A high body mass index strengthens the association between the time of eye rubbing and keratoconus in a Chinese population: a case control study.

BACKGROUND: Although body mass index (BMI) and eye rubbing are linked to an increased risk of keratoconus (KC), the interactive effect of eye rubbing and BMI on KC is largely unknown. This study aimed to evaluate the independent and interactive effects of BMI and eye rubbing on KC and to further explore the role of environmental factors on the occurrence of KC. METHODS: A total of 621 individuals (291 KC patients and 330 control individuals) were enrolled in this hospital­based study on KC patients in Central China after individuals missing BMI data were excluded. BMI was calculated as weight in kilograms divided by the square of height in meters. Data on eye rubbing was recorded through face-to-face interviews. Generalized linear regression models were used to analyze associations among BMI, eye rubbing and KC. Interaction plots were used to describe the interactive effects of BMI and eye rubbing on KC. RESULTS: The ß and 95% confidence interval (CI) were 0.923 (0.112, 1.733) (p = 0.026) and 3.356 (1.953, 4.759) (p < 0.001), respectively, for the effect of each 10 kg/m2 increase in BMI and each 1 min increase in eye rubbing on KC. The interaction of BMI and eye rubbing were positively correlated with KC (p < 0.001). CONCLUSION: These findings suggested that a high BMI aggravated the negative effect of eye rubbing on KC, implying that individuals with a high BMI may be more susceptible to exposure to eye rubbing, which is related to an increased risk of KC.

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.

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.

Genetic factors increase the identification efficiency of predictive models for dyslipidaemia: a prospective cohort study.

BACKGROUND: Few studies have developed risk models for dyslipidaemia, especially for rural populations. Furthermore, the performance of genetic factors in predicting dyslipidaemia has not been explored. The purpose of this study is to develop and evaluate prediction models with and without genetic factors for dyslipidaemia in rural populations. METHODS: A total of 3596 individuals from the Henan Rural Cohort Study were included in this study. According to the ratio of 7:3, all individuals were divided into a training set and a testing set. The conventional models and conventional+GRS (genetic risk score) models were developed with Cox regression, artificial neural network (ANN), random forest (RF), and gradient boosting machine (GBM) classifiers in the training set. The area under the receiver operating characteristic curve (AUC), net reclassification index (NRI), and integrated discrimination index (IDI) were used to assess the discrimination ability of the models, and the calibration curve was used to show calibration ability in the testing set. RESULTS: Compared to the lowest quartile of GRS, the hazard ratio (HR) (95% confidence interval (CI)) of individuals in the highest quartile of GRS was 1.23(1.07, 1.41) in the total population. Age, family history of diabetes, physical activity, body mass index (BMI), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were used to develop the conventional models, and the AUCs of the Cox, ANN, RF, and GBM classifiers were 0.702(0.673, 0.729), 0.736(0.708, 0.762), 0.787 (0.762, 0.811), and 0.816(0.792, 0.839), respectively. After adding GRS, the AUCs increased by 0.005, 0.018, 0.023, and 0.015 with the Cox, ANN, RF, and GBM classifiers, respectively. The corresponding NRI and IDI were 25.6, 7.8, 14.1, and 18.1% and 2.3, 1.0, 2.5, and 1.8%, respectively. CONCLUSION: Genetic factors could improve the predictive ability of the dyslipidaemia risk model, suggesting that genetic information could be provided as a potential predictor to screen for clinical dyslipidaemia. TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register. (Trial registration: ChiCTR-OOC-15006699 . Registered 6 July 2015 - Retrospectively registered).

Health-related quality of life among rural adults with type 2 diabetes mellitus: a cross-sectional study.

BACKGROUND: Previous reports about health-related quality of life (HRQoL) of type 2 diabetes mellitus (T2DM) concentrated on general patients rather than patients in rural areas with poor infrastructure and limited resources. Thus, the aims of this study were to evaluate the HRQoL of diabetics in the countryside and explore its influencing factors. METHODS: A total of 23 053 participants aged from 18 to 79 years were drawn from the Henan Rural Cohort Study for this cross-sectional study. The HRQoL of participants were assessed by utility index and VAS-score of European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) instrument. Binary logistic regression, generalized linear and tobit regression models were used to estimate the potential influencing factors on HRQoL. RESULTS: This study (23 053 participants) included 2231 T2DM patients with a crude prevalence of 9.68%. The utility index and VAS-score in health group were 0.96 ± 0.10 and 78.85 ± 14.53, while in T2DM group were 0.93 ± 0.15 and 74.09 ± 16.09, respectively. In total, most diabetics reported problem about pain/discomfort dimension. Being old, poverty, low physical activity, and with comorbidities was negatively related to HRQoL of diabetics, while high educational level was positively related to HRQoL. CONCLUSION: HRQoL of rural T2DM patients depended on several sociodemographic factors. More attention should be paid to diabetics with poor socioeconomic status in rural areas. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375.

Long-term exposure to ambient PM1 strengthened the association of depression/anxiety symptoms with poor sleep quality: The Henan Rural Cohort study.

Evidence from numerous epidemiological studies for the relationship between mental disorder and sleep quality was inconclusive and few studies assessed the modification effect of exposure to ambient air PM1 (particulate matter with an aerodynamic diameter ≤ 1.0 µm) on this association. In this study, 27,572 participants aged 18-79 years from The Henan Rural Cohort study were included in the final analyses. The Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) scales were used to estimate the frequency of depression and anxiety symptoms of all participants, respectively. The Pittsburgh Sleep Quality Index (PSQI) scale was used to assess night sleep quality and PSQI global score (GSC) ≥ 6 was classified as poor sleep quality. The three-year average exposure concentration of PM1 before the baseline survey was determined as long-term exposure concentration of ambient PM1. Logistic regression model was conducted to estimate the independent or joint effect of depression/anxiety symptoms and ambient PM1 exposure on poor sleep quality. In the adjusted models, the odds ratios (ORs) and 95% confidence intervals (95% CIs) of poor sleep quality associated with depression and anxiety symptoms were 3.75 (3.37, 4.17) and 3.42 (3.06, 3.81), respectively, and that associated with long-term exposure to PM1 was 1.06 (1.03, 1.09). An interaction effect was observed between anxiety symptoms score and PM1 concentration on poor sleep quality. With the increment of PM1 concentration, the association was strengthened between depression/anxiety symptoms and poor sleep quality. Besides, compared with the reference group, the ORs (95% CIs) of poor sleep quality in those with comorbidity of depression and anxiety symptoms were 4.98 (3.95, 6.29), 5.23 (3.98, 6.87), 5.76 (4.42, 7.49), and 5.58 (3.83, 8.14), respectively, from the first to the fourth quartile level of the PM1 concentration. These findings suggested that long-term exposure to PM1 strengthened the association of depression/anxiety symptoms with poor sleep quality in rural China.

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.

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.

SOCS3 methylation mediated the effect of sedentary time on type 2 diabetes mellitus: The Henan Rural Cohort study.

BACKGROUND AND AIMS: To assess the associations of sedentary time, suppressor of cytokine signaling (SOCS)-3 DNA methylation with type 2 diabetes mellitus (T2DM), and further identify the role of SOCS3 methylation in mediating the association of sedentary time with T2DM in a Chinese rural population. METHODS AND RESULTS: A case-control study including 1032 participants from the Henan Rural Cohort study was conducted. Restricted cubic spline analysis and logistic regression model were performed to evaluate the associations between sedentary time, SOCS3 methylation and T2DM. The mediation effect of SOCS3 methylation on the association between sedentary time and T2DM was assessed. Sensitivity analysis was conducted by excluding individuals with diagnosed T2DM. Linear dose-response relationships were found between sedentary time, methylation level of Chr17:76356190 (one novel site on SOCS3) and T2DM. Compared with the first quartile (less than 5 h/d) of sedentary time, the adjusted odds ratio (OR, 95% confidence interval, 95%CI) for those in the third (7-10 h/d) and fourth (≥10 h/d) quartiles were 1.87 (1.22-2.85) and 3.54 (2.14-5.85), respectively. Participants in the fourth quartile of methylation level of Chr17:76356190 had lower risk of T2DM than those in the first quartile (OR (95%CI): 0.23 (0.14-0.38)). Mediation analysis showed 9.66% (6.38%-14.80%) of the association between sedentary time and T2DM was attributable to Chr17:76356190. The comparable effect estimates were observed between sedentary time, methylation level of Chr17:76356190 and undiagnosed T2DM. CONCLUSION: Sedentary time and methylation level of Chr17:76356190 were both independently associated with T2DM in the Chinese rural population. Furthermore, Chr17:76356190 appeared to partially mediate the effect of sedentary time on T2DM. CHINESE CLINICAL TRIAL REGISTRATION: ChiCTR-OOC-15006699 (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.

Mediation effect of body mass index on the association between spicy food intake and hyperuricemia in rural Chinese adults: the Henan rural cohort study.

BACKGROUND: The relationship of spicy food intake with hyperuricemia remains unknown. The objective of this study was to examine the association between spicy food intake and hyperuricemia, and whether this association was mediated by body mass index (BMI) in Chinese rural population. METHODS: 38, 027 adults aged 18-79 years were recruited from the Henan Rural Cohort Study. Information on spicy food intake was obtained using a validated questionnaire survey. Multivariable logistic regression model was used to estimate the association between spicy food intake and hyperuricemia, multiple linear regression model was performed to estimate the relationships between spicy food intake, BMI and serum urate level. BMI was used as a mediator to evaluate the mediation effect. RESULTS: After adjusting for potential confounders, compared with no spicy food flavor, the odds ratio (OR) and 95% confidence interval (CI) of mild, middle, and heavy flavor for hyperuricemia were 1.09 (1.00-1.19), 1.10 (0.97-1.24), and 1.21 (1.10-1.46), respectively (Ptrend = 0.017). Similarly, compared with those without intake in spicy food, the multivariable adjusted OR (95% CI) of 1-2 days/week, 3-5 days/week, and 6-7 days/week were 1.15 (1.01-1.31), 1.14 (1.01-1.30) and 1.15 (1.05-1.26), respectively (Ptrend = 0.007). However, when we further controlling for BMI, the associations were substantially attenuated. Furthermore, mediation analysis showed that BMI play a full mediating role in the relationship of spicy food intake with hyperuricemia. CONCLUSION: Spicy food flavor and intake frequency are positively related with hyperuricemia in Chinese rural population. BMI may play a full mediating role in the relationship. TRIAL REGISTRATION: The Henan Rural Cohort Study registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699 ). Date of registration: 2015-07-06.

Adiposity reduces the risk of osteoporosis in Chinese rural population: the Henan rural cohort study.

BACKGROUND: Adiposity plays a crucial role in the risk of osteoporosis. However, the impact of body fat distribution on the skeleton is contentious. The study was designed to explore the association of various adiposity indices with estimated bone mineral density (BMD) and the risk of osteoporosis based on body mass index (BMI), body fat percentage (BFP), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), and visceral fat index (VFI). METHODS: A total of 8475 subjects derived from the Henan Rural Cohort Study were analyzed. The estimated BMD of study participants were measured by calcaneal quantitative ultrasound (QUS). Linear regression and binary logistic regression were performed to estimate the association of adiposity and the outcomes. RESULTS: The mean age of the study participants was 55.23 ± 11.09 years and 59.61% were women. The crude and age-standardized prevalence of high osteoporosis risk was 16.24 and 11.82%. Per unit increment in adiposity indices was associated with 0.005-0.021 g/cm2 increase in estimated BMD. The adjusted odds ratios (95% confidence interval) for high osteoporosis risk in per 1 SD increase of WC, WHR, WHtR, BMI, BFP, and VFI were 0.820 (0.748, 0.898), 0.872 (0.811, 0.938), 0.825 (0.765, 0.891), 0.798 (0.726, 0.878), 0.882 (0.800, 0.972), and 0.807 (0.732, 0.889), respectively. Stratified analyses indicated greater effects on individuals aged 55 years or older. CONCLUSIONS: The adiposity indices have an inverse association with the risk of osteoporosis among Chinese rural population, especially in the elderly.

Night sleep duration and sleep initiation time with hypertension in Chinese rural population: the Henan Rural Cohort.

BACKGROUND: The study was conducted to evaluate the independent dose-response of the night sleep duration and sleep initiation time on hypertension, and to explore their combined effect with hypertension. METHODS: Participants from the Henan Rural Cohort were enrolled in this study. Information on sleep was collected using the Pittsburgh Sleep Quality Index. Hypertension was defined as systolic blood pressure/diastolic blood pressure ≥140/90 mmHg or self-reported hypertension and current use of anti-hypertensive medicines. Logistic regression and restricted cubic spline were conducted to evaluate the association of night sleep duration and sleep initiation time with hypertension. RESULTS: Of the 37 317 included participants, 12 333 suffered from hypertension. 14 474 (38.79%) were men and 22 843 (61.21%) were women, the mean age were 57.18 ± 12.10 and 55.24 ± 11.98 in men and women. Compared to reference (7-h), fully adjusted odd ratios (ORs) and 95% confidence interval (CI) of hypertension were 0.91 (0.66-1.25) in <5 h group and 1.74 (1.41-2.16) in ≥10 h among men, respectively. Fully adjusted ORs (95% CIs) for hypertension compared with reference (21:00-22:00) were 1.05 (95% CI 0.78-1.41) in the <20:00 group, 1.52 (1.25-1.85) in ≥24:00 in men. The combined effect of sleep duration and sleep initiation time on hypertension were statistically significant in the category of (≥8 h)/night and ≥24:00 (OR 1.87, 95% CI 1.07-3.25) compared to reference in fully adjusted model among men. CONCLUSIONS: Long night sleep duration and late sleep initiation time were associated with the higher odds of hypertension, and the sleep duration and sleep initiation time might cumulatively increase the prevalence of hypertension in men. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx? proj=11375.

Epidemiology and prevalence of hyperuricemia among men and women in Chinese rural population: The Henan Rural Cohort Study.

Objective: The aim of this study was to explore the latest prevalence of hyperuricemia and influencing factors in Chinese rural population.Methods: A survey was conducted from July 2015 to September 2017. A total of 38,855 (15,371 men and 23,484 women) subjects were recruited from the Henan Rural Cohort Study. Hyperuricemia was defined as a serum urate level of >7.0 mg/dL for men and >6.0 mg/dL for women. A meta-analysis of 19 studies that focused on hyperuricemia prevalence was performed to validate the result of the cross-sectional survey.Results: The crude and age-standardized prevalence of hyperuricemia was 10.24% and 12.60%, respectively. The prevalence of hyperuricemia decreased in men with increasing age, but the opposite trend was observed in women. The results of meta-analysis demonstrated that hyperuricemia prevalence in Chinese rural areas was 11.7%, consistent with the result of current survey. Multivariate logistic regression revealed that overweight or obesity, hypercholesterolemia, hypertriglyceridemia, hypoalphalipoproteinemia and high serum creatinine level could increase the risk of hyperuricemia, while high physical activity and fasting plasma glucose were associated with a lower risk of hyperuricemia in all participants.Conclusion: The latest prevalence of hyperuricemia is high in rural China and is associated with multiple factors, indicating that prevention and control strategies for hyperuricemia are needed urgently.