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1.
Artigo em Inglês | MEDLINE | ID: mdl-31961500

RESUMO

OBJECTIVE: Although several individual nutrients/foods are associated with uric acid status, the association of overall diet quality with hyperuricemia remains unclear. We thus examined the association between adherence to the dietary approaches to stop hypertension (DASH) diet and odds of having hyperuricemia in a Chinese adult population. METHODS: Included were 71,893 Chinese participants of the Kailuan Study I and the Kailuan Study II (mean age: 51.4 y), free of gout prior to or in 2014. Dietary intakes were assessed using a validated food frequency questionnaire and the DASH score was calculated based on consumptions of vegetables, fruit, dairy, beans, whole grains, meat, fat, sodium and sugar-sweetened beverage. Fasting blood samples were collected in 2014 and hyperuricemia was defined as serum uric acid concentrations of ≥7mg/dl for men and ≥ 6mg/dl for women. Association between the DASH score and hyperuricemia was assessed using multiple logistic regression models, adjusting for age, sex, total energy, obesity, physical activity, education, smoking, alcohol drinking, blood pressure, fasting glucose, lipid profiles, renal function and presence of cardiovascular disease. RESULTS: High DASH score was associated with low odds of having hyperuricemia (adjusted OR for quartile 4 vs. quartile 1=0.70; 95% CI, 0.66 to 0.75; P-trend <0.001), after adjusting for potential confounders. The association between the DASH diet and hyperuricemia was more pronounced among older people (≥50 y), women and physically inactive participants, compared with their counterparts (p-interaction <0.01 for all). CONCLUSION: The DASH diet was associated with a low likelihood of having hyperuricemia in Chinese adults.

2.
Ann Clin Transl Neurol ; 6(12): 2368-2376, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31714690

RESUMO

OBJECTIVE: To examine how urate concentrations are related to the risk of having possible REM sleep behavior disorder (pRBD) in a community-based cohort. METHODS: The study included 12,923 Chinese adults of the Kailuan Study, free of Parkinson disease (PD) and dementia. Plasma urate concentrations were measured in 2006, 2008, and 2010. Cumulative average urate concentration was used as primary exposure. In 2012, we determined pRBD status using a validated RBD questionnaire-Hong Kong (RBDQ-HK). Logistic regression analysis was performed to estimate the association between urate concentrations during 2006-2010 and odds of having pRBD in 2012 or pRBD case with symptom onset within 1 year. RESULTS: Higher average urate concentrations were associated with a lower odds of pRBD (P-trend <0.001). The adjusted odds ratio (OR), for the highest versus lowest urate quintiles, was 0.43 (95% confidence intervals (CIs) 0.32-0.57). Significant association was consistently observed when we examined the association of a single urate assessment (2006 or 2010) or the rate of change in urate concentrations during 2006-2010 with pRBD (P-trend <0.001 for all). However, restricting to pRBD onset during 2011-2012, we observed a nonsignificant trend between high urate concentration and high odds of pRBD (P-trend = 0.09). INTERPRETATION: Higher average urate concentrations were associated with a lower likelihood of having pRBD, but not new-onset pRBD. Because of its observational study design, the result should be interpreted with caution due to the possibility of residual confounding.

3.
Clin Rheumatol ; 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31659539

RESUMO

OBJECTIVE: To explore whether cumulative serum urate (cumSU) is correlated with diabetes type II mellitus incidence. METHODS: In this study, we recruited individuals participating in all Kailuan health examinations from 2006 to 2013 without stroke, cancer, gestation, myocardial infarction, and diabetes type II diagnosis in the first three examinations. CumSU was calculated by multiplying the average serum urate concentration and the time between the two examinations (umol/L × year). CumSU levels were categorized into five groups: Q1-Q5. The effect of cumSU on diabetes type II incidence was estimated by logistic regression. RESULTS: A total of 36,277 individuals (27,077 men and 9200 women) participated in the final analysis. The multivariate logistic regression model showed the odds ratios (95% confidence intervals) of diabetes type II from Q1 to Q5 were 1.00 (reference), 1.25 (1.00 to 1.56), 1.43 (1.15 to 1.79), 1.49 (1.18 to 1.87), and 1.80 (1.40 to 2.32), respectively. Multivariable odds ratios per 1-standard deviation increase in cumSU were 1.26 (1.17 to 1.37) in all populations, 1.20 (1.10 to 1.32) for men, and 1.52 (1.27 to 1.81) for women, respectively. CONCLUSIONS: CumSU is a significant risk factor for diabetes type II. Individuals with higher cumSU, especially women, are at a higher risk of diabetes type II independent of other known risk factors. Key Points • Cumulative exposure to serum urate is a significant risk factor for diabetes type II. • Individuals with higher cumSU, especially women, are at a higher risk of diabetes type II.

4.
J Am Heart Assoc ; 8(13): e012020, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31213103

RESUMO

Background Current evidence on the association between serum urate and risk of atrial fibrillation ( AF ) is limited by cross-sectional designs and 1-time measurement of serum urate. The roles of serum urate, gout-related inflammation, and systemic inflammation in the etiology of AF are currently unknown. This gap is important, given that systemic inflammation is a recognized risk factor for AF . Methods and Results We conducted a prospective cohort study of 123 238 Chinese patients from 2006 to 2014. Serum urate concentrations were measured in 2006, 2008, 2010, and 2012. Incident AF cases were identified via biennial 12-lead ECG assessment. We used a Cox proportional hazards model to examine the sex-specific associations of cumulative average serum urate and changes in serum urate accounting for baseline level with risk of incident AF . We also assessed the joint associations of serum urate and high-sensitivity C-reactive protein levels. Comparing extreme categories, participants with the highest quintile of serum urate had 1.91-fold higher risk of AF (adjusted hazard ratio: 1.91; 95% CI, 1.32-2.76; P=0.001 for trend). Participants with both high serum urate and high-sensitivity C-reactive protein had 2.6-fold elevated risk of incident AF compared with those with normal levels of serum urate and high-sensitivity C-reactive protein (adjusted hazard ratio: 2.63; 95% CI, 1.63-4.23). Conclusions High serum urate levels and increases in serum urate over time were associated with increased risk of incident AF . Patients with high levels of both serum urate and high-sensitivity C-reactive protein had substantially higher risk of AF .

5.
Clin Rheumatol ; 38(9): 2373-2381, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31020475

RESUMO

BACKGROUND/OBJECTIVE: Neck circumference (NC) is associated with metabolic abnormalities, independent of other obesity indices. However, data are limited regarding the potential relation between NC and serum uric acid (UA) concentrations. Therefore, we evaluated the cross-sectional association between NC and UA concentration, and odds of having hyperuricemia in a community-based cohort. SUBJECTS AND METHODS: The current study included 87,782 participants (16,317 women and 71,465 men, 52.2 ± 14.1 y) of the Kailuan Study. NC and UA concentration were measured in 2014. We used generalized linear model to investigate the association between NC and serum UA concentration and logistic regression model to investigate the association between NC and likelihood of having hyperuricemia (≥ 7 mg/dl in men and ≥ 6 mg/dl in women), adjusting for demographic factor, anthropometric indices, plasma lipid profiles, blood glucose, blood pressure, physical exercise, snoring, smoking, diet quality, and alcohol consumption. RESULTS: Higher NC was associated with higher serum UA concentration, and higher odds of hyperuricemia in both men and women after adjusting for potential confounders (both p < 0.001). Each additional 5-cm increase in NC was associated with 6% higher likelihood of having hyperuricemia (adjusted OR = 1.06; 95% CI 1.02, 1.1) in men and 17% in women (adjusted OR = 1.17; 95% CI 1.06, 1.28) (p interaction = 0.01). Similar pattern was observed after excluding participants who reported use of anti-hypertensive drugs, participants with obesity or higher waist circumference, and participants with history of gout and chronic kidney diseases. CONCLUSIONS: Higher NC was associated with higher serum UA concentration and higher risk of hyperuricemia in Chinese adult population. CLINICAL TRIAL NUMBER: Kailuan Study (ChiCTR-TNRC-11001489).

6.
PLoS One ; 14(2): e0211946, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30768617

RESUMO

BACKGROUND: A hospitalized-based cohort study suggested that elevated C-reactive protein (CRP) levels are associated with radiographic sacroiliitis progression in ankylosing spondylitis (AS) patients. However, data from community-based populations are limited. OBJECTIVE: We sought to determine the association between elevated CRP levels and AS diagnosis in a prospective community-based study of 129,681 Chinese adults over a follow-up period of 8 years. METHODS: We measured the plasma CRP concentration at baseline and every 2 years thereafter with the high-sensitivity (hs)-CRP test. Incident AS cases were confirmed on the basis of modified New York diagnostic criteria after review of medical records. We used Cox proportional-hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for AS on the basis of hs-CRP concentrations, adjusting for age, sex, education, income, cigarette smoking, alcohol intake, physical activity, body mass index, blood-pressure status, blood glucose status, total cholesterol, history of cardiovascular disease, and use of antihypertensives, lipid-lowering agents, and aspirin. RESULTS: During 1,033,609 person-years (average 7.97 ± 1.36 years per person) of follow-up, we identified 55 incident AS cases. Baseline hs-CRP was positively associated with the risk of future AS. Compared with hs-CRP <1 mg/L, the HR was 1.28 (95% CI 0.54-3.08) for hs-CRP of 1.00-2.99 mg/L, 4.71 (95% CI 2.26-9.81) for hs-CRP of 3.00-9.99 mg/L, and 19.8 (95% CI 9.6-40.9) for hs-CRP ≥10.00 mg/L (P-trend <0.001) after adjustment for potential confounders. We found similar results after excluding AS cases that occurred in the first 2 years of follow-up, and using the cumulative average hs-CRP concentration as a predictor. CONCLUSION: This is the first study in a community-based cohort to demonstrate that CRP plasma concentrations predict the risk of future AS, thus providing a test that is easy to routinely perform in the clinic to assess for AS risk.


Assuntos
Proteína C-Reativa/metabolismo , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/epidemiologia , Regulação para Cima , Adulto , Idoso , Biomarcadores/sangue , China/epidemiologia , Diagnóstico Precoce , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Espondilite Anquilosante/metabolismo
7.
Hypertension ; 73(4): 893-899, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30776974

RESUMO

Arterial stiffness and blood pressure (BP) both increase with aging synchronously. Whether elevated BP results from thickening of arterial wall or vice versa is controversial in previous studies. This study included 17 862 participants without history of myocardial infarction, stroke, atrial fibrillation or flutter, or cancer and with brachial-ankle pulse wave velocity (baPWV) and BP measurements during 2010 to 2016. Age was calculated from the self-reported birthdate to the first date of baPWV examination. Mediation analyses were applied to assess the mediation effect by baPWV in the association between age and BP. Temporal relation between baPWV and BP was assessed by cross-lagged analyses among 1508 participants with repeated assessment of baPWV. We found that systolic BP increased 0.47 (95% CI, 0.45-0.49) mm Hg per 1 year older by the mediation effect of baPWV and that the direct effect of aging on systolic BP was -0.07 (95% CI, -0.09 to -0.05) mm Hg per 1 year older. The standard regression coefficient from baseline baPWV to follow-up systolic BP was 0.09 (95% CI, 0.04-0.15), which was greater than the standard regression coefficient from baseline systolic BP to follow-up baPWV (0.01; 95% CI, -0.04 to 0.06). Arterial stiffness mediated the positive association between aging and BP, and arterial stiffness might precede elevated BP. Clinical Trial Registration- URL: http://www.chictr.org.cn . Unique identifier: ChiCTR-TNRC-11001489.


Assuntos
Envelhecimento/fisiologia , Pressão Sanguínea/fisiologia , Hipertensão/epidemiologia , Rigidez Vascular/fisiologia , Fatores Etários , Índice Tornozelo-Braço , China/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Estudos Prospectivos , Análise de Onda de Pulso , Fatores de Risco
8.
Int J Rheum Dis ; 21(9): 1709-1715, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30345647

RESUMO

AIM: The objective of this study was to evaluate the impact of rheumatoid arthritis (RA) on physical function and health-related quality of life (HRQoL) in China. METHOD: A cross-section survey was conducted in 21 general hospitals in China. Eight hundred and seven patients were recruited. Data on demographics, clinical data, physical function (Stanford Health Assessment Questionnaire Disability Index, HAQ-DI) and HRQoL (Study Short Form 36 Health Survey, SF-36) were collected on site. RESULTS: In our cohort, physical function was impaired in 77.6% of patients (HAQ-DI >0). The median (interquartile range, IQR) of HAQ-DI was 0.750 (0.125, 1.500). Rated by HAQ-DI 0-1, >1-2, and >2-3, percentage of patients with mild, moderate and severe disability was 61.0%, 25.4%, and 13.6%, respectively. Older age, long disease duration, presence of extra-articular manifestations, tender joint count (TJC), overall status (assessed by patient Global Visual Analogue Scale [G-VAS] and physician G-VAS) and lacking disease-modifying anti-rheumatic drugs were identified as predictive factors for worse physical function (P < .05). The composite scores of SF-36 in the observed patients were: physical component summary 40.4 (IQR 27.4, 60.3), and mental component summary 49.0 (IQR 33.6, 70.9). Impaired physical health may be predicted by low income, presence of extra-articular manifestations, TJC, patient G-VAS and high HAQ-DI. Predictors for suboptimal mental health were low income, physical labor, married status, increased swollen joint count (SJC), physician G-VAS and high HAQ-DI. CONCLUSION: Rheumatoid arthritis has profound effects on physical function and HRQoL in Chinese patients. Patients with identified predictive factors for poor outcome should be closely monitored.


Assuntos
Artrite Reumatoide/diagnóstico , Avaliação da Deficiência , Qualidade de Vida , Adulto , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/fisiopatologia , Artrite Reumatoide/psicologia , China/epidemiologia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Renda , Descrição de Cargo , Masculino , Estado Civil , Saúde Mental , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Índice de Gravidade de Doença , Determinantes Sociais da Saúde
9.
J Am Heart Assoc ; 7(21): e010596, 2018 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-30608199

RESUMO

Background Current evaluation about the relationship of sequential change in estimated glomerular filtration rate ( eGFR ) and clinical outcomes are still inconsistent. We aimed to investigate the association between the change in kidney function over time and the risk of all-cause mortality and cardiovascular disease. Methods and Results This prospective cohort including 37 691 participants aged ≥45 years used data from the Kailuan Health Registry. The relationship of the annual percentage and absolute change in eGFR and outcomes were analyzed with Cox proportional regression. The participants were stratified according to the quintiles distribution of the percentage annual change in eGFR (Q1-Q5). After adjusting for baseline covariates including initial eGFR , participants with annual eGFR decline were at significantly greater risk for all-cause mortality (Q1: hazard ratio, 1.22 [95% confidence interval, 1.04-1.43]; Q2: 1.19 [1.01-1.40]) than noted for patients in Q3. Cardiovascular disease risk was also significantly higher in participants with annual eGFR decline (Q1 and Q2). No significantly increased risk of adverse outcomes was noted for patients with annual eGFR increased groups (Q4 and Q5). When considering the absolute eGFR annual change rate (no/mild/rapid decline), we obtained similar results in chronic kidney disease participants, whereas non-chronic kidney disease participants had less pronounced association of eGFR decline with cardiovascular disease, though not with mortality. Conclusions A decline in eGFR over time is associated with higher risk for all-cause mortality and cardiovascular disease independent of initial eGFR and other known risk factors at baseline. Our data support the serial evaluation of change in kidney function as a better prognostic indicator than single eGFR assessments.


Assuntos
Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Nefropatias/mortalidade , Nefropatias/fisiopatologia , Rim/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/complicações , Causas de Morte , China , Feminino , Taxa de Filtração Glomerular , Humanos , Nefropatias/complicações , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros
10.
Inhal Toxicol ; 30(13-14): 492-497, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30654669

RESUMO

Coal workers' pneumoconiosis (CWP) is caused by long-term exposure to inhaled coal dust; it is likely influenced by the interaction between environmental factors and multiple susceptibility genes, such as the CYBA (cytochrome b-245α polypeptide) gene that has recently been identified to be involved in the genetic susceptibility for several pulmonary diseases. The aim of this case-control study was to explore the association between CYBA gene polymorphisms and the development of CWP in coal miners belonging to the Han ethnic group in China. Single nucleotide polymorphisms (SNPs) rs7195830, rs13306296, rs4673, rs9932581, and rs16966671 of the CYBA gene were analyzed in CWP patients (n = 652) and dust-exposed control subjects (n = 648) using the matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) on the Sequenom MassARRAY® platform (Sequenom, San Diego, CA, USA). Results from the present study showed a strong allele association between CWP patients and the CYBA SNP rs7195830 polymorphism (p < .001, OR = 1.550). Using the additive and the dominant model, the CYBA SNP rs7195830 polymorphism also showed significant associations with CWP patients (p < .001, OR = 1.621; p = .003, OR = 1.711, respectively). No statistically significant difference was demonstrated in either the allele or genotype frequencies of the other four examined SNPs (rs13306296, rs4673, rs9932581, and rs16966671) between the CWP group and dust-exposed control group (all p > .05). The present study is the first to have demonstrated an association between CYBA (rs7195830) polymorphism and the risk of developing CWP in subjects belong to the Han ethnic group in China and provides further clues for research into the pathogenesis of CWP.


Assuntos
Antracose/genética , Grupo com Ancestrais do Continente Asiático/genética , NADPH Oxidases/genética , Idoso , Idoso de 80 Anos ou mais , Antracose/epidemiologia , Estudos de Casos e Controles , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único
11.
Mod Rheumatol ; 27(6): 1066-1071, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28395604

RESUMO

OBJECTIVE: The objective of this study is to determine the serum uric acid (SUA) level and the prevalence of hyperuricemia (HUA) in Chinese population. METHODS: We conducted a cross-sectional study among 100,226 employees (79.9% male) of the Kailuan Group using physical examination data in 2006-2007. HUA was defined as SUA >356.9 µmol/L (6.0 mg/dL) for women and SUA >416.4 µmol/L (7.0 mg/dL) for men. We investigated crude and age adjusted HUA prevalence and compared characteristics of subjects with and without HUA in men and women using multivariate logistic regression. RESULTS: SUA levels were 244.9 ± 71.5 µmol/L in women and 302.0 ± 83.5 µmol/L in men. About 8290 (8.27%) subjects were diagnosed with HUA. Age-adjusted prevalence of HUA was 8.02% in the total sample (6.87% in women and 8.57% in men). The SUA level and HUA prevalence showed U-shaped or J-shaped associations with age. Multivariate logistic regression revealed age, waist circumference, total cholesterol, triglyceride, hypertension and non-alcoholic fatty liver disease history, prolonged sitting, alcohol consumption, and oral diuretics were independent risk factors of HUA, while long sleep duration was protective against HUA. CONCLUSIONS: The prevalence of HUA is 6.87% and 8.57% in Chinese women and men. HUA is likely related with life style and metabolic disorders.


Assuntos
Hiperuricemia/epidemiologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Postura , Prevalência , Fatores de Risco , Sono , Fatores de Tempo , Ácido Úrico/sangue
12.
Clin Rheumatol ; 36(5): 1103-1110, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28176036

RESUMO

Whether hyperuricemia is an independent risk factor for hypertension in adults is still under debate. To determine the association between serum uric acid and risk of hypertension in the Chinese population, we conducted a prospective study using the "Kailuan Corporation cohort." A total of 39,233 adult subjects with available data on serum uric acid were enrolled from 2006 to 2007. Subjects with established hypertension were excluded and were then grouped based on the gender and baseline quartile serum uric acid into F1-4 for women and M1-4 for men with F1 and M1 being the lowest quartiles. Incidence of newly described primary hypertension was reevaluated in 2010-2011. The median (interquantile range) baseline uric acid (UA) was 290 (243-344) µmol/L in men and 230 (194-274) µmol/L in women. During a 4-year follow-up period, 12,844 subjects (31.31 %) were newly diagnosed with hypertension. The incidence of hypertension was 14.36, 16.57, 19.06, and 22.35 % in F1 to F4 and 33.64, 33.97, 36.54, and 40.74 % in M1 to M4, respectively. Multiple logistic regression analysis showed that the odds ratios (ORs) of incident hypertension were 1.17 [95 % confidence interval (CI) 1.00-1.37, P = 0.055], 1.24 (95 % CI 1.06-1.45, P = 0.009), and 1.20 (95 % CI 1.02-1.41, P = 0.027) in F2 to F4 compared to the F1 and 0.98 (95 % CI 0.91-1.05, P = 0.534), 1.05 (95 % CI 0.98-1.13, P = 0.190), and 1.13 (95 % CI 1.05-1.22, P = 0.002) in M2 to M4 compared to the M1. Elevated level of serum uric acid is associated with an increased risk of hypertension in adults.


Assuntos
Pressão Sanguínea , Hipertensão/epidemiologia , Hiperuricemia/complicações , Medição de Risco/métodos , Ácido Úrico/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , China/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/sangue , Hipertensão/etiologia , Hiperuricemia/sangue , Hiperuricemia/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
13.
Arthritis Care Res (Hoboken) ; 69(5): 703-708, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27454342

RESUMO

OBJECTIVE: To test whether prenatal exposure to earthquake (as a surrogate for acute prenatal stress) could have unfavorable effects on uric acid levels later in life. METHODS: We included 536 individuals who had been prenatally exposed to the Tangshan earthquake in 1976, and 536 sex- and age-matched individuals without that exposure. Serum uric acid concentrations were measured based on fasting blood samples, which were repeatedly collected in 2006, 2008, and 2010. Mean uric acid concentrations in 2010 and the increasing rate from 2006 to 2010 were compared between the 2 groups, after adjustment for age, sex, body mass index, serum concentrations of glucose, triglycerides, C-reactive protein level, estimated glomerular filtration rate, and other potential confounders. We also used multiple logistic regression to estimate the risk of hyperuricemia (>416 µmole/liter in men or >357 µmole/liter in women) in 2010 by calculating the odds ratios (ORs) and 95% confidence intervals (95% CIs) after adjustment for the previously mentioned covariates. RESULTS: Participants with prenatal exposure to the earthquake had higher concentrations of serum uric acid (adjusted means 315 µmole/liter versus 296 µmole/liter; P = 0.001) and a higher likelihood of having hyperuricemia (multivariate adjusted OR 1.70 [95% CI 1.09-2.66]) in 2010 relative to those without the exposure. Prenatal exposure to the earthquake was consistently significantly associated with a faster increase in uric acid concentration from 2006 to 2010 (P < 0.001). CONCLUSION: Prenatal exposure to the earthquake was associated with higher serum uric acid and higher odds of hyperuricemia in early adulthood.


Assuntos
Desastres , Terremotos , Hiperuricemia/sangue , Efeitos Tardios da Exposição Pré-Natal/sangue , Ácido Úrico/sangue , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , China , Feminino , Seguimentos , Humanos , Hiperuricemia/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Estudos Prospectivos , Fatores de Risco
14.
Medicine (Baltimore) ; 95(46): e5350, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27861364

RESUMO

The worldwide prevalence and incidence of diabetes and obesity are increasing in pandemic proportions. This is particularly relevant for China, where an extremely large population is growing, aging, and urbanizing. We thus conducted a prospective study to examine the prevalence and incidence of impaired fasting glucose (IFG) and diabetes, the rate at which fasting blood glucose rises, and the major modifiable risk factors associated with these outcomes in a large Chinese population from the Kailuan prospective study.A prospective cohort included 100,279 Chinese participants, aged 18 years or more, who had available information on fasting blood glucose concentrations at the start of the study (2006). Examination surveys were conducted every 2 years in 2008 and 2010. For the analyses of incident diabetes, we included 76,869 participants who were free of diabetes, cardiovascular disease, and cancer at the baseline and participants in the 2008 and/or 2010 follow-up. Diabetes was defined by a fasting blood glucose concentration ≥7 mmol/L, self-reported history, or active treatment with insulin or any oral hypoglycemic agent. IFG was defined by a fasting blood glucose concentration between 5.6 and 6.9 mmol/L.During the 4-year study, the prevalence of diabetes and IFG rose from 6.6% to 7.7%, and 17.3% to 22.6%, respectively. There were 17,811 incident cases of IFG and 4867 incident cases of diabetes. The age-standardized incident rate of IFG and diabetes were 62.6/1000 person-years (51.2/1000 person-years in women and 73.8/1000 person-years in men) and 10.0/1000 person-years (7.8/1000 person-years in women and 12.1/1000 person-years in men), respectively. We observed steady increases in fasting blood glucose with body anthropometrics and in every defined category of body mass index, including in those traditionally considered to be well within the "normal" range.In this large longitudinal study of Chinese adults, we observed a high prevalence and incidence of IFG and diabetes over 4 years of follow-up. Our findings are alarming for Chinese public health since steady rises in fasting blood glucose were seen across all permutations of body habitus, even apparently very lean individuals.


Assuntos
Glicemia/análise , Diabetes Mellitus Tipo 2/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Jejum , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos
15.
J Am Heart Assoc ; 5(9)2016 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-27638783

RESUMO

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.


Assuntos
Glicemia/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , Colesterol/sangue , Diabetes Mellitus/epidemiologia , Exercício , Comportamentos Relacionados com a Saúde , Nível de Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos de Coortes , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo
16.
Clin Rheumatol ; 35(12): 2901-2908, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27553386

RESUMO

Environmental factors play an important role in the development of rheumatoid arthritis (RA). Among these factors, smoking is generally considered to be an established risk factor for RA. Data regarding the impact of diet on risk of RA development is limited. This study assessed the impact of dietary patterns on RA susceptibility in Chinese populations. This was a large scale, case-control study composed of 968 patients with RA and 1037 matched healthy controls. Subjects were recruited from 18 teaching hospitals. Socio-demographic characteristics and dietary intakes 5 years prior to the onset of RA were reported by a self-administered questionnaire. Differences in quantity of consumption between cases and controls were analyzed by Student's t test. Multiple logistic regression analysis was applied to identify independent dietary risk factor(s) responsible for RA susceptibility. Compared to healthy individuals, RA patients had decreased consumption of mushrooms (P = 0.000), beans (P = 0.006), citrus (P = 0.000), poultry (P = 0.000), fish (P = 0.000), edible viscera (P = 0.018), and dairy products (P = 0.005). Multivariate analyses revealed that several dietary items may have protective effects on RA development, such as mushrooms (aOR = 0.669; 95%CI = 0.518-0.864, P = 0.002), citrus fruits (aOR = 0.990; 95%CI = 0.981-0.999, P = 0.04), and dairy products (aOR = 0.921; 95%CI 0.867-0.977, P = 0.006). Several dietary factors had independent effects on RA susceptibility. Dietary interventions may reduce the risk of RA.


Assuntos
Artrite Reumatoide/epidemiologia , Dieta , Adulto , Idoso , Artrite Reumatoide/diagnóstico , Grupo com Ancestrais do Continente Asiático , Estudos de Casos e Controles , China/epidemiologia , Estudos Transversais , Progressão da Doença , Exposição Ambiental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Análise de Regressão , Fatores de Risco , Fumar , Adulto Jovem
17.
OMICS ; 20(6): 343-51, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27310476

RESUMO

Rheumatoid arthritis (RA), a systemic, chronic, and progressive inflammatory autoimmune disease, affects up to 1.0% of the world population doubling mortality rate of patients and is a major global health burden. Worrisomely, we lack robust diagnostics of RA and its remission status. Research with the next-generation biomarker technology platforms such as glycomics offers new promises in this context. We report here a clinical case-control study comprising 128 patients suffering from chronic RA (80.22% in remission, 19.78% active clinically) and 195 gender- and age-matched controls, with a view to the putative glycan biomarkers of RA as well as its activity or remission status in Han Chinese RA patients. Hydrophilic interaction liquid chromatography-ultra-performance liquid chromatography (HILIC-UPLC) was used for the analysis of IgG glycans. The regression model identified the glycans that predict RA status, while a receiver operating characteristic (ROC) curve analysis validated the sensitivity and prediction power. Among the total 24 glycan peaks (GP1-GP24), ROC analysis showed only GP1 prediction to be highly sensitive with an area under the curve (AUC) = 0.881. Even though GP21 and GP22 could predict active status among the RA cases (p < 0.05), they had lower sensitivity of prediction with an AUC = 0.658. Taken together, these observations suggest that GP1 might have potential as a putative biomarker for RA in the Han Chinese population, while the change in IgG glycosylation shows association with the RA active and remission states. To the best of our knowledge, this is the first glycomics study with respect to disease activity and remission states in RA.


Assuntos
Artrite Reumatoide/metabolismo , Artrite Reumatoide/patologia , Biomarcadores/metabolismo , Polissacarídeos/metabolismo , Adulto , Área Sob a Curva , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC
18.
Arthritis Care Res (Hoboken) ; 68(5): 660-6, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26714267

RESUMO

OBJECTIVE: Hyperuricemia has been shown to be associated with increased risks of gout and cardiovascular diseases. We prospectively investigated the association between the American Heart Association (AHA) ideal cardiovascular health metrics, including smoking, body mass index, dietary intake, physical activity, blood pressure, total cholesterol, and fasting blood glucose, and the risk of developing hyperuricemia. METHODS: We included 77,787 Chinese adults, ages ≥18 years (60,951 men and 16,836 women), without hyperuricemia at the baseline (2006) in this study. Information on the cardiovascular health metrics at baseline was collected. Incident hyperuricemia cases were identified by elevated serum uric acid concentrations, which were repeatedly assessed in 2006, 2008, 2010, and 2012, respectively. Cox regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident hyperuricemia according to the baseline ideal cardiovascular health metrics. RESULTS: We observed an inverse relation between the greater numbers of ideal cardiovascular health metrics at baseline and lower risks of developing hyperuricemia during 6 years of followup. After adjusting for age, sex, alcohol consumption, and other potential confounders, the HRs for incident hyperuricemia were 0.95, 0.84, 0.72, and 0.64 (95% CIs 0.58-0.70, P for trend < 0.0001) for participants who met 2, 3, 4, and 5-7 metrics, respectively, compared with those who met 0-1 cardiovascular health metrics. CONCLUSION: Greater cardiovascular health metrics were associated with lower risk of hyperuricemia in this Chinese population, suggesting that the modifiable construct defined by the AHA could be of significance in reducing the risk of developing hyperuricemia-related diseases, such as gout.


Assuntos
Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/fisiopatologia , Hiperuricemia/etiologia , Adulto , Glicemia/análise , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , China/epidemiologia , Colesterol/sangue , Dieta , Exercício , Jejum/sangue , Feminino , Humanos , Hiperuricemia/epidemiologia , Incidência , Masculino , Modelos de Riscos Proporcionais , Estudos Prospectivos , Análise de Regressão , Fatores de Risco , Fumar , Ácido Úrico/sangue
19.
Zhonghua Yu Fang Yi Xue Za Zhi ; 49(7): 600-4, 2015 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-26310471

RESUMO

OBJECTIVE: To investigate the association between exposure to the famine during early life and elevated resting heart rate (RHR) in adulthood. METHOD: From June 2006 to October 2007, the employees of kailuan group who took part in the health examination were selected. Of those, 18 619 cases who was born during October 1, 1956 to September 30, 1964 in Hebei province were finally included in the analysis based on the inclusion and exclusion criteria. All the subjects were received questionnaire survey, smoking and drinking, physical examination, Lab examination and the measurement of RHR. The subjects of famine exposure group (3 190 cases) were born from October 1, 1959 to September 30, 1961, semi-exposure group (3 851 cases) were born from October 1, 1958 to September 30, 1959 and from October 1, 1961 to September 30, 1962, control group (11 578 cases) were born from October 1, 1956 to September 30, 1958 and from October 1, 1962 to September 30, 1964. The RHR and the detection rate of elevated RHR were compared among the three groups. The Multivariate logistic regression model was used to analyze the association between of exposure to famine during early life and elevated RHR in adulthood. RESULTS: The RHR level was higher in famine exposure group and semi-exposed group than control group, which were (74.34 ± 9.71), (74.41 ± 9.48) and (73.90 ± 9.45) beat per minute (bpm) (P values were 0.003 and 0.020, respectively). In all of the subjects. The results of multivariate logistic regression showed that exposure of famine during early life increased the risk of elevated RHR in adulthood after adjustment for age, gender and other confounders (OR = 1.10, 95% CI: 1.01-1.21). In men, exposure of famine during early life also increased the risk of elevated RHR in adulthood (OR = 1.15, 95% CI: 1.04-1.28); In women, there was no association between the famine exposure and elevated RHR (OR = 0.92, 95% CI: 0.74-1.14). CONCLUSION: Exposure of famine during early life increases the risk of elevated RHR in adulthood. This negative effect existed mainly in the male.


Assuntos
Frequência Cardíaca , Desenvolvimento Humano , Inanição , Adulto , Consumo de Bebidas Alcoólicas , China , Feminino , Humanos , Modelos Logísticos , Masculino , Fatores de Risco , Fumar
20.
Arthritis Rheumatol ; 67(11): 2978-89, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26200652

RESUMO

OBJECTIVE: Glycans attached to the Fc portion of IgG are important modulators of IgG effector functions. Interindividual differences in IgG glycome composition are large and they associate strongly with different inflammatory and autoimmune diseases. IKZF1, HLA-DQ2A/B, and BACH2 genetic loci that affect IgG glycome composition show pleiotropy with systemic lupus erythematosus (SLE), indicating a potentially causative role of aberrant IgG glycosylation in SLE. We undertook this large multicenter case-control study to determine whether SLE is associated with altered IgG glycosylation. METHODS: Using ultra-performance liquid chromatography analysis of released glycans, we analyzed the composition of the IgG glycome in 261 SLE patients and 247 matched controls of Latin American Mestizo origin (the discovery cohort) and in 2 independent replication cohorts of different ethnicity (108 SLE patients and 193 controls from Trinidad, and 106 SLE patients and 105 controls from China). RESULTS: Multiple statistically significant differences in IgG glycome composition were observed between patients and controls. The most significant changes included decreased galactosylation and sialylation of IgG (which regulate proinflammatory and antiinflammatory actions of IgG) as well as decreased core fucose and increased bisecting N-acetylglucosamine (which affect antibody-dependent cell-mediated cytotoxicity). CONCLUSION: The IgG glycome in SLE patients is significantly altered in a way that decreases immunosuppressive action of circulating immunoglobulins. The magnitude of observed changes is associated with the intensity of the disease, indicating that aberrant IgG glycome composition or changes in IgG glycosylation may be an important molecular mechanism in SLE.


Assuntos
Predisposição Genética para Doença , Imunoglobulina G/genética , Lúpus Eritematoso Sistêmico/imunologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Imunoglobulina G/imunologia , Imunoglobulina G/metabolismo , Lúpus Eritematoso Sistêmico/genética , Lúpus Eritematoso Sistêmico/metabolismo , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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