Interrelation of Chronic Lung Disease and Cardiovascular Disease Based on Two National Prospective Cohort Studies.

BACKGROUND: Chronic lung diseases (CLDs) and cardiovascular diseases (CVDs) are the main chronic diseases responsible for a considerable burden of disease. This study aimed to estimate the interrelation of CLDs and CVDs using two Chinese national longitudinal cohort studies. METHODS: The China Health and Retirement Longitudinal Study (CHARLS) and Chinese Longitudinal Healthy Longevity Survey (CLHLS) were used in this study with 15,052 and 9,765 participants, respectively. The Cox proportional risk model was used to estimate the interrelation between CLDs and CVDs. Mediating effects were performed to detect possible influencing pathways between CLDs and CVDs. RESULTS: The association of CLDs with CVDs was identified in 1,647 participants (10.9%) with newly diagnosed CVDs in CHARLS and 332 participants (11.6%) in CLHLS. The Cox proportional risk model showed that CLDs were a significant predictor of CVDs (HR 1.49, 95% CI 1.27-1.76) after adjusting for covariates, and the hazard ratios of stroke and CVDs excluding stroke were (HR 1.02, 95% CI 0.79-1.31) and (HR 1.76, 95% CI 1.46-2.13), respectively. These association were mediated by body mass index (BMI) and Center for Epidemiological Studies Depression Scale (CES-D-10) scores. No significant association was found in CHARLS and CLHLS regarding CVDs with CLDs. In CHARLS, CVDs was a significant predictor of CLDs (HR 1.40, 95% CI 1.09-1.79). CONCLUSIONS: Chronic lung disease was associated with increased incidence of CVDs in middle-aged and older people in the community population and vice versa. Body mass index and depressive symptoms might be mediated by the effect of CLD on CVD.

Prevalence of sarcopenia under different diagnostic criteria and the changes in muscle mass, muscle strength, and physical function with age in Chinese old adults.

BACKGROUND: At present, there are several diagnostic criteria of sarcopenia were used in China, and the diagnostic criteria were not unified. This study aims to investigate the consistency between the latest sarcopenia diagnostic criteria Asian Working Group for Sarcopenia(AWGS 2019) and other common diagnostic criteria. The changes of muscle mass, muscle strength and physical function with age and their effects on the diagnosis of sarcopenia were also analyzed. METHODS: A total of 1009 men aged ≥60 years were enrolled from multiple communities. Skeletal muscle mass index, grip strength and 6 m gait speed were measured. The consistency of AWGS 2019 with other diagnostic criteria was analyzed and the trends of these three indicators were observed. The differences of muscle mass, muscle strength and function among different diagnostic criteria and age groups were evaluated. In addition, the change trends of these three indicators with age were observed. RESULTS: According to AWGS 2019 diagnostic criteria, the incidence of sarcopenia in male aged 60-69 years, 70-79 years and over 80 years was 1.5%, 9.6% and 33.1%, respectively. AWGS 2019 was highly consistent with other diagnostic criteria (Kappa = 0.66-0.80, P < 0.01), except the Foundation for the National Institutes of Health(FNIH) (Kappa = 0.32, P < 0.01). When AWGSA2019 diagnostic criteria are applied, the prevalence of decreased muscle strength (39.1%) and physical function (46.4%) was significantly higher than that of low muscle mass (35.9%) in the men over 80 years old. Muscle strength (P < 0.01) and function (P < 0.01) decreased at the same rate with age, both of which were more significant than muscle mass (P < 0.01). CONCLUSION: AWGS 2019 was highly consistent with other criteria. Maintaining muscle mass should be the focus of attention before age 80, while improving muscle strength and function should be focused after age 80 to prevent disability.

Gender Differences in the Association Between Obstructive Sleep Apnea and Diabetes.

OBJECTIVE: This study aimed to explore the association between obstructive sleep apnea (OSA) and diabetes in a Chinese population based on a cross-sectional analysis of patient data from a large tertiary care hospital in China and analyses whether there are any gender differences in this association. METHODS: A total of 794 (615 men and 179 women) inpatients were involved in this study. Polysomnography (PSG) was used to diagnose OSA, and overnight PSG testing was performed on each subject included in this study. All study subjects were also diagnosed with whether they had diabetes by an endocrinologist in the hospital. RESULTS: After adjusting for sex, age, smoking status, alcohol consumption and body mass index (BMI) groups, the results showed that the number of apnea-hypopnea index (AHI) events was a risk factor for diabetes, with a 9% (95% CI: 1-17%) increase in the risk of diabetes per unit increase, while subjects with higher (per unit increase) lowest oxygen saturation value monitored during the subject's sleep (LSaO2) with a 13% (95% CI: 4-22%) decrease in the risk of diabetes. Stratified analyses by gender, after adjustment, in men, OSA and its associated monitoring indicators were statistically significantly associated with diabetes [OR for severe OSA was 2.269 (95% CI: 1.164, 4.425), P=0.016, and OR for severe hypoxemia was 2.228 (95% CI: 1.145, 4.334), P=0.018], while not in women. CONCLUSION: Our study found a significant association between OSA and diabetes in a Chinese clinical-based population as well as a dose-response relationship between the severity of AHI and severe hypoxemia (LSaO2 < 80%) and blood glucose, the association has gender difference and was only present significant association in men, which demonstrated that diabetes prevention and blood glucose screening and management should be enhanced for Chinese men with OSA.

Chronic Lung Diseases and the Risk of Depressive Symptoms Based on the China Health and Retirement Longitudinal Study: A Prospective Cohort Study.

Chronic lung diseases (CLDs) can reduce patients' quality of life. However, evidence for the relationship between CLD and occurrence with depressive symptoms remains unclear. This study aims to determine the associations between CLD and depressive symptoms incidence, using the data from the China Health and Retirement Longitudinal Study (CHARLS). CLD was identified via survey questionnaire and hospitalization. The follow-up survey was conducted in 2018 and depressive symptoms were assessed by the 10-item Center for Epidemiological Studies Depression Scale (CES-D-10). A total of 10,508 participants were studied with an average follow-up period of 3 years. A total of 2706 patients (25.8%) with newly diagnosed depressive symptoms were identified. The standardized incidence rate of depressive symptoms in baseline population with and without chronic pulmonary disease was 11.9/100 and 8.3/100 person-years, respectively. The Cox proportional risk model showed that CLD was a significant predictor of depressive symptoms (HR: 1.449, 95% CI: 1.235-1.700) after adjusting for covariates, and the HRs of depressive symptoms were higher in those participants with current smoking (HR: 1.761, 95% CI: 1.319-2.352), men (HR: 1.529, 95% CI: 1.236-1.892), living in rural areas (HR: 1.671, 95% CI: 1.229-2.272), with dyslipidemia (HR: 1.896, 95% CI: 1.180-3.045), and suffering from comorbidity (HR: 1.518, 95% CI: 1.104-2.087) at baseline survey. CLD was an independent risk factor of depressive symptoms in China. The mental health of CLD patients deserves more attention.