126
|
Wu L, He Y, Jiang B, Zuo F, Liu Q, Zhang L, Zhou C, Liu M, Chen H, Cheng KK, Chan SSC, Lam TH. Effectiveness of additional follow-up telephone counseling in a smoking cessation clinic in Beijing and predictors of quitting among Chinese male smokers. BMC Public Health 2016; 16:63. [PMID: 26801402 PMCID: PMC4722719 DOI: 10.1186/s12889-016-2718-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 01/08/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND No previous studies have investigated whether additional telephone follow-up counseling sessions after face-to-face counseling can increase quitting in China, and whether this strategy is feasible and effective for promoting smoking cessation is still unclear. METHODS A non-randomized controlled study was conducted in Beijing. We compared the quit rates of one group which received face-to-face counseling (FC) alone (one session of 40 min) to another group which received the same face-to-face counseling plus four follow-up sessions of brief telephone counseling (15-20 min each) at 1 week, 1, 3 and 6 month follow-up (FCF). No smoking cessation medication was provided. From October 2008 to August 2013, Chinese male smokers who sought treatment in a part-time regular smoking cessation clinic of a large general hospital in Beijing were invited to participate in the present study. Eligible male smokers (n = 547) were divided into two groups: FC (n = 149) and FCF (n = 398). Main outcomes were self-reported 7-day point prevalence and 6 month continuous quit rates at 12 month follow-up. RESULTS By intention to treat, at 12 month follow-up, the 7-day point prevalence and 6 month continuous quit rates of FC and FCF were 14.8 % and 26.4 %, and 10.7 % and 19.6 % respectively. The adjusted odds ratios (95 % confidence intervals) of quitting in FCF compared to FC was 2.34 (1.34-4.10) (P = 0.003) and 2.41 (1.28-4.52) (P = 0.006), respectively. Stepwise logistic regression showed that FCF, being married, unemployed and a lower Fagerström score were significant independent predictors of 6 month continuous quitting at 12 month follow-up. CONCLUSIONS Using systematically collected data from real-world practice, our smoking cessation clinic has shown that the additional telephone follow-up counseling sessions doubled the quit rate.
Collapse
|
127
|
Jiang B, He Y, Zuo F, Wu L, Liu QH, Zhang L, Zhou CX, Cheng KK, Chan SSC, Lam TH. Effectiveness of varenicline and counselling for smoking cessation in an observational cohort study in China. BMJ Open 2016; 6:e009381. [PMID: 26739730 PMCID: PMC4716213 DOI: 10.1136/bmjopen-2015-009381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 11/04/2015] [Accepted: 12/14/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of varenicline for smoking cessation in Chinese smokers in a real world cessation clinic practice. DESIGN A prospective observational study. SETTING Beijing, China. PARTICIPANTS A total of 924 smokers (883 men and 41 women) who attended a smoking cessation clinic of a large general hospital were assessed with data from structured questionnaires at baseline and follow-up at 1, 3 and 6 months. Trained physician counsellors provided free individual counselling for all subjects and follow-up interviews with brief counselling. 332 subjects additionally prescribed varenicline according to their own choice were compared with those without varenicline. MAIN OUTCOME MEASURES Primary outcomes were self-reported 7-day point prevalence abstinence rate and 3-month continuous abstinence rate at 6-month follow-up. Secondary outcomes were 7-day point prevalence abstinence rates at 1 and 3-month follow-up, and 1-month continuous abstinence rate at 3-month follow-up. RESULTS By intention-to-treat, the 7-day point prevalence abstinence rate with varenicline and counselling at 6 months was significantly higher than counselling only (37.0% vs 23.1%; OR, 1.75; 95% CI 1.46 to 2.62; p=0.001). The 3-month continuous abstinence rate at 6 months was higher with varenicline (33.1% vs 18.4%; OR, 2.04; 95% CI 1.61 to 2.99; p<0.001). Varenicline also showed better secondary outcomes. CONCLUSIONS Varenicline prescription in the smoking cessation clinic appeared to be effective with doubling of quit rates in Chinese smokers in a real world cessation clinic practice. CLINICAL TRIAL REGISTRATION NCT01935505; Results.
Collapse
|
128
|
Ostovaneh MR, Poustchi H, Hemming K, Marjani H, Pourshams A, Nateghi A, Majed M, Navabakhsh B, Khoshnia M, Jaafari E, Mohammadifard N, Malekzadeh F, Merat S, Sadeghi M, Naemi M, Etemadi A, Thomas GN, Sarrafzadegan N, Cheng KK, Marshall T, Malekzadeh R. Polypill for the prevention of cardiovascular disease (PolyIran): study design and rationale for a pragmatic cluster randomized controlled trial. Eur J Prev Cardiol 2015; 22:1609-17. [PMID: 25230980 PMCID: PMC5836725 DOI: 10.1177/2047487314550803] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 08/20/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND The complexity of treatment regimens, costs and pill burden decrease the medication adherence and contribute to shortfall in cardiovascular preventive drug coverage. The polypill, a fixed dose combination pill of established drugs, is expected to increase adherence and reduce the costs whilst preventing major cardiovascular events (MCVE). DESIGN AND METHODS The PolyIran trial is a pragmatic cluster randomized trial nested within the Golestan Cohort Study (GCS). Subjects were randomized to either non-pharmacological preventive interventions alone (minimal care arm) or together with a polypill (polypill arm) comprising hydrochlorothiazide, aspirin, atorvastatin and either enalapril or valsartan. This study benefits from the infrastructure of the primary health care system in Iran and the interventions are delivered by the local auxiliary health workers (Behvarz) to the participants. The primary outcome of the study is the occurrence of first MCVE within five years defined as non-fatal and fatal myocardial infarction, unstable angina, sudden death, heart failure, coronary artery revascularization procedures, and non-fatal and fatal stroke. TRIAL STATUS From February 2011 to April 2013, 8410 individuals (236 clusters) attended the eligibility assessment. Of those, 3421 in the polypill arm and 3417 in the minimal care arm were eligible. The study is ongoing. CONCLUSION The infrastructure of GCS and the primary health care system in Iran enabled the conduct of this pragmatic large-scale trial. If the polypill strategy proves effective, it may be implemented to prevent cardiovascular disease in developing countries.
Collapse
|
129
|
Zhu XQ, Xu YH, Liao CX, Liu WG, Cheng KK, Chen JX. Differentiating the extent of cartilage repair in rabbit ears using nonlinear optical microscopy. J Microsc 2015; 260:219-26. [PMID: 26366638 DOI: 10.1111/jmi.12288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 06/09/2015] [Indexed: 11/26/2022]
Abstract
Nonlinear optical microscopy (NLOM) was used as a noninvasive and label-free tool to detect and quantify the extent of the cartilage recovery. Two cartilage injury models were established in the outer ears of rabbits that created a different extent of cartilage recovery based on the presence or absence of the perichondrium. High-resolution NLOM images were used to measure cartilage repair, specifically through spectral analysis and image texture. In contrast to a wound lacking a perichondrium, wounds with intact perichondria demonstrated significantly larger TPEF signals from cells and matrix, coarser texture indicating the more deposition of type I collagen. Spectral analysis of cells and matrix can reveal the matrix properties and cell growth. In addition, texture analysis of NLOM images showed significant differences in the distribution of cells and matrix of repaired tissues with or without perichondrium. Specifically, the decay length of autocorrelation coefficient based on TPEF images is 11.2 ± 1.1 in Wound 2 (with perichondrium) and 7.5 ± 2.0 in Wound 1 (without perichondrium), indicating coarser image texture and faster growth of cells in repaired tissues with perichondrium (p < 0.05). Moreover, the decay length of autocorrelation coefficient based on collagen SHG images also showed significant difference between Wound 2 and 1 (16.2 ± 1.2 vs. 12.2 ± 2.1, p < 0.05), indicating coarser image texture and faster deposition of collagen in repaired tissues with perichondrium (Wound 2). These findings suggest that NLOM is an ideal tool for studying cartilage repair, with potential applications in clinical medicine. NLOM can capture macromolecular details and distinguish between different extents of cartilage repair without the need for labelling agents.
Collapse
|
130
|
Cheng KK, Lau S. Spontaneous Oesophageal Intramural Haematoma: an Uncommon Condition in Two Patients. HONG KONG JOURNAL OF RADIOLOGY 2015. [DOI: 10.12809/hkjr1514257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
131
|
Cheng KK, Lam SCH, Cho DHY, Lau S. N-Butyl Cyanoacrylate Embolisation for Acute Arterial Haemorrhage and Pseudoaneurysms in Extracranial Locations. HONG KONG JOURNAL OF RADIOLOGY 2015. [DOI: 10.12809/hkjr1514290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
132
|
Xu L, Jiang CQ, Cheng KK, Au Yeung SLR, Zhang WS, Lam TH, Schooling CM. Alcohol Use and Gamma-Glutamyltransferase Using a Mendelian Randomization Design in the Guangzhou Biobank Cohort Study. PLoS One 2015; 10:e0137790. [PMID: 26356841 PMCID: PMC4565586 DOI: 10.1371/journal.pone.0137790] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/21/2015] [Indexed: 12/11/2022] Open
Abstract
Background Observational studies and small intervention studies suggest alcohol raises gamma-glutamyltransferase (GGT). We used Mendelian randomization to assess the causal effect of alcohol use on GGT in older Chinese people. Methods An instrumental variable (IV) analysis in 2,321 men and 2,757 women aged 50+ years from phase 3 of the Guangzhou Biobank Cohort Study with ALDH2 (rs671) genotyped, alcohol use and GGT available was used to assess the causal effect of alcohol use on GGT. Rs671 was used as an IV and F-statistics was used to test for weak instrument hypothesis. An F-statistic of ≥10 indicates the IV is not weak. Results In men, the F-statistic for rs671 on alcohol use was 70. Using IV analysis alcohol use increased GGT by 10.60 U/L per alcohol unit (10 gram ethanol) per day (95% confidence interval (CI) 6.58 to 14.62). The estimate was lower in observational multivariate regression: 3.48 U/L GGT per alcohol unit per day (95% CI 2.84 to 4.11) adjusted for age, education, physical activity and smoking. In women, rs671 was not associated with alcohol or GGT and the F-statistic was 7 precluding IV analysis. Conclusion In Mendelian randomization, we found confirmative evidence that alcohol use increases GGT among Southern Chinese men. Moreover, we found that the ALDH2 variant rs671 was not associated with GGT among Southern Chinese women who generally consume very low levels of alcohol. Taken together our findings strongly suggest that alcohol increases GGT, although we cannot rule out the possibility that other unknown factors may cause a different relation between alcohol and GGT in other populations.
Collapse
|
133
|
Sun Y, Jiang CQ, Cheng KK, Zhang WS, Leung GM, Lam TH, Schooling CM. Nut Consumption and Cardiovascular Risk in Older Chinese: The Guangzhou Biobank Cohort Study. PLoS One 2015; 10:e0137178. [PMID: 26332759 PMCID: PMC4558011 DOI: 10.1371/journal.pone.0137178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 08/14/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES In Western contexts nut consumption is associated with better health. We examined the associations of nut consumption with cardiovascular disease risk in the non-Western setting of Southern China. METHODS In the Guangzhou Biobank Cohort Study we used multivariable linear regression to examine the associations of baseline nut (mainly peanuts) consumption (none (n = 6688), <3 portions/week (n = 2596) and ≥3 portions/week (n = 2444)) with follow-up assessment of Framingham cardiovascular disease score (excluding smoking) and its components in older Chinese (≥50 years) (follow-up 57.8%). RESULTS Nut consumption was not associated with Framingham score (≥3 portions/week compared to none: 0.02 95% confidence interval (CI) -0.11 to 0.15), systolic blood pressure (-0.66 mmHg 95% CI -1.94, 0.62), diastolic blood pressure (-0.69 mmHg 95% CI -1.44, 0.07), HDL-cholesterol (-0.01 mmol/L 95% CI -0.02, 0.005), LDL-cholesterol (-0.01 mmol/L 95% CI -0.05, 0.02) or fasting glucose (0.04 mmol/L 95% CI -0.02, 0.09), adjusted for baseline values, energy intake, age, sex, phase of recruitment, socio-economic position, lifestyle and baseline health status. CONCLUSIONS Observations concerning the benefits of nut consumption may be contextually specific, perhaps depending on the type of nut consumed.
Collapse
|
134
|
Kitchen MO, Bryan RT, Haworth KE, Emes RD, Luscombe C, Gommersall L, Cheng KK, Zeegers MP, James ND, Devall AJ, Fryer AA, Farrell WE. Methylation of HOXA9 and ISL1 Predicts Patient Outcome in High-Grade Non-Invasive Bladder Cancer. PLoS One 2015; 10:e0137003. [PMID: 26332997 PMCID: PMC4558003 DOI: 10.1371/journal.pone.0137003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/11/2015] [Indexed: 12/28/2022] Open
Abstract
Introduction Inappropriate DNA methylation is frequently associated with human tumour development, and in specific cases, is associated with clinical outcomes. Previous reports of DNA methylation in low/intermediate grade non-muscle invasive bladder cancer (NMIBC) have suggested that specific patterns of DNA methylation may have a role as diagnostic or prognostic biomarkers. In view of the aggressive and clinically unpredictable nature of high-grade (HG) NMIBC, and the current shortage of the preferred treatment option (Bacillus:Calmette-Guerin), novel methylation analyses may similarly reveal biomarkers of disease outcome that could risk-stratify patients and guide clinical management at initial diagnosis. Methods Promoter-associated CpG island methylation was determined in primary tumour tissue of 36 initial presentation high-grade NMIBCs, 12 low/intermediate-grade NMIBCs and 3 normal bladder controls. The genes HOXA9, ISL1, NKX6-2, SPAG6, ZIC1 and ZNF154 were selected for investigation on the basis of previous reports and/or prognostic utility in low/intermediate-grade NMIBC. Methylation was determined by Pyrosequencing of sodium-bisulphite converted DNA, and then correlated with gene expression using RT-qPCR. Methylation was additionally correlated with tumour behaviour, including tumour recurrence and progression to muscle invasive bladder cancer or metastases. Results The ISL1 genes’ promoter-associated island was more frequently methylated in recurrent and progressive high-grade tumours than their non-recurrent counterparts (60.0% vs. 18.2%, p = 0.008). ISL1 and HOXA9 showed significantly higher mean methylation in recurrent and progressive tumours compared to non-recurrent tumours (43.3% vs. 20.9%, p = 0.016 and 34.5% vs 17.6%, p = 0.017, respectively). Concurrent ISL1/HOXA9 methylation in HG-NMIBC reliably predicted tumour recurrence and progression within one year (Positive Predictive Value 91.7%), and was associated with disease-specific mortality (DSM). Conclusions In this study we report methylation differences and similarities between clinical sub-types of high-grade NMIBC. We report the potential ability of methylation biomarkers, at initial diagnosis, to predict tumour recurrence and progression within one year of diagnosis. We found that specific biomarkers reliably predict disease outcome and therefore may help guide patient treatment despite the unpredictable clinical course and heterogeneity of high-grade NMIBC. Further investigation is required, including validation in a larger patient cohort, to confirm the clinical utility of methylation biomarkers in high-grade NMIBC.
Collapse
|
135
|
Au Yeung SL, Jiang C, Long M, Cheng KK, Liu B, Zhang W, Lam TH, Leung GM, Schooling CM. Evaluation of Moderate Alcohol Use With QT Interval and Heart Rate Using Mendelian Randomization Analysis Among Older Southern Chinese Men in the Guangzhou Biobank Cohort Study. Am J Epidemiol 2015; 182:320-7. [PMID: 26153479 DOI: 10.1093/aje/kwv069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/10/2015] [Indexed: 12/22/2022] Open
Abstract
Western observational studies show that moderate alcohol use is associated with lower cardiovascular disease (CVD) risk, but these associations may be confounded by the healthier attributes of moderate users in these settings. Mendelian randomization analysis may help to ascertain the causal effect of moderate alcohol use on specific factors related to CVD and thereby clarify the role of alcohol. We used Mendelian randomization analysis with the aldehyde dehydrogenase 2 gene (ALDH2) as an instrumental variable to examine the association of alcohol units (10 g of ethanol) per day with heart rate-corrected QT interval and heart rate assessed from electrocardiogram among 4,588 older southern Chinese men in the Guangzhou Biobank Cohort Study (2003-2008). The F statistic was 77 for ALDH2 on alcohol use, suggesting little weak-instrument bias. Instrumental variable analysis showed that alcohol units were not associated with the corrected QT interval, with β = 1.04 (95% confidence interval: -0.61, 2.70) milliseconds, but they were associated with increased heart rate, with β = 0.98 (95% confidence interval: 0.04, 1.92) beat per minute. This study suggests that moderate alcohol use in men is not beneficial for heart function via QT interval or heart rate but could be detrimental. Future studies using specific cardiovascular outcomes may elucidate how alcohol affects different aspects of the cardiovascular system and, hence, the overall effects of alcohol on CVD can be estimated.
Collapse
|
136
|
Sun Y, Jiang CQ, Cheng KK, Zhang WS, Leung GM, Lam TH, Schooling CM. Fruit and vegetable consumption and cardiovascular risk factors in older Chinese: the Guangzhou biobank cohort study. PLoS One 2015; 10:e0135380. [PMID: 26258947 PMCID: PMC4530892 DOI: 10.1371/journal.pone.0135380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 07/21/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To examine the adjusted associations of fruit consumption and vegetable consumption with the Framingham score and its components in the non-Western setting of Southern China, considering health status. METHOD Linear regression was used to assess the cross-sectional associations of fruit and vegetable consumption with the Framingham score and its components, among 19,518 older Chinese (≥50 years) from the Guangzhou Biobank Cohort Study in Southern China (2003-2006), and whether these differed by health status. RESULTS The association of fruit consumption with the Framingham score varied by health status (P-value<0.001), but not vegetable consumption (P-value 0.51). Fruit consumption was associated with a lower Framingham score (-0.04 per portions/day, 95% confidence interval (CI) -0.08 to -0.004) among participants in poor health, adjusted for age, sex, recruitment phase, socio-economic position and lifestyle. However, similarly adjusted, fruit consumption was associated with a higher Framingham score (0.05, 95% CI 0.02 to 0.09) among participants in good health, perhaps due to a positive association of fruit consumption with fasting glucose. Similarly adjusted, vegetable consumption was associated with a higher Framingham score (0.03, 95% CI 0.01 to 0.05) among all participants, with no difference by health status. CONCLUSION This large study from a non-western setting found that fruit and vegetable consumption was barely associated with the Framingham score, or major CVD risk factors.
Collapse
|
137
|
Yang S, Jin Y, He Y, Jiang C, Cheng KK, Zhang W, Lam TH. Childhood Passive Smoking Exposure and Age at Menarche in Chinese Women Who Had Never Smoked: The Guangzhou Biobank Cohort Study. PLoS One 2015; 10:e0130429. [PMID: 26186646 PMCID: PMC4506068 DOI: 10.1371/journal.pone.0130429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/07/2015] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE We examined the associations between childhood passive smoking exposure and age at menarche in women who had never smoked in southern China. METHODS Among 30,518 participants in Guangzhou Biobank Cohort Study (GBCS) from 2003-2008, 20,061 women who had never smoked and had complete outcome data were included. Childhood passive smoking exposure was defined as living with 1 or more smokers in the same household during childhood. Data on the number of smokers in the household and frequency of exposure (density and frequency) were also obtained. Age at menarche was measured as a continuous variable. RESULTS 11,379 (56.7%) participants were exposed to passive smoking during childhood. Compared to those with no passive smoking exposure during childhood, those with exposure ≥ 5 days/week had menarche 0.19 year (95% confidence interval (CI): 0.13-0.25) earlier on average. Those exposed to more than two smokers had menarche 0.38 year earlier (95% CI: 0.29-0.47). Childhood exposure was associated with early age at menarche (≤ 13 vs. >13 years), with an adjusted odds ratio of 1.34 (95% CI: 1.21-1.48) for high density, and 1.17 (95% CI: 1.09-1.26) for high frequency of exposure. CONCLUSION Childhood passive smoking exposure was associated with earlier age at menarche, with a dose-response relationship in Chinese women who had never smoked. If causal, the results support the promotion of smoking cessation in families with children, particularly young girls.
Collapse
|
138
|
Xu L, Jiang CQ, Schooling CM, Zhang WS, Cheng KK, Lam TH. Liver enzymes and incident diabetes in China: a prospective analysis of 10 764 participants in the Guangzhou Biobank Cohort Study. J Epidemiol Community Health 2015; 69:1040-4. [PMID: 26139641 DOI: 10.1136/jech-2015-205518] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/08/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Impaired liver function has been shown to be associated with incident diabetes. The independent role of the different liver enzymes, including γ-glutamyltransferase (GGT), alanine transaminase (ALT) and aspartate transaminase (AST), has not been addressed properly, taking into account their high collinearity. We used partial least squares (PLS) regression to identify the contribution of ALT, AST and GGT, which appears causally associated with diabetes as a validation factor, to incident diabetes in a South China population where liver impairment and diabetes are common. METHODS Participants were from the Guangzhou Biobank Cohort Study recruited in 2003-2008, with follow-up re-examination up to the end of 2012. Multivariable generalised linear models and PLS were used to examine the adjusted associations of ALT, AST and GGT with diabetes. Incident diabetes was defined as self-reported diabetes, and/or initiation of hypoglycaemia medication or insulin during follow-up, or fasting glucose ≥7.0 mmol/L, or 2 h oral glucose tolerance test, glucose ≥11.1 mmol/L at follow-up examination. RESULTS In 10 764 Chinese participants aged ≥50 years with no diabetes at baseline, 1228 (11.4%) developed diabetes during the median 4 years of follow-up. Using PLS, the risk for incident diabetes was higher by 18% (95% CI 8% to 27%) per 1 SD increment in log-ALT, and expectedly higher by 36% (95% CI 26% to 52%) for log-GGT, adjusted for age, sex, education, smoking, alcohol, physical activity, waist circumference and body mass index. Similarly adjusted, no association for log-AST (relative risk 0.92, 95% CI 0.85 to 1.01) was found. CONCLUSIONS ALT but not AST was associated with incident diabetes. Further experimental studies are needed to confirm the causal association and clarify the underlying mechanisms.
Collapse
|
139
|
Li B, Adab P, Cheng KK. The role of grandparents in childhood obesity in China - evidence from a mixed methods study. Int J Behav Nutr Phys Act 2015; 12:91. [PMID: 26122955 PMCID: PMC4507318 DOI: 10.1186/s12966-015-0251-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 06/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current literature on the influences of family environment on childhood obesity is predominantly based on western populations and has focused on the role of parents. This study examined the influence of grandparents on the development of obesity among Chinese primary school aged children. METHODS A mixed methods study was conducted in four socioeconomically distinct primary school communities in two cities of southern China. The qualitative study (17 focus groups and four personal interviews) involved parents, grandparents, school staff, and food retailers in the vicinity of the schools (n = 99) and explored perceived causes of childhood obesity. The cross-sectional study examined the association between children's objectively measured weight status and reported health behaviours, and the presence and role of grandparents in the household. It included children from three randomly selected third grade (8 to 10 years) classes from each school (n = 497). RESULTS Grandparents were commonly perceived to contribute to childhood obesity through inappropriate perception (e.g. fat children are healthy and well cared for), knowledge (e.g. obesity related diseases can only happen in adults; the higher the dietary energy/fat content, the more nutritious the food), and behaviour (e.g. overfeeding and indulging through excusing the children from household chores). Conflicting child care beliefs and practices between grandparents and parents, and between grandparents and school teachers, were felt to undermine efforts to promote healthy behaviours in children. In the cross-sectional study, children who were mainly cared for by their grandparents were more likely to be overweight/obese (adjusted OR = 2.03; 95 % CI = 1.19 to 3.47); and to consume more sugar-added drinks and unhealthy snacks (B = 2.13, 95 % CI = 0.87 to 3.40), than children who were mainly cared for by their parents or other adult. Children who lived with two or more grandparents in the household were more likely to be overweight/obese than children who did not live with any grandparent (adjusted OR = 1.72; 95 % CI = 1.00 to 2.94). CONCLUSIONS Involvement of grandparents in childcare is an important factor contributing to childhood obesity in China. Future preventive interventions should include strategies that target grandparents.
Collapse
|
140
|
Adab P, Pallan MJ, Lancashire ER, Hemming K, Frew E, Griffin T, Barrett T, Bhopal R, Cade JE, Daley A, Deeks J, Duda J, Ekelund U, Gill P, McGee E, Parry J, Passmore S, Cheng KK. A cluster-randomised controlled trial to assess the effectiveness and cost-effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6-7 year old children: the WAVES study protocol. BMC Public Health 2015; 15:488. [PMID: 25968599 PMCID: PMC4457211 DOI: 10.1186/s12889-015-1800-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 04/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is some evidence that school-based interventions are effective in preventing childhood obesity. However, longer term outcomes, equity of effects and cost-effectiveness of interventions have not been assessed. The aim of this trial is to assess the clinical and cost-effectiveness of a multi-component intervention programme targeting the school and family environment through primary schools, in preventing obesity in 6-7 year old children, compared to usual practice. METHODS This cluster randomised controlled trial is set in 54 primary schools within the West Midlands, UK, including a multi-ethnic, socioeconomically diverse population of children aged 6-7 years. The 12-month intervention consists of healthy diet and physical activity promotion. These include: activities to increase time spent doing physical activity within the school day, participation in the 'Villa Vitality' programme (a programme that is delivered by an iconic sporting institution (Aston Villa Football Club), which provides interactive learning opportunities for physical activity and healthy eating), healthy cooking skills workshops in school time for parents and children, and provision of information to families signposting local leisure opportunities. The primary (clinical) outcome is the difference in body mass index (BMI) z-scores between arms at 3 and 18 months post-intervention completion. Cost per Quality Adjusted Life Year (QALY) will also be assessed. The sample size estimate (1000 children split across 50 schools at follow-up) is based on 90% power to detect differences in BMI z-score of 0.25 (estimated ICC ≤ 0.04), assuming a correlation between baseline and follow-up BMI z-score of 0.9. Treatment effects will be examined using mixed model ANCOVA. Primary analysis will adjust for baseline BMI z-score, and secondary analysis will adjust for pre-specified baseline school and child level covariates. DISCUSSION The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study is the first trial that will examine the cost-effectiveness and long term outcomes of a childhood obesity prevention programme in a multi-ethnic population, with a sufficient sample size to detect clinically important differences in adiposity. The intervention was developed using the Medical Research Council framework for complex interventions, and outcomes are measured objectively, together with a comprehensive process evaluation. TRIAL REGISTRATION Current Controlled Trials ISRCTN97000586 (registered May 2010).
Collapse
|
141
|
Zhao J, Jiang C, Lam TH, Liu B, Cheng KK, Xu L, Au Yeung SL, Zhang W, Leung GM, Schooling CM. Genetically predicted testosterone and systemic inflammation in men: a separate-sample Mendelian randomization analysis in older Chinese men. PLoS One 2015; 10:e0126442. [PMID: 25950910 PMCID: PMC4423952 DOI: 10.1371/journal.pone.0126442] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 02/17/2015] [Indexed: 02/04/2023] Open
Abstract
Objectives Observationally, testosterone is negatively associated with systemic inflammation, but this association is open to both residual confounding and reverse causality. Large-scale randomized controlled trials (RCTs), assessing exogenous effects, are presently unavailable. We examined the association of endogenous testosterone with well-established systemic inflammatory markers (white blood cell, granulocyte, lymphocyte and high-sensitivity C-reactive protein (hsCRP)) using a separate-sample Mendelian randomization analysis to minimize reverse causality. Methods A genetic prediction rule for serum testosterone was developed in 289 young Chinese men with mean age of 21.0, using selected testosterone-related SNPs (rs10046, rs1008805 and rs1256031). Multivariable linear regression was used to examine the association of genetically predicted serum testosterone with inflammatory markers among 4,212 older Chinese men from the Guangzhou Biobank Cohort Study. Results Genetically predicted testosterone was unrelated to white blood cell count (-0.01 109/L per nmol/L testosterone, 95% confidence interval (CI) -0.05 to 0.04), granulocyte count (-0.02 109/L, 95% CI -0.06 to 0.02), lymphocyte count (0.005 109/L, 95% CI -0.01 to 0.02) and hsCRP (-0.05 mg/L, 95% CI -0.15 to 0.06). Conclusion Our findings did not corroborate any anti-inflammatory effects of testosterone or corresponding potentially protective effects of testosterone on chronic diseases resulting from reduced low-grade systemic inflammation.
Collapse
|
142
|
Bryan RT, Regan HL, Pirrie SJ, Devall AJ, Cheng KK, Zeegers MP, James ND, Knowles MA, Ward DG. Protein shedding in urothelial bladder cancer: prognostic implications of soluble urinary EGFR and EpCAM. Br J Cancer 2015; 112:1052-8. [PMID: 25719831 PMCID: PMC4366887 DOI: 10.1038/bjc.2015.21] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 01/05/2015] [Accepted: 01/12/2015] [Indexed: 12/30/2022] Open
Abstract
Background: Better biomarkers must be found to develop clinically useful urine tests for bladder cancer. Proteomics can be used to identify the proteins released by cancer cell lines and generate candidate markers for developing such tests. Methods: We used shotgun proteomics to identify proteins released into culture media by eight bladder cancer cell lines. These data were compared with protein expression data from the Human Protein Atlas. Epidermal growth factor receptor (EGFR) was identified as a candidate biomarker and measured by ELISA in urine from 60 noncancer control subjects and from 436 patients with bladder cancer and long-term clinical follow-up. Results: Bladder cancer cell lines shed soluble EGFR ectodomain. Soluble EGFR is also detectable in urine and is highly elevated in some patients with high-grade bladder cancer. Urinary EGFR is an independent indicator of poor bladder cancer-specific survival with a hazard ratio of 2.89 (95% CI 1.81–4.62, P<0.001). In multivariable models including both urinary EGFR and EpCAM, both biomarkers are predictive of bladder cancer-specific survival and have prognostic value over and above that provided by standard clinical observations. Conclusions: Measuring urinary EGFR and EpCAM may represent a simple and useful approach for fast-tracking the investigation and treatment of patients with the most aggressive bladder cancers.
Collapse
|
143
|
Jagielski AC, Jiang CQ, Xu L, Taheri S, Zhang WS, Cheng KK, Lam TH, Thomas GN. Glycaemia is associated with cognitive impairment in older adults: the Guangzhou Biobank Cohort Study. Age Ageing 2015; 44:65-71. [PMID: 25005262 DOI: 10.1093/ageing/afu088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population. METHODS the Guangzhou Biobank Cohort Study included 27,971 individuals (50-96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured. RESULTS after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00-1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73-1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI -0.03 to -0.002) and 0.03 in MMSE score (P = 0.114, 95% CI -0.06-0.01). CONCLUSIONS an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range.
Collapse
|
144
|
He JR, Xia HM, Liu Y, Xia XY, Mo WJ, Wang P, Cheng KK, Leung GM, Feng Q, Schooling CM, Qiu X. A new birthweight reference in Guangzhou, southern China, and its comparison with the global reference. Arch Dis Child 2014; 99:1091-7. [PMID: 24962952 DOI: 10.1136/archdischild-2013-305923] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To formulate a new birthweight reference for different gestational ages in Guangzhou, southern China, and compare it with the currently used reference in China and the global reference. DESIGN AND SETTING All singleton live births of more than 26 weeks' gestational age recorded in the Guangzhou Perinatal Health Care and Delivery Surveillance System for the years 2009, 2010 and 2011 (n=510 837) were retrospectively included in the study. In addition, the study sample was supplemented by all singleton live births (n=3538) at gestational ages 26-33 weeks from 2007 and 2008. We used Gaussian mixture models and robust regression to exclude outliers of birth weight and then applied Generalized Additive Models for Location, Scale, and Shape (GAMLSS) to generate smoothed percentile curves separately for gender and parity. RESULTS Of infants defined as small for gestational age (SGA) in the new reference, 15.3-47.7% (depending on gestational age) were considered appropriate for gestational age (AGA) by the currently used reference of China. Of the infants defined as SGA by the new reference, 9.2% with gestational ages 34-36 weeks and 14.3% with 37-41 weeks were considered AGA by the global reference. At the 50th centile line, the new reference curve was similar to that of the global reference for gestational ages 26-33 weeks and above the global reference for 34-40 weeks. CONCLUSIONS The new birthweight reference based on birthweight data for neonates in Guangzhou, China, differs from the reference currently used in China and the global reference, and appears to be more relevant to the local population.
Collapse
|
145
|
Xu L, Jiang CQ, Lam TH, Zhang WS, Cherny SS, Thomas GN, Cheng KK. Sleep duration and memory in the elderly Chinese: longitudinal analysis of the Guangzhou Biobank Cohort Study. Sleep 2014; 37:1737-44. [PMID: 25364069 PMCID: PMC4196057 DOI: 10.5665/sleep.4162] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Previous cross-sectional studies showed that short or long sleep duration was associated with memory impairment (MI), but longitudinal studies are scarce. We examined whether sleep duration was associated with memory decline or development of MI. DESIGN SETTING PARTICIPANTS We conducted a prospective analysis based on the Guangzhou Biobank Cohort Study on 13,888 participants aged 50+ years without MI at baseline and with a follow-up for a mean of 4.1 years. MEASURES AND RESULTS Memory decline was assessed using the Delayed 10-Word Recall Test (DWRT), and in a subset (n = 6,020) with the Mini-Mental State Examination (MMSE). Short and long sleep duration was defined as ≤ 5 hours/day and ≥ 9 hours/day, respectively. Data were analyzed both continuously for memory decline and dichotomously for MI (independently defined as DWRT, < 4; MMSE, < 25). After adjusting for multiple potential confounders, both short and long sleep durations were associated with memory decline using DWRT or MMSE score changes (all P < 0.001). Seven percent (n = 980) developed DWRT-defined MI and 4.0% (n = 194) MMSE-defined MI during the follow-up. Only those with a short (≤ 5 h/day) sleep duration had a significantly increased risk of DWRT-defined MI (odds ratio = 1.53 (95% confidence interval; 1.21-1.93); P < 0.001) relative to normal sleepers (7 h/day). The association remained significant after excluding those with poor self-reported health. No associations were observed with MMSE-defined MI for both long and short sleep durations. CONCLUSIONS This is the largest study to date addressing the association between extremes of sleep duration and memory decline. The observed adverse relationships provide support for an intervention study to examine the potential benefits of normalizing sleep duration in attenuating memory decline.
Collapse
|
146
|
Jordan RE, Adab P, Jowett S, Marsh JL, Riley RD, Enocson A, Miller MR, Cooper BG, Turner AM, Ayres JG, Cheng KK, Jolly K, Stockley RA, Greenfield S, Siebert S, Daley A, Fitzmaurice DA. TargetCOPD: a pragmatic randomised controlled trial of targeted case finding for COPD versus routine practice in primary care: protocol. BMC Pulm Med 2014; 14:157. [PMID: 25280869 PMCID: PMC4271517 DOI: 10.1186/1471-2466-14-157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 09/26/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Many people with clinically significant chronic obstructive pulmonary disease (COPD) remain undiagnosed worldwide. There are a number of small studies which have examined possible methods of case finding through primary care, but no large RCTs that have adequately assessed the most cost-effective approach. METHODS/DESIGN In this study, using a cluster randomised controlled trial (RCT) in 56 general practices in the West Midlands, we plan to investigate the effectiveness and cost-effectiveness of a Targeted approach to case finding for COPD compared with routine practice. Using an individual patient RCT nested in the Targeted arm, we plan also to compare the effectiveness and cost-effectiveness of Active case finding using a postal questionnaire (with supplementary opportunistic questionnaires), and Opportunistic-only case finding during routine surgery consultations.All ever-smoking patients aged 40-79 years, without a current diagnosis of COPD and registered with participating practices will be eligible. Patients in the Targeted arm who report positive respiratory symptoms (chronic cough or phlegm, wheeze or dyspnoea) using a brief questionnaire will be invited for further spirometric assessment to ascertain whether they have COPD or not. Post-bronchodilator spirometry will be conducted to ATS standards using an Easy One spirometer by trained research assistants.The primary outcomes will be new cases of COPD and cost per new case identified, comparing targeted case finding with routine care, and two types of targeted case finding (active versus opportunistic). A multilevel logistic regression model will be used to model the probability of detecting a new case of COPD for each treatment arm, with clustering of patients (by practice and household) accounted for using a multi-level structure.A trial-based analysis will be undertaken using costs and outcomes collected during the trial. Secondary outcomes include the feasibility, efficiency, long-term cost-effectiveness, patient and primary care staff views of each approach. DISCUSSION This will be the largest RCT of its kind, and should inform how best to identify undiagnosed patients with COPD in the UK and other similar healthcare systems. Sensitivity analyses will help local policy-makers decide which sub-groups of the population to target first. TRIAL REGISTRATION Current controlled trials ISRCTN14930255.
Collapse
|
147
|
Sun Y, Jiang CQ, Cheng KK, Zhang WS, Leung GM, Lam TH, Schooling CM. Leg length is associated with lower values of inflammatory markers in older Chinese: The Guangzhou Biobank Cohort Study. Ann Hum Biol 2014; 42:143-9. [PMID: 25007857 DOI: 10.3109/03014460.2014.932009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In developed western populations, longer legs are a biomarker of better childhood conditions and negatively associated with cardiovascular disease risk factors. These associations are less obvious in non-western settings. However, early life is also a key immune system development phase. AIM To examine the associations of height, leg length, sitting height and leg length/sitting height ratio with inflammatory markers (white blood, lymphocyte and granulocyte cell counts and C-reactive protein (CRP)) in a developing population of southern China. SUBJECTS AND METHODS This study used multivariable linear regression to examine the adjusted associations in 30,499 Chinese (50+ years). RESULTS Height z-score was associated with lower white blood, lymphocyte and granulocyte cell counts. Leg length z-score was associated with lower white blood, lymphocyte and granulocyte cell counts and CRP. Sitting height z-score was associated with lower white blood and granulocyte cell counts, but not with lymphocyte cell count or CRP. Leg length/sitting height ratio z-score was associated with lower white blood, lymphocyte and granulocyte cell counts and CRP. CONCLUSION Factors enabling more early growth may also lead to changes in immunity that are associated with reduced CVD risk.
Collapse
|
148
|
Zhong Y, Jiang CQ, Cheng KK, Zhang WS, Liu B, Jin YL, Lam TH, Leung GM, Schooling CM. Height, its components, and coagulability among older Chinese: the Guangzhou biobank cohort study. Am J Hum Biol 2014; 26:603-8. [PMID: 24909113 DOI: 10.1002/ajhb.22568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/21/2014] [Accepted: 05/12/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The causal role of some cardiovascular risk factors, such as HDL cholesterol, has been increasingly challenged and attention is returning to all elements of Virchow's triad, i.e., hypercoagulability (including viscosity) as well as endothelial function and blood flow. We examined the life course origins of coagulability. METHODS We used multivariable linear regression to assess whether childhood influences, proxied by height and its components, were associated with hematocrit (Hct), hemoglobin (HGB), and other hematological parameters in 28,595 older Chinese adults (mean age = 61.8 years) from the Guangzhou Biobank Cohort Study. RESULTS Adjusted for age, sex, and recruitment phase, leg length was negatively associated with platelets (PLT) (-0.83 × 10(9) /l per centimeter (cm), 95% confidence interval (CI) -1.01 to -0.65). Sitting height and height were positively associated with Hct (0.05% per cm, 95% CI 0.04-0.07 for sitting height; 0.02% per cm, 95% CI 0.01-0.02 for height), HGB (0.21 g/l per cm, 95% CI 0.17-0.25; 0.07 g/l per cm, 95% CI 0.04-0.09) and negatively associated with PLT (-1.2 × 10(9) /l per cm, 95% CI -1.4 to -1.0; -0.83 × 10(9) /l per cm, 95% CI -0.95 to -0.70). Further adjustment for potential confounders did little to change the estimates. CONCLUSIONS For the first time we provide anthropometric evidence for the different roles of prepubertal and pubertal influences in relation to Hct and HGB. Whether factors that promote leg growth but reduce growth of sitting height may help to prevent cardiovascular events, via effects on hypercoagulability or viscosity, overall or in specific subgroups, remains to be determined.
Collapse
|
149
|
Au Yeung SL, Jiang C, Cheng KK, Adab P, Lam KB, Liu B, Zhang W, Lam TH, Leung GM, Schooling CM. Aldehyde dehydrogenase 2-a potential genetic risk factor for lung function among southern Chinese: evidence from the Guangzhou Biobank Cohort Study. Ann Epidemiol 2014; 24:606-11. [PMID: 25084704 DOI: 10.1016/j.annepidem.2014.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/26/2014] [Accepted: 05/30/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE In Asia, moderate alcohol users have better lung function. Never users have more inactive aldehyde dehydrogenase 2 (ALDH2) alleles (A) potentially generating confounding because inactive alleles may increase acetaldehyde exposure and reduce lung function. METHODS We examined the association of ALDH2 genotypes with percentage predicted lung function (forced expiratory volume in 1 second; forced vital capacity) for age, sex, and height among 5641 older Chinese using multivariable linear regression. RESULTS ALDH2 genotypes were associated with alcohol use and height but not other attributes. Inactive alleles were inversely associated with lung function (percentage predicted forced expiratory volume in 1 second -1.52%, 95% confidence interval [CI], -2.52% to -0.51% for one inactive allele and -2.05%, 95% CI, -3.85% to -0.26% for two inactive alleles compared with two active alleles; and for percentage predicted forced vital capacity -1.25%, 95% CI -2.15% to -0.35% and -1.65%, 95% CI, -3.25% to -0.04%). The association of moderate use with lung function was attenuated after adjusting for ALDH2, in addition to other potential confounders. CONCLUSIONS Previous findings in Chinese may be confounded by ALDH2. High frequency of inactive ALDH2 alleles in East Asia may exacerbate the effect of environmental acetaldehyde exposure on lung function and potentially on chronic obstructive pulmonary disease.
Collapse
|
150
|
Gui H, Jiang CQ, Cherny SS, Sham PC, Xu L, Liu B, Jin YL, Zhu T, Zhang WS, Thomas GN, Cheng KK, Lam TH. Influence of Alzheimer's disease genes on cognitive decline: the Guangzhou Biobank Cohort Study. Neurobiol Aging 2014; 35:2422.e3-8. [PMID: 24863667 DOI: 10.1016/j.neurobiolaging.2014.04.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 04/02/2014] [Accepted: 04/22/2014] [Indexed: 01/09/2023]
Abstract
Cognitive decline is a reduction in cognitive ability usually associated with aging, and those with more extreme cognitive decline either have or are at risk of progressing to mild cognitive impairment and dementia including Alzheimer's disease (AD). We hypothesized that genetic variants predisposing to AD should be predictive of cognitive decline in elderly individuals. We selected 1325 subjects with extreme cognitive decline and 1083 well-matched control subjects from the Guangzhou Biobank Cohort Study in which more than 30,000 southern Chinese older people have been recruited and followed up. Thirty single-nucleotide polymorphisms in 29 AD-associated genes were genotyped. No statistically significant allelic associations with cognitive decline were found by individual variant analysis. At the level of genotypic association, we confirmed that the APOE ε4 homozygote significantly accelerated cognitive decline and found that carriers of the ACE rs1800764_C allele were more likely to show cognitive decline than noncarriers, particularly in those without college education. However, these effects do not survive after multiple testing corrections, and together they only explain 1.7% of the phenotypic variance in cognitive score change. This study suggests that AD risk variants and/or genes are not powerful predictors of cognitive decline in our Chinese sample.
Collapse
|