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1.
J Cardiovasc Dev Dis ; 8(11)2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34821699

RESUMO

AIMS: We investigated the association between vascular medication adherence, assessed by different methods, and the risk of cardio-cerebrovascular events and all-cause mortality. METHODS: A meta-analysis with a systematic search of PubMed, Web of Science, EMBASE, and Cochrane databases from inception date to 21 June 2021 was used to identify relevant studies that had evaluated the association between cardiovascular medication adherence levels and cardiovascular events (CVEs), stroke, and all-cause mortality risks. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis. Restricted cubic splines were used to model the dose-response association. RESULTS: We identified 46 articles in the dose-response meta-analysis. The dose-response analysis indicated that a 20% increment in cardiovascular medication, antihypertensive medication, and lipid-lowering medication adherence level were associated with 9% (RR: 0.91, 95% CI 0.88-0.94), 7% (RR 0.93, 95% CI: 0.84-1.03), and 10% (RR 0.90, 95% CI: 0.88-0.92) lowers risk of CVEs, respectively. The reduced risk of stroke respectively was 16% (RR: 0.84, 95% CI: 0.81-0.87), 17% (RR 0.83, 95% CI: 0.78-0.89), and 13% (RR 0.87, 95% CI: 0.84-0.91). The reduced risk of all-cause mortality respectively was 10% (RR: 0.90, 95% CI: 0.87-0.92), 12% (RR 0.88, 95% CI: 0.82-0.94), and 9% (RR 0.91, 95% CI: 0.89-0.94). CONCLUSIONS: A better medication adherence level was associated with a reduced risk of cardio-cerebrovascular events and all-cause mortality.

2.
Br J Nutr ; : 1-8, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34632975

RESUMO

To investigate the association between the Metabolic Score for Visceral Fat (METS-VF) and risk of type 2 diabetes mellitus (T2DM) and compare the predictive value of the METS-VF for T2DM incidence with other obesity indices in Chinese people. A total of 12 237 non-T2DM participants aged over 18 years from the Rural Chinese Cohort Study of 2007-2008 were included at baseline and followed up during 2013-2014. The cox proportional hazards regression was used to calculate hazard ratios (HR) and 95 % CI for the association between baseline METS-VF and T2DM risk. Restricted cubic splines were used to model the association between METS-VF and T2DM risk. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the ability of METS-VF to predict T2DM incidence. During a median follow-up of 6·01 (95 % CI 5·09, 6·06) years, 837 cases developed T2DM. After adjusting for potential confounding factors, the adjusted HR for the highest v. lowest METS-VF quartile was 5·97 (95 % CI 4·28, 8·32), with a per 1-sd increase in METS-VF positively associated with T2DM risk. Positive associations were also found in the sensitivity and subgroup analyses, respectively. A significant nonlinear dose-response association was observed between METS-VF and T2DM risk for all participants (Pnonlinearity = 0·0347). Finally, the AUC value of METS-VF for predicting T2DM was largest among six indices. The METS-VF may be a reliable and applicable predictor of T2DM incidence in Chinese people regardless of sex, age or BMI.

3.
Br J Nutr ; : 1-8, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34467835

RESUMO

Early life exposure to famine was associated with adulthood metabolic syndrome and nonalcoholic fatty liver disease (NAFLD), and NAFLD was also affected by cardiometabolic traits. However, the role of cardiometabolic traits in the associations from famine exposure to NAFLD was largely unknown. This study aimed to investigate whether the relationship between early life famine exposure and adulthood NAFLD risk was mediated by cardiometabolic traits. Overall, 7578 subjects aged 56·0 (sd 3·7) years in the Dongfeng-Tongji cohort were included and classified into late-exposed (1952-1954), middle-exposed (1954-1956), early-childhood-exposed (1956-1958), fetal-exposed (1959-1961) and non-exposed (1962-1966, reference) group according to the birth year. NAFLD was diagnosed by experienced physicians via abdominal B-type ultrasound inspection. Mediation analysis was used to evaluate the mediating effects of cardiometabolic traits. Compared with those non-exposed, after multivariable adjustment, participants in fetal-exposed group (OR: 1·37; 95 % CI 1·08, 1·73) had 37 % higher risk to develop NAFLD, and the overall childhood-exposed group had marginally significant association with NAFLD (OR: 1·39; 95 % CI 0·99, 1·94). Stratification analysis found the famine-NAFLD associations more evident in women and those born in areas severely affected by famine. Mediation analysis showed that cardiometabolic traits such as total cholesterol, TAG glucose index, γ-glutamyl transpeptidase, alkaline phosphatase and alanine aminotransferase mediated 6·7-22·2 % of the relation from famine exposure to higher NAFLD risk. Early life exposure to famine was related to increased adulthood NAFLD risk, and this relationship was partly mediated by cardiometabolic traits.

4.
JMIR Public Health Surveill ; 7(10): e26840, 2021 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-34479184

RESUMO

BACKGROUND: The outbreak of COVID-19 in China occurred around the Chinese New Year (January 25, 2020), and infections decreased continuously afterward. General adoption of preventive measures during the Chinese New Year period was crucial in driving the decline. It is imperative to investigate preventive behaviors among Chinese university students, who could have spread COVID-19 when travelling home during the Chinese New Year break. OBJECTIVE: In this study, we investigated levels of COVID-19-related personal measures undertaken during the 7-day Chinese New Year holidays by university students in China, and associated COVID-19-related cognitive factors. METHODS: A cross-sectional anonymous web-based survey was conducted during the period from February 1 to 10, 2020. Data from 23,863 students (from 26 universities, 16 cities, 13 provincial-level regions) about personal measures (frequent face-mask wearing, frequent handwashing, frequent home staying, and an indicator that combined the 3 behaviors) were analyzed (overall response rate 70%). Multilevel multiple logistic regression analysis was performed. RESULTS: Only 28.0% of respondents (6684/23,863) had left home for >4 hours, and 49.3% (11,757/23,863) had never left home during the 7-day Chinese New Year period; 79.7% (19,026/23,863) always used face-masks in public areas. The frequency of handwashing with soap was relatively low (6424/23,863, 26.9% for >5 times/day); 72.4% (17,282/23,863) had frequently undertaken ≥2 of these 3 measures. COVID-19-related cognitive factors (perceptions on modes of transmission, permanent bodily damage, efficacy of personal or governmental preventive measures, nonavailability of vaccines and treatments) were significantly associated with preventive measures. Associations with frequent face-mask wearing were stronger than those with frequent home staying. CONCLUSIONS: University students had strong behavioral responses during the very early phase of the COVID-19 outbreak. Levels of personal prevention, especially frequent home staying and face-mask wearing, were high. Health promotion may modify cognitive factors. Some structural factors (eg, social distancing policy) might explain why the frequency of home staying was higher than that of handwashing. Other populations might have behaved similarly; however, such data were not available to us.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Surtos de Doenças/prevenção & controle , COVID-19/epidemiologia , China/epidemiologia , Estudos Transversais , Feminino , Desinfecção das Mãos , Humanos , Masculino , Máscaras , Distanciamento Físico , Estudantes , Inquéritos e Questionários , Universidades
5.
Nutrition ; 93: 111443, 2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34563934

RESUMO

OBJECTIVES: The aim of this study was to investigate the association of the Metabolic Score for Visceral Fat (METS-VF) with the risk for hypertension and to compare the ability of the METS-VF, the metabolic score for insulin resistance, visceral adiposity index, waist-to-height ratio, waist circumference, and body mass index to predict hypertension incidence based on a large prospective study of rural Chinese individuals. METHODS: In all, 10 297 non-hypertensive adults (≥18 y of age) from a rural Chinese cohort study in 2007 and 2008 were included at baseline and followed up in 2013 and 2014. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between baseline METS-VF and hypertension risk. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the ability of METS-VF to predict hypertension incidence. RESULTS: We identified 2071 hypertension cases during follow-up. After adjusting for multivariable confounding factors, the adjusted ORs (95% CIs) for the highest versus lowest METS-VF quartile overall and for men and women were 3.84 (3.23-4.56), 3.25 (2.48-4.24), and 4.14 (3.30-5.20), respectively. Also, per-SD increase in METS-VF was positively associated with hypertension risk overall and for men and women. Similar results were found in the sensitivity and subgroup analyses. Finally, the AUC value for hypertension was higher for METS-VF than the other five indices overall and for men and women. CONCLUSIONS: The present study indicated that METS-VF was positively associated with hypertension incidence and performed better in predicting hypertension risk than five other indices, which suggests that METS-VF is a reliable predictor of hypertension in the Chinese population.

6.
J Geriatr Cardiol ; 18(8): 645-653, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34527030

RESUMO

BACKGROUND: Association between tea consumption and incident hypertension remains uncertain. This study conducted to examine the health effects of tea consumption on blood pressure progression and hypertension incidence. METHODS: A population-based cohort of 38,913 Chinese participants without hypertension at baseline were included in the current study. Information on tea consumption was collected through standardized questionnaires. Associations of tea consumption with blood pressure progression and incident hypertension were analyzed using logistic regression models and Cox proportional hazards regression models, respectively. RESULTS: During a median follow-up of 5.9 years, 17,657 individuals had experienced progression to a higher blood pressure stage and 5,935 individuals had developed hypertension. In multivariate analyses, habitual tea drinkers (≥ 3 times/week for at least six months) had a 17% lower risk for blood pressure progression [odds ratio (OR) = 0.83, 95% CI: 0.79-0.88] and a 14% decreased risk for incident hypertension [hazard ratio (HR) = 0.86, 95% CI: 0.80-0.91] compared with non-habitual tea drinkers. Individuals in different baseline blood pressure groups could obtain similar benefit from habitual tea drinking. In terms of tea consumption amount, an inverse, linear dose-response relation between monthly consumption of tea leaves and risk of blood pressure progression was observed, while the risk of incident hypertension did not reduce further after consuming around 100 g of tea leaves per month. CONCLUSIONS: Our study demonstrated that habitual tea consumption could provide preventive effect against blood pressure progression and hypertension incidence.

7.
Ecotoxicol Environ Saf ; 224: 112641, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34461320

RESUMO

BACKGROUND: Active commuting as a contributor to daily physical activity is beneficial for cardiovascular health, but leads to more chances of exposure to ambient air pollution. This study aimed to investigate associations between active commuting to work with cardiovascular disease (CVD), mortality and life expectancy among general Chinese adults, and to further evaluate the modification effect of fine particulate matter (PM2.5) exposure on these associations. METHODS: We included 76,176 Chinese adults without CVD from three large cohorts of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project. Information about commuting mode and physical activity were collected by unified questionnaire. Satellite-based PM2.5 concentrations at 1-km spatial resolution was used for estimating PM2.5 exposure of participants. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD incidence, mortality and all-cause mortality were estimated using Cox proportional hazards regression models. Multiplicative interaction term of commuting mode and PM2.5 level was tested to investigate potential effect modification. RESULTS: During 448,499 person-years of follow-up, 2230 CVD events and 2777 all-cause deaths were recorded. Compared with the non-active commuters, the multivariable-adjusted HRs (95% CIs) of CVD incidence and all-cause mortality were 0.95(0.85-1.05) and 0.79(0.72-0.87) for walking commuters, respectively. Corresponding HRs (95% CIs) for cycling commuters were 0.71(0.62-0.82) and 0.67(0.59-0.76). Active commuters over 45 years old were estimated to have more CVD-free years and life expectancy than non-active commuters under lower PM2.5 concentration. However, these beneficial effects of active commuting were alleviated or counteracted by long-term exposure to high PM2.5 concentration. Significant multiplicative interaction of commuting mode and PM2.5 level was showed in all-cause mortality, with the lowest risk observed in cycling participants exposed to lower level of PM2.5. CONCLUSIONS: Active commuting was associated with lower risk of CVD, all-cause mortality, and longer life expectancy among Chinese adults under ambient settings with lower PM2.5 level. It will be valuable to encourage active commuting among adults and develop stringent strategies on ambient PM2.5 pollution control for prevention of CVD and prolongation of life expectancy.

8.
Nutr Metab Cardiovasc Dis ; 31(10): 2792-2799, 2021 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-34332862

RESUMO

AIMS: A comprehensive assessment of the association of shift work with risk of metabolic syndrome (MetS) through a systematic review and meta-analysis has not been reported. We aimed to evaluate the relationship from observational studies. DATA SYNTHESIS: We searched PubMed, Embase, and Web of Science databases from inception to December 16, 2020. Articles were chosen according to established inclusion criteria. Studies with data on men and women and different types of shift work were treated as independent studies. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled by using random-effects models with heterogeneity (I2) > 50%; otherwise, a fixed-effects model was used. A total of 7192 articles was searched from PubMed, Embase and Web of science. Finally, we included 23 articles (38 studies) in this meta-analysis. The pooled RRs and 95% CI of MetS risk with shift work, 1-shift work, 2-shift work, and 3-shift work versus non-shift work were 1.30 (95% CI 1.19-1.41), 0.95 (95% CI 0.82-1.11), 1.19 (95% CI 0.91-1.56) and 1.17 (95% CI 1.00-1.37), respectively. The results from subgroup analyses stratified by sex, age, and region supported our overall findings that shift work is a risk factor for MetS. CONCLUSIONS: This meta-analysis suggests that shift work increases risk of MetS. Higher risk of MetS was found in the shift workers who were 2-shift or 3-shift or women or Asian workers.


Assuntos
Síndrome Metabólica/epidemiologia , Jornada de Trabalho em Turnos/efeitos adversos , Adulto , Fatores de Risco Cardiometabólico , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Medição de Risco , Fatores de Tempo
9.
Diabetes Res Clin Pract ; 179: 108997, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34371063

RESUMO

AIMS: To evaluate the risk of type 2 diabetes mellitus (T2DM) in a prospective study with hypertriglyceridemic waist-to-height ratio (HWHtR) and its dynamic status. METHODS: We collected data for 12,248 participants ≥18 years in this study. Cox's proportional-hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for T2DM risk by baseline HWHtR. Multiple logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs for T2DM risk by transformation in HWHtR. RESULTS: We identified 839 T2DM cases during a median follow-up of 5.92 years. Compared with normal TG level and normal WHtR, T2DM risk was increased with high TG level and high WHtR (aHR 2.04, 95% CI 1.49-2.79). Similar results were observed in subgroup analyses by sex and age. During follow-up, T2DM risk was increased with stable high TG level and high WHtR (aOR 4.45, 95% CI 2.76-7.17) compared with stable normal TG level and normal WHtR. The results above were robust in sensitivity analyses. CONCLUSIONS: HWHtR phenotype and its dynamic status were associated with risk of T2DM. Our study suggests that primary prevention and avoiding the appearance of the HWHtR phenotype in the rural Chinese population may reduce the T2DM risk.


Assuntos
Diabetes Mellitus Tipo 2 , Cintura Hipertrigliceridêmica , China/epidemiologia , Estudos de Coortes , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Cintura Hipertrigliceridêmica/complicações , Cintura Hipertrigliceridêmica/epidemiologia , Estudos Prospectivos , Fatores de Risco
10.
J Diabetes ; 13(12): 975-986, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34260825

RESUMO

BACKGROUND: To estimate the associations between single-nucleotide polymorphisms (SNPs) and methylation of KCNQ1 gene and type 2 diabetes mellitus (T2DM) risk and the interactions among SNPs, methylation, and environmental factors on T2DM risk. METHODS: We genotyped five SNPs and tested methylation at 39 CpG loci of KCNQ1 in 290 T2DM cases and 290 matched controls nested in the Rural Chinese Cohort Study. Conditional logistic regression model was used to estimate the associations between SNPs and KCNQ1 methylation and T2DM risk. Multifactor dimensionality reduction (MDR) analysis was used to estimate the effect of the interactions SNPs-SNPs, SNPs-methylation, methylation-methylation and SNPs, and methylation-environment on T2DM risk. RESULTS: Probability of T2DM was decreased with rs2283228 of KCNQ1 (CA vs AA, odds ratio [OR] = 0.65, 95% confidence interval [CI] 0.42-0.99). T2DM probability was significantly increased with rs2237895 combined with hypertriglyceridemia (OReg  = 2.76, 95% CI 1.35-5.62), with hypertension (OReg  = 2.23, 95% CI 1.25-3.98), and with body mass index (BMI; OReg  = 1.93, 95% CI 1.12-3.34). T2DM probability was associated with methylation of CG11 and CG41 (OR = 1.89, 95% CI 1.23-2.89, P = .003). It was significantly associated with the interaction between BMI, hypertriglyceridemia, and CG5 methylation (P = .028 and .028), and the combined effects of CG11 with hypertriglyceridemia and hypertension. On MDR analysis, no significant interaction was observed. CONCLUSION: T2DM probability was reduced 35% with rs2283228 polymorphism. It was associated with rs2237895 combined with hypertension, with BMI and with hypertriglyceridemia. The methylation at two CpG loci of KCNQ1 significantly increased T2DM risk by 89%.

11.
Environ Res ; 201: 111611, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34217719

RESUMO

Although emerging researches have linked ambient fine particulate matter (PM2.5) to obesity, evidence from high-polluted regions is still lacking. We thus assessed the long-term impacts of PM2.5 on body mass index (BMI) and the risk of the prevalence of overweight/obesity (BMI≥25 kg/m2), by incorporating the well-established Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project comprising 77,609 participants with satellite-based PM2.5 estimates at 1-km spatial resolution. The average of long-term PM2.5 level was 70.4 µg/m3, with the range of 32.1-94.2 µg/m3. Each 10 µg/m3 increment of PM2.5 was associated with 0.421 kg/m2 (95% confidence interval [CI]: 0.402, 0.439) and 13.5% (95% CI: 12.8%, 14.3%) increased BMI and overweight/obesity risk, respectively. Moreover, compared with the lowest quartile of PM2.5 (≤57.5 µg/m3), the relative risk of the prevalence of overweight/obesity from the highest quartile (>85.9 µg/m3) was 1.611 (95% CI: 1.566, 1.657). The exposure-response curve suggested a non-linear relationship between PM2.5 exposure and overweight/obesity. Besides, the association was modified by age, diabetes mellitus, hypertension and dyslipidemia status. Our study provides the evidence for the adverse impacts of long-term PM2.5 on BMI and overweight/obesity in China, and the findings are important for policy development on air quality, especially in severely polluted areas.


Assuntos
Sobrepeso , Material Particulado , Adulto , China/epidemiologia , Humanos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Material Particulado/toxicidade
12.
Vascular ; : 17085381211035282, 2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34311590

RESUMO

BACKGROUND: It is indicated that Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C ratio) has greater predictive value for thickened carotid intima-media thickness (CIMT) comparing with classic lipid parameters. However, there have been few reports about their association in general Chinese population. METHOD: We included a total of 1220 CIMT participants and 2440 matched controls, who had ultrasonography of carotid artery during 2009 and 2016. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for thickened CIMT risk associated with LDL-C/HDL-C ratio. RESULT: In the univariate logistic regression model, there was significant association between LDL-C/HDL-C ratio and thickened CIMT (Q4 vs. Q1, OR = 1.94, 95% CI: 1.60-2.36; ptrend < 0.05). After adjusting for potential covariates, LDL-C/HDL-C ratio remained significantly associated with thickened CIMT (Q4 vs. Q1, OR = 1.81, 95% CI: 1.41-2.34, ptrend < 0.001; ≥3.05 v.s. <3.05, OR = 1.66, 95% CI: 1.37-2.02). In subgroup analyses, the association between LDL-C/HDL-C ratio and thickened CIMT remained significant in the subgroups stratified by sex, impaired fasting glucose (IFG), hypertension, and fatty liver disease but only remained significant in the subgroups of ≥45 years (OR = 2.01, 95% CI: 1.46-2.76; Ptrend<0.05), BMI ≥24 (kg/m2) (OR = 2.22; 95% CI = 1.63-3.03; Ptrend < 0.05) and BMI ≥25 (kg/m2) (OR = 2.50, 95% CI: 1.76-3.54; Ptrend < 0.05), dyslipidemia (OR = 3.28, 95% CI: 1.83-5,85; Ptrend < 0.001), and without periodontitis (OR = 2.08, 95% CI: 1.54-2.81 ; Ptrend < 0.05) comparing Q4 to Q1. Similar results were observed in the subgroup analyses for LDL-C/HDL-C ratio ≥3.05 v.s. <3.05 except for the age stratification. CONCLUSION: High LDL-C/HDL-C ratio could significantly increase the risk of thickened CIMT independent of gender, IFG, hypertension, and fatty liver disease in general Chinese population.

13.
Lancet Reg Health West Pac ; 8: 100096, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34327424

RESUMO

Background: World Health Organization (WHO) released region-specific cardiovascular disease (CVD) risk prediction charts recently, but the extent to which the charts can apply to Chinese population is unknown. We aimed to validate the WHO CVD risk charts for East Asia, and evaluate their practicability combining with China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) equations among Chinese adults. Methods: The China-PAR cohort with 93,234 participants aged 40-80 years was followed up during 1992-2015, including 29,337 participants from three sub-cohorts with follow-up period of over 10 years. We validated the WHO CVD risk charts using the China-PAR cohort by assessment of the predicted number of events, C index, calibration χ², and calibration plots, further elaborated the concordance between the China-PAR equations and the WHO risk charts. Findings: During an average follow-up of 13•64 years, 1849 incident CVD cases were identified from 29,337 participants. Both the laboratory-based and non-laboratory-based charts overestimated CVD events by 59% and 58% in men, and by 72% and 85% in women, respectively. However, 92% of participants identified as high risk by the China-PAR equations could be successfully detected by the laboratory-based charts at the cut-off point of 10%. We also observed that the non-laboratory-based charts demonstrated the poor performance for diabetic population, with high proportion of high-risk individuals (17% for men, 31% for women) would be missed. Interpretation: Although the WHO CVD risk charts for East Asia apparently overestimated CVD risk among Chinese population, they could be pragmatic pre-selection tools, as potential supplement to the China-PAR equations. The widespread use of the WHO risk charts along with the China-PAR equations might facilitate the implementation of the risk-based CVD prevention in China. Funding: Full funding sources are listed at the end of the paper (see Acknowledgments).

14.
Sci Total Environ ; 796: 148620, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34274662

RESUMO

AIMS: The association of long-term ambient air pollution and hypertension has been inconsistently reported. We performed an updated systematic review and meta-analysis to assess the association between long-term exposure to ambient air pollution and risk of hypertension in adults and in children. METHODS: PubMed, EMBASE, and Web of Science were searched up to August 7, 2020 for published articles examining the association of long-term exposure to ambient air pollution, including particulate matter (PM; ultrafine particles, PM1, PM1-2.5, PM2.5, PM2.5-10 and PM10), nitrogen dioxide (NO2), nitrogen oxides (NOx), sulfur dioxide (SO2), ozone (O3), carbon monoxide (CO) and hypertension. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension with each 10-µg/m3 increase in air pollutants were calculated by random-effects models. RESULTS: We included 57 studies (53 of adults and 4 of children) in the meta-analysis. Risk of hypertension was significantly increased in adults with each 10-µg/m3 increase in exposure to PM2.5 (OR 1.10, 95% CI 1.07-1.14; I2 = 93.1%; n = 37), PM10 (1.04, 1.02-1.07; I2 = 44.8%; n = 22), and SO2 (1.21, 1.08-1.36; I2 = 96.6%; n = 3). Hypertension was not significantly associated with PM1 (n = 2), PM2.5-10 (n = 16), NO2 (n = 27), or NOx (n = 17). In children, the summary ORs (95% CIs) for each 10-µg/m3 increase in PM2.5, PM10, SO2 and O3 were 2.82 (0.51-15.68; I2 = 83.8%; n = 2), 1.15 (1.01-1.32; I2 = 0; n = 2), 8.57 (0.13-575.58; I2 = 94.2%; n = 2), and 1.26 (0.81-1.09, I2 = 91.6%; n = 2), respectively. CONCLUSIONS: Long-term ambient air pollution is a potential risk factor for hypertension in adults. More studies are needed to explore the effects of long-term air pollution on hypertension in children.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Hipertensão , Ozônio , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Criança , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Hipertensão/induzido quimicamente , Hipertensão/epidemiologia , Dióxido de Nitrogênio/efeitos adversos , Dióxido de Nitrogênio/análise , Ozônio/efeitos adversos , Ozônio/análise , Material Particulado/efeitos adversos , Material Particulado/análise
15.
Indoor Air ; 31(6): 1722-1732, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34110043

RESUMO

Although solid fuel use has been increasingly linked to cardiovascular events (CVEs), conclusions have been inconsistent. We systematically searched 3 databases (PubMed, Embase, and Web of Science) up to July 3, 2020, to identify English language reports that assessed the association of solid fuel use with CVEs. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated with a random-effects model. Subgroup analyses and sensitivity analyses were conducted to explore the potential sources of heterogeneity and to test the stability of the results. We finally included 13 observational studies (8 cohort, 3 cross-sectional, and 2 case-control studies comprising 791,220 participants) in the meta-analysis. The risk of CVEs was increased 21% with the highest versus the lowest solid fuel use (highest/lowest, RRpooled  = 1.21, 95% CI: 1.10-1.34). As for the subgroup analyses on study design, the pooled RR for cohort studies, case-control studies, and cross-sectional studies were 1.11 (95%CI: 1.03-1.19), 4.80 (95%CI: 2.22-10.39), and 1.46 (95%CI: 0.82-2.62), respectively. The results of this study suggested that high solid fuel use was associated with increased CVE risk, and that reducing the use of solid fuel will be important for improving the health of the populations in developing countries.


Assuntos
Poluição do Ar em Ambientes Fechados , Doenças Cardiovasculares , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Estudos Observacionais como Assunto
17.
Nutr Metab Cardiovasc Dis ; 31(7): 1976-1984, 2021 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-33965298

RESUMO

AIMS: The relation of body mass index (BMI) with cardiovascular disease (CVD) and mortality has been extensively investigated in the general population but is less clear in individuals with type 2 diabetes mellitus (T2DM). We performed a meta-analysis of cohort studies to quantitatively evaluate the association of BMI with CVD incidence and mortality in patients with T2DM. DATA SYNTHESIS: PubMed and Embase databases were searched for relevant cohort articles published up to June 8, 2020. Restricted cubic splines were used to evaluate the potential linear or non-linear dose-response associations. We identified 17 articles (21 studies) with 1,349,075 participants and 57,725 cases (49,354 CVD incidence and 8371 CVD mortality) in the meta-analysis. We found a linear association between BMI and risk of CVD incidence (Pnon-linearity = 0.182); the pooled RR for CVD incidence was 1.12 (95% CI, 1.04-1.20) with a 5-unit increase in BMI. We found an overall nonlinear relationship between BMI and CVD mortality (Pnon-linearity < 0.001). The lowest risk was at BMI about 28.4 kg/m2, with increased mortality risk for higher BMI values; the RR with a 5-unit increase in BMI was 0.87 (95% CI, 0.79-0.96) and 1.11 (95% CI, 1.04-1.18) for BMI ≤28.4 kg/m2 and BMI >28.4 kg/m2, respectively. CONCLUSIONS: In individuals with T2DM, BMI may have a positive linear association with risk of CVD incidence but a nonlinear association with CVD mortality. Our results can provide evidence for weight control and lifestyle intervention for preventing and managing cardiovascular disease in T2DM.


Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Obesidade/epidemiologia , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/terapia , Feminino , Estilo de Vida Saudável , Fatores de Risco de Doenças Cardíacas , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/mortalidade , Obesidade/terapia , Prognóstico , Medição de Risco , Comportamento de Redução do Risco
18.
Prim Care Diabetes ; 15(5): 825-831, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34024742

RESUMO

OBJECTIVES: To investigate the association of the baseline New Chinese Diabetes Risk Score (NCDRS) with metabolic syndrome (MetS) risk and to evaluate the power of the baseline NCDRS to predict MetS based on the rural Chinese cohort study. METHODS: Study participants were classified by baseline quartiles of NCDRS by gender. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of MetS according to different diagnostic criteria. The receiver operating characteristic curve (ROC) and area under the ROC curve (AUC) were used to evaluate the power of the baseline NCDRS for predicting MetS according to different diagnostic criteria. RESULTS: We included 7,133 participants, and 1,651 MetS cases were identified after 6 years follow-up. After adjusting for multivariable confounding factors and with NCDRS quartile 1 as the reference, with quartile 4, the risk of MetS was increased for all participants, men and women: ORs (95% CIs) 4.03 (3.23-5.02), 3.59 (2.56-5.05) and 5.71 (4.23-7.70), respectively. Similar results were found on sensitivity analysis. The baseline NCDRS was a good predictor of MetS for all participants, men and women with MetS defined according to the diagnostic criteria of the Chinese Joint Committee on the Development of Guidelines for the Prevention and Treatment of Dyslipidemia in Adults (JCDCG). CONCLUSIONS: Our study, based on the cohort study, found that the baseline NCDRS was positively associated with risk of MetS. Furthermore, our study might provide suggestions for developing a useful and inexpensive tool for predicting MetS in the Chinese population.


Assuntos
Diabetes Mellitus , Síndrome Metabólica , Adulto , China/epidemiologia , Estudos de Coortes , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Curva ROC , Fatores de Risco
19.
Prev Chronic Dis ; 18: E45, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33988499

RESUMO

INTRODUCTION: Studies investigating the effect of high-density lipoprotein cholesterol (HDL-C) on stroke and stroke subtypes have reached inconsistent conclusions. The purpose of our study was to clarify the dose-response association between HDL-C level and risk of total stroke and stroke subtypes by a systematic review and meta-analysis. METHODS: We performed a systematic search of PubMed, Embase, and Web of Science databases through July 30, 2020, for prospective cohort studies that reported the HDL-C-stroke association and extracted the estimate that was adjusted for the greatest number of confounding factors. Restricted cubic splines were used to evaluate the linear and nonlinear dose-response associations. RESULTS: We included 29 articles, which reported on 62 prospective cohort studies including 900,501 study participants and 25,678 with stroke. The summary relative risk per 1-mmol/L increase in HDL-C level for total stroke was 0.82 (95% CI, 0.76-0.89; I2 = 42.9%; n = 18); ischemic stroke (IS), 0.75 (95% CI, 0.69-0.82; I2 = 50.1%; n = 22); intracerebral hemorrhage (ICH), 1.21 (95% CI, 1.04-1.42; I2 = 33.4%; n = 10); and subarachnoid hemorrhage (SAH), 0.98 (95% CI, 0.96-1.00; I2 = 0%; n = 7). We found a linear inverse association between HDL-C level and risk of total stroke and SAH, a nonlinear inverse association for IS risk, but a linear positive association for ICH risk. The strength and the direction of the effect size estimate for total stroke, IS, ICH, and SAH remained stable for most subgroups. We found no publication bias with Begg's test and Egger's test for the association of HDL-C level with risk of total stroke, IS, and ICH. CONCLUSION: A high HDL-C level is associated with reduced risk of total stroke and IS and an increased risk of ICH.


Assuntos
HDL-Colesterol/sangue , Acidente Vascular Cerebral/sangue , Feminino , Humanos , Masculino , Risco , Fatores de Risco , Acidente Vascular Cerebral/etiologia
20.
Infection ; 49(5): 977-981, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33988829

RESUMO

PURPOSE: Studies have demonstrated improvements in hand hygiene (HH) compliance through interventions, noting the negative association of HH and healthcare associated infections (HAIs), but how to sustain long-term improvement is still unknown in the Chinese population. This study sought to determine the extent of change in HH compliance after multimodal HH interventions, and to evaluate the relationship between that change and HAI incidence. METHODS: We conducted a longitudinal study in a general teaching hospital in China from 2017 to 2020. Trained investigators observed HH practices based on the World Health Organization's 5 moments for HH. We identified the incidence of HAIs using semi-automated constant surveillance software. We used the Cochran-Mantel-Haenszel test to assess the secular trend of HH compliance and HAIs. The Spearman correlation coefficient (rs) was used to evaluate the relationship between the incidence of HAIs and compliance with HH. RESULTS: The study made 480,943 observations, where HH was occurring between 2017 and 2020. HH compliance increased from 68.90 to 91.76% during that period (Ptrend < 0.01), while the incidence of HAIs decreased from 1.10 to 0.91%. Compliance also increased for each moment type and for each healthcare worker (Ptrend < 0.01). Lower HH compliance was observed in before-patient contact and after contact with patient surroundings, and among interns and cleaners. We also observed a weak but statistically significant negative correlation between the monthly HH compliance and incidence of HAIs (rs = - 0.27; P = 0.037). CONCLUSIONS: The multimodal HH implementation delivered sustained improvement in HH compliance, and this change was associated with a decline in the incidence of HAIs.


Assuntos
Infecção Hospitalar , Higiene das Mãos , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes , Hospitais de Ensino , Humanos , Incidência , Controle de Infecções , Estudos Longitudinais
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