationship was partly mediated by BMI. CLINICAL TRIALS: ChiCTR-OOC-15006699 (2015-07-06).

Adverse associations of different obesity measures and the interactions with long-term exposure to air pollutants with prevalent type 2 diabetes mellitus: The Henan Rural Cohort study.

BACKGROUND: Obesity and ambient air pollution are independent risk factors of type 2 diabetes mellitus (T2DM), however, the evidence regarding their joint associations on T2DM was sparsely studied in low-middle income countries. METHODS: A total of 38,841 participants were selected from Henan Rural Cohort study which was carried out during 2015-2017. Obesity was identified by body mass index (BMI), WC (waist circumstance), WHR (waist-to-hip ratio), WHtR (waist-to-height ratio), BFP (body fat percent), and VFI (visceral fat index). Three-year averaged-concentrations of NO2, PM1, PM2.5, and PM10 were assessed by using the method of spatiotemporal model incorporated into the satellites data. The independent associations of obesity indicators and exposure to air pollutants on fasting blood glucose (FBG) and T2DM were assessed by generalized linear and logistic regression model, respectively, and their interaction associations on T2DM were quantified by using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S). RESULTS: Positive associations of six obesity measures and four air pollutants with FBG levels and prevalent T2DM were observed. Obese participants measured by BMI plus high exposure to NO2, PM1, PM2.5 and PM10 were related to a 2.96-fold (2.66-3.29), 2.87-fold (2.58-3.20), 2.98-fold (2.67-3.32) and 3.01-fold (2.70-3.35) increased risk for prevalent T2DM, respectively; similarity of joint associations of the other obesity measures and air pollutants on T2DM were observed. The additive associations of different obesity measures and air pollutants with prevalent T2DM were further found. CONCLUSIONS: The synergistic associations of obesity and air pollutants on FBG levels and prevalent T2DM were observed, indicating that obese participants were at high risk for prevalent T2DM in highly polluted rural regions.

Snoring and napping independently increased the serum uric acid levels and hyperuricemia risk: The Henan Rural Cohort Study.

BACKGROUND AND AIMS: Evidence on the association of snoring, daily sleep duration (daytime napping and night sleep duration) with hyperuricemia (HUA) was limited, especially in the resources-poor areas. This study aimed to investigate the independent effect of snoring frequency and daily sleep duration on HUA prevalence in rural Chinese adults. METHODS AND RESULTS: 29,643 participants aged 18-79 years were included in the final cross-sectional analysis from the Henan Rural Cohort Study. Multivariate logistic regression and linear regression models with HUA and serum uric acid (SUA) levels as dependent variables were conducted, respectively. Of the 29,643 included adults, 3498 suffered from HUA. Compared to never snoring, the adjusted odds ratio (OR) and 95% confidence interval (CI) of HUA for rare snoring, occasional snoring, and habitual snoring were 1.35 (1.17, 1.56), 1.30 (1.14, 1.47), and 1.59 (1.47, 1.73), respectively (P for trend <0.001). Compared with no napping, participants who had daytime napping of 61-90 and > 91 min were associated with a 29% and 30% increase in the prevalence of HUA, respectively (P for trend <0.001). But in night sleep duration groups, no significant associations were observed. The positive associations between snoring and HUA were attenuated in people aged ≥65 and people with type 2 diabetes mellitus (both P for interaction <0.05). CONCLUSION: Habitual snoring or longer daytime napping was independently associated with increased HUA prevalence and SUA levels in rural Chinese adults, which indicates the significance of early intervention and treatment of snoring and longer daytime napping to prevent hyperuricemia.

Gender-specific relationship between frequency of food-away-from-home with serum lipid levels and dyslipidemia in chinese rural adults.

OBJECTIVE: Food-away-from-home (FAFH) is one of the leading dietary patterns in Chinese families. However, the relationship between FAFH and dyslipidemia remains unclear, especially in the rural adult population. This study explored the relationship of FAFH frequency with serum lipid levels and dyslipidemia in rural Chinese adults. METHODS: A total of 12,002 men and 17,477 women aged 18-79 were included from the Henan rural cohort. Serum lipid levels were measured by enzyme colorimetry. Information on FAFH frequency was collected using a validated questionnaire. The associations of FAFH frequency and serum lipid levels were assessed through multiple linear regression modeling. Logistic regression was performed to explore the linkages of the FAFH frequency to dyslipidemia and its four parameter types. Mediation analysis examined whether body mass index (BMI) acted as a mediator between the FAFH frequency and dyslipidemia. RESULTS: After adjusting for potential confounders, the adjusted odds ratio (OR) and 95% confidence interval (CI) of the groups with 8-11 FAFH times/week for dyslipidemia were 1.991 (1.569, 2.526) in men compared with 0-frequency subgroup. Participants who consumed 8-11 FAFH times/week had a higher risk of high total cholesterol (TC), high triglycerides (TG), high LDL-cholesterol (LDL-C), and low HDL-cholesterol (HDL-C) with the OR and 95% CI of 1.928 (1.247, 2.980), 1.723 (1.321, 2.247), 1.875 (1.215, 2.893), and 1.513 (1.168, 1.959), respectively. In addition, the interaction effect between FAFH and gender was significantly associated with dyslipidemia and lipid levels (P < 0.001). BMI played a fully mediating effect between FAFH frequency and dyslipidemia in men, and the Sobel test showed the significance of the mediating effect (z = 4.2158, P < 0.001). CONCLUSION: In rural Chinese adults, FAFH was significantly associated with a higher risk of dyslipidemia, which indicated the importance of FAFH reduction and dietary intervention in patients with dyslipidemia and cardiovascular disease, especially in clinical practice. TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15,006,699).

Association between serum uric acid and carotid atherosclerosis in elderly postmenopausal women: A hospital-based study.

BACKGROUND: Carotid atherosclerosis (CAS) is associated with increased cardiovascular risk and implicated in 20-30% of strokes. METHODS: 504 patients were included in this study. The detailed medical history and the results of physical examination, carotid ultrasound examination, and routine laboratory tests were collected. Logistic regression analyses were conducted to analyze the relationship between the SUA and the presence of carotid plaques. And the relationship between SUA and the progression of CAS was analyzed by multiple linear regression. The effect of hormone replacement therapy (HRT) on CAS has also be evaluated. RESULTS: 412 patients (81.7%) had carotid plaques of different sizes by carotid ultrasound examination. We found a positive association between the level of SUA and the probability of having carotid plaque by univariate logistic regression (OR: 2.01, 95% CI: 1.83-2.19, p = 0.003). At 2 years post-discharge, we found that 1 mg/dL increase in SUA levels was expected to 0.946% increase in plaque score and 0.026 cm increase in carotid intima-media thickness, separately. Moreover, patients treated by long-term HRT (≥5 years) had a lower level of SUA and blood lipid and the less change of plaque score and carotid intima-media thickness than patients without HRT. CONCLUSION: The presence and progression of CAS had significantly positive associations with the level of SUA. And the HRT may have the ability to prevent the presence and progression of CAS. However, the safety and long-term outcome of HRT on CAS should be evaluated in further studies.

Low socioeconomic status aggravated associations of exposure to mixture of air pollutants with obesity in rural Chinese adults: A cross-sectional study.

OBJECTIVES: Socio-economic status (SES) and air pollutants are thought to play an important role in human obesity. The evidence of interactive effect between SES and long-term exposure to mixture of air pollutants on obesity is limited, thus, this study is aimed to investigate their interactive effects on obesity among a rural Chinese population. METHODS: A total of 38,817 individuals were selected from the Henan Rural Cohort Study. Structural equation modeling (SEM) was applied to construct the latent variables of low SES (educational level, marital status, family yearly income, and number of family members), air pollution (particulate matter with aerodynamics diameters ≤ 1.0 µm, ≤ 2.5 µm or ≤ 10 µm, and nitrogen dioxide) and obesity (body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, body fat percentage and visceral fat index). Generalized linear regression models were used to assess associations between the constructed latent variables. Interaction plots were applied to describe interactive effect of air pollution and low SES on obesity and biological interaction indicators (the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S)) were also calculated. RESULTS: Increased latent variables of low SES and mixture of air pollution were associated with a higher odds of latent variable of obesity (odds ratios (OR) (95% confidence interval (CI)) were 1.055 (1.049, 1.060) and 1.050 (1.045, 1.055)). The association of the mixture of air pollutants on obesity was aggravated by increased values of the latent variable of low SES (P < 0.001). Furthermore, the values of RERI, AP and S were 0.073 (0.051, 0.094), 0.057 (0.040, 0.073) and 1.340 (1.214, 1.479), respectively, indicating an additive effect of estimated latent variable of low SES and air pollution on obesity. CONCLUSIONS: These findings suggested that low SES aggravated the negative effect of mixture of air pollutants on obesity, implying that individuals with low SES may be more susceptible to exposure to high levels of mixture of air pollutants related to increased risk of prevalent obesity.

Janus kinase 2 (JAK2) methylation and obesity: A Mendelian randomization study.

BACKGROUND AND AIMS: Janus kinase 2 (JAK2) play an important role in the energy metabolism. Whether there is a causal relationship between JAK2 methylation levels and obesity remains unclear. Based on the instrumental variables of 5 SNP sites, this study was aimed to explore the causal relationship between JAK2 methylation levels and obesity by Mendelian randomization analysis. METHODS AND RESULTS: A total of 1021 participants (511 cases and 510 controls defined by body mass index (BMI) ≥ 28.0 kg/m2) was conducted from the Henan Rural Cohort study. SNPscan® was performed to test the SNP genotyping and MethylTarget™ was applied to detect the DNA methylation level. The logistic regression model was used to evaluate the associations between SNP or methylation of JAK2 and obesity (according to BMI). Mendelian randomization analysis was used to assess the potential causal association between JAK2 methylation and obesity. According to the logistic regression model, 1 CpG sit in the promotor was related to an increased risk of obesity (P < 0.05). 10 CpG sites in the exon were associated with decreased risk of obesity (P < 0.05). Mendelian randomization analysis showed a causal association between the methylated level of JAK2 and obesity, based on the instrumental variables of 5 SNPs (P < 0.05). CONCLUSIONS: This study supported that the methylation degree of JAK2 has a complex relationship with obesity, which might be related to the region of methylation. A causal relationship exists between the methylated level of JAK2 and obesity.

Associations of spicy food flavour and intake frequency with blood lipid levels and risk of abnormal serum lipid levels in Chinese rural population: a cross-sectional study.

OBJECTIVE: The purpose of the current study was to investigate associations between spicy food intake and serum lipids levels in Chinese rural population. DESIGN: Information on spicy food flavour and intake frequency was obtained using a two-item questionnaire survey. Dietary data were collected using a validated thirteen-item FFQ. Fasting blood samples were collected and measured for total cholesterol (TC), TAG, HDL-cholesterol and LDL-cholesterol. Multivariate linear and logistic regression models were employed to examine the relationship between spicy food and serum lipids levels according to the spicy food flavour and intake frequency, respectively. SETTING: A cross-sectional study in Henan Province. PARTICIPANTS: 38 238 participants aged 18-79 years old. RESULTS: Spicy flavour and intake frequency were consistently associated with decreased TC and non-HDL-cholesterol levels but mildly associated with elevated TAG levels. Each level increment in spicy flavour was inversely associated with high TC (OR: 0·91; 95 % CI 0·88, 0·93) and high non-HDL-cholesterol (OR: 0·88; 95 % CI 0·85, 0·91) but positively associated with high TAG (OR: 1·04; 95 % CI 1·01, 1·07). Similarly, 1-d increment in spicy food intake frequency was also inversely associated with high TC (OR: 0·92; 95 % CI 0·91, 0·94) and high non-HDL-cholesterol (OR: 0·91; 95 % CI 0·89, 0·93) but positively associated with high TAG (OR: 1·04; 95 % CI 1·02, 1·06). CONCLUSIONS: Spicy food intake was mildly associated with increased risk of abnormal TAG level, significantly associated with decreased risk of abnormal TC and non-HDL levels. Spicy food intake may be contribute to the management of lipid levels.

Prevalence and characteristics of alcohol consumption and risk of type 2 diabetes mellitus in rural China.

BACKGROUND: The study aimed to characterize the prevalence of alcohol consumption and further investigate the relationship between alcohol consumption and type 2 diabetes mellitus (T2DM). METHODS: We studied 39,259 participants aged 18 to 79 years of the Henan Rural Cohort study. The associations between alcohol consumption and T2DM were examined using the logistic regression models and restricted cubic spline. RESULTS: For men, alcohol abstinence was associated with an increased risk of T2DM (1.491(1.265, 1.758)), whereas current drinkers were not associated with T2DM (1.03(0.91, 1.15)). Further analysis of alcohol drinkers revealed that only high-risk drinkers of WHO drinking risk levels increased the risk of T2DM (1.289(1.061,1.566)) compared to never drinkers. The risk of T2DM increased as the age of starting to consume alcohol decreased and as the number of years of consuming alcohol and the alcohol intake increased only in men. We further found that the risk of T2DM decreased as the number of years of abstinence increases and no association between alcohol abstinence and T2DM was found after more than 10 years of abstinence among men. CONCLUSIONS: Our results suggested that reducing the amount of alcohol consumed and adhering to abstinence from alcohol consumption are beneficial in reducing the risk of T2DM. TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375.

Associations of midpoint of sleep and night sleep duration with type 2 diabetes mellitus in Chinese rural population: the Henan rural cohort study.

BACKGROUND: The study aimed to investigate the independent and combined effects of midpoint of sleep and night sleep duration on type 2 diabetes mellitus (T2DM) in areas with limited resources. METHODS: A total of 37,276 participants (14,456 men and 22,820 women) were derived from the Henan Rural Cohort Study. Sleep information was assessed based on the Pittsburgh Sleep Quality Index. Logistic regression models and restricted cubic splines were used to estimate the relationship of the midpoint of sleep and night sleep duration with T2DM. RESULTS: Of the 37,276 included participants, 3580 subjects suffered from T2DM. The mean midpoint of sleep among the Early, Intermediate and Late groups were 1:05 AM ±23 min, 1:56 AM ±14 min, and 2:57 AM ±34 min, respectively. Compared to the Intermediate group, adjusted odds ratios (ORs) and 95% confidence interval (CI) of T2DM were 1.13 (1.04-1.22) and 1.14 (1.03-1.26) in the Early group and the Late group. Adjusted OR (95% CI) for T2DM compared with the reference (7- h) was 1.28 (1.08-1.51) for longer (≥ 10 h) night sleep duration. The combination of late midpoint of sleep and night sleep duration (≥ 9 h) increased 38% (95% CI 10-74%) prevalence of T2DM. These associations were more obvious in women than men. CONCLUSIONS: Late and early midpoint of sleep and long night sleep duration were all associated with higher prevalence of T2DM. Meanwhile, midpoint of sleep and night sleep duration might have combined effects on the prevalence of T2DM, which provided potential health implications for T2DM prevention, especially in rural women. TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699 ). Date of registration: 2015-07-06.

Associations between depressive symptoms, anxiety symptoms, their comorbidity and health-related quality of life: a large-scale cross-sectional study.

BACKGROUND: There were few studies exploring the associations between depressive symptoms, anxiety symptoms and health-related quality of life (HRQoL) in the general population, especially in resource limited area. The aims of this study were to assess the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL in rural area. METHODS: A total of 23,496 eligible participants from Henan rural cohort were included. The Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) were employed to assess depressive and anxiety symptoms, respectively. HRQoL was measured via European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L). Tobit regression and generalized linear model were utilized to explore the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL. RESULTS: A total of 1320 individuals were identified as depressive symptoms with a prevalence rate of 5.62%, while 1198 participants were classified as anxiety symptoms with a prevalence rate of 5.10%. After multiple adjustment, the regression coefficients (ß) and 95% confidence interval (CI) of utility index for depressive and anxiety symptoms were - 0.166 (- 0.182, - 0.149) and - 0.132 (- 0.149, - 0.114), respectively. The ß and 95% CI of VAS score for depressive and anxiety symptoms were - 7.65 (- 8.60, - 6.70) and - 5.79 (- 6.78, - 4.80), respectively. Additionally, the comorbidity was strongly associated with low utility index and VAS score. These findings were observed robustly in men and women. CONCLUSION: Depressive symptoms, anxiety symptoms and their comorbidity were associated with low HRQoL in rural population, which needed further efforts on preventive and treatment interventions. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699 ). Date of registration: 06 July, 2015.

Residential greenness and atherosclerotic cardiovascular disease risk in a rural Chinese adult population.

Residential greenness may be beneficial for cardiovascular health, but the evidence is still scarce, especially in developing countries. This study aimed to assess the associations between exposure to residential greenness and 10-year atherosclerotic cardiovascular disease (ASCVD) risk in a large rural Chinese adult population. This was a cross-sectional study based on 31,162 participants aged 35-74 years with complete data on predictors of the 10-year ASCVD risk from the Henan Rural Cohort Study. The satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were used to quantify residential greenness in a buffer radius of 500 m, 1000 m, and 3000 m. The high 10-years ASCVD risk was defined as the estimated risk ≥10% based on prediction equations from the China-PAR Project for Chinese populations. Multivariable-adjusted logistic regression models were performed to estimate the associations of greenness exposures with high 10-year ASCVD risk, and mediation analyses were employed to the potential mediators. For per interquartile range (IQR) increase in NDVI500-m, NDVI1000-m, NDVI3000-m, EVI500-m, EVI1000-m, and EVI3000-m, the adjusted OR (95% CI) of high 10-years ASCVD risk was 0.828 (0.793-0.866), 0.850 (0.817-0.885), 0.823 (0.792-0.855), 0.848 (0.809-0.889), 0.863 (0.826-0.901), 0.843 (0.805-0.883), respectively. Strong associations of NDVI500-m and EVI500-m with high 10-years ASCVD risk were found among participants with lower education level and lower averaged monthly income. The associations of greenness exposures with high 10-year ASCVD risk were partially explained by particulate matter with an aerodynamic diameter ≤1 µm, BMI, and physical activity. Enhancing residential greenness exposure may be beneficial for reducing the high 10-year ASCVD risk in rural Chinese adults.

Pueraria lobata root polysaccharide alleviates glucose and lipid metabolic dysfunction in diabetic db/db mice.

CONTEXT: Pueraria lobata (Willd.) Ohwi (Fabaceae) root extract can lower blood glucose levels; however, whether Pueraria lobata root polysaccharide (PLP) possesses these effects is still unknown. OBJECTIVE: This study evaluates the therapeutic effect of PLP on diabetic metabolic syndrome. MATERIALS AND METHODS: The db/m mice were assigned to normal control group (NC), db/db mice were divided into four groups randomly (n = 8). The db/db mice received rosiglitazone (10 mg/kg BW) or PLP (100 or 200 mg/kg BW) via oral gavage for 6 weeks. Afterward, blood glucose, insulin, and glycogen content were assayed, and insulin tolerance test (ITT), oral glucose tolerance test (OGTT) were performed. Glucose and lipid metabolism-related parameters and gene expression levels were assayed by ELISA and RT-PCR, respectively. RESULTS: After treatment with HPLP, the values of body weight, epididymal fat, subcutaneous fat, fasting blood glucose, insulin, and HOMA-IR decreased to 45.89 ± 1.66 g, 1.65 ± 0.14 g, 1.97 ± 0.16 g, 14.84 ± 1.52 mM, 9.35 ± 0.98 mU/L, and 5.56 ± 1.26, respectively; the levels of TG, TC, LDL-C, and FFA decreased to 1.67 ± 0.11 mmol/L, 6.23 ± 0.76 mmol/L, 1.29 ± 0.07 mmol/L, and 1.71 ± 0.16 mmol/L, respectively. HPLP down-regulated PEPCK, G6PC, FOXO1, SREBP-1, and ACC mRNA expression (p < 0.01), and up-regulated GS, Akt2, PI3K, GLUT2, PPARα, and LDLR mRNA expression in the liver (p < 0.01). DISCUSSION AND CONCLUSION: PLP exerts antidiabetic effects via activating the PI3K/AKT signalling pathway, thus improving insulin resistance, glucose, and lipid metabolism in db/db mice. Thus, PLP may be considered as a potential antidiabetic agent in clinical therapy.

Fruit and vegetable intake modifies the associations between suppressor of cytokine signaling 3 genetic variants and type 2 diabetes.

PURPOSE: Type 2 diabetes is a complex disease determined by variable genes and environmental factors. The study was designed to investigate the effect of interactions of four polymorphisms of suppressor of cytokine signaling 3 (SOCS3) with fruit and vegetable (F&V) intake on type 2 diabetes in a rural population of China. METHODS: A total of 4411 participants from the rural areas of Henan, China were included in the study. Multivariate logistic regression and restricted cubic splines were used to estimate the associations between polymorphisms and risk allele score of SOCS3 and type 2 diabetes in different groups. Haplotype analysis was conducted to examine the effects of linkage inheritance at these four loci on type 2 diabetes. RESULTS: Three of the four polymorphisms showed significant associations with type 2 diabetes in the less F&V intake group after adjusting the covariates, the odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were 1.24 (1.08-1.41) for rs4969168, 1.16 (1.02-1.32) for rs9892622, and 1.21 (1.06-1.39) for rs9914220. No significant association was detected in the more F&V intake group. The obvious dose-response relationship between the risk allele score and type 2 diabetes was also noted only in the less F&V intake group. CONCLUSIONS: Variants of SOCS3 gene were associated with type 2 diabetes and the associations could be modified by the F&V intake.

Association of long-term exposure to ambient air pollutants with prolonged sleep latency: The Henan Rural Cohort Study.

BACKGROUND: Prolonged sleep latency is associated with far-reaching public health consequences. Although evidence about the effect of air pollution on sleep problem has been shown, the effect on sleep latency remained unknown. The study aimed to analyze the association between long-term exposure to air pollution and prolonged sleep latency in rural China. METHODS: In all, 27935 participants were included in the study from Henan Rural Cohort Study. A satellite-based spatiotemporal model was used to evaluate the 3-year average concentration of air pollutants at the home address of participants before the baseline survey. Air pollutants included NO2 (nitrogen dioxide), PM1 (particulate matter with aerodynamic diameters ≤1 µm), PM2.5 (particulate matter with aerodynamic diameters ≤ 2.5 µm), and PM10 (particulate matter with aerodynamic diametes ≤ 10 µm). A logistic regression model was conducted to assess the odds ratio (OR) and 95% confidence interval (95% CI) between air pollutants and prolonged sleep latency. RESULTS: There were 5825 (20.85%) participants with prolonged sleep latency. The average concentration of NO2, PM1, PM2.5, and PM10 were 38.22 (2.54) µg/m3, 56.29 (1.75) µg/m3, 72.30 (1.87) µg/m3, and 130.01 (4.58) µg/m3. The odds ratio (95%CI) of prolonged sleep latency with an IQR increase of NO2, PM1, PM2.5, and PM10 were 1.59 (1.33-1.90), 1.23 (1.13-1.33), 1.28 (1.13-1.45) and 1.43 (1.22-1.67). The stratified analysis showed the effect of air pollutants was stronger among those with stroke. CONCLUSION: Long-term exposure to NO2, PM1, PM2.5 and PM10 were associated with prolonged sleep latency. The adverse impact of air pollution should be considered when treating sleep problems.

Long-term exposure to air pollution might increase prevalence of osteoporosis in Chinese rural population.

OBJECTIVES: The associations of long-term exposure to air pollution with osteoporosis are rarely reported, especially in rural China. This study aimed to explore the association among rural Chinese population. METHODS: A total of 8033 participants (18-79 years) derived from the Henan Rural Cohort Study (n = 39,259) were included in this cross-sectional study. Exposure to air pollutants was estimated using machine learning algorithms with satellite remote sensing, land use information, and meteorological data [including particulate matter with aerodynamic diameters ≤1.0 µm (PM1), ≤2.5 µm (PM2.5), and ≤10 µm (PM10), and nitrogen dioxide (NO2)]. The bone mineral density of each individual was measured by using ultrasonic bone density apparatus and osteoporosis was defined based on the T-score ≤ -2.5. Multiple logistic regression models were used to examine the association of air pollution and osteoporosis prevalence. RESULTS: We observed that per 1 µg/m3 increase in PM1, PM2.5, PM10 and NO2 were associated with a 14.9%, 14.6%, 7.3%, and 16.5% elevated risk of osteoporosis. Compared with individuals in the first quartile, individuals in the fourth quartile had higher odds ratio (OR) of osteoporosis (P-trend < 0.001), the ORs (95% confidence interval) were 2.08 (1.72, 2.50) for PM1, 2.28 (1.90, 2.74) for PM2.5, 1.93 (1.60, 2.32) for PM10, and 2.02 (1.68, 2.41) for NO2. It was estimated that 20.29%-24.36% of osteoporosis cases could be attributable to air pollution in the rural population from China. CONCLUSIONS: Long-term exposure to air pollutants were positively associated with high-risk of osteoporosis, indicated that improving air quality may be beneficial to improve rural residents health.

Long-term effects of ambient air pollutants on suicidal ideation in China: The Henan Rural Cohort Study.

BACKGROUND: The association between ambient air pollutants exposure and suicidal ideation (SI) has rarely been explored, especially in Chinese population. Therefore, we aimed to investigate the long-term effects of ambient air pollutants on SI among a Chinese rural population. METHOD: We recruited 29997 participants from the Henan Rural Cohort study in 2016-2017. SI was evaluated by using the ninth item of the Patient Health Questionnaire-9 (PHQ-9) in the baseline survey. We adopted a satellite-based spatiotemporal model to estimate participants' exposure to particulate matters (PMs) (PM with an aerodynamic diameter ≤1 µm (PM1), ≤2.5 µm (PM2.5) or ≤10 µm (PM10), respectively) and nitrogen dioxide (NO2), and then calculated the 3-year average concentrations of the four pollutants. We used logistic regression models to explore the association between long-term exposure to ambient air pollutants and SI. In addition, we conducted several stratified analyses to examine effect modification of selected factors. RESULTS: The odds ratios (95% confidence intervals [CI]) of SI in response to each 1 µg/m3 increase in PM1, PM2.5, PM10 and NO2 concentrations were 1.08 (1.01, 1.15), 1.10 (1.02, 1.19), 1.05 (1.01, 1.09) and 1.12 (1.04, 1.21), respectively. Individuals exposed to PM1, PM2.5, PM10 or NO2 concentrations in the fourth quartile had a 1.36-fold (95%CI: 1.08, 1.72), 1.69-fold (95%CI: 1.05, 2.72), 1.49-fold (95%CI: 1.09, 2.05) or 1.71-fold (95%CI: 1.15, 2.85) risks of SI, compared to the ones with corresponding air pollutants in the first quartile. Besides, the risks of SI increased with the quartiles of air pollutants (PM1: Ptrend = 0.002, PM2.5: Ptrend = 0.003, PM10: Ptrend = 0.010, NO2: Ptrend = 0.010). Stratified analyses suggested that males, highly educated participants, ever-drinkers and people aged range 36-64 years were more vulnerable to the adverse effects of air pollutants. CONCLUSIONS: This study provided evidence for the long-term effects of ambient PMs and NO2 on SI in rural Chinese adults, particularly for males, highly educated participants, ever-drinkers and people aged range 36-64 years.

Age at menopause, body mass index, and risk of type 2 diabetes mellitus in postmenopausal Chinese women: The Henan Rural Cohort study.

BACKGROUND AND AIM: The present study was conducted to explore the stratified and joint effects of age at menopause and body mass index (BMI) with the risk of type 2 diabetes mellitus (T2DM) in Chinese rural adults. METHODS AND RESULTS: A total of 15,406 postmenopausal Chinese women were included in this study. Multivariable logistic regression analysis was used to quantify the stratified and joint effects of age at menopause and BMI on T2DM. Overall, the mean age at menopause and BMI was 48.8 ± 4.7 years and 25.1 ± 3.6 kg/m2, respectively. In general, data suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, later menopause had a higher risk of T2DM (OR, 1.52; 95% CI, 1.16-2.01); 3) the risk of T2DM was higher only in patients with early or normal age at menopause and BMI ≥ 24, with 0R (95% CI) of (1.58, 1.28-1.94) and (1.48, 1.31-1.67), respectively. CONCLUSION: Our findings suggest that: 1) women with BMI ≥ 24 had a higher risk of T2DM, irrespective of age at menopause; 2) in women with BMI < 24, a higher risk of T2DM was found only in those with later menopause; 3) women with later menopause had a higher risk of T2DM, irrespective of BMI; 4) in patients with early or normal age at menopause, a higher risk of T2DM was found only in patients with BMI ≥ 24. THE CHINESE CLINICAL TRIAL REGISTRATION: ChiCTR-OOC-1500669(URL:http://www.chictr.org.cn/showproj.aspx?proj=11375).

Associations of SRD5A1 gene variants and testosterone with dysglycemia: Henan Rural Cohort study.

BACKGROUND AND AIM: Multiple studies support a complex relationship between testosterone and type 2 diabetes mellitus (T2DM) and the transformation of testosterone is affected by several reductases. Thus, we aimed to explore the associations of steroid-5α-reductase type 1 (SRD5A1) gene polymorphism with impaired fasting glucose (IFG) and T2DM and the interactive effects of testosterone and genotypes on glycometabolism. METHODS AND RESULTS: A case-control study including 2365 participants was performed. Genomic DNA was extracted from the whole blood and genotyped for the SRD5A1 single nucleotide polymorphisms (SNP) rs1691053. Multivariable logistic regression and linear regression were performed to estimate the associations of SRD5A1 rs1691053 alleles and genotypes with glycometabolism. Generalized linear models were used to investigate the modulatory effects of serum testosterone on glycometabolism indexes in males. After multivariable adjustment, the odds ratio (OR) of homozygous CC genotypes in male carriers was 2.62 (95%CI: 1.11-6.18) for IFG. Furthermore, significant associations of SRD5A1 rs1691053 polymorphisms with adverse indices of glycometabolism were observed in males. Interestingly, the opposite associations in females were observed. The interactive associations of SNP and testosterone were found and mutations were more likely to lead unfavorable metabolic phenotypes. CONCLUSION: These results showed that SRD5A1 rs1691053 gene polymorphism was independently associated with glycometabolism. The interaction between a genetic polymorphism from SRD5A1 and testosterone involved glycometabolism was identified in males. Although this preliminary data should be replicated with other rigorous researches, it highlighted the importance of the SNP-testosterone interaction over the present of glycometabolism.