Mediating effect of hemoglobin and hematocrit on the association between alcohol consumption and blood pressure among middle-aged and elderly male residents in Guangzhou / 中华心血管病杂志

Objective@#To explore the mediating effect of hemoglobin (Hb) and hematocrit (HCT) on the association between alcohol consumption and blood pressure, and provide evidence for the prevention and control of alcohol-attributed hypertension.@*Methods@#1 091 male (age >50 years old) participants with drinking habit were selected from the Guangzhou biobank cohort study (GBCS). Mediation analysis was used to evaluate the mediating effect of Hb and HCT on the association of alcohol consumption (unit/day) with systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure(PP) and mean arterial pressure (MAP).@*Results@#After adjusting for age, body mass index, education level, personal annual income, smoking, occupation and physical activity, the associations of alcohol consumption with SBP, DBP, PP and MAP were partly mediated by Hb, the proportion of mediating effect was 11.8% (95%CI 4.8%-24.7%), 15.3% (95%CI 6.5%-32.0%), 8.4% (95%CI 2.2%-22.5%) and 13.5% (95%CI 5.9%-27.5%), respectively. The associations of alcohol consumption with SBP, DBP, and MAP were also partly mediated by HCT, the proportion of mediating effect was 6.3% (95%CI 1.0%-16.0%), 8.7% (95%CI 1.4%-21.4%), and 7.5% (95%CI 1.0%-18.6%), respectively.@*Conclusion@#There is a significant mediating effect of Hb and HCT on the association between alcohol consumption and blood pressure. Besides efforts on alcohol control, the potential effects of alcohol-induced increase on Hb and HCT, which might also increase the blood pressure, need to be considered to achieve optimal monitoring and prevention of alcohol-related hypertension.

Association between lack of care in childhood and cognitive impairment in middle-aged and elderly population / 中华流行病学杂志

Objective To investigate the association between people who were under lack of care in childhood and the development of cognitive impairment in their middle-aged and elderly life spans.Methods Based on the baseline survey data of the third phase of "Guangzhou Biobank Cohort study" conducted from January 2007 to January 2008,9 223 residents aged ≥50 years with records on Mini Mental State Examination (MMSE) were included in a retrospective survey on received childhood carc of their early lives.Questions would include:feelings of care and support from their close relatives during childhood,the status of separation from their mothers for ≥ 1 year,and the current status of their parents.Linear regression,unconditional and multinomial logistic regression models were used to analyze the associations between the received childhood care and cognitive function (i.e.,MMSE scores and cognitive impairment) in middle and old age,of this population under study.Results After adjusting for age,gender,education,place of residence,marital status,physical activity,smoking,drinking,occupation,personal income,childhood socioeconomic position and depressive symptoms etc.,factors as feeling lack of concern and support from close relatives (LC),status of separation from the mother for ≥ 1 year (SM),and the current status of their parents etc.,were all negatively associated with the MMSE score when in middle and old age,with partial regression coefficient β (95％CI) as-0.44 (-0.65--0.23),-0.26 (-0.38--0.14) and-0.61 (-0.96--0.27),respectively.The presence ofLC,SM or PD were associated with the increased risks of cognitive impairment,and the adjusted odds ratio OR (95％CI) appeared as 1.43 (1.15-1.78),1.26 (1.08-1.47) and 1.64 (1.16-2.31)respectively in all the participants,but 1.27 (1.01-1.62),1.29 (1.09-1.55) and 1.75 (1.19-2.55) respectively,in those with education level of primary school or below.In those with secondary school education or above,only the presence of item A was associated with an increased risk of cognitive impairment (OR=2.26,95％CI:1.41-3.50).Conclusion We noticed that ‘lack of care'in childhood was associated with cognitive impairment during middle and old age,mainly in those population with lower education.

Association between lack of care in childhood and cognitive impairment in middle-aged and elderly population / 中华流行病学杂志

Objective To investigate the association between people who were under lack of care in childhood and the development of cognitive impairment in their middle-aged and elderly life spans.Methods Based on the baseline survey data of the third phase of "Guangzhou Biobank Cohort study" conducted from January 2007 to January 2008,9 223 residents aged ≥50 years with records on Mini Mental State Examination (MMSE) were included in a retrospective survey on received childhood carc of their early lives.Questions would include:feelings of care and support from their close relatives during childhood,the status of separation from their mothers for ≥ 1 year,and the current status of their parents.Linear regression,unconditional and multinomial logistic regression models were used to analyze the associations between the received childhood care and cognitive function (i.e.,MMSE scores and cognitive impairment) in middle and old age,of this population under study.Results After adjusting for age,gender,education,place of residence,marital status,physical activity,smoking,drinking,occupation,personal income,childhood socioeconomic position and depressive symptoms etc.,factors as feeling lack of concern and support from close relatives (LC),status of separation from the mother for ≥ 1 year (SM),and the current status of their parents etc.,were all negatively associated with the MMSE score when in middle and old age,with partial regression coefficient β (95％CI) as-0.44 (-0.65--0.23),-0.26 (-0.38--0.14) and-0.61 (-0.96--0.27),respectively.The presence ofLC,SM or PD were associated with the increased risks of cognitive impairment,and the adjusted odds ratio OR (95％CI) appeared as 1.43 (1.15-1.78),1.26 (1.08-1.47) and 1.64 (1.16-2.31)respectively in all the participants,but 1.27 (1.01-1.62),1.29 (1.09-1.55) and 1.75 (1.19-2.55) respectively,in those with education level of primary school or below.In those with secondary school education or above,only the presence of item A was associated with an increased risk of cognitive impairment (OR=2.26,95％CI:1.41-3.50).Conclusion We noticed that ‘lack of care'in childhood was associated with cognitive impairment during middle and old age,mainly in those population with lower education.

Association between body weight change during early and middle adulthood and the risk of type 2 diabetes in middle aged and elderly population / 中华流行病学杂志

Objective To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population.Methods Based on the Guangzhou Biobank Cohort Study (GBCS),28 736 residents aged ≥50 years were included in Guangzhou.Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population.Adjustments on age,smoking,alcohol consumption,physical activity,education level,occupation,district of residence and body mass index etc.,were made.Results The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women,with the prevalence rates of diabetes as 13.1％ and 13.7％ in men and women,respectively.Compared to those with stable body weight,the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend ＜0.01).Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83,95％ CI:1.99-4.02) and women (OR=3.13,95％CI:2.47-3.96).Compared to those who reached the highest weight at age 20,those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes,with OR being 5.32 (95％CI:1.92-14.8) in men and 3.41 (95％CI:2.49-4.67) in women,respectively.Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women.Conclusion Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population.The detrimental effect of obesity on diabetes might become significantly visible in the next decades.

Association between body weight change during early and middle adulthood and the risk of type 2 diabetes in middle aged and elderly population / 中华流行病学杂志

Objective To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population.Methods Based on the Guangzhou Biobank Cohort Study (GBCS),28 736 residents aged ≥50 years were included in Guangzhou.Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population.Adjustments on age,smoking,alcohol consumption,physical activity,education level,occupation,district of residence and body mass index etc.,were made.Results The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women,with the prevalence rates of diabetes as 13.1％ and 13.7％ in men and women,respectively.Compared to those with stable body weight,the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend ＜0.01).Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83,95％ CI:1.99-4.02) and women (OR=3.13,95％CI:2.47-3.96).Compared to those who reached the highest weight at age 20,those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes,with OR being 5.32 (95％CI:1.92-14.8) in men and 3.41 (95％CI:2.49-4.67) in women,respectively.Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women.Conclusion Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population.The detrimental effect of obesity on diabetes might become significantly visible in the next decades.

Association between serum uric acid and fasting plasma glucose in middle and elderly Chinese / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese.</p><p><b>METHODS</b>10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history, physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level, association between FPG and SUA. Levels of hyperuricemia (HUA) were evaluated.</p><p><b>RESULTS</b>The SUA levels and the incidence of HUA showed trends of increasing, with the increasing FPG levels in women, with statistically significant differences seen among all the FPG groups (P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group (DM group) and impaired fasting glucose (IFG) groups were non-significant (P > 0.05) but it was higher than normal FPG group in men (P < 0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age, smoking status, drinking status, physical activity, hypertension, body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group, the risk of women suffering from HUA increased by 40% (95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals, the risk of diabetic patients suffering from HUA also increased by 44% (95% CI:1.15-1.79) in women. However, the risk of suffering from HUA did not relate to the increase of FPG in men.</p><p><b>CONCLUSION</b>The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA, but not in men.</p>

Association between serum uric acid and fasting plasma glucose in middle and elderly Chinese / 中华流行病学杂志

Objective To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese. Methods 10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history,physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level,association between FPG and SUA. Levels of hyperuricemia(HUA)were evaluated. Results The SUA levels and the incidence of HUA showed trends of increasing,with the increasing FPG levels in women,with statistically significant differences seen among all the FPG groups(P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group(DM group)and impaired fasting glucose(IFG)groups were non-significant(P>0.05)but it was higher than normal FPG group in men (P<0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age,smoking status,drinking status,physical activity, hypertension,body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group,the risk of women suffering from HUA increased by 40%(95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals,the risk of diabetic patients suffering from HUA also increased by 44%(95%CI:1.15-1.79) in women. However,the risk of suffering from HUA did not relate to the increase of FPG in men. Conclusion The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA,but not in men.

Association between serum uric acid and fasting plasma glucose in middle and elderly Chinese / 中华流行病学杂志

Objective To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese. Methods 10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history,physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level,association between FPG and SUA. Levels of hyperuricemia(HUA)were evaluated. Results The SUA levels and the incidence of HUA showed trends of increasing,with the increasing FPG levels in women,with statistically significant differences seen among all the FPG groups(P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group(DM group)and impaired fasting glucose(IFG)groups were non-significant(P>0.05)but it was higher than normal FPG group in men (P<0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age,smoking status,drinking status,physical activity, hypertension,body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group,the risk of women suffering from HUA increased by 40%(95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals,the risk of diabetic patients suffering from HUA also increased by 44%(95%CI:1.15-1.79) in women. However,the risk of suffering from HUA did not relate to the increase of FPG in men. Conclusion The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA,but not in men.

Effects of psychological intervention, auricular acupuncture and smoking cessation medication on cigarette smoking behavior in soldiers: a pilot randomized controlled trial / 中华健康管理学杂志

Objective To evaluate the effects of different smoking cessation interventions on cigarette consumption for young soldiers.Methods Sixty-eight soldiers were prospectively investigated in this randomly controlled clinical trial and assigned to the psychological intervention group,auricular acupuncture group,and smoking cessation medication group.Results All the participants showed significant reduction(33.3％ to 73.9％)in post-treatment cigarette consumption.The highest quit rate was found at 7 days,although this declining trend was faded over time.One-year follow-up indicated a 6-month quit rate of 16.7％,23.8％ and 30.4％ in three groups,respectively.Conclusion Psychological intervention,auricular acupuncture and smoking cessation medication may be effective methods of reducing cigarette consumption and improving quit rate in young soldiers.

The prevalence and characteristics of aortic arch calcification among middle and elderly population in Guangzhou / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the prevalence and characteristics of aortic arch calcification (AAC) in residents aged 50 or over in Guangzhou, China.</p><p><b>METHODS</b>Face-to-face interview, physical examination and laboratory tests were conducted on 10 413 Chinese adults aged 50 or over. Posterior-anterior plain chest X-ray radiographs were obtained from 10 305 subjects using a Toshiba KSO-15R machine. The radiographs were reviewed together by two radiologists while 300 radiographs were independently gone through by two radiologists to assess the agreement with Kappa coefficient method.</p><p><b>RESULTS</b>The rate of agreement on Diagnosis for the two radiologists was 85.0% and Kappa coefficient was 0.68, with P < 0.001 which showed a moderate agreement between the two radiologists. Among the 10 305 subjects, there were 3064 men and 7349 women, with their mean age (+/- standard deviation) as 64.0 +/- 6.0 and 66.2 +/- 5.8, respectively. Most of them had educational level of middle school or below, and most of their occupations were factory or agricultural workers. The prevalence of AAC was 40.6%. Women showed significantly higher prevalence rate than men (41.4% versus 38.6%, P < 0.001) and the prevalence of AAC increased significantly with age. Subjects with primary educational level or below had the highest prevalence of AAC. There was no significant association found between occupation and AAC prevalence. 98.7% of the subjects with AAC occurred in aortic arch. Most AAC had a length of 10 mm or longer and a width from 1-4 mm, which indicated the severity of AAC among the subjects.</p><p><b>CONCLUSION</b>The prevalence of AAC among Guangzhou Biobank Cohort was about 40.6%, higher than those reported in foreign studies, while most of the lesions were quite serious.</p>

Study on mortality, incidence and risk factors of stroke in a cohort of elderly in Xi'an, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To prospectively study the relationship between risk factors and stroke incidence and mortality in the Chinese elderly.</p><p><b>METHODS</b>An analytic study in a cohort population of 1,268 male retired cadres in a military setting. A health-screening program was carried out for all cadres aged 55 years or older in Xi'an in February 1987. Baseline data on smoking, cholesterol, triglyceride, blood pressure, body mass index (BMI), histories of hypertension, hyperlipidemia and coronary heart disease (CHD), stroke, diabetes and family histories of cardiovascular disease were investigated. Main outcome measures were stroke incidence, stroke and all-cause mortality.</p><p><b>RESULTS</b>The cohort was followed up until June 30, 2001 and a total number of follow-up person-year was 15,546. During the follow-up period, there were 113 new stroke cases identified and the adjusted incidence was 727 per 100,000 person-year. Forty-five deaths were due to stroke and the adjusted mortality was 289 per 100,000 person-year. Using Cox model analysis, after adjustment on age, total cholesterol, triglyceride, smoking, drinking and physical exercise, we noticed that the systolic pressure, BMI, history of CHD and hyperlipidemia were independent risk factors for stroke incidence and morality.</p><p><b>CONCLUSION</b>The incidence and mortality of stroke in this cohort were lower than those in the same age group of general population. Monitoring and controlling body mass index and blood pressure level seemed to be important factors for the prevention of stroke in the elderly.</p>

[A prospective study on smoking, quitting and mortality in a cohort of elderly in Xi'an, China].

OBJECTIVE: To prospective examine the relationship between smoking, quitting and mortality in older Chinese men by in Xi'an, China. METHODS: The design was a cohort analytic study. One thousand two hundred and sixty-eight retired male military veterans aged 60 or older were examined in 1987. At baseline, there were 388 never-smokers, 461 former smokers and 419 current smokers. Main outcome measure was all-cause and tobacco-associated mortality. RESULTS: Through 1999, 299 had died, 943 were alive and 26 lost. The mean follow-up time was 11 years and total person-year of follow-up was 14 163. After adjusting for age, blood pressure, body mass index, total cholesterol, triglycerides, alcohol intake, exercise and existing diseases, using Cox proportional hazard regression model, the relative risks (95% confidence intervals) for ever-smoking, deaths resulting from all causes, chronic obstructive pulmonary disease (COPD), lung cancer and coronary heart disease (CHD) were 1.34 (1.02 - 1.76), 3.23 (0.95 - 10.91), 2.31 (0.95 - 5.61) and 1.60 (0.81 - 3.19) respectively. The risks increased significantly with increasing amount and duration of smoking. Compared with current smokers, former smokers had lower risks of total mortality (excess risk reduction of 56%) and from CHD death (93%), but had higher risks for COPD death (excess risk increased 174%). CONCLUSIONS: Smoking is a major cause of death in older Chinese men and quitting can save lives. These results showing that higher risks of COPD death in former smokers with or without existing diagnosed COPD at baseline than those in current smokers could be explained by either the "healthy smoker effect" or the "ill quitter effect" or both. Early recognition of the significance of COPD symptoms followed by prompt quitting should be emphasized as strategies in the control of the growing tobacco epidemic.