[Orthopaedic robot assisted femoral neck dynamic cross fixation system for the treatment of femoral neck fractures].

OBJECTIVE: To explore and compare the clinical efficacy of orthopedic robot assisted femoral neck system （FNS） and traditional manual FNS in the treatment of femoral neck fractures in middle-aged and young people. METHODS: The clinical data of 62 consecutive patients with femoral neck fracture and age less than 65 years old admitted to the Intelligent Orthopaedic Department of Beijing Jishuitan Hospital from June 2021 to June 2022 were retrospectively analyzed. According to whether orthopedic robot-assisted surgery the patients were divided into two groups：30 patients aged 34 to 56 years old were treated with orthopedic robot assisted FNS internal fixation after closed or limited open reduction（experimental group）； 32 patients aged 33 to 54 years old underwent FNS internal fixation after closed or limited open reduction（control group）. The age, gender, time from injury to admission, average hospital stay, surgical duration, intraoperative bleeding volume, and intraoperative fluoroscopy frequency of two groups of patients were analyzed and compared. The hip joint function in both groups of patients was evaluated using the Harris hip joint scoring standard at 6 months after surgery. RESULTS: All 62 patients with femoral neck fractures successfully completed the surgery. There was no significant difference（P>0.05） between the experimental group and the control group in terms of baseline data such as age, gender, time from injury to admission, time from admission to surgery and the intraoperative bleeding. The surgical duration of the experimental group was significantly shorter than that of the control group [42.1（28.5, 50.7）min vs. 53.4（36.9, 62.5） min, Z=-2.338, P=0.019]. The intraoperative X-ray fluoroscopy frequency of the experimental group was significantly lower than that of the control group[8.0 （6.0, 11.0） times vs. 15.0（13.0, 17.0） times, Z=-5.960, P<0.001]. In terms of postoperative hip joint function, there was no significant difference in Harris score between the two groups of patients at 6-month follow-up（P>0.05）. CONCLUSION: Compared with manual operation of FNS, orthopedic robot assisted FNS in the treatment of femoral neck fractures can help shorten surgical time, reduce intraoperative fluoroscopy frequency, and have similar therapeutic effects on long-term hip joint function recovery.

Corn Silk Flavonoids Ameliorate Hyperuricemia via PI3K/AKT/NF-κB Pathway.

Hyperuricemia (HUA) is a widespread metabolic disease marked by an elevated level of uric acid, and is a risk factor for premature death. The protective effect of corn silk flavonoids (CSF) against HUA and its potential mechanisms were explored. Five important apoptosis and inflammation-related signaling pathways were identified by network pharmacological analysis. The CSF exhibited significant uric acid (UA)-lowering activity in vitro by decreasing xanthine oxidase (XOD) and increasing hypoxanthine-guanine phosphoribosyl transferase levels. In a potassium oxonate-induced HUA in vivo, CSF treatment effectively inhibited XOD activity and promoted UA excretion. Furthermore, it decreased the levels of TNF-α and IL-6 and restored pathological damage. In summary, CSF is a functional food component to improve HUA by reducing inflammation and apoptosis through the down-regulating PI3K/AKT/NF-κB pathway.

Acidic Stigma maydis polysaccharides protect against podocyte injury in membranous nephropathy by maintenance of glomerular filtration barrier integrity and gut-kidney axis.

Membranous nephropathy (MN) is a chronic kidney disease and a precursor to end-stage kidney disease. In this study, we evaluated the potential protective effects of acidic and neutral Stigma maydis polysaccharides (ASMP and NSMP, respectively) on cationized bovine serum albumin-induced MN in mice. Both polysaccharides (SMPs) provided effective protection from kidney injury by decreasing daily proteinuria, kidney dysfunction, and hyperlipidemia and minimizing structural changes and immune complex expression. Furthermore, SMPs improved intestinal barrier damage by increasing the expression of tight junction proteins in the intestinal tissue. They also maintained the integrity of the glomerular filtration barrier by promoting slit diaphragm proteins expression and PI3K/AKT signaling. However, ASMP offered better protection against podocyte injury than NSMP. The use of natural polysaccharides could thus be a new protective measure against podocyte injury and perhaps be utilized for the development of functional foods to protect against MN.

Ameliorated membranous nephropathy activities of two ethanol extracts from corn silk and identification of flavonoid active compounds by LC-MS2.

The current study looks to evaluate the effect of corn silk flavonoids on membranous nephropathy (MN). Polyamide resin (PR) can be used to enrich corn silk ethanol extract (CSEE) to obtain flavonoid-rich extract (PR-CSEE), the total flavonoid content (TFC) of which we found to be 57.4%. The results of scanning electron microscope, Fourier-transform infrared, and high-performance liquid chromatography analyses determined that PR-CSEE and CSEE have different structural characteristics, but that PR-CSEE has higher TFC. MN mice models were induced by cationic bovine serum albumin, and we found that PR-CSEE administration reduced urine protein levels markedly, while renal function, glomerular atrophy, inflammatory infiltration, and in-serum immunoglobulin G and complement 3 content were improved. Through LC-MS2 spectrometry analysis, we pinpointed the 12 major flavonoid active compounds in PR-CSEE. These findings suggest that PR-CSEE can act as a potential functional food material by which to improve MN.

Myocardial Infarction-Associated Extracellular Vesicle-Delivered miR-208b Affects the Growth of Human Umbilical Vein Endothelial Cells via Regulating CDKN1A.

This study was aimed at investigating the effects of myocardial infarction- (MI-) associated extracellular vesicle- (EV-) delivered miR-208b on human umbilical vein endothelial cells (HUVECs). EVs were isolated and subsequently stained with PHK67. A dual-luciferase reporter gene assay was used to determine the target of miR-208b. Afterwards, HUVECs were transfected with either MI-associated EVs or miR-208b mimics, and cell viability, migration, and apoptosis were subsequently measured. Real-time quantitative polymerase chain reaction (RT-qPCR) was applied to determine the expressions of the tested genes. NanoSight, transmission electron microscopy, and western blotting showed that EVs were successfully isolated. Among the potential microRNA biomarkers for MI, miR-208b was chosen for subsequent experiments. We found that MI-associated EVs could be taken up by HUVECs and confirmed that CDKN1A was a direct target of miR-208b. Additionally, miR-208b mimics and MI-associated EVs significantly inhibited the viability and migration of HUVECs (P < 0.05) and promoted cell apoptosis, as well as reduced S phase and increased G2/M phase cell distribution. RT-qPCR revealed that both miR-208b mimics and MI-associated EVs upregulated the expressions of CDKN1A, FAK, Raf-1, MAPK1, and Bax but downregulated the expression of Bcl2 and reduced the Bcl2/Bax ratio. Our study concludes that MI-associated EVs delivered miR-208b to HUVECs, and EV-delivered miR-208b could affect the growth of HUVECs by regulating the miR-208b/CDKN1A pathway; thus, miR-208b can be therefore served as important therapeutic targets for MI treatment.

Reversion From Pre-Diabetes Mellitus to Normoglycemia and Risk of Cardiovascular Disease and All-Cause Mortality in a Chinese Population: A Prospective Cohort Study.

Background It is unclear whether reversion from pre-diabetes mellitus to normoglycemia reduces cardiovascular disease (CVD) and all-cause mortality risk in a Chinese population. We aimed to fill this research gap. Methods and Results The current study included 14 231 Chinese participants (mean age, 58.08 years) who were free from myocardial infarction and stroke at the time of survey participation (2006-2007 and 2008-2009). Participants were divided into 3 categories according to the 2-year changes in pre-diabetes mellitus, defined by fasting plasma glucose: those with progression to diabetes mellitus, those with reversion from pre-diabetes mellitus to normoglycemia, and those with persistent pre-diabetes mellitus. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their 95% CIs for CVD and all-cause mortality. After a median follow-up period of 8.75 years, a total of 879 CVD events (including 180 myocardial infarction events and 713 stroke events) and 941 all-cause mortality events were recorded. After adjustment for confounding factors, reversion from pre-diabetes mellitus to normoglycemia was associated with decreased risks of CVD (HR, 0.78; 95% CI, 0.64-0.96), myocardial infarction (HR, 0.62; 95% CI, 0.40-0.97), stroke (HR, 0.79; 95% CI, 0.63-0.98), and all-cause mortality (HR, 0.82; 95% CI, 0.68-0.99) compared with progression to diabetes mellitus. Conclusions Reversion from fasting plasma glucose-defined pre-diabetes mellitus to normoglycemia was associated with a reduction in the future risk of CVD and all-cause mortality in a Chinese population. Registration URL: https://www.chictr.org; Unique identifier: ChiCTRTNC-11001489.

Prediabetes and risk for myocardial infarction by hypertension status in a Chinese population: a prospective cohort study.

BACKGROUND: Whether prediabetes alone or combined with hypertension is a more important risk factor for cardiovascular disease is controversial. In this study, we aimed to examine this association to fill the research gap. METHODS AND RESULTS: A total of 85 570 participants (mean age: 58.0 years) without diabetes and no previous myocardial infarction (MI) were recruited for this study. Participants were divided into four groups according to prediabetes status and were further stratified according to hypertension status. Hazard ratios with 95% confidence intervals (CIs) were calculated using Cox regression models. After a mean follow-up period of 11.0 years, 1122 (rate 1.19/1000 person-years) individuals developed MI. Compared with participants without either condition, the multivariable-adjusted hazard ratios for MI events among participants with prediabetes alone, hypertension alone, and both prediabetes and hypertension were 1.06 (95% CI: 0.84-1.36), 1.73 (95% CI 1.49-2.00), and 1.89 (95% CI 1.57-2.27), respectively. Among participants with and without hypertension, there was no association between prediabetes and an increased risk for MI (hazard ratio: 1.11 95% CI 0.94-1.32 and hazard ratio: 1.02 95% CI 0.80-1.30, respectively). CONCLUSION: The current study indicated that among the Chinese general population, the increased risk of MI associated with prediabetes is largely driven by concomitant hypertension rather than prediabetes per se.

Long sleep duration and risk of increased arterial stiffness in a Chinese population.

To examine the relationship between self-reported sleep duration and arterial stiffness in a large Chinese population from Kailuan.From July 2010 to December 2015, a total of 17,018 participants aged 18 to 98 years were enrolled after excluding those with a history of cerebrovascular events and coronary artery disease. Participants were divided into 5 categories according to self-reported night sleep duration: ≤5.0, 6.0, 7 (ref), 8, and ≥9.0 hours. A brachial-ankle pulse wave velocity ≥1400 cm/s was considered to represent arterial stiffness. Multivariate logistic regression models were used to calculate the odds ratio (OR) and confidence interval (CI) for arterial stiffness according to the sleep duration.Using 7 hours of sleep as the reference group, the multivariable adjusted ORs (95% CI) for arterial stiffness were 1.00 (0.87-1.16), 1.00 (0.90-1.11), 1.0 (ref), 1.03 (0.93-1.14), and 1.48 (1.05-2.08) from the lowest to highest category of sleep duration, respectively. Secondary analysis showed no evidence of interactions between sleep duration and age/sex on the risk of arterial stiffness (P-interaction = .390/.198).A long night sleep duration was associated with increased arterial stiffness.

Visit-to-visit variability of lipid measurements and the risk of myocardial infarction and all-cause mortality: A prospective cohort study.

BACKGROUND AND AIMS: Previous studies suggested that increased visit-to-visit variability in lipid measurements is associated with cardiovascular disease in specific or high-risk populations. Because it is unknown whether this notion applies to the general population, we investigated whether lipid variability has additive effects on the risk of all-cause mortality and myocardial infarction (MI) in the general population. METHODS: We identified 51,620 subjects from the Kailuan cohort who had no history of MI, stroke and cancer and who underwent ≥3 health examinations from 2006 to 2010. Variability in total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) measurements was measured using the coefficient of variation (CV), standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV). Cox proportional hazards models were used to calculate the hazard ratios (HRs). RESULTS: During a median of 7.03 years of follow-up, 426 (1.21) incidents of MI and 2243 (6.45) incidents of all-cause mortality occurred. In the multivariable-adjusted model, the HRs comparing participants in the highest versus lowest quartile of the CV for HDL-C were 1.56 (95% CI, 1.17-2.08; p for trend<0.01) for MI and 1.22 (95% CI, 1.09-1.37; p for trend<0.01) for all-cause mortality. For the highest quartile compared with the lowest quartile of LDL-C variability, the risk of MI and all-cause mortality increased by 34% (HR, 1.34; 95% CI, 1.03-1.82; p for trend<0.05) and 19% (HR, 1.19; 95% CI, 1.04-1.36; p for trend<0.05), respectively. We did not observe any significant association between TG variability and MI or all-cause mortality. CONCLUSIONS: These findings suggest that high visit-to-visit HDL-C and LDL-C variability is associated with an increased incidence of MI and all-cause mortality in a Chinese community population.

Night sleep duration and risk of each lipid profile abnormality in a Chinese population: a prospective cohort study.

BACKGROUND: To explore the associations between sleep duration and abnormalities in serum lipid levels in a Chinese population. METHODS: A prospective study was conducted with 34,260 participants from the general Chinese population. Sleep duration was categorized as ≤5, 6, 7, 8 or ≥ 9 h. Each lipid profile abnormality was defined according to the Chinese Guidelines for the Prevention and Treatment of Dyslipidemia in Adults (2016). The Cox proportional hazards model was used to assess the association between sleep duration and dyslipidemia. RESULTS: Compared with a 7 h sleep duration, long sleep duration (≥9 h) was significantly associated with low high-density lipoprotein cholesterol (HDL-C) levels (hazard ratio (HR): 1.24; 95% CI: 1.12-1.38). In subgroup analyses, the positive association between long sleep duration and low HDL-C level in men and in the different age groups was more pronounced than the association in women. No significant interactions were observed in the association between sleep duration and each abnormal serum lipid level by sex/age in the study population (P-interaction> 0.05). CONCLUSIONS: These findings suggest that long sleep duration is associated with low HDL-C level among the Kailuan community population.

Cumulative alcohol consumption and stroke risk in men.

BACKGROUNDS: Views on the relationship between alcohol consumption and stroke risk remain controversial. Moreover, data on cumulative alcohol intake are limited. We examined the potential impact of cumulative alcohol consumption on the risk of total stroke and its subtypes in men. METHODS: This prospective study included 23,433 men from the Kailuan Study. Cumulative alcohol consumption was taken as the primary exposure by calculating self-reported alcohol consumption from three consecutive examinations (in 2006, 2008, and 2010). The first occurrence of stroke was confirmed by reviewing medical records from 2010 to 2016. We used Cox proportional hazards regression to analyze the data. RESULTS: During the 5.9 ± 0.8 years of follow-up, 678 total strokes were identified, including 595 ischemic stroke (IS), 90 intracerebral hemorrhage and 19 subarachnoid hemorrhage cases. The adjusted hazard ratios (95% confidence intervals) of total stroke for light, moderate and heavy cumulative alcohol consumption were 1.23 (1.01-1.51), 1.49 (1.13-1.97), and 1.50 (1.21-1.86), respectively, compared with those of nondrinkers. The results were similar for IS. Cumulative alcohol consumption was not associated with intracerebral hemorrhage risk (hazard ratio 1.46; 95% confidence interval, 0.74-2.08). CONCLUSIONS: Cumulative alcohol consumption is an independent risk factor of total stroke and IS in men in a community-based cohort. Even light alcohol intake increases the risk of total stroke and IS.

Enzymatic transformation of ginsenosides Re, Rg1, and Rf to ginsenosides Rg2 and aglycon PPT by using ß-glucosidase from Thermotoga neapolitana.

OBJECTIVES: To enzymatically transform protopanaxatriol by using ß-glucosidase from Thermotoga neapolitana (T. neapolitana) DSM 4359. RESULTS: Recombinant ß-glucosidase was purified, which molecular weight was about 79.5 kDa. High levels of ginsenoside were obtained using the follow reaction conditions: 2 mg ml-1 ginsenoside, 25 U ml-1 enzyme, 85 °C, and pH 5.0. ß-glucosidase converted ginsenoside Re to Rg2, Rf and Rg1 to APPT completely after 3 h under the given conditions, respectively. The enzyme created 1.66 mg ml-1 Rg2 from Re with 553 mg l-1 h-1, 0.85 mg ml-1, and 1.01 mg ml-1 APPT from Rg1 and Rf with 283 and 316 mg l-1 h-1 APPT. CONCLUSIONS: ß-glucosidase could be useful for the high-yield, rapid, and low-cost preparation of ginsenoside Rg2 from Re, and APPT from the ginsenosides Rg1 and Rf.

A validated UPLC-MS/MS method for the quantitation of an unstable peptide, monocyte locomotion inhibitory factor (MLIF) in human plasma and its application to a pharmacokinetic study.

Monocyte locomotion inhibitory factor (MLIF, Met-Gln-Cys-Asn-Ser), a pentapeptide with anti-inflammatory activity, was developed for neural protection in acute ischemic stroke. Determination of MLIF in human plasma samples is of great importance for pharmacokinetic evaluation in clinical studies. A reliable and sensitive method based on ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) was established for the measurement of MLIF in human plasma. Instability of peptide in matrix was the primary challenge in method development, which was properly resolved by addition of acidification reagents like sulfuric acid. Samples were prepared by protein precipitation and then analyzed using a gradient chromatographic separation over an ACQUITY UPLC HSS T3 column. The mobile phase consisted of acetonitrile containing 0.2% formic acid and water containing 0.2% formic acid and gradient elution was performed at a flow rate of 0.4 mL/min. Detection was carried out on a Xevo TQ-S tandem mass spectrometer and positive electrospray ionization was employed in the multiple reaction monitoring (MRM) mode. This method was fully validated over the concentration range of 0.5-40 ng/mL with a lower limit of quantification (LLOQ) of 0.5 ng/mL. The inter- and intra-batch precision was no more than 8.8% and the accuracy was between 88.7 and 104.2%. The mean extraction recovery was 43.3% and the detection was independent of matrix. Besides, the analyte proved to be stable under various handling processes and storage conditions after acidification. Finally, the method was applied to the first-in-human (FIH) study of MLIF in Chinese healthy subjects.

Night Sleep Duration and Risk of Incident Anemia in a Chinese Population: A Prospective Cohort Study.

The purpose was to study the association between sleep duration and the prevalence of anemia in Chinese people. There were 84,791 participants (men: 79.1%; women: 20.9%) aged 18-98 years in the prospective study. We divided the participants into five categories based on the individual sleep duration: ≤5 h, 6 h, 7 h(reference), 8 h, and ≥9 h. Anemia was defined based on hemoglobin <12 g/dL for men and <11 g/dL for women. The Cox proportional hazards model was used to assess the association between sleep duration and anemia. During median follow-up of 7.9 years, 2698 cases of anemia had occurred. The HRand (95% CI) of anemia (7 h as the reference group) for individuals reporting ≤5 h, 6 h, 8 h, and ≥9 h were 1.23(1.04-1.45), 1.26(1.11-1.44), 1.04(0.92-1.16) and 1.42(1.08-1.86), respectively. It showed that there was a significant interaction on the risk of anemia between sleep duration and sex in the secondary analysis (p < 0.001).The significant association between long sleepduration and anemia was found in women (HR, 2.29; 95% CI, 1.56-3.37), not in men(HR, 0.90; 95% CI, 0.60-1.34). Both short and long night sleep duration were associated with increased risk of anemia.

Association between Ideal Cardiovascular Health Metrics and Suboptimal Health Status in Chinese Population.

Suboptimal health status (SHS) is a physical state between health and illness, and previous studies suggested that SHS is associated with majority components of cardiovascular health metrics defined by American Heart Association (AHA). We investigated the association between SHS and cardiovascular health metrics in a cross-sectional analysis of China suboptimal health cohort study (COACS) consisting of 4313 participants (60.30% women) aged from 18 to 65 years old. The respective prevalence of SHS is 7.10%, 9.18%, 10.04% and 10.62% in the first, second, third and fourth quartiles of ideal cardiovascular health (CVH) metrics (P for trend = 0.012). Participants in the largest quartile of ideal CVH metrics show a lower likelihood of having optimal SHS score compared to those in the smallest quartile (odds ratio (OR), 0.43; 95% confidence interval (CI), 0.32-0.59), after adjusting for age, gender, marital status, alcohol consumption, income level and education. Four metrics (smoking, physical inactivity, poor dietary intake and ideal control of blood pressure are significantly correlated with the risk of SHS. The present study suggests that ideal CVH metrics are associated with a lower prevalence of SHS, and the combined evaluation of SHS and CVH metrics allows the risk classification of cardiovascular disease, and thus consequently contributes to the prevention of cardiovascular diseases.

Long Sleep Duration Is an Independent Risk Factor for Incident Atrial Fibrillation in a Chinese Population: A Prospective Cohort Study.

There is limited information on the relation between sleep duration and incident atrial fibrillation. We aimed to investigate this association in a Chinese population using cohort data from a study in Kailuan. The analysis included 87,693 participants (age range, 18-98 years) free of atrial fibrillation at the baseline survey. Participants were divided into three categories according to self-reported sleep duration: ≤6.0 hours, 7 hours (ref), ≥8.0 hours. Atrial fibrillation diagnosis was made on a standard 12-lead electrocardiogram and via self-reported history. Cox proportional hazards models were used to calculate hazard ratio (HR) and confidence interval (CI) for atrial fibrillation, according to sleep duration. During median follow-up of 7.89 (range, 6.36-8.57) years, 322 cases of atrial fibrillation had occurred. Using 7 hours of sleep as the reference group, multivariable adjusted HRs (95% CI) for atrial fibrillation were 1.07 (0.75-1.53), 1.0 (ref), and 1.50 (1.07-2.10), from lowest to highest category of sleep duration. Secondary analysis showed no evidence of interactions between sleep duration and sex and snoring on the risk of incident atrial fibrillation (p = 0.75/0.25). We conclude long sleep duration may be a potential predictor/marker for incident atrial fibrillation.

Changes in sleep duration and risk of metabolic syndrome: the Kailuan prospective study.

Using a large longitudinal data set spanning 4 years, we examined whether a change in self-reported sleep duration is associated with metabolic syndrome (MetS). Current analysis included 15,753 participants who were free of MetS during both 2006-2007 and 2010-2011. Sleep duration was categorized into seven groups: ≤5.5 h, 6.0-6.5 h, 7.0 h, 7.5-8.0 h, ≥8.5 h, decrease ≥2 h, and increase ≥2 h. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CI) for MetS, according to sleep duration. Compared to the reference group of persistent 7-h sleepers, a decrease of ≥2 h sleep per night was associated with a higher risk of incident MetS (HR = 1.23, 95% CI = 1.05-1.44) in analyses adjusted for age, sex, sleep duration at baseline, marital status, monthly income per family member, education level, smoking status, drinking status, physical activity, body mass index, snoring status and resting heart rate. An increased risk of MetS incidence was also observed in persistent short sleepers (average ≤5.5 h/night; HR = 1.22, 95% CI = 1.01-1.50). This study suggests individuals whose sleep duration decreases ≥2 h per night are at an increased risk of MetS.

Short-term changes in sleep duration and risk of type 2 diabetes: Kailuan prospective study.

Evidence suggests short or long sleep duration is associated with a higher risk of diabetes. Using a large longitudinal data set spanning 2 years, we examined whether a change in sleep duration is associated with diabetes.Current analysis included 56,588 participants who were free of diabetes during both 2006-2007 (exam1) and 2008-2009 (exam2). Sleep duration was categorized into 7 groups: ≤5.5 hours, 6.0 to 6.5 hours, 7.0 hours, 7.5 to 8.0 hours, ≥8.5 hours, decrease ≥2 hours, and increase ≥2 hours. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CI) for diabetes, according to sleep duration.Compared to the reference group of persistent 7-h sleepers, participants who slept 7.5 to 8 hours per night (HR, 1.20; 95% CI, 1.02-1.40), ≥8.5 hours per night (HR, 1.37; 95% CI, 1.03-1.81) and an increase of ≥2 hours sleep per night (HR, 1.24; 95% CI, 1.05-1.48) were all associated with an increased risk of developing diabetes in analyses adjusted for age, sex, education level, income level, smoking status, drinking status, physical activity, BMI, snoring status, hypertension, hyperlipidemia, and family history of diabetes. The abovementioned associations of sleep duration and incident diabetes were only prominent among individuals aged <64 years.This study suggests that individuals whose sleep duration increases ≥2 hours per night are at an increased risk of diabetes.

Long Sleep Duration and Risk of Ischemic Stroke and Hemorrhagic Stroke: the Kailuan Prospective Study.

The objective of this study was to examine the relationship between sleep duration and ischemic and hemorrhagic stroke in a community-based cohort. The current analysis included 95,023 Chinese participants who were free of stroke at the baseline survey (2006-2007). Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for stroke, according to sleep duration. After a mean follow-up period of 7.9 years, 3,135 participants developed stroke (2,504 ischemic stroke and 631 hemorrhagic stroke). The full adjusted hazard ratio (95% CI) of total stroke (with 6-8 hours of night sleep being considered for the reference group) for individuals reporting greater than 8 hours was 1.29 (1.01-1.64). More significant association between long sleep duration and total stroke was found in the elderly (HR, 1.47; 95% CI, 1.05-2.07). Compared with participants getting 6-8 hours of sleep, only women who reported sleeping more than 8 hours per night were associated with hemorrhagic stroke (HR, 3.58; 95% CI, 1.28-10.06). This study suggested that long sleep duration might be a potential predictor/ marker for total stroke, especially in the elderly. And long sleep duration increased the risk of hemorrhagic stroke only in women.

Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population: The Kailuan Study.

BACKGROUND: It is unclear whether ideal cardiovascular health (CVH), and particularly cumulative exposure to ideal CVH (cumCVH), is associated with incident diabetes. We aimed to fill this research gap. METHODS AND RESULTS: The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006-2007 and who were subsequently followed up at 2- (Exam 2), 4- (Exam 3), and 6 (Exam 4)-year intervals after baseline. The main analysis is restricted to those individuals with complete follow-up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal CVH (cumCVH) was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cumCVH and incident diabetes. In fully adjusted models, compared with the lowest quintile of cumCVH, individuals in the highest quintile had ~68% (95% confidence interval [CI] 60-75) lower risk for incident diabetes (compared with 61% [95% CI 52-69] lower risk when using baseline CVH). Every additional year lived with a 1-unit increase in ideal CVH was associated with a 24% (95% CI 21-28) reduction in incident diabetes. CONCLUSIONS: Ideal CVH is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of CVH exposure are used. Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes. CLINICAL TRIAL REGISTRATION: URL: https://www.chictr.org. Unique identifier: ChiCTRTNC-11001489.