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Gonçalves Soares A, Santos S, Seyve E, Nedelec R, Puhakka S, Eloranta AM, Mikkonen S, Yuan WL, Lawlor DA, Heron J, Vrijheid M, Lepeule J, Nieuwenhuijsen M, Fossati S, Jaddoe VW, Lakka T, Sebert S, Heude B, Felix JF, Elhakeem A, Timpson NJ. Prenatal Urban Environment and Blood Pressure Trajectories From Childhood to Early Adulthood. JACC. ADVANCES 2024; 3:100808. [PMID: 38939392 PMCID: PMC11198279 DOI: 10.1016/j.jacadv.2023.100808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/25/2023] [Accepted: 10/23/2023] [Indexed: 06/29/2024]
Abstract
Background Prenatal urban environmental exposures have been associated with blood pressure in children. The dynamic of these associations across childhood and later ages is unknown. Objectives The purpose of this study was to assess associations of prenatal urban environmental exposures with blood pressure trajectories from childhood to early adulthood. Methods Repeated measures of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were collected in up to 7,454 participants from a UK birth cohort. Prenatal urban exposures (n = 43) covered measures of noise, air pollution, built environment, natural spaces, traffic, meteorology, and food environment. An exposome-wide association study approach was used. Linear spline mixed-effects models were used to model associations of each exposure with trajectories of blood pressure. Replication was sought in 4 independent European cohorts (up to 9,261). Results In discovery analyses, higher humidity was associated with a faster increase (mean yearly change in SBP for an interquartile range increase in humidity: 0.29 mm Hg/y, 95% CI: 0.20-0.39) and higher temperature with a slower increase (mean yearly change in SBP per interquartile range increase in temperature: -0.17 mm Hg/y, 95% CI: -0.28 to -0.07) in SBP in childhood. Higher levels of humidity and air pollution were associated with faster increase in DBP in childhood and slower increase in adolescence. There was little evidence of an association of other exposures with change in SBP or DBP. Results for humidity and temperature, but not for air pollution, were replicated in other cohorts. Conclusions Replicated findings suggest that higher prenatal humidity and temperature could modulate blood pressure changes across childhood.
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Affiliation(s)
- Ana Gonçalves Soares
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Susana Santos
- The Generation R Study Group, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| | - Emie Seyve
- Inserm, CNRS, Institute for Advanced Biosciences, Grenoble Alpes University, Grenoble, France
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Rozenn Nedelec
- Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Soile Puhakka
- Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, Finland
| | - Aino-Maija Eloranta
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Santtu Mikkonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Wen Lun Yuan
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A∗STAR), Singapore, Singapore
| | - Deborah A. Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jon Heron
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Johanna Lepeule
- Inserm, CNRS, Institute for Advanced Biosciences, Grenoble Alpes University, Grenoble, France
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Serena Fossati
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Vincent W.V. Jaddoe
- The Generation R Study Group, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Sylvain Sebert
- Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Janine F. Felix
- The Generation R Study Group, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Maimaitiwusiman Z, Wumaier A, Xiao W, Xuekelati S, Halan B, Xiang H, Wang H. Ethnic and geographic variations in multiple chronic conditions among community-dwelling older people in Xinjiang: a cross-sectional study. BMC Geriatr 2023; 23:455. [PMID: 37488530 PMCID: PMC10367248 DOI: 10.1186/s12877-023-04159-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Multiple chronic conditions (MCC) refer to the presence of two or more chronic diseases. The incidence of MCC is higher in older people, and increases with age. Studies have shown an association between MCC and increased adverse outcome, as well as the higher mortality, decline of physical function, and poor quality of life in older populations. Herein, for the first time we provide the data of ethnic and geographic variations in the prevalence of MCC among community-dwelling older people in Xinjiang, China. METHODS A multilevel random sampling method was employed to perform an epidemiological survey in community-dwelling older adults in southern, northern, and eastern Xinjiang between January 2019 to December 2019. In total, 87,000 participants volunteered, with a response rate of 96.67%; 490 participants with incomplete data were excluded and data from 86,510 participants were analyzed. RESULTS Our analysis demonstrated that hypertension (51.5%), obesity (27.0%), diabetes (16.9%), heart disease (8.2%), and anxiety/depression (4.5%) were the five main chronic diseases in Xinjiang. The prevalence of MCC in the population surveyed was 33.4% (95%CI, 33.1-33.7). The prevalence in females was 36.6% (95%CI, 36.1-37), which was higher than that in male (30%,95%CI, 29.5-30.4). The prevalence of MCC in older people aged 60-69, 70-79, 80-89, and ≥ 90 years was 32.7% (95%CI, 32.2-33.3), 34.3% (95%CI, 33.9-34.7), 32.5% (95% CI, 31.7-33.3), and 25.9% (95% CI, 23.5-28.3) respectively. As far as the ethnic group was concerned, the prevalence of MCC in Uygur, Han, Kazak, Hui, and Mongolian was 31.3% (95%CI, 30.9-31.7), 34.4% (95%CI, 33.9-35), 40.4% (95%CI, 39.1-41.8), 40.8% (95%CI, 38.9-42.7), 44.4% (95%CI, 38.1-50.6), respectively. The prevalence of MCC was 32.8% (95%CI, 32.1-33.5), 31.7% (95%CI, 31.2-32.1), 36.0% (95%CI, 35.3-36.7) and 39.2% (95%CI, 38.1-40.3) among uneducated, educated for 1-6, 7-9, and more than 10 years. After adjusting for age, sex, smoking, alcohol consumption, and education by level, the binary logistic analysis showed that, compared with eastern Xinjiang, the risk of MCC in the southern area was increased (odds ratio [OR], 1.418; 95% confidence interval [CI], 1.367-1.471), and it was relatively higher in northern Xinjiang (OR, 2.021; 95% CI, 1.944-2.102). Compared with Uygur, Han, Kazakh, Hui and Mongolian had an increased risk of MCC, which was (OR, 1.075; 95% CI, 1.040-1.111), (OR, 1.414; 95% CI, 1.332-1.501), (OR, 1.515; 95% CI, 1.396-1.644), (OR, 1.566; 95% CI, 1.216-2.017), respectively. CONCLUSIONS There are ethnic and geographic variations in multiple chronic conditions among community-dwelling older people in Xinjiang. The older adults living in northern and southern Xinjiang and Han, Kazakh, Mongolian and Hui older adults have a higher risk of MCC.
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Affiliation(s)
- Zhuoya Maimaitiwusiman
- The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China
| | - Aishanjiang Wumaier
- The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China
| | - Wenwen Xiao
- The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China
| | - Saiyare Xuekelati
- The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China
| | - Buluhan Halan
- The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China
| | - Hong Xiang
- The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China
| | - Hongmei Wang
- The Second Ward of the Health Center for Cadre of People's Hospital of Xinjiang Uygur Autonomous Region, No. 91, Tianchi Road, Urumqi, Xinjiang, China.
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Liu J, Qu Q, Xuekelati S, Bai X, Wang L, Xiang H, Wang H. Geographic and Age Variations in Low Body Mass Index Among Community-Dwelling Older People in Xinjiang: A Cross-Sectional Study. Front Med (Lausanne) 2021; 8:675931. [PMID: 34336883 PMCID: PMC8319472 DOI: 10.3389/fmed.2021.675931] [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: 03/04/2021] [Accepted: 06/07/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Studies have shown an association between undernutrition and increased adverse outcome, as well as substantial geographic and age variations in undernutrition. Body mass index (BMI), a core indicator of undernutrition, is easy to measure and reflects the nutritional and health status of the human body. It is a simple and suitable tool for epidemiological investigations in large sample populations. Herein, we provide the first description of geographic and age variations in the prevalence of low BMI among community-dwelling older people in Xinjiang. Methods: From January 2019 to December 2019, using a multi-stage random sampling method, we conducted a cross-sectional epidemiological survey of the community-dwelling older people in Xinjiang at different latitudes. Of the 87,000 participants, the statistical analyses included 86,514 participants with complete data. Results: In Xinjiang, the prevalence of low BMI was 7.7% in the community-dwelling older people. The BMI gradually decreased with increasing age and gradually increased with latitude. The prevalence of low BMI in northern Xinjiang was 5.3%, which was significantly lower than that in eastern (7.7%) and southern (9.3%) Xinjiang. In the 60–69-, 70–79-, 80–89-, and ≥90-year age groups, the prevalence rates of low BMI were 5.8, 7.9, 10.0, and 13.9%, respectively. After adjusting for confounding factors (sex, ethnic group, hypertension, diabetes, hyperlipemia, smoking, and drinking), multivariate logistic regression analysis showed that the odds ratios (95% CI) for low BMI in eastern and southern Xinjiang were 1.165 (1.056–1.285) and 1.400 (1.274–1.538), respectively, compared to northern Xinjiang. The adjusted odds ratios (95% CI) for low BMI in the 70–79-, 80–89-, and ≥90-year age groups were 1.511 (1.39–1.635), 2.233 (2.030–2.456), and 3.003 (2.439–3.696), respectively, compared to the 60–69-year age group. Conclusion: The results of this study revealed geographic and age variations in the prevalence of low BMI in the community-dwelling older people in Xinjiang. The prevalence of low BMI gradually increased as the latitude decreased and as age increased.
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Affiliation(s)
- Jinling Liu
- Second Department of the Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Qun Qu
- The Health Center for the Cadre of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Saiyare Xuekelati
- Second Department of the Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Xue Bai
- Second Department of the Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Li Wang
- Second Department of the Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Hong Xiang
- Second Department of the Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Hongmei Wang
- Second Department of the Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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