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Li Q, Wang P, Ma R, Guo X, Sun Y, Zhang X. A novel criterion of metabolically healthy obesity could effectively identify individuals with low cardiovascular risk among Chinese cohort. Front Endocrinol (Lausanne) 2023; 14:1140472. [PMID: 37334301 PMCID: PMC10273263 DOI: 10.3389/fendo.2023.1140472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023] Open
Abstract
Background and objective Obesity has become a serious public health problem and brings a heavy burden of cardiovascular disease. Metabolically healthy obesity (MHO) is defined as individuals with obesity with no or only minor metabolic complications. Whether individuals with MHO have a lower cardiovascular risk remains controversial. In this study, a new criterion was used to define MHO and assess its predictive value for cardiovascular events and death. At the same time, the new criterion and the traditional criterion are compared to analyze the differences between different diagnostic criteria. Methods A prospective cohort was established in northeast rural China from 2012 to 2013. Follow-up was conducted in 2015 and 2018 to investigate the incidence of cardiovascular events and survival. Subjects were grouped according to the metabolic health and obesity status. Kaplan-Meier curves were drawn to describe the cumulative risk of endpoint events in the four groups. Cox regression analysis model was constructed to evaluate the risk of endpoint events. Analysis of variance and post hoc analyses were used to calculate and compare differences in metabolic markers between MHO subjects diagnosed by novel and traditional criteria. Results A total of 9345 participants 35 years of age or older without a history of cardiovascular disease were included in this study. After a median follow-up of 4.66 years, the data showed that participants in the MHO group had no significant increase in the risk of composite cardiovascular events and stroke, but had a 162% increase in the risk of coronary heart disease (HR: 2.62; 95%CI: 1.21-5.67). However, when using conventional criteria for metabolic health, mMHO group had a 52% increase in combined CVD risk (HR: 1.52; 95%CI: 1.14-2.03). By comparing the differences of metabolic indicators between MHO subjects diagnosed by the two criteria, MHO subjects diagnosed by the new criterion had higher WC, WHR, TG, FPG, and lower HDL-C levels except for lower blood pressure, showing more exposure to cardiovascular risk factors. Conclusions The risk of combined CVD and stroke was not increased in MHO subjects. The new metabolic health criterion is superior to the traditional criterion and can effectively identify individuals with obesity with a lower risk of combined CVD. Blood pressure levels may be responsible for the inconsistent risk of combined CVD in MHO subjects diagnosed with both criteria.
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Influence of Snoring on the Incidence of Metabolic Syndrome: A Community-Based Prospective Cohort Study in Rural Northeast China. J Clin Med 2023; 12:jcm12020447. [PMID: 36675375 PMCID: PMC9866208 DOI: 10.3390/jcm12020447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/08/2023] Open
Abstract
In recent years, there has been an increase in the incidence of metabolic syndrome (MetS) in rural China. Thus, for better intervention, it is necessary to identify the possible risk factors of MetS. This community-based prospective cohort study was performed to evaluate the relationship between the snoring status and incidence of MetS. In this Northeast China rural cardiovascular health study, 4980 residents aged ≥35 years (2586 men and 2394 women; follow-up proportion: 87.5%) at baseline were recruited between 2012 and 2013 and were followed up between 2015 and 2017. The primary outcome was the incidence of MetS, as defined by the unified criteria for MetS defined in 2009. The residents were classified based on their snoring status, and the outcomes were compared between the two groups. The odds ratio (OR) for MetS incidence was estimated using a logistic regression model and adjusted for confounding factors. With a median follow-up duration of 4.6 years, the MetS incidence was higher among the snorers (men, 26.2%; women, 33.5%) than in the non-snorers (men, 19.7%; women, 23.2%). The participants' diastolic blood pressure was increased at follow-up as compared with the baseline values among the male snorers; however, a decrease was noted among the male non-snorers. Similarly, the female snorers had higher blood glucose levels during the follow-up, whereas the non-snorers had lower blood sugar levels. A significant association was noted between snoring and the incidence of MetS (adjusted OR = 1.51; 95% confidence interval = 1.32-1.74). Moreover, the incidence of severe snoring increased with increased levels of snoring, with severe snorers having an OR twice as high as that of the non-snorers (adjusted OR = 2.10; 95% confidence interval = 1.38-3.20). Overall, snoring was independently associated with a higher incidence of newly diagnosed MetS in rural Northeast China. Thus, more attention should be paid to residents with snoring problems.
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Shi M, Kelly TN, Zhu Z, Li C, Shen C, Sun Y, Wang A, Shan G, Bu X, Guo D, Zhao J, Xu T, Peng H, Xu T, Zhong C, Sun X, Chen J, Zhang Y, He J. Large-Scale Targeted Sequencing Study of Ischemic Stroke in the Han Chinese Population. J Am Heart Assoc 2022; 11:e025245. [PMID: 36193932 PMCID: PMC9673712 DOI: 10.1161/jaha.122.025245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Ischemic stroke is likely caused by interactions of multiple genes and environmental determinants. However, large‐scale sequencing studies to discern functional genetic variants and their interactions with clinical and lifestyle risk factors on ischemic stroke are limited. Methods and Results We sequenced functional regions of 740 previously identified genes associated with atherosclerotic disease among 999 ischemic stroke cases and 1001 controls of Chinese ancestry. Multiple logistic regression models were used to examine the associations between variants and ischemic stroke and test interactions between variants and clinical and lifestyle risk factors. Functional variants achieving suggestive significance were replicated in an independent sample of 4724 ischemic stroke cases and 5029 controls. Driven by variant main effects, each minor allele of the correlated rs174535, rs174545, and rs3834458 variants at MYRF‐FADS1‐FADS2 conferred an average 0.83‐fold (95% CI, 0.78–0.88) decreased odds of stroke. Significant main effects of MTHFR rs1801133 missense variant were also observed, with each copy of the A allele associated with a 1.20‐fold (95% CI, 1.13–1.27) higher odds of ischemic stroke. The functional ALDH2 rs671 variant was identified in interaction analyses with alcohol drinking (Meta‐P=3.39×10−17). Each minor allele conferred a 0.54‐fold (95% CI, 0.45–0.64) decreased odds of stroke among drinkers and a 0.89‐fold (95% CI, 0.83–0.97) decreased odds among nondrinkers. Conclusions Significant associations at MYRF‐FADS1‐FADS2 indicate that genetically elevated polyunsaturated fatty acids may decrease ischemic stroke risk in East Asians. Significant associations at MTHFR and ALDH2 robustly confirm deleterious effects of genetically elevated homocysteine and alcohol intake, respectively, on ischemic stroke.
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Affiliation(s)
- Mengyao Shi
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA.,Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Tanika N Kelly
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA.,Tulane University Translational Science Institute New Orleans LA
| | - Zhengbao Zhu
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Changwei Li
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA
| | - Chong Shen
- Department of Epidemiology, School of Public Health Nanjing Medical University Nanjing China
| | - Yingxian Sun
- Department of Cardiology the First Affiliated Hospital of China Medical University Shenyang China
| | - Aili Wang
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Guangliang Shan
- Department of Epidemiology, School of Basic Medicine Peking Union Medical College Beijing China
| | - Xiaoqing Bu
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China.,Department of Epidemiology, School of Public Health and Management Chongqing Medical University Chongqing China
| | - Daoxia Guo
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Jingbo Zhao
- Department of Epidemiology, School of Public Health Harbin Medical University Harbin China
| | - Tan Xu
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Hao Peng
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Tian Xu
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China.,Department of Neurology Affiliated Hospital of Nantong University Nantong China
| | - Chongke Zhong
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Xiao Sun
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA
| | - Jing Chen
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA.,Tulane University Translational Science Institute New Orleans LA
| | - Yonghong Zhang
- Department of Epidemiology School of Public Health, and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou China
| | - Jiang He
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA.,Tulane University Translational Science Institute New Orleans LA
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Yu S, Guo X, Li G, Yang H, Zheng L, Sun Y. Low educational status correlates with a high incidence of mortality among hypertensive subjects from Northeast Rural China. Front Public Health 2022; 10:951930. [PMID: 36091501 PMCID: PMC9453591 DOI: 10.3389/fpubh.2022.951930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/08/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Cumulative evidence indicates that education plays a major role in predicting cardiovascular risk factors. In this study, we intend to examine the possible relationship between education status and mortality in a large general subject from rural China. Methods Adult hypertensive subjects (n = 5,227, age = 57.22 ± 10.18 years; 49.1% men) were recruited from general population surveys (Northeast China Rural Cardiovascular Health Study). Their educational status was categorized into two groups as follows: (1) Low education (illiterate or lower than primary school) and (2) medium-high education (higher than primary school). Cardiometabolic comorbidities, related cardiovascular risk factors, and echocardiographic measurements were analyzed in both groups. Results Less educated hypertensive subjects had significantly higher prevalence of obesity, diabetes, dyslipidemia, and left ventricular hypertrophy than medium-high educated hypertensive subjects. In the medium-high educated subjects, a significant increase in left ventricular ejection fraction and lower rate of antihypertensive medication was found. Cox proportional hazards analysis indicated that medium-high education was independently associated with all-cause mortality (hazard ratio = 0.76; 95% confidence interval, 0.58, 0.99; P = 0.043) and cardiovascular mortality (hazard ratio = 0.65; 95% confidence interval, 0.44, 0.96; P = 0.028). Conclusion Education may act as the best predictor of all-cause and cardiovascular mortality in rural hypertensive subjects. This finding suggests that in rural areas, education is likely to represent a cardiovascular specific risk factor and should be evaluated in the strategies of hypertension.
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Affiliation(s)
- Shasha Yu
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China
| | - GuangXiao Li
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, First Hospital of China Medical University, Shenyang, China
| | - Hongmei Yang
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yingxian Sun
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China,*Correspondence: Yingxian Sun
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Zheng L, Xie Y, Sun Z, Zhang R, Ma Y, Xu J, Zheng J, Xu Q, Li Z, Guo X, Sun G, Xing F, Sun Y, Wen D. Serum Spermidine in Relation to Risk of Stroke: A Multilevel Study. Front Nutr 2022; 9:843616. [PMID: 35464025 PMCID: PMC9021784 DOI: 10.3389/fnut.2022.843616] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/28/2022] [Indexed: 12/29/2022] Open
Abstract
The relationship between serum spermidine levels and future cardiovascular disease risk has not yet been well elucidated in the general population based on community studies. Using a nested case-control study, we estimated the association between serum spermidine level and future stroke. New stroke cases had higher baseline levels of spermidine than controls [182.8 (141.8–231.5) vs. 152.0 (124.3–193.0), P < 0.001]. After multivariable adjustment, individuals with spermidine ≥ 205.9 nmol/L (T3) higher risks of stroke (HR 5.02, 95% CI 1.58–16.02) with the lowest quartile (< 136.9 nmol/L) as reference. The association between serum spermidine levels and risk of stroke seemed to be consistent and was reproducible in our cross-sectional studies. In addition, comparisons of the areas under receiver operator characteristics curves confirmed that a model including spermidine had better discrimination than without (0.755 vs. 0.715, P = 0.04). Here we report a close relationship exists between serum spermidine levels and risk of stroke.
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Affiliation(s)
- Liqiang Zheng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Liqiang Zheng,
| | - Yanxia Xie
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Rui Zhang
- College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Jiahui Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qianyi Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao Li
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Guozhe Sun
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fuguo Xing
- Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Yingxian Sun
- Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, China
- Yingxian Sun,
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, China
- Deliang Wen,
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Li Q, Wang P, Li G, Chang Y, Guo X, Sun Y, Zhang X. Using the changes of several simple anthropometric indices to predict the occurrence of metabolic syndrome: Findings from medically under-resourced communities in rural China. Front Endocrinol (Lausanne) 2022; 13:1014541. [PMID: 36325456 PMCID: PMC9618802 DOI: 10.3389/fendo.2022.1014541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Various anthropometric indices have been proved to be useful to predict metabolic syndrome(MetS), but the association between changes in anthropometric indices and the onset of MetS is unclear. This study selected six indices that are easy to measure and calculate in daily life and evaluated the relationships. METHODS We established a prospective cohort in rural China during 2012-2013 and involved 5,221 participants without MetS. The follow-up visit was conducted in 2015 to repeat anthropometric indices measurements and assess MetS onset. Binary logistic regression model was used to calculate the association between changes in anthropometric indices and MetS onset. Receiver operating characteristic (ROC) curve was drawn to compare their abilities in MetS prediction. RESULTS Over a median follow-up time of 2.42 years, 1,367 participants (26.2%) developed MetS. The increase in all the six indices is associated with an increased risk of MetS. Changes in WC and WHtR are the strongest predictors, with a 5 cm increase in WC and a 0.025 increase in WHtR giving the best prediction of MetS onset. CONCLUSIONS People should be aware of changes in these six anthropometric indices in daily life, as their increase is closely related to an increased risk of MetS, especially WC and WHtR. We recommend an increase of 5 cm in WC and 0.025 in WHtR as the optimal cut-off for the MetS prediction.
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Affiliation(s)
- Qiyu Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Pengbo Wang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Guangxiao Li
- Department of Medical Record Management, The First Hospital of China Medical University, Shenyang, China
| | - Ye Chang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Xingang Zhang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Xingang Zhang,
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Wang P, Li Q, Guo X, Zhou Y, Li Z, Yang H, Yu S, Sun G, Zheng L, Sun Y, Zhang X. Usefulness of metabolic score for insulin resistance index in estimating the risk of mildly reduced estimate glomerular filtration rate: a cross-sectional study of rural population in China. BMJ Open 2021; 11:e050907. [PMID: 34916312 PMCID: PMC8679137 DOI: 10.1136/bmjopen-2021-050907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES This study aimed to reveal the association between metabolic score for insulin resistance (MetS-IR) and the risk of mildly decreased estimated glomerular filtration rate (eGFR), and explore the evaluation effect of MetS-IR on the progress of eGFR decline. STUDY DESIGN A cross-sectional study. SETTING AND PARTICIPANTS A total of 11 956 rural participants (aged ≥35 years) from northeastern China were enrolled in the study. After excluding the subjects whose data were not integrated or who met the exclusion criteria, we finally obtained 11 042 participants in the present study. MAIN OUTCOME MEASURES Mildly decreased eGFR was defined as 60-90 mL/min/1.73 m2. RESULTS The prevalence of mildly decreased eGFR in the general population was 36.9%. After adjustment of covariates, each SD increment of MetS-IR could bring 26.3% additional risk of mildly decreased eGFR (OR: 1.263, 95% CI: 1.066 to 1.497, p=0.007). When MetS-IR was classified into four levels by quartile, we observed participants in the top level had 3.032-fold risk of mildly decreased eGFR (OR: 3.032, 95% CI: 1.841 to 4.991, p<0.001) compared with those from the bottom level. Further, we found the participants with higher MetS-IR score were more likely to aggravate into a worse renal state which presented as higher risk of accelerated decline of eGFR, by additional 28.3% risk in whole participants (OR: 1.283, 95% CI: 1.150 to 1.430, p<0.001) and 41.9% in men (OR: 1.419, 95% CI: 1.183 to 1.701, p<0.001). CONCLUSION High MetS-IR was associated with high risk of mildly reduced eGFR and often accompanied by a high risk of accelerated decline in eGFR. Hence, we believed MetS-IR was a suitable indicator to evaluate the risk of early-stage renal dysfunction.
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Affiliation(s)
- Pengbo Wang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qiyu Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ying Zhou
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xingang Zhang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Yu S, Guo X, Li G, Yang H, Zheng L, Sun Y. Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China. BMC Geriatr 2021; 21:505. [PMID: 34563137 PMCID: PMC8464148 DOI: 10.1186/s12877-021-02393-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to estimate whether metabolic syndrome (MetS) and its components could be used to predict cardiovascular disease (CVD) in a longitudinal analysis in a rural elderly Chinese population. METHOD At baseline during 2012-2013, a total of 2486 elderly from rural Chinese were enrolled and were followed up during 2015-2017. Stroke and coronary heart disease (CHD) were included in CVD and were diagnosed by clinicians. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) criteria were used to define MetS separately. RESULT Hazard ratios adjusting for CHD, stroke and CVD in those with MetS using the NCEP ATP III criteria in females were 1.27 (95 % CI 0.73, 2.21), 1.54 (95 % CI 0.99, 2.40) and 1.45 (95 % CI 1.00, 2.10), respectively; 1.33 (95 % CI 0.77, 2.32), 1.44 (95 % CI 0.92, 2.25) and 1.36 (95 % CI 0.94, 1.97), respectively, with the AHA/NHLBI criteria; and 1.10 (95 % CI 0.89,1.36), 1.62 (95 % CI 1.03, 2.55) and 1.36 (95 % CI 0.93, 1.97), respectively, with the IDF criteria. Additionally, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95 % CI 1.01, 2.52). However, among rural elderly males, neither MetS nor its components predicted new-onset CVD. CONCLUSIONS MetS is correlated with high incidence of CVD among rural elderly female, and only using the NCEP ATP III criteria to define MetS could make the incidence of CVD obvious difference. In order to reduce rural elderly CVD, effective measures to prevent, diagnose, and treat MetS should be enacted in a timely manner, especially among females.
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Affiliation(s)
- Shasha Yu
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, China
| | - GuangXiao Li
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, First Hospital of China Medical University, 110001, Shenyang, China
| | - Hongmei Yang
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, 110004, Shenyang, China
| | - Yingxian Sun
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, 110001, Shenyang, China.
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Li G, Li T, Chen Y, Guo X, Li Z, Zhou Y, Yang H, Yu S, Sun G, Zheng L, Sun Y. Associations between aortic regurgitation severity and risk of incident myocardial infarction and stroke among patients with degenerative aortic valve disease: insights from a large Chinese population-based cohort study. BMJ Open 2021; 11:e046824. [PMID: 34446485 PMCID: PMC8395354 DOI: 10.1136/bmjopen-2020-046824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Few studies have explored whether the risk of myocardial infarction (MI) or stroke varies among patients with degenerative aortic valve disease (DAVD) with different severity of aortic regurgitation (AR) or not. Thus, a prospective study was conducted to elucidate the causal relationship between AR severity and risk of incident MI and stroke among patients with DAVD recruited from a general population in Northeast China. DESIGN Prospective cohort study. SETTING Community-based study carried out in rural areas of Northeast China. METHODS There were 3675 patients with DAVD aged ≥45 years eligible for the prospective study. During a median follow-up time of 4.64 years, 99 participants lost to follow-up. Cox regression analyses were used to investigate the association between baseline AR severity and the risk of incident MI or stroke. RESULTS In the final cohort of 3576 patients with DAVD, there were 3153 patients without AR (88.2%), 386 patients with mild AR (10.8%) and 37 patients with moderate or severe AR (1.0%). Multivariate analyses showed that, compared with participants without AR, those with moderate/severe AR were associated with 8.33 and 6.22-fold increased risk of MI and MI mortality, respectively. However, no significant associations between AR and the risk of stroke or stroke mortality were observed. CONCLUSIONS As compared with no AR, moderate/severe AR but not mild AR was an independent predictor for the risk of MI and MI mortality. AR was not significantly associated with stroke or stroke mortality, irrespective of AR severity. Secondary prevention strategies should be taken to delay the progression of DAVD and thus reduce the incidence of MI.
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Affiliation(s)
- Guangxiao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
- Department of Medical Record Management Center, The First Hospital of China Medical University, Shenyang, China
| | - Tan Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Yanli Chen
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Ying Zhou
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
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Guo X, Li Z, Zhou Y, Yu S, Yang H, Sun G, Zheng L, Lee BK, Pletcher MJ, Sun Y. Corrected QT Interval Is Associated With Stroke but Not Coronary Heart Disease: Insights From a General Chinese Population. Front Cardiovasc Med 2021; 8:605774. [PMID: 34368239 PMCID: PMC8333696 DOI: 10.3389/fcvm.2021.605774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Prolonged heart rate-corrected QT (QTc) interval has been associated with incident cardiovascular diseases (CVD) in general Western populations. However, this association is unclear in Asian population. We aim to estimate the association between QTc interval and incident CVD in a general Chinese population. Methods: We analyzed 8,867 participants age ≥35 years and free of CVD at baseline in the Northeast China Rural Cardiovascular Health Study. A resting 12-lead electrocardiogram was performed on all participants, and QTc interval computed using the Framingham formula. Cox proportional hazards models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for associations between QTc interval and incident stroke, coronary heart disease, and combined CVD events. Results: Over a median follow-up of 4.66 years, a total of 439 CVD events occurred (298 stroke cases and 152 CHD cases). After full adjustment, prolonged QTc defined by a sex-specific cutoff was associated with increased risk of developing stroke (HR: 1.82, 95% CI 1.20–2.75, P = 0.004) and combined CVD (HR: 1.52, 95% CI 1.05–2.19, P = 0.026). Spline analyses demonstrated no clear thresholds; when modeled as a linear relationship, each 10 ms increase of QTc interval was associated with an HR of 1.12 (95% CI 1.06–1.19, P < 0.001) for stroke and an HR of 1.10 (95% CI 1.05–1.15, P < 0.001) for combined CVD. Baseline QTc interval was not associated with incident CHD with either modeling strategy. Conclusions: Baseline QTc interval is associated with incident stroke and CVD in adults without prior CVD from a general Chinese population.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Ying Zhou
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, China
| | - Byron K Lee
- Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
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Li T, Li G, Guo X, Li Z, Sun Y. Echocardiographic left ventricular geometry profiles for prediction of stroke, coronary heart disease and all-cause mortality in the Chinese community: a rural cohort population study. BMC Cardiovasc Disord 2021; 21:238. [PMID: 33980151 PMCID: PMC8114526 DOI: 10.1186/s12872-021-02055-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/07/2021] [Indexed: 01/19/2023] Open
Abstract
Background The utility of echocardiographic left ventricular (LV) geometry in the prediction of stroke/coronary heart disease (CHD) and all-cause mortality is not well characterized. This study aimed to evaluate the overall and sex-specific prognostic value of different geometric patterns on the incidence of stroke/CHD and all-cause mortality in a Chinese population-based cohort. Methods We conducted a prospective study in the general population in Northeast China, and a total of 9940 participants aged ≥ 35 years underwent echocardiography for LV geometry and were successfully followed up for incident stroke/CHD and all-cause death. Cox proportional hazards models were utilized to estimate the association of baseline LV geometry with adverse outcomes. Results Over a median follow-up of 4.66 years, abnormal LV geometric patterns had increased crude incident rates of stroke/CHD and all-cause mortality compared with normal geometry in overall population and each sex group (all P < 0.05). Multivariable Cox analysis reported that LV concentric and eccentric hypertrophy were associated with incident stroke/CHD (concentric hypertrophy: hazard ratio (HR) = 1.39, 95% confidence interval (CI) = 1.04–1.86; eccentric hypertrophy: HR = 1.42, 95% CI = 1.11–1.82) and all-cause mortality (concentric hypertrophy: HR = 1.50, 95% CI = 1.07–2.12; eccentric hypertrophy: HR = 1.58, 95% CI = 1.19–2.10), and LV concentric remodeling was related to stroke/CHD incidence (HR = 1.42, 95% CI = 1.09–1.84) in total population compared to normal geometry after the adjustment for potential confounders. In men, a significant increase was observed from LV eccentric hypertrophy for incident stroke/CHD, whereas in women, LV concentric hypertrophy was associated with elevated incidence of both stroke/CHD and all-cause death, and eccentric hypertrophy was correlated with increased all-cause mortality (all P < 0.05). Conclusions Our prospective cohort supports that abnormal LV geometry by echocardiography has a prognostic significance for incident stroke/CHD and all-cause mortality, implying that early detection and intervention of LV structural remodeling in rural China are urgently needed to prevent adverse outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02055-w.
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Affiliation(s)
- Tan Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Guangxiao Li
- Department of Medical Record Management Center, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, No.155 Nanjing Bei Street, Heping District, Shenyang, 110001, Liaoning Province, People's Republic of China.
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Li T, Li G, Guo X, Li Z, Yang J, Sun Y. Predictive value of echocardiographic left atrial size for incident stoke and stroke cause mortality: a population-based study. BMJ Open 2021; 11:e043595. [PMID: 33822739 PMCID: PMC7942247 DOI: 10.1136/bmjopen-2020-043595] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate the associations between echocardiographic left atrial (LA) size and incident stoke and stroke cause mortality among a rural population in China. DESIGN A prospective study. SETTING AND PARTICIPANTS Based on the Northeast China Rural Cardiovascular Health Study, we selected a total of 10 041 participants aged ≥35 years who agreed to have transthoracic echocardiography at baseline and were successfully followed up for incident stoke and stroke cause mortality. PRIMARY OUTCOME MEASURE The outcomes were stroke and stroke cause death according to medical records and death certificates during the follow-up period. RESULTS LA enlargement (LAE) group had a higher prevalence of cardiovascular disease than normal LA diameter (LAD) group. After excluding individuals who had a prior stroke, subjects with LAE showed higher incident rates of stroke and its mortality in the overall and specific stratified analyses (all p<0.05). Kaplan-Meier analysis revealed that LAE could predict stroke incidence and stroke-free survival, but the association was no longer observed after the adjustment for potential confounding factors. Cox regression analysis reported that per 1 SD increment in LAD and LAD/body surface area (BSA) was associated with an increased incidence of stroke (LAD: HR=1.20, 95% CI 1.08 to 1.33, p<0.001; LAD/BSA: HR=1.22, 95% CI 1.11 to 1.35, p<0.001) and stroke cause mortality (LAD: HR=1.27, 95% CI 1.08 to 1.50, p<0.01; LAD/BSA: HR=1.41, 95% CI 1.20 to 1.65, p<0.001) in the total population, and similar trends were found in both genders (all p<0.05). LAD or LAD/BSA was related to ischaemic and haemorrhagic stroke incidence, and the risk of ischaemic and haemorrhagic stroke mortality (all p<0.05). The dose-response curves further suggested linear associations between LAD, LAD/BSA and the incidence of stroke and subsequent mortality in the general population (all p<0.05). CONCLUSIONS Our population-based study implied that LA size, especially LAD and LAD/BSA, might be useful echocardiographic biomarkers that had the potential to predict incident stroke and stroke cause mortality.
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Affiliation(s)
- Tan Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Guangxiao Li
- Department of Medical Record Management Center, The First Hospital of China Medical University, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
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Guo X, Li Z, Zhou Y, Yu S, Yang H, Sun G, Zheng L, Afzal J, Liu Y, Sun Y. The effects of transitions in metabolic health and obesity status on incident cardiovascular disease: Insights from a general Chinese population. Eur J Prev Cardiol 2020; 28:1250-1258. [PMID: 34551085 DOI: 10.1177/2047487320935550] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/29/2020] [Indexed: 12/29/2022]
Abstract
Abstract
Background
Recent studies have investigated the association of transitions in metabolic health and obesity status over time with the risk of cardiovascular disease, focusing on the subgroup demonstrating metabolically healthy obesity. However, these studies have produced inconsistent results. This study evaluates the relation in a general Chinese population.
Methods
We conducted a prospective cohort study in a general population in Northeast China, with examinations of cardiovascular health from 2012–2015 and follow-up for incident cardiovascular disease until 2018. Cox proportional hazards and logistic regression models were used to investigate the association of baseline metabolic health and obesity status and transitions in those statuses with cardiovascular disease risk.
Results
A total of 7472 participants aged ≥35 years who were free of cardiovascular disease at baseline were included in this analysis. Over a median follow-up of 4.66 years, a total of 344 cardiovascular disease events occurred. Among the 3380 participants who were obese at baseline, 37.1% were metabolically healthy. Metabolically healthy obesity was associated with a 48% increased risk of cardiovascular disease (hazard ratio: 1.48; 95% confidence interval: 1.07–2.06) compared with the metabolically healthy non-obese group at baseline. Transition from metabolically healthy obesity to metabolically unhealthy obesity was associated with elevated cardiovascular disease risk with an odds ratio of 1.82 (95% confidence interval: 1.06–3.14) compared with metabolically healthy non-obesity throughout after adjustment. Even maintaining metabolically healthy obesity over time was associated with a higher risk of cardiovascular disease (odds ratio: 1.72; 95% confidence interval: 1.00–2.97).
Conclusions
Weight control and management of existing metabolic disorders should be prioritized in all obese population.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, China
| | - Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, China
| | - Ying Zhou
- Department of Cardiology, The First Hospital of China Medical University, China
| | - Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, China
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, China
| | - Junaid Afzal
- Division of Cardiology, University of California, USA
| | - Yamin Liu
- Division of Cardiology, University of California, USA
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, China
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Metabolic Profile for Prediction of Ischemic Stroke in Chinese Hypertensive Population. J Stroke Cerebrovasc Dis 2019; 28:1062-1069. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.12.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/11/2018] [Accepted: 12/24/2018] [Indexed: 12/12/2022] Open
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15
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Wang H, Chen Y, Yi X, Sun Y. Improving diagnosis of left ventricular hypertrophy in Chinese obese individuals: Which indexation criteria of left ventricular mass? Int J Cardiol 2018; 271:344. [PMID: 30223367 DOI: 10.1016/j.ijcard.2018.04.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Haoyu Wang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China
| | - Xin Yi
- Department of Cardiovascular Medicine, Beijing Moslem Hospital, Beijing 100054, China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
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16
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The burden, management rates and influencing factors of high blood pressure in a Chinese rural population: the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study. J Hum Hypertens 2018; 32:236-246. [PMID: 29440701 DOI: 10.1038/s41371-018-0039-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/03/2018] [Accepted: 01/29/2018] [Indexed: 01/26/2023]
Abstract
The aim of the present study was to examine the prevalence, awareness, treatment, control, and potentially influencing factors of high blood pressure (HBP) in Chinese rural adults based on a cross-sectional study. Using data from the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study, a total of 30,834 participants aged 18-74 years were enrolled for the epidemiological study. The multivariate logistic regression model including all selected potentially influencing factors was carried out for the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Overall, a total of 9872 individuals were diagnosed as HBP (32.02%) with substantial imparity between men and women (32.87% vs. 30.58%), and the corresponding age-standardized prevalence of HBP were 19.50% (20.94% in men and 18.85% in women). Among the HBP patients, 6654 were aware of the diagnosis (67.40%), 5391 were taking medication (54.61%), and 2572 had their blood pressure controlled (26.05%).The corresponding age-adjusted awareness, treatment, and control of HBP were 59.35%, 45.91%, and 23.87%, respectively, and the corresponding rates were higher in women than those in men. The age-specific prevalence and management rates of HBP displayed increased trends with aging in both sexes(P trend < 0.05). Aging, low level of education, unhealthy lifestyle, positive family history of hypertension, overweight, obesity, diabetes, and dyslipidemia were associated with the prevalence, awareness, treatment, and control of HBP. In conclusion, uncontrolled HBP was common with high prevalence in Chinese rural residents. Strengthening the primary prevention through lifestyle modifications is necessary for reducing the disease burden and improving the management rates of HBP.
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17
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Ma M, Tan X, Zhu S. Prehypertension and its optimal indicator among adults in Hubei Province, Central China, 2013-2015. Clin Exp Hypertens 2017; 39:532-538. [PMID: 28590139 DOI: 10.1080/10641963.2017.1281948] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hypertension accounts for 7% of the annual global disease burden, despite great efforts to counter this trend. Thus, interventions targeted at prehypertension might lead to a breakthrough for hypertension prevention. This study focused on the prevalence of prehypertension among adults in Central China and the best indicator of prehypertension, which would provide the basis for future interventions. METHODS This cross-sectional study was conducted using multistage stratified random sampling in seven counties in Hubei Province. Data from 30,634 survey respondents were analyzed using logistic regression and receiver operating characteristic (ROC) curve statistical tests, for the prevalence of prehypertension and the predictive ability of body mass index (BMI), waist-to-height ratio (WHtR), and waist circumference (WC) for prehypertension. RESULTS The prevalence of prehypertension in adults was 42.2%. The following factors contributed to the risk of prehypertension: male sex, elder age, divorce/separation, drinking, heavy labor intensity, and high BMI (p < 0.05). Being a farmer and exercise exhibited positive associations with prehypertension (p < 0.05). Compared with BMI and WHtR, WC had a higher predictive value for prehypertension (area under ROC curve, AUC = 0.630, 95% confidence interval: 0.623-0.637, p < 0.0001), especially for men. The optimal cutoffs of WC for prehypertension were 79.95 cm in men and 76.85 cm in women. CONCLUSIONS The prehypertension rate in adults was high in Central China. Significant factors related to hypertension were identified. More interventions targeting individuals with WC above the cutoff level are needed for timely awareness of prehypertension and early prevention of hypertension.
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Affiliation(s)
- Mengdi Ma
- a School of Health Sciences , Wuhan University , Wuhan , China
| | - Xiaodong Tan
- a School of Health Sciences , Wuhan University , Wuhan , China
| | - Shuzhen Zhu
- b Department of Chronic Disease Control , Hubei Provincial Center for Disease Control and Prevention , Wuhan , China
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Bao X, Meng G, Zhang Q, Liu L, Wu H, Du H, Shi H, Xia Y, Guo X, Liu X, Han P, Dong R, Wang X, Li C, Su Q, Gu Y, Fang L, Yu F, Yang H, Kang L, Ma Y, Yu B, Ma X, Sun S, Wang X, Zhou M, Jia Q, Guo Q, Song K, Wang G, Huang G, Niu K. Elevated serum complement C3 levels are associated with prehypertension in an adult population. Clin Exp Hypertens 2017; 39:42-49. [PMID: 28055286 DOI: 10.1080/10641963.2016.1210622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Xue Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Huanmin Du
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongbin Shi
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Xia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaoyan Guo
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xing Liu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Renwei Dong
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Xiuyang Wang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Chunlei Li
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qian Su
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Liyun Fang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Fei Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Huijun Yang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Li Kang
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Yixuan Ma
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Bin Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xinyu Ma
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Kun Song
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - GuoLin Wang
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Guowei Huang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
- Health Management Center, Tianjin Medical University General Hospital, Tianjin, China
- Collaborative Innovation Center of Non-communicable Disease, Tianjin Medical University, Tianjin, China
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Li Z, Guo X, Liu Y, Zhang N, Chang Y, Chen Y, Sun Y, Abraham MR. Metabolism rather than obesity is associated with ischemic stroke: a cross-sectional study in rural Northeastern China. SPRINGERPLUS 2016; 5:1419. [PMID: 27625973 PMCID: PMC4999385 DOI: 10.1186/s40064-016-3088-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/16/2016] [Indexed: 12/19/2022]
Abstract
Little is known about stroke with different obesity phenotype as determined using the Adult Treatment Panel-III criteria with metabolic health or not. This study aimed to investigate the effects of metabolically healthy and unhealthy obesity on ischemic stroke in a general population. A total of 11,150 adults were examined using a multi-stage cluster sampling method to select a representative sample of individuals 35 years or older. Ischemic stroke was defined as history of a cerebrovascular event, as documented by doctors via either cranial CT or MR scan within the past 2 years. All subjects were categorized as having metabolically healthy non-obesity (MHNO), metabolically unhealthy non-obesity (MUNO), metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO) using the Adult Treatment Panel-III criteria. Stratified analysis were done based on different body mass index group. For the total population, multiple regression analyses revealed that individuals with MUNO and MUO were more likely to experience ischemic stroke compared with those with MHNO (OR 2.136, 95 % CI 1.677-2.720; OR 2.712, 95 % CI 1.798-4.092; all p < 0.001). The OR for ischemic stroke did not significantly differ between MHO and MHNO. Stratification based on different BMI group showed that, compared with people who were normal weight without Mes, participants who were in Mes with overweight or obesity had significantly higher OR for ischemic stroke(both p < 0.05); participants who were not in Mes with overweight or obesity did not showed OR significantly higher. Ischemic stroke is likely associated with poor metabolic health rather than with obesity itself.
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Affiliation(s)
- Zhao Li
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning People’s Republic of China
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning People’s Republic of China
| | - Yamin Liu
- Department of Pharmacy, Zhongda Hospital, Southeast University, Nanjing, Jiangsu People’s Republic of China
| | - Naijin Zhang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning People’s Republic of China
| | - Ye Chang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning People’s Republic of China
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning People’s Republic of China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning People’s Republic of China
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Li Z, Bai Y, Guo X, Zheng L, Sun Y, Roselle AM. Alcohol consumption and cardiovascular diseases in rural China. Int J Cardiol 2016; 215:257-62. [DOI: 10.1016/j.ijcard.2016.04.095] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/11/2016] [Indexed: 01/08/2023]
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Yu S, Yang H, Guo X, Zhang X, Zheng L, Sun Y. Prevalence of dyslipidemia and associated factors among the hypertensive population from rural Northeast China. BMC Public Health 2015; 15:1152. [PMID: 26589291 PMCID: PMC4654887 DOI: 10.1186/s12889-015-2486-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/10/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Our latest study reported the grim status of hypertension in rural China with the prevalence of hypertension reached 51.1%. However, we lack the latest data about the prevalence and epidemiological features of dyslipidemia among hypertensive residents in rural China. METHODS A cross-sectional survey was conducted from July 2012 to August 2013 through a cluster multistage sampling to a resident group of 4048 individuals (2152 men, 2896 women) with hypertension, age ≥ 35 years, in the rural Northeast China. Serum lipids level were proposed by National Cholesterol Education Program Adult Treatment Panel III. RESULTS Of the hypertension residents without antihypertension treatment, 34.5% had borderline high total cholesterol, 19.2% had high total cholesterol, 11.4% had low high-density lipoprotein cholesterol and 37.4% had high non HDL-C. The population with borderline high, high, and very high low-density lipoprotein cholesterol was 20.9, 6.7 and 2.3%, respectively. In addition, 14.3% had borderline high triglycerides, 17.4% had high TG and 2.4% had very high TG. The awareness rate of dyslipidemia among the study population was 5.9%. After adjusting for independent variables, fasting plasma glucose, body mass index, Han nationality, current drinking and smoking, higher annual income and classification of blood pressure were risk factors for dyslipidemia while moderate physical activity was protective factor for dyslipidemia. On the contrary, gender and current drinking decrease the risk of HDL-C. CONCLUSION The prevalence of dyslipidemia was dramatically high and dyslipidemia screening was in-need in all diagnosed hypertensive individuals.
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Affiliation(s)
- Shasha Yu
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Hongmei Yang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Xiaofan Guo
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Xingang Zhang
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China.
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Shenjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China.
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Hadaegh F, Hasheminia M, Abdi H, Khalili D, Bozorgmanesh M, Arshi B, Azizi F. Prehypertension Tsunami: A Decade Follow-Up of an Iranian Adult Population. PLoS One 2015; 10:e0139412. [PMID: 26439847 PMCID: PMC4595371 DOI: 10.1371/journal.pone.0139412] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/14/2015] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Prehypertension is associated with cardiovascular disease (CVD). There is no study to examine the incidence and risk factors of prehypertension in a sex stratified setting. The aim of this study was to examine the effect modification of sex for different risk factors which predicts the progression from normotension to prehypertension in a Middle East population-based cohort, during a median follow-up of 9.2 years. METHODS A multivariate Cox analysis was performed among 1466 and 2131 Iranian men and women, respectively, who were free of prehypertension, hypertension, CVD and diabetes at baseline and free of incident hypertension without preceding prehypertension at follow-up. Incident prehypertension at follow-up was defined as systolic blood pressure (SBP) of 120-139 mmHg and/or diastolic blood pressure (DBP) of 80-89 mmHg. RESULTS Overall, 1440 new cases of prehypertension were identified resulting in an incidence rate of 593/10000 person-years; the corresponding values for women and men were 489/10000 and 764/10000person-years, respectively. There were significant interactions between gender with age, DBP, waist-to-hip-ratio (WHpR) and estimated glomerular filtration rate (eGFR) (all P-values <0.05) in multivariate analysis. Strong associations were found between age, body mass index (BMI) and SBP with incident prehypertension in both genders. However, the effect of DBP and WHpR was significant among women and 2-hour post challenge plasma glucose (2h-PCPG)was an independent risk factor for men. In the sex-adjusted analysis, glomerular hyperfiltration [Hazard ratio (HR) and 95%CI: 1.01 (1.00-1.01), P-value = 0.02], age, BMI, WHpR, SBP and DBP had higher risks while being female [HR (95%CI): 0.81(0.69-0.94), P-value = 0.01] had a lower risk for incident prehypertension. CONCLUSION According to this study results, among Iranian population with high incidence of prehypertension, general adiposity and glomerular hyperfiltration in total, 2h-PCPG in men and central adiposity in women should be emphasized as risk factors for prehypertension.
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Affiliation(s)
- Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hengameh Abdi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Bozorgmanesh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Banafsheh Arshi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Huang Y, Qiu W, Liu C, Zhu D, Hua J, Cai X, Wu Y, Hu Y, Xu D. Prevalence and risk factors associated with prehypertension in Shunde District, southern China. BMJ Open 2014; 4:e006551. [PMID: 25394820 PMCID: PMC4244395 DOI: 10.1136/bmjopen-2014-006551] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To explore the prevalence and combined cardiovascular risk factors of prehypertension in southern China. DESIGN A retrospective study; the logistic regression model was used to find the risk factors of prehypertension. SETTING The study was conducted in Shunde District, southern China, using the community-based health check-up information. PARTICIPANTS Participants aged ≥35 years with complete health check-up information data between January 2011 and December 2013 were enrolled and divided into hypertension, prehypertension and optimal blood pressure (BP) groups. Prehypertension was further divided into low-range (BP 120-129/80-84 mm Hg) and high-range (BP 130-139/85-89 mm Hg) subgroups. OUTCOME MEASURES The prevalence of prehypertension and the combined cardiovascular risk factors within the prehypertensive subgroups. RESULTS Of the 5362 initially reviewed cases (aged ≥35 years), 651 were excluded because of missing data. The proportions of optimal BP, prehypertension and hypertension were 39.1%, 38.6% and 22.3%, respectively. The average age, proportion of male sex, overweight, impaired fasting glucose (IFG), dyslipidaemia and hyperuricaemia were significantly higher in the prehypertension group than in the optimal BP group (all p <0.05). Compared with low-range prehypertension, the proportions of overweight, dyslipidaemia and IFG were higher in the high-range prehypertension group (all p<0.05). Multivariate logistic regression analysis showed that overweight (OR=2.84, 95% CI 1.55 to 5.20), male sex (OR=2.19, 95% CI 1.39 to 3.45), age (per 10 years, OR=1.21, 95% CI 1.02 to 1.44, p=0.03) and hyperuricaemia (OR=1.70, 95% CI 1.14 to 2.54) were independent risk factors of prehypertension. CONCLUSIONS Prehypertension is highly prevalent in southern China. Prehypertensive individuals presented with many other cardiovascular risk factors. There was heterogeneity of combined risk factors within the prehypertensive subgroups.
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Affiliation(s)
- Yuli Huang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China Department of Cardiology, The First People's Hospital of Shunde, Foshan, People's Republic of China
| | - Wenke Qiu
- Department of Health Management Center, The First People's Hospital of Shunde, Foshan, People's Republic of China
| | - Changhua Liu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Dingji Zhu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Jinghai Hua
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xiaoyan Cai
- Department of Cardiology, The First People's Hospital of Shunde, Foshan, People's Republic of China
| | - Yanxian Wu
- Department of Cardiology, The First People's Hospital of Shunde, Foshan, People's Republic of China
| | - Yunzhao Hu
- Department of Cardiology, The First People's Hospital of Shunde, Foshan, People's Republic of China
| | - Dingli Xu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
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