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1.
J Diabetes Investig ; 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33650324

RESUMO

AIMS: The correlation between triglyceride to high-density lipoprotein-cholesterol (TG/HDL-C) ratio variability and incident diabetes has not been fully elucidated. We aim to characterize the relationship between TG/HDL-C ratio variability and new-onset diabetes in Chinese adults. MATERIALS AND METHODS: A total of 45,911 patients with three TG and HDL measurements between 2006 and 2011 were enrolled. Average real variability (ARV) were used to evaluate variability, and subjects were grouped according to tertiles of TG/HDL-ARV. RESULTS: There were 3,724 cases of incident diabetes mellitus during the observation period (6.24±1.2 years). The 7-year cumulative incidences of diabetes mellitus in tertiles 1, 2, and 3 were 6.13%, 8.09%, and 11.77%, respectively. New-onset diabetes increased with the tertiles of TG/HDL-ARV. This association was further confirmed after adjustment for mean TG/HDL-C ratio, TG/HDL-C ratio change slope, fasting plasma glucose variability (ARV), and other traditional risk factors for diabetes, the hazard ratio value for incident diabetes was 1.38 (1.25-1.50) for the highest tertile, and risk of diabetes increases by 4% with 1-SD increase in TG/HDL-C ratio variability. Restricted cubic splines showed a dose-response relationship between TG/HDL-C ratio variability and incident diabetes. Similar results were obtained in various subgroup and sensitivity analyses. CONCLUSIONS: High TG/HDL-C variability was associated with a higher risk of diabetes in Chinese adults, independent of the direction of TG/HDL-C variability.

2.
Nutr J ; 20(1): 13, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33522924

RESUMO

BACKGROUND: Studies regarding whether light to moderate alcohol consumption is associated with a lower risk of cardiovascular diseases (CVD) have generated mixed results. Further, few studies have examined the potential impact of alcohol consumption on diverse disease outcomes simultaneously. We aimed to prospectively study the dose-response association between alcohol consumption and risk of CVD, cancer, and mortality. METHODS: This study included 83,732 adult Chinese participants, free of CVD and cancer at baseline. Participants were categorized into 6 groups based on self-report alcohol consumption: 0, 1-25, 26-150, 151-350, 351-750, and > 750 g alcohol/wk. Incident cases of CVD, cancers, and mortality were confirmed by medical records. Hazard ratios (HRs) for the composite risk of these three outcomes, and each individual outcome, were calculated using Cox proportional hazard model. RESULTS: During a median follow-up of 10.0 years, there were 6411 incident cases of CVD, 2947 cancers and 6646 deaths. We observed a J-shaped relation between alcohol intake and risk of CVD, cancer, and mortality, with the lowest risk at 25 g/wk., which is equivalent to ~ 2 servings/wk. Compared to consuming 1-25 g/wk., the adjusted HR for composite outcomes was 1.38 (95% confidence interval (CI):1.29-1.49) for non-drinker, 1.15 (95% CI: 1.04-1.27) for 26-150 g/wk., 1.22 (95% CI: 1.10-1.34) for 151-350 g/wk., 1.33 (95% CI: 1.21-1.46) for 351-750 g/wk., and 1.57 (95% CI: 1.30-1.90) for > 750 g/wk., after adjusting for age, sex, lifestyle, social economic status, and medication use. CONCLUSIONS: Light alcohol consumption at ~ 25 g/wk was associated with lower risk of CVD, cancer, and mortality than none or higher consumption in Chinese adults.

3.
Invest Ophthalmol Vis Sci ; 62(2): 20, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33595612

RESUMO

Purpose: The purpose of this study was to determine systemic stressors, including fasting plasma glucose (FPG), and other major atherosclerotic cardiovascular disease (ASCVD) risk factors of the retinal microvasculature in people without diabetes. Methods: The Kailuan Eye Study enrolled applicants from the community-based longitudinal Kailuan Study. Applicants underwent optical coherence tomographic angiography (OCTA) and systemic examinations. Both the macula and optic disc were screened, whereas superficial capillary plexus (SCP), deep capillary plexus (DCP), foveal vessel density in the 300 µm ring (FD-300), and radial peripapillary capillaries (RPCs) density were measured in the study. Results: This study included 353 eligible applicants (mean age = 49.86 ± 11.41 years; 47% men; FPG =5.32 ± 1.19 mmol/L). Lower DCP density was associated with elder age (P = 0.001), male gender (P < 0.001), and higher FPG (P = 0.008). Male gender (P < 0.001), axial length (P < 0.001), and FPG (P = 0.029) were inversely associated with RPC density. Meanwhile, a higher FPG concentration was significantly correlated with lower DCP density (P = 0.006) and higher intraocular pressure (P = 0.006), after adjusting mean arterial blood pressure (P = 0.001) and sex (P = 0.042). Conclusions: DCP density showed a significantly negative correlation with FPG concentration in people without diabetes. These data suggest hyperglycemia could cause early retinal capillary alterations in patients without clinical signs of retinopathy and indicate the potential clinical applications of routine OCTA may be beneficial to screen for subclinical microvasculature and monitor patients with high risks of ASCVD.

4.
Cardiovasc Diabetol ; 20(1): 46, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33602208

RESUMO

BACKGROUND: Triglyceride-glucose (TyG) index was recently suggested to be a reliable surrogate marker of insulin resistance. We aim to investigate the associations between baseline and long-term TyG index with subsequent stroke and its subtypes in a community-based cohort. METHODS: A total of 97,653 participants free of history of stroke in the Kailuan Study were included. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Baseline TyG index was measured during 2006-2007. Updated cumulative average TyG index used all available TyG index from baseline to the outcome events of interest or the end of follow up. The outcome was the first occurrence of stroke, including ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage. The associations of TyG index with outcomes were explored with Cox regression. RESULTS: During a median of 11.02 years of follow-up, 5122 participants developed stroke of whom 4277 were ischemic stroke, 880 intracerebral hemorrhage, and 144 subarachnoid hemorrhage. After adjusting for confounding variables, compared with participants in the lowest quartile of baseline TyG index, those in the third and fourth quartile were associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12-1.33, and adjusted HR 1.32, 95% CI 1.21-1.44, respectively, P for trend < 0.001). We also found a linear association between baseline TyG index with stroke. Similar results were found for ischemic stroke. However, no significant associations were observed between baseline TyG index and risk of intracranial hemorrhage. Parallel results were observed for the associations of updated cumulative average TyG index with outcomes. CONCLUSIONS: Elevated levels of both baseline and long-term updated cumulative average TyG index can independently predict stroke and ischemic stroke but not intracerebral hemorrhage in the general population during an 11-year follow-up.

5.
Am J Med Sci ; 2021 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-33621529

RESUMO

BACKGROUND: Abdominal obesity and brachial-ankle pulse wave velocity (baPWV) are indicators of atherosclerosis. But few studies have shown the relationship between baPWV combined with waist-hip ratio (WHR) and cardiac-cerebrovascular events (CCVEs). METHODS: A total of 18944 subjects from Kailuan study were enrolled in this study. Follow-up was conducted three times over 4.82±1.92 years. All the participants were divided into 4 groups according to baPWV and WHR status on baseline: Q1 (normal baPWV, normal WHR), Q2 (normal baPWV, increased WHR), Q3 (increased baPWV, normal WHR) and Q4 (increased baPWV, increased WHR). The incidence and risk factors and further analysis of hypertension subgroups were analyzed. RESULTS: During follow-up, 88 myocardial infarctions (MI), 278 cerebral ischemic strokes (CI), 285 strokes and 371 CCVEs occurred, with the cumulative incidence of 0.46%, 1.47%, 1.50%, and 1.96%, respectively. Multivariate Cox regression analysis revealed the risk of CI, stroke and CCVEs was higher in patients with increased baPWV and increased WHR than in the other three groups, followed by the Q3 group (increased baPWV, normal WHR) and Q2 group (normal baPWV, increased WHR) group (all adjusted P<0.01). Further hypertension subgroups analysis showed similar results, but differences were more significant among hypertensive patients. Accordingly, the combination of baPWV and WHR increased the risk of total CCVEs, especially in hypertensive patients. CONCLUSIONS: BaPWV and WHR were important risk factors for CCVEs and had synergistic effects. When baPWV increased, WHR may contribute more to the risk of CCVEs in hypertensive patients.

6.
Sci Rep ; 11(1): 1330, 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33446746

RESUMO

On the basis of 45,092 participants (mean age of 54.04 ± 13.09 years) from the Kailuan study, this study was performed to explore the relationships among total cholesterol (TC), brachial-ankle pulse wave velocity (BaPWV), and systolic blood pressure (SBP) and quantify their separate effects. The correlations among TC, SBP, and BaPWV were analyzed using multivariate linear regression models. Mediation analysis was performed to determine whether the effect of TC on SBP can be explained by arterial stiffness. Multivariate linear regression analysis showed that for every one standard deviation increase in TC and BaPWV, SBP increased by 0.33 mmHg and 0.044 mmHg, respectively; for every one standard deviation increase in TC, BaPWV increased by 5.34 cm/s. Mediation analysis showed that the TC-induced SBP elevation was mediated by arterial stiffness in more than half of the whole cohort (indirect effect, 0.73; percent mediated, 54.5%). Furthermore, the TC-induced SBP elevation was mediated by arterial stiffness in less than half of the males (indirect effect, 0.70; percent mediated, 47.9%); however, the results were not statistically significant in females. In conclusion, TC and BaPWV are positively correlated with SBP, whereas TC is positively correlated with BaPWV. Almost half of the increase in SBP contributed to TC is mediated by arterial stiffness.

7.
J Am Heart Assoc ; 10(3): e019045, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33496188

RESUMO

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.

8.
Cardiovasc Diabetol ; 20(1): 19, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33435964

RESUMO

BACKGROUND: The triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance, has been suggested as a contributor of cardiovascular disease. However, evidence on the effect of long-term elevation of the TyG index exposure on myocardial infarction (MI) is limited. The current study aimed to evaluate the association of baseline and long-term elevation of the TyG index exposure with the risk of MI. METHODS: A total of 98,849 participants without MI at baseline (2006) were enrolled from the Kailuan study. The baseline TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The long-term TyG index was characterized in two ways as follows. The updated mean TyG index was calculated as the mean of TyG index at all previous visits before MI occurred or the end of follow-up; alternatively, the TyG index was calculated as the number of visits with a high TyG index in 2006, 2008, and 2010, ranging from 0 (no exposure) to 3 (had high TyG index at all three study visits). Hazard ratio (HR) and 95% confidence interval (CI) was estimated using multivariable Cox proportion hazard models. RESULTS: During a median follow-up of 11.03 years, 1555 incident MI occurred. In the multivariable-adjusted model, the risk of MI increased with quartiles of the baseline and updated mean TyG index, the HR in quartile 4 versus quartile 1 was 2.08 (95% CI,1.77-2.45) and 1.58 (1.18-2.12), respectively. Individuals with a high TyG index at all three visits had a 2.04-fold higher risk (95% CI, 1.63-2.56) of MI compared with no exposure. Subgroup analyses showed that the associations were more pronounced in women than in men (Pinteraction = 0.0411). CONCLUSIONS: Elevated levels of the baseline and long-term TyG index are associated with an increased risk of MI. This finding indicates that the TyG index might be useful in identifying people at high risk of developing MI.

9.
Nutr Metab Cardiovasc Dis ; 31(1): 102-109, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33500102

RESUMO

BACKGROUND AND AIMS: Some studies have reported that metabolic syndrome (MS) and a high inflammatory state are risk factors for atrial fibrillation (AF). However, the combined effect of MS and a high inflammatory state on AF is still unknown. We aimed to investigate the association of MS and high-sensitivity C-reactive protein (hs-CRP) levels with the risk of AF in a large community-based population. METHODS AND RESULTS: A total of 81,092 subjects from the Kailuan Study with electrocardiogram examination and hs-CRP data at baseline (1st examination, 2006-2007) were included in this study. The enrolled population was divided into 4 groups according to the presence or absence of metabolic syndrome and high hs-CRP (>3 mg/L). The follow-up examinations were performed every two years (2nd examination, 2008-2009; 3rd examination, 2010-2011; 4th examination, 2012-2013; 5th examination, 2014-2015). All participants were followed until the occurrence of AF or the date of the last examination. After a mean time of 7.2 ± 2.0 years, a total of 271 individuals developed incident AF. MS or high hs-CRP alone was not associated with incident AF after multivariable adjustment. However, multiple Cox regression analysis showed that subjects with MS and hs-CRP > 3 mg/L had a greater risk for AF than those without MS and with hs-CRP ≤ 3 mg/L (hazard ratio, 1.61; 95% confidence interval 1.08-2.41; P = 0.019). CONCLUSION: MS combined with a high hs-CRP level is associated with an increased risk for AF in the Chinese population. However, the mechanism is unknown and awaits further study. TRIAL REGISTRATION SITE: http://www.chictr.org.cn/index.aspx. REGISTRATION NUMBER: ChiCTR-TNRC-11001489.


Assuntos
Fibrilação Atrial/epidemiologia , Proteína C-Reativa/análise , Inflamação/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/diagnóstico , Biomarcadores/sangue , China/epidemiologia , Feminino , Humanos , Incidência , Inflamação/sangue , Inflamação/diagnóstico , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Regulação para Cima , Adulto Jovem
10.
J Hypertens ; 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33470733

RESUMO

OBJECTIVE: Using the brachial--ankle pulse wave velocity (baPWV) as a biomarker for arteriosclerosis, we studied the effect of blood pressure (BP) and BP control on arteriosclerosis progression. METHODS AND RESULTS: The community-based longitudinal Kailuan study included 6552 participants [4938 (75.37%) men] with a mean follow-up of 4.62 ±â€Š2.21 years. Hypertension was defined based on the Joint National Committee (JNC7) criteria and the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. All study participants had hypertension and were stratified as follows according to BP at baseline and follow-up: the normal--normal [normal BP (under therapy) at baseline and final follow-up], normal--hypertensive, hypertensive--normal, and hypertensive--hypertensive groups. Using the JNC7-based hypertension definition, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group [17.32 cm/s; 95% confidence interval [CI]:9.7--24.9], followed by the normal--hypertensive group (14.44 cm/s; 95% CI:5.5--23.4), and the hypertensive--normal group (0.88 cm/s; 95% CI: -7.84 to 9.60), with the normal--normal group as the reference group in a multivariable model. The model additionally included parameters, such as age, baseline baPWV, heart rate, BMI, serum glucose concentration, prevalence of antihypertensive treatment and alcohol consumption, heart rate, and estimated glomerular filtration rate. Applying the ACC/AHA guidelines and the same multivariable model, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group (43.54 cm/s; 95% CI: 22.54--64.55), followed by the normal--hypertensive group (34.01 cm/s; 95% CI: 10.39--57.62) and the hypertensive--normal group (24.12 cm/s; 95% CI: 1.24--47.00). CONCLUSION: Lower BP and medical reduction in increased BP were associated with a reduction in the baPWV increase and may delay the progression of arteriosclerosis in hypertensive patients.

11.
J Hypertens ; 39(1): 77-83, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32868639

RESUMO

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.

12.
Am J Clin Nutr ; 113(2): 338-347, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33330917

RESUMO

BACKGROUND: Single measurements of waist circumference (WC) predict the incident cardiovascular disease (CVD); however, long-term patterns of WC and their association with the incidence of CVD are poorly characterized. OBJECTIVE: We aimed to identify WC trajectories and determine their association with incident CVD (stroke and myocardial infarction) and examine whether the association persisted among individuals without obesity. METHODS: We included 75,535 participants from a community-based cohort in China who were aged >18 y and free of stroke, coronary artery disease, and cancer in 2010 (the baseline). WC and other covariates were repeatedly measured in 2006, 2008, and 2010. WC trajectories were identified by latent mixture modeling. A Cox proportional hazards model was used to examine the association between WC trajectories and incident CVD, after adjustment for age, sex, income, education, systolic blood pressure, lipid profiles, plasma concentrations of glucose, C-reactive protein, smoking, and alcohol drinking. RESULTS: We identified 4 WC trajectories based on 2006 WC measurement and change patterns during 2006-2010: low stable (n = 12,072; mean WC 74.1-75.1 cm), moderate stable (n = 41,750; mean WC 85.1-86.6 cm), moderate-high stable (n = 19,914; mean WC 95.6-97.2 cm), and high stable (n = 1,799; mean WC 106.3-110.9 cm). During 2010-2016, we documented 2819 incident CVD events. Compared with the low-stable group, groups with elevated WC trajectories had a higher risk of CVD events during 6 y of follow-up (2010-2016). Adjusted HRs (95% CIs) were 1.49 (1.21, 1.83) for the moderate stable group, 1.71(1.38, 2.12) for the moderate-high stable group, and 1.45 (1.06, 2.00) for the high stable group. After further adjusting for BMI or excluding obese participants, we observed similar results. The positive association between WC and incident CVD was higher in individuals who were aged <60 y (P-interaction < 0.0001). CONCLUSIONS: WC trajectory patterns were associated with altered risk of CVD among Chinese adults, even among people without BMI-defined obesity. When stratifying by age, the association was observed to be higher in younger adults.

13.
Stroke ; : STROKEAHA120030433, 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33272125

RESUMO

BACKGROUND AND PURPOSE: We assessed prospectively whether nonalcoholic fatty liver disease (NAFLD) and its severity predict future ischemic stroke (IS) events in a community-based cohort. METHODS: From the Kailuan study, participants free of history of stroke, cancer, or myocardial infarction were enrolled after excluding alcohol abuse and other liver diseases. NAFLD was evaluated through ultrasonography. Participants with NAFLD were further stratified into mild, moderate, and severe groups. The outcome was the first occurrence of IS. The secondary outcomes included myocardial infarction and combined vascular events. We used Cox proportional hazards models to estimate hazard ratios and 95% CIs of incident IS according to presence and severity of NAFLD, adjusting for age, sex, physical activity, body mass index, smoker, history of hypertension, diabetes, hypercholesterolemia, lipid-lowering medication, HDL (high-density lipoprotein), triglyceride, hsCRP (high-sensitivity C-reactive protein), and fasting blood glucose. RESULTS: During a median of 10.34 years of follow-up, we documented 3490 incident stroke cases among 79 905 participants. NAFLD was found in 24 874 (31.18%) participants. Relative to participants without NAFLD at the baseline, those with NAFLD had a 16% higher risk (95% CI, 1.07-1.26) of developing ischemic stroke, after adjusted for confounding variables. The hazard ratios for patients with mild, moderate, and severe NAFLD were 1.15 (95% CI, 1.05-1.25), 1.19 (95% CI, 1.06-1.34), and 1.21 (95% CI, 1.08-1.50), respectively. CONCLUSIONS: The severity of NAFLD is associated with a higher risk of future ischemic stroke events.

14.
Arthritis Rheumatol ; 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33258552

RESUMO

OBJECTIVE: To investigate whether early life exposure to the Great Chinese Famine of 1959-1961 was associated with risk of RA in adulthood. METHODS: Included were 101,510 participants of the Kailuan Study that joined at baseline (2006). RA cases were confirmed by medical record review. We used logistic regression to calculate the odds ratio (OR) and 95% confidence interval (95% CI) for RA, according to famine exposure status (exposed in utero, or between years 0 and 3, years 3 and 6, or at 6 years or older), in comparison to participants born after 1961 (not exposed to famine). RESULTS: During 12 years of follow-up (2006-2018), we identified 187 RA cases. Individuals exposed to famine in utero or during years 0-3, had a higher prevalence of RA, relative to other groups (0.24%-0.35% vs 0.08-0.20%). After adjustment for potential confounders, the OR of RA was 2.95 (95% CI: 1.55, 5.59) for in utero exposed individuals, 4.53 (95% CI: 2.72, 7.54) for those exposed in age 0-3 y, 2.55 (95% CI: 1.43, 4.57) for those exposed in age 3-6 y, and 2.72 (95% CI: 1.70, 4.36) for those exposed after age 6 y versus individuals born after 1961. A similar association was observed for men and women (P-interaction= 0.89). CONCLUSION: Individuals exposed to famine in utero or early childhood (0-3 years), were more likely to suffer from RA in adulthood, highlighting the importance of early life as a vulnerable developmental period.

15.
Eur J Neurol ; 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33263194

RESUMO

BACKGROUND: Epidemiological studies have found that the association between famine exposure and increased risk of cardiovascular disease. However, it is unclear whether fetal exposure to the Great Chinese Famine 1959-1961 was associated with risk of ischemic stroke in midlife. METHODS: A total of 17,787 participants of the Kailuan Study, who were free of cardiovascular disease and cancer at baseline (2006) were enrolled in the study. All participants were divided into three groups: unexposed (born between October 1, 1962 and September 30, 1964, used as the reference group in current analyses), fetal-exposed (born between October 1, 1959 and September 30, 1961), early-childhood-exposed (born between October 1, 1956 and September 30, 1958). Incident ischemic stroke cases between 2006 and 2017 were confirmed by review of medical records. Cox proportional hazards regression was applied to analyze the effect of fetal famine exposure on ischemic stroke risk. RESULTS: During the mean (10.4±2.2) years of follow-up, 547 incident ischemic stroke cases were identified. After adjustment for potential confounders, the hazard ratio (HR) and 95% confidence interval (CI) for ischemic stroke was 1.45 (1.14, 1.84) for fetal famine-exposed compared with unexposed individuals. Similar associations were observed in men (adjusted HR: 1.40; 95% CI: 1.08, 1.80) and individuals with overweight (adjusted HR: 1.56; 95% CI: 1.18, 2.07), but not in their counterparts. The results of the early-childhood-exposed group were similar to the above. CONCLUSIONS: Our findings support an association between fetal malnutrition and higher risk of ischemic stroke in adulthood.

16.
J Hypertens ; 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-33323908

RESUMO

OBJECTIVES: The aim of this study was to investigate the association between neck-to-height ratio (NHR) and arterial stiffness in adults from a community-based Chinese cohort in a cross-sectional study. METHODS: We conducted cross-sectional analysis using data from the Kailuan study, a population-based cohort research. Altogether, 18 972 individuals were included in the analysis. Brachial ankle pulse wave velocity (baPWV), anthropometric indexes and cardiovascular risk factors were recorded. Data were analyzed by multiple lineal regression model. RESULTS: NHR was positively associated with baPWV after adjusted for age, sex, blood pressure, heart rate, BMI, waist-hip ratio, current smoking, fasting blood glucose, serum cholesterol, uric acid, high-sensitivity C reactive protein and creatinine clearance (ß = 5.76, P < 0.001), while the association of neck circumference and baPWV was NS after adjusting the variables mentioned above. In subgroups analysis, the association between NHR and baPWV did not reach statistical significance in female, while in males, the association was significant. Interaction effects were observed among BMI stratifications and the individuals with metabolic syndrome and history of cardiovascular events (P for intereaction = 0.002, 0.038 and 0.003, respectively). CONCLUSION: The current study demonstrated for the first time that NHR was positively associated with baPWV in community-based population, NHR might be a promising independent predictor for cardiovascular disease.

17.
Artigo em Inglês | MEDLINE | ID: mdl-33223407

RESUMO

BACKGROUND AND AIMS: Efficient analysis strategies for complex network with cardiovascular disease (CVD) risk stratification remain lacking. We sought to identify an optimized model to study CVD prognosis using survival conditional inference tree (SCTREE), a machine-learning method. METHODS AND RESULTS: We identified 5379 new onset CVD from 2006 (baseline) to May, 2017 in the Kailuan I study including 101,510 participants (the training dataset). The second cohort composing 1,287 CVD survivors was used to validate the algorithm (the Kailuan II study, n = 57,511). All variables (e.g., age, sex, family history of CVD, metabolic risk factors, renal function indexes, heart rate, atrial fibrillation, and high sensitivity C-reactive protein) were measured at baseline and biennially during the follow-up period. Up to December 2017, we documented 1,104 deaths after CVD in the Kailuan I study and 170 deaths in the Kailuan II study. Older age, hyperglycemia and proteinuria were identified by the SCTREE as main predictors of post-CVD mortality. CVD survivors in the high risk group (presence of 2-3 of these top risk factors), had higher mortality risk in the training dataset (hazard ratio (HR): 5.41; 95% confidence Interval (CI): 4.49-6.52) and in the validation dataset (HR: 6.04; 95%CI: 3.59-10.2), than those in the lowest risk group (presence of 0-1 of these factors). CONCLUSION: Older age, hyperglycemia and proteinuria were the main predictors of post-CVD mortality. TRIAL REGISTRATION: ChiCTR-TNRC-11001489.

18.
Public Health Nutr ; : 1-23, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33183388

RESUMO

OBJECTIVE: To assess the association between total alcohol intake, specific alcoholic beverages, and sleep quality in a community-based cohort. DESIGN: A cross-sectional study. SETTING: The Kailuan community, China. PARTICIPANTS: Included were 11,905 participants who were free of a history of cardiovascular diseases, cancer, Parkinson's disease, dementia, and head injury in or prior to 2012. Alcohol consumption (amount and frequency intake) and alcoholic beverage type were collected in 2006 (baseline) and 2012. Participants were grouped into non-, light- (women: 0-0.4 serving/day; men: 0-0.9 serving/day), moderate- (women: 0.5-1.0 serving/day; men: 1.0-2.0 servings/day), and heavy- (women: >1.0 servings/day; men: >2.0 servings/day) drinker. Overall sleep quality was measured in 2012 and included four sleep parameters (insomnia, daytime sleepiness, sleep duration, snoring/obstructive sleep apnea). RESULTS: We observed a dose-response association between higher alcohol consumption in 2006 and worse sleep quality in 2012 (P-trend <0.001), after adjusting for age, sex, social-economic status, smoking status, physical activity, obesity, plasma lipid profiles, diabetes and hypertension. A similar association was observed when alcohol consumption in 2012 was used as exposure. Alcohol was associated with higher odds of having short sleep duration (adjusted odds ratio for heavy- vs. non-drinkers = 1.32; 95% confidence interval: 1.09-1.57), and snoring (adjusted odds ratio for heavy- vs. non-drinkers: 1.38; 95% confidence interval: 1.22-1.57). Consumption of hard liquor, but not beer or wine, was significantly associated with poor sleep quality. CONCLUSIONS: Higher alcohol consumption was associated with poorer sleep quality and higher odds of having snoring and short sleep duration.

19.
BMC Geriatr ; 20(1): 447, 2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33148194

RESUMO

BACKGROUND: Biologic studies have suggested that tea may have neuroprotective activity. However, tea's protective effect on cognitive function is controversial in human epidemiological studies, and no data, including the middle-aged, are available. The objective of this study was to investigate the association of habit, frequency, and types of tea consumption with incident cognitive impairment in middle-aged and older adults. METHODS: Data from the Asymptomatic Polyvascular Abnormalities in Community study were used (aged over 40y). We gathered information on tea consumption, including habit, frequency, and types, via a standardized questionnaire and assessed cognitive function by Mini-Mental State Examination (MMSE) and/or Montreal Cognitive Assessment (MoCA). Three thousand eight hundred sixty-eight and 806 participants were selected in MMSE and MoCA subgroups. Multivariate logistic regression models were utilized to examine associations between tea consumption and cognitive impairment in middle-aged and older participants. RESULTS: In MMSE analyses, after adjustment for potential confounding factors, habitual (odds ratio (OR) 0.47, [95% confidence interval (CI) 0.33-0.68], p < 0.001) and high frequency (p trend < 0.001) of tea intake were associated with a lower risk of cognitive impairment. The risk of cognitive impairment was lower in green tea consumption (OR 0.36, [95% CI 0.22-0.61], p < 0.001) than other types (OR 0.59, [95% CI 0.38-0.91], p = 0.017). In MoCA analyses, we got similar results. CONCLUSIONS: Habitual tea consumption, especially high-frequency and green tea consumption, was significantly associated with a lower prevalence of cognitive impairment in middle-aged and older individuals.

20.
Transl Stroke Res ; 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33089468

RESUMO

The purpose of this study was to investigate the risks of stroke in subjects with metabolically abnormal normal weight (MANW) in China. We recruited 102,037 participants from the Zhejiang Metabolic Syndrome Cohort and the Kailuan cohort. The mean years of follow-up were 9.9 years. General obesity was defined by body mass index (BMI) ≥ 28, overweight by BMI < 28 and ≥ 24, and normal weight by BMI < 24 and ≥ 18.5. Metabolic abnormality was defined as two or more abnormal components (elevated triglycerides, low high-density lipoprotein cholesterol, elevated systolic blood pressure or diastolic blood pressure, or use of antihypertensive drug therapy, elevated fasting plasma glucose, or antidiabetic treatment). A multiple Cox regression model was used to calculate hazard ratio (HR) and its 95% confidence interval (CI), adjusted by potential confounding factors. Overall HR of the risks in two cohorts was calculated by a meta-analysis. Compared with the subjects who were metabolically normal with normal weight (MNNW), the pooled HR for stroke in MANW subjects was 1.82 (95% CI, 1.59-2.07). The risks of stroke in MANW subjects were significantly lower than that in subjects with metabolically abnormal obesity (MAO), but higher than that in those with metabolically normal obesity (MNO) (P < 0.05). These associations remained in the subtypes of cerebral infarction and cerebral hemorrhage. In normal-weight subjects, the HR for stroke was significantly positively correlated with the number of abnormal metabolic components (Ptrend < 0.001). In brief, metabolic abnormality increased the risk of stroke irrespective of obesity status. MANW individuals showed a greater risk of stroke, and this risk was positively correlated with the number of abnormal metabolic components.

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