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Wu Y, Shen P, Xu L, Yang Z, Sun Y, Yu L, Zhu Z, Li T, Luo D, Lin H, Shui L, Tang M, Jin M, Chen K, Wang J. Association between visit-to-visit lipid variability and risk of ischemic heart disease: a cohort study in China. Endocrine 2024; 84:914-923. [PMID: 38159173 DOI: 10.1007/s12020-023-03661-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
AIMS To explore the associations between visit-to-visit lipid variability and risk of ischemic heart disease (IHD) in a population-based cohort in China. METHODS We evaluated lipid variability in 30,217 individuals from the Yinzhou Health Information System who had ≥3 recorded lipid measurements during 2010-2014. We used various indicators including standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV) to quantify the variability in triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Overall, a total of 1305 participants with IHD were identified during the follow-up of 194,421 person-years. Subjects in Q4 had a 21% elevated risk of IHD (HR = 1.21, 95% CI: 1.03-1.41) for LDL-C variability (CV) compared with the reference (Q1). The HRs for Q4 vs Q1 were 1.21 (95% CI: 1.04-1.42) for HDL-C variability, and 1.28 (95% CI: 1.10-1.50) for TC variability. However, no association was observed between triglycerides variability and risk of IHD. CONCLUSIONS Higher variability in LDL-C, HDL-C, and TC levels was associated with an elevated risk of IHD, suggesting that lipid variability could be considered as an independent risk factor of IHD.
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Affiliation(s)
- Yonghao Wu
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310058, China
| | - Peng Shen
- Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Lisha Xu
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310058, China
| | - Zongming Yang
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310058, China
| | - Yexiang Sun
- Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Luhua Yu
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310058, China
| | - Zhanghang Zhu
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Tiezheng Li
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310058, China
| | - Dan Luo
- Hangzhou Medical College, Hangzhou, 310053, China
| | - Hongbo Lin
- Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Liming Shui
- Yinzhou District Health Bureau of Ningbo, Ningbo, 315040, China
| | - Mengling Tang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mingjuan Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Kun Chen
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Jianbing Wang
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310058, China.
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Gu Q, Zheng Q, Zhang X, Lin L, Li S, Chen F, Zhang X, Yan LL, Chen W. Trends in Health Service Use for Dry Eye Disease From 2017 to 2021: A Real-World Analysis of 369,755 Outpatient Visits. Transl Vis Sci Technol 2024; 13:17. [PMID: 38236189 PMCID: PMC10807500 DOI: 10.1167/tvst.13.1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024] Open
Abstract
Purpose We aimed to analyze the trends and patterns in outpatient health service treatment of dry eye disease (DED) using real-world data from Yinzhou District in China. Methods The Yinzhou Health Information System is a comprehensive database including electronic medical records from 277 medical institutions representing over 1.64 million residents. We extracted outpatient records from January 1, 2017, to December 31, 2021, that included the first diagnosis of DED according to the International Classification of Diseases, 10th Revision (H04.101, H04.103, H11.104, H16.202, or H18.803). We analyzed the trends and patterns of DED outpatient visits using the Mann-Kendall trend test and Cochran-Armitage trend test. Results We identified a total of 369,755 outpatient visits from 145,712 patients with DED of all ages (60.37% female; 54.10% 50 years or older). Primary medical institutions had the largest number of DED outpatient visits (42%), followed by tertiary medical institutions (35%). Over the 5-year period, the number of DED outpatient visits increased from 59,260 to 90,807 (53.23%). We observed significant consecutive annual proportion increases in females (from 61.09% to 62.01%; P = 0.001), patients 50 years or older (from 55.10% to 60.08%; P < 0.001), and outpatient visits in primary medical institutions (from 33.19% to 48.75%; P < 0.001). Conclusions Our study found an increase in outpatient health service use for DED in Yinzhou from 2017 to 2021, with higher proportions and increases among females, patients 50 years or older, and primary medical institutions. Translational Relevance The rapid growth in the prevalence of DED indicates high eye healthcare needs in patients.
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Affiliation(s)
- Qinyi Gu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qinxiang Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Ningbo Eye Hospital, Wenzhou Medical University, Ningbo, China
| | - Xiaoyu Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Lei Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Saiqing Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fangwei Chen
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Xian Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Lijing L. Yan
- Ningbo Eye Hospital, Wenzhou Medical University, Ningbo, China
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Peking University Institute for Global Health and Development, Beijing, China
- School of Public Health, Wuhan University, Wuhan, China
| | - Wei Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Ningbo Eye Hospital, Wenzhou Medical University, Ningbo, China
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Zheng Q, Li S, Wen F, Lin Z, Feng K, Sun Y, Bao J, Weng H, Shen P, Lin H, Chen W. The Association Between Sleep Disorders and Incidence of Dry Eye Disease in Ningbo: Data From an Integrated Health Care Network. Front Med (Lausanne) 2022; 9:832851. [PMID: 35187009 PMCID: PMC8854755 DOI: 10.3389/fmed.2022.832851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate the association between sleep disorders and dry eye disease (DED) in Ningbo, China. METHODS Our data came from the Yinzhou Health Information System (HIS), including 257932 patients and was based on a 1:1 matching method (sleep disorder patients vs. patients without sleep disorders) during 2013-2020. Sleep disorders and DED were identified using ICD-10 codes. Cox proportional hazards regression was used to identify the association between sleep disorders and DED. RESULTS The eight-year incidence of DED was significantly higher in participants with diagnosis of sleep disorders (sleep disorders: 50.66%, no sleep disorders: 16.48%, P < 0.01). Sleep disorders were positively associated with the diagnosis of DED (HR: 3.06, 95% CI: 2.99-3.13, P < 0.01), when sex, age, hypertension, diabetes and other systemic diseases were adjusted. In the sleep disorders patients, advancing age, female sex, and presence of coexisting disease (hypertension, diabetes, hyperlipidemia, thyroid disease, depression, heart disease, and arthritis) were significantly associated with the development of DED by the multivariate cox regression analysis (all P < 0.05).In addition, there was a significantly positive association between estazolam and the incidence of DED in both sleep disorder and non-sleep disorder groups (all P < 0.05). CONCLUSIONS Sleep disrder was associated with a three-time increased risk of DED. This association can be helpful in effective management of both sleep disorders and DED.
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Affiliation(s)
- Qinxiang Zheng
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Saiqing Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Feng Wen
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Zhong Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Kemi Feng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yexiang Sun
- Department of Chronic Diseases and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Jie Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Hongfei Weng
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Peng Shen
- Department of Chronic Diseases and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Hongbo Lin
- Department of Chronic Diseases and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Wei Chen
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
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Yang Z, Wu M, Lu J, Gao K, Yu Z, Li T, Liu W, Shen P, Lin H, Shui L, Tang M, Jin M, Chen K, Wang J. Interaction between walkability and fine particulate matter on risk of ischemic stroke: A prospective cohort study in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118482. [PMID: 34763020 DOI: 10.1016/j.envpol.2021.118482] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 06/13/2023]
Abstract
Living in walkable neighborhoods has been reported to be associated with a lower risk of cardiovascular disease. Features of walkable neighborhoods, however, may be related to particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5), which could increase risk of cardiovascular disease. The interaction effect between walkability and PM2.5 on risk of ischemic stroke remains to be elucidated. In this study, we recruited a total of 27,375 participants aged ≥40 years from Yinzhou District, Ningbo, Zhejiang Province, China to investigate the associations of walkability and PM2.5 with risk of ischemic stroke. We used amenity categories and decay functions to evaluate walkability and high-spatiotemporal-resolution land-use regression models to assess PM2.5 concentrations. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 4.08 years, we identified a total of 637 incident cases of ischemic stroke in the entire cohort. Higher walkability was associated with a lower risk of ischemic stroke (quartile, Q4 vs. Q1 walkability: HR = 0.59, 95% CI: 0.47-0.75), whereas PM2.5 was positively associated with risk of ischemic stroke (Q4 vs. Q1 PM2.5: HR = 1.70, 95% CI: 1.29-2.25). Furthermore, we observed a significant interaction between walkability and PM2.5 on risk of ischemic stroke. Walkability was inversely associated with risk of ischemic stroke at lower PM2.5 concentrations, but this association was attenuated with increasing PM2.5 concentrations. Although walkable neighborhoods appear to decrease the risk of ischemic stroke, benefits may be offset by adverse effects of PM2.5 exposure in the most polluted areas. These findings are meaningful for future neighborhood design, air pollution control, and stroke prevention.
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Affiliation(s)
- Zongming Yang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mengyin Wu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Jieming Lu
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Kai Gao
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Zhebin Yu
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Tiezheng Li
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Wen Liu
- Department of Urban Planning, Wuhan University School of Urban Design, Wuhan, 430072, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Hongbo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315040, China
| | - Liming Shui
- Yinzhou District Health Bureau of Ningbo, Ningbo, 315040, China
| | - Mengling Tang
- Department of Epidemiology and Biostatistics at School Public Health and the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics at School of Public Health and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
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Wang J, Liu J, Teng H, Zhang Y, Dong X, Chen W, Yin J. Blood pressure categories defined by the 2017 ACC/AHA guideline and all-cause mortality: a national cohort study in China and meta-analysis. J Hum Hypertens 2022; 36:95-105. [PMID: 33589762 DOI: 10.1038/s41371-021-00495-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 01/05/2021] [Accepted: 01/25/2021] [Indexed: 01/31/2023]
Abstract
The 2017 American College of Cardiology/American Heart Association guideline recommends a lowered threshold for hypertension diagnosis. Nonetheless, the association of blood pressure (BP) groups defined by the new guideline and all-cause mortality has not been fully estimated, especially in general Chinese. Based on the China Health and Retirement Longitudinal Study (CHARLS) during 2011-2018, 12,964 participants aged 45 years or older at baseline were enrolled for a follow-up of 7 years. Cox proportional hazards models were used to examine the relationship of BP classifications with all-cause mortality, with normal BP (<120/80 mmHg) as a reference. Afterwards, eligible studies shed light in this field were searched in public databases, and meta-analysis was conducted. In CHARLS, there were 41.21% and 16.08% individuals with stage 2 hypertension and stage 1 hypertension, respectively. During the follow-up, 1293 death occurred. The redefined stage 1 (130-139/80-89 mmHg) and stage 2 hypertension (≥140/≥90 mmHg) were found to have increased risk of death in the crude model, but only stage 2 hypertension maintained statistically significance after adjustment. Furthermore, meta-analysis including CHARLS and nine other prospective studies, with a total of 290,609 participants followed up for 3,081,532 person-years, resulted in similar results (combined hazard ratio (95% confidence interval) was 1.07 (0.99-1.15) for stage 1 hypertension, and 1.39 (1.25-1.53) for stage 2 hypertension). The present study detected that individuals with stage 2 and stage 1 hypertension had increased likelihood to die from any cause, but only the former association achieved statistically significance. Further cohorts with long-term follow-up duration are warranted, especially in China.
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Affiliation(s)
- Jiaxiang Wang
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jieyu Liu
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Haoyue Teng
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yushan Zhang
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xingxuan Dong
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Wei Chen
- Zhuhai Center for Chronic Disease Control, Zhuhai, Guangdong, China.
| | - Jieyun Yin
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China.
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Lian Q, Jafar TH, Allen JC, Ma S, Malhotra R. Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study. J Aging Health 2021; 34:674-683. [PMID: 34814767 DOI: 10.1177/08982643211055245] [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: 11/17/2022]
Abstract
OBJECTIVES To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. METHODS Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60-97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. RESULTS Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100-119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23-4.72); SBP 160-179 mmHg: 1.51 (1.02-2.22); and SBP ≥180 mmHg: 1.78 (1.12-2.81). With DBP of 70-79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28-4.54) and DBP ≥110 mmHg: 2.16 (1.09-4.31). DISCUSSION Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.
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Affiliation(s)
- Qian Lian
- 37581Singapore General Hospital, Singapore
| | - Tazeen H Jafar
- Program in Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore.,199688Duke Global Health Institute, Duke University, Durham, NC, USA
| | - John C Allen
- Centre for Quantitative Medicine, 121579Duke-NUS Medical School, Singapore
| | - Stefan Ma
- Epidemiology & Disease Control Division, 50107Ministry of Health, Singapore
| | - Rahul Malhotra
- Program in Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore.,Centre for Ageing Research and Education, 121579Duke-NUS Medical School, Singapore
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Lu JM, Wu MY, Yang ZM, Zhu Y, Li D, Yu ZB, Shen P, Tang ML, Jin MJ, Lin HB, Shui LM, Chen K, Wang JB. Low LDL-C levels are associated with risk of mortality in a Chinese cohort study. Endocrine 2021; 73:563-572. [PMID: 33990892 DOI: 10.1007/s12020-021-02746-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/30/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Although low-density lipoprotein cholesterol (LDL-C) has been considered as a risk factor of atherosclerotic cardiovascular disease, limited studies can be available to evaluate the association of LDL-C with risk of mortality in the general population. This study aimed to examine the association of LDL-C level with risk of mortality using a propensity-score weighting method in a Chinese population, based on the health examination data. METHODS We performed a retrospective cohort study with 65,517 participants aged 40 years or older in Ningbo city, Zhejiang. LDL-C levels were categorized as five groups according to the Chinese dyslipidemia guidelines in adults. To minimize potential biases resulting from a complex array of covariates, we implemented a generalized boosted model to generate propensity-score weights on covariates. Then, we used Cox proportional hazard regression models with all-cause and cause-specific mortality as the dependent variables to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS During the 439,186.5 person years of follow-up, 2403 deaths occurred. Compared with the median LDL-C group (100-130 mg/dL), subjects with extremely low LDL-C levels (group 1) had a higher risk of deaths from all-cause (HR = 2.53, 95% CI:1.80-3.53), CVD (HR = 1.84, 95% CI: 1.28-2.61), ischemic stroke (HR = 2.29, 95% CI:1.32-3.94), hemorrhagic stroke (HR = 3.49, 95% CI: 1.57-7.85), and cancer (HR = 2.12, 95% CI: 1.04-4.31) while the corresponding HRs in LDL-C group 2 were relatively lower than that in group 1. CONCLUSIONS Low LDL-C levels were associated with an increased risk of all-cause, CVD, ischemic stroke, hemorrhagic stroke, and cancer mortality in the Chinese population.
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Affiliation(s)
- Jie-Ming Lu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
| | - Meng-Yin Wu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
| | - Zong-Ming Yang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
| | - Yao Zhu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
| | - Die Li
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
| | - Zhe-Bin Yu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Meng-Ling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
| | - Ming-Juan Jin
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, 310058, Hangzhou, China
| | - Hong-Bo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Li-Ming Shui
- Yinzhou District Health Bureau of Ningbo, Ningbo, Zhejiang, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China.
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, 310058, Hangzhou, China.
| | - Jian-Bing Wang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Zhejiang, 310058, Hangzhou, China.
- Department of Epidemiology and Biostatistics, the Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, 310058, Hangzhou, China.
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8
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Yang ZM, Wu MY, Lu JM, Zhu Y, Li D, Yu ZB, Shen P, Tang ML, Jin MJ, Lin HB, Shui LM, Chen K, Wang JB. HDL-C, longitudinal change and risk of mortality in a Chinese cohort study. Nutr Metab Cardiovasc Dis 2021; 31:2669-2677. [PMID: 34362638 DOI: 10.1016/j.numecd.2021.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS High-density lipoprotein cholesterol (HDL-C) concentration and variability are both important factors of cardiovascular disease (CVD) and mortality. We aimed to explore the associations of HDL-C and longitudinal change in HDL-C with risk of mortality. METHODS AND RESULTS We recruited a total of 69,163 participants aged ≥40 years and had medical examination records of HDL-C during 2010-2014 from the Yinzhou District, Ningbo, China. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. We observed a non-linear association of HDL-C with risks of non-accidental and CVD mortality. Compared with the moderate concentration group (1.4-1.6 mmol/L), HDL-C <1 mmol/L was associated with a higher risk of non-accidental mortality (HR: 1.13 (95% CI: 1.01-1.27)) and both HDL-C <1 mmol/L and ≥2 mmol/L were associated with a higher risk of CVD mortality (HRs: 1.23 (95% CI: 1.01-1.50) and 1.37 (95% CI: 1.03-1.82), respectively). Compared with the stable group ([-0.1, +0.1 mmol/L]), a large decrease ([-0.5, -0.3 mmol/L]) and very large decrease (<-0.5 mmol/L) in HDL-C were associated with a higher risk of non-accidental mortality (HRs: 1.40 (95% CI: 1.21-1.63) and 1.78 (95% CI: 1.44-2.20), respectively). Similar results were observed for CVD mortality and cancer mortality. CONCLUSION Extremely low or high HDL-C and a large decrease or very large decrease in HDL-C were associated with a higher risk of cause-specific mortality. Monitoring of HDL-C may have utility in identifying individuals at higher risk of mortality.
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Affiliation(s)
- Zong-Ming Yang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China
| | - Meng-Yin Wu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China
| | - Jie-Ming Lu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China
| | - Yao Zhu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China
| | - Die Li
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China
| | - Zhe-Bin Yu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315100, Zhejiang province, China
| | - Meng-Ling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China
| | - Ming-Juan Jin
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China; Department of Epidemiology and Biostatistics, Cancer Institute of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang province, China
| | - Hong-Bo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, 315100, Zhejiang province, China
| | - Li-Ming Shui
- Yinzhou District Health Bureau of Ningbo, Ningbo, 315100, Zhejiang province, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China; Department of Epidemiology and Biostatistics, Cancer Institute of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang province, China.
| | - Jian-Bing Wang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, 310058, Zhejiang province, China; Department of Epidemiology and Biostatistics, National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang province, China.
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9
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Yang ZM, Wu MY, Lu JM, Li TZ, Shen P, Tang ML, Jin MJ, Lin HB, Shui LM, Chen K, Wang JB. Effect of COVID-19 on hospital visits in Ningbo, China: an interrupted time-series analysis. Int J Qual Health Care 2021; 33:6257012. [PMID: 33909042 PMCID: PMC8135444 DOI: 10.1093/intqhc/mzab078] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/08/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Objective Unprecedented rigorous public health measures were implemented during the coronavirus disease 2019 (COVID-19) epidemic, but it is still unclear how the intervention influenced hospital visits for different types of diseases. We aimed to evaluate the impact of the intervention on hospital visits in Yinzhou District, Ningbo, Zhejiang province, China. Methods We conducted an interrupted time-series analysis from 1 January 2017 to 6 September 2020 based on the Yinzhou Health Information System in Ningbo, Zhejiang province. The beginning of the intervention was on 23 January 2020, and thus, there were 160 weeks before the intervention and 32 weeks after the implementation of the intervention. Level changes between expected and observed hospital visits in the post-intervention period were estimated using quasi-Poisson regression models. Results Compared with the expected level, there was an estimated decrease of −22.60% (95% confidence interval (CI): −27.53%, −17.36%) in the observed total hospital visits following the intervention. Observed hospital visits for diseases of the respiratory system were found to be decreased dramatically (−62.25%; 95% CI: −65.62%, −58.60%). However, observed hospital visits for certain diseases were estimated to be increased, including diseases of the nervous system (+11.17%; 95% CI: +3.21%, +19.74%); diseases of pregnancy, childbirth and the puerperium (+27.01%; 95% CI: +17.89%, +36.85%); certain conditions originating in the perinatal period (+45.05%; 95% CI: +30.24%, +61.56%); and congenital malformation deformations and chromosomal abnormalities (+35.50%; 95% CI: +21.24%, +51.45%). Conclusions Our findings provided scientific evidence that cause-specific hospital visits evolve differently following the intervention during the COVID-19 epidemic.
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Affiliation(s)
- Zong-Ming Yang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Meng-Yin Wu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Jie-Ming Lu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Tie-Zheng Li
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, 1221 Xueshi Road, Ningbo, Zhejiang 315100, China
| | - Meng-Ling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Ming-Juan Jin
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China.,Department of Epidemiology and Biostatistics, and Cancer Institute of the Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Hong-Bo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, 1221 Xueshi Road, Ningbo, Zhejiang 315100, China
| | - Li-Ming Shui
- Yinzhou District Health Bureau of Ningbo, 1221 Xueshi Road, Ningbo, Zhejiang 315100, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China.,Department of Epidemiology and Biostatistics, and Cancer Institute of the Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
| | - Jian-Bing Wang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China.,Department of Epidemiology and Biostatistics, and National Clinical Research Center for Child Health of the Children's Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, Zhejiang 310058, China
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10
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Zhou Y, Wang Z, Lu J, Yang Z, Li D, Yu Z, Shen P, Tang M, Jin M, Lin H, Chen K, Wang J. Effects of nighttime sleep duration and sex on the association between siesta and hypertension. Sleep Med 2021; 82:200-209. [PMID: 33957416 DOI: 10.1016/j.sleep.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To examine the association between siesta and hypertension by sex and nighttime sleep duration among Chinese adults aged ≥35 years in Yinzhou, Ningbo City. METHODS All data were obtained from physical examinations and structured questionnaires. A total of 44, 652 participants were included. Logistic regression models were applied to calculate odds ratios and 95% confidence intervals for the association between siesta and hypertension. RESULTS When compared with no siesta, siesta durations of 60∼89 min (OR = 1.10, 95% CI:1.04-1.17) and ≥90 min (OR = 1.21, 95% CI:1.08-1.36) were associated with higher risk of hypertension in women. But no significant association was observed in men. Siesta durations of 30∼59 min (OR = 1.09, 95% CI:1.00-1.19) and 60-89 min (OR = 1.10, 95% CI:1.05-1.16) were associated with hypertension in people with 6∼8 h sleep, and this association appeared seemingly stronger with ≥90 min siesta either in short (<6 h) sleepers (OR = 1.20, 95% CI: 0.99-1.47) or in long (>8 h) sleepers (OR = 1.29, 95% CI: 1.00-1.68). However, in short sleepers, 60∼89 min siesta seemed to be associated with decreased risk of hypertension (OR = 0.95, 95% CI: 0.85-1.06); while in long sleepers, the same range of siesta seemed to be associated with increased risk of hypertension (OR = 1.11, 95% CI: 0.93-1.34). CONCLUSION Long siesta was associated with increased risk of hypertension in women but not in men. Not too long siesta may be related to decreased risk of hypertension in short sleepers but not in people with adequate or even long sleep. These findings warrant further examination with prospective studies and laboratory investigations.
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Affiliation(s)
- Yiyi Zhou
- Zhejiang University School of Medicine, Hangzhou, China
| | | | - Jieming Lu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China
| | - Zongming Yang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China
| | - Die Li
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhebin Yu
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Mengling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University School of Medicine, Hangzhou, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics, Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hongbo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics, The Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China.
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11
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Wu MY, Wang JB, Zhu Y, Lu JM, Li D, Yu ZB, Shen P, Jiang DJ, Lin HB, Chen K. Impact of Individual and Combined Lifestyle Factors on Mortality in China: A Cohort Study. Am J Prev Med 2020; 59:461-468. [PMID: 32417020 DOI: 10.1016/j.amepre.2020.01.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Although numerous studies have suggested that lifestyle-related factors are associated with chronic diseases and preventable deaths, limited evidence is available for the Chinese population. METHODS This study established a prospective cohort of >360,000 residents on the basis of the Yinzhou Health Information System in China during 2004-2017 and calculated the combined effects of lifestyle-related factors, including BMI, smoking, alcohol consumption, and physical activity, using a points system. A Cox regression model estimated the combined effects of lifestyle-related factors on total mortality, and a competing risk model estimated the combined effects on cancer and cardiovascular disease mortality. All data analyses were conducted in 2018‒2019. RESULTS During 3,755,879 person-years of follow-up, 11,791 deaths were identified, including 4,983 from cancer and 3,143 from cardiovascular disease. Having a standard BMI, never smoking, never drinking, and engaging in physical activity more than 4 times per week had protective effects on total mortality. Overall, the risk of total and cause-specific mortality increased with the increment of risk score. Compared with subjects in the lowest quartile, the risk of total and cause-specific mortality peaked among individuals in the fourth quartile (total mortality: hazard ratio=1.87, 95% CI=1.77, 1.98; cancer mortality: hazard ratio=2.05, 95% CI=1.87, 2.25; cardiovascular disease mortality: hazard ratio=1.51, 95% CI=1.35, 1.68). Sensitivity analyses excluding individuals with follow-up <3 years did not materially change the results. CONCLUSIONS The combined effects of lifestyle-related factors, including BMI, smoking, alcohol drinking, and physical activity, are associated with total, cancer, and cardiovascular disease mortality among the Chinese population.
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Affiliation(s)
- Meng-Yin Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jian-Bing Wang
- Department of Epidemiology and Biostatistics, the Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yao Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jie-Ming Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Die Li
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Zhe-Bin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Dan-Jie Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Hong-Bo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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12
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Lu J, Yu Z, Zhang X, Wu M, Lin S, Zhu Y, Xu Z, You L, Wei F, Tang M, Jin M, Wang J, Chen K. Association between social health status and health-related quality of life among community-dwelling elderly in Zhejiang. Health Qual Life Outcomes 2020; 18:110. [PMID: 32345322 PMCID: PMC7189640 DOI: 10.1186/s12955-020-01358-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 04/08/2020] [Indexed: 12/11/2022] Open
Abstract
Background Population aging is an inevitable trend and previous studies have showed the relationship between social health related factors and health-related quality of life (HR-QOL) in the elderly. The objective of this study is to investigate the association of social health status with HR-QOL among community-dwelling elderly in Zhejiang. Methods This cross-sectional study was based on community-dwelling elderly individuals from July 2018 to September 2018 in Zhejiang, China. HR-QOL was measured by the 12-item Short-Form Health Survey (SF-12). Social health status was estimated by the long-form of the Social Health Scale for the Elderly (SHSE-L) and classified into three categories (poor, moderate and good). Multivariable linear regression models were conducted to evaluate the association between social health status and HR-QOL (PCS, MCS and SF-12 total score). Results A total of 2952 elderly participants were included in this study. The mean age was 70.68 ± 7.75 years (mean ± SD); of the eligible participants, more than half (50.4%) were females; the mean scores were 48.10 ± 8.49, 47.70 ± 7.09 and 47.90 ± 5.86 for PCS, MCS and SF-12 total score, separately. Results from the multivariable models showed that social health status was positively related to HR-QOL after adjusting for covariates. Compared with individuals with a poor social health status, those who had a moderate or good social health status were more likely to report better HR-QOL (for moderate social health status: β = 1.90(95%CI: 1.09, 2.71) for PCS, β = 1.78(1.08, 2.48) for MCS, β = 1.84(1.29, 2.39) for SF-12 total score; for good social health status: β = 3.29(2.24, 4.34) for PCS, β = 3.10(2.12, 4.01) for MCS, β = 3.20(2.48, 3.91) for SF-12 total score). Conclusion In our study, we found that social health status was positively associated with HR-QOL among the elderly in Zhejiang. Our findings could provide valuable information for decision-makers to develop interventions to improve the HR-QOL of the elderly.
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Affiliation(s)
- Jieming Lu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Zhebin Yu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaocong Zhang
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Mengyin Wu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Shujuan Lin
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Yao Zhu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Zenghao Xu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Liuqing You
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Fang Wei
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Mengling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics, the Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China.
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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13
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Du X, Fang L, Xu J, Chen X, Zhang J, Bai Y, Wu J, Ma J, Yu M, Zhong J. Prevalence, awareness, treatment and control of hypertension and sodium intake in Zhejiang Province, China: A cross-sectional survey in 2017. PLoS One 2019; 14:e0226756. [PMID: 31869377 PMCID: PMC6927602 DOI: 10.1371/journal.pone.0226756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 12/03/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In recent decades, hypertension has become a popular public health problem in China. In 2017, a cross-sectional survey about hypertension and sodium intake measured by 24-hour (24-h) urine was launched in Zhejiang Province, to provide the basis of the Chinese population to develop a salt reduction intervention and prevention of hypertension strategy. METHODS Cross-sectional data were obtained from 7512 participants aged 18 to 69 years in Zhejiang Province of China by complex, multistage sampling methods. The survey included face-to-face questionnaires and physical examination among all participants. Blood pressures and the use of anti-hypertension medications were used to determine hypertension. One thousand five hundred participants of them were asked to collect 24-h urine to measure sodium and potassium levels to assess intake. All rates and means were weighted by sampling weight and population structure of the province. RESULTS The weighted means of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 127.78 mm Hg (95% confidence interval [CI], 127.21-128.36) and 79.40 mm Hg (95%CI, 79.04-79.76). The weighted hypertension prevalence was 30.41% (95%CI, 28.91-31.91). Among those classified as having hypertension, 43.55% (95%CI, 40.77-46.34) were aware of the fact that they were suffering from hypertension, 32.05% (95%CI, 29.49-34.61) of them reported taking anti-hypertension medications, only 14.48% (95%CI, 12.54-16.42) had their blood pressure controlled. The weighted means of 24-h urinary sodium was 165.52 mmol (standard deviation [SD], 2.92), representing that the mean intake of sodium chloride was 9.68g (SD, 0.17) through conversion. CONCLUSION These cross-sectional survey results show that hypertension and excessive sodium intake in adults are prevalent in Zhejiang Province, China. Salt reduction and prevention of hypertension is still an urgent public health work.
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Affiliation(s)
- Xiaofu Du
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Le Fang
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Jianwei Xu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Xiangyu Chen
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Jie Zhang
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Yamin Bai
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Jixiang Ma
- Division of Non-communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Min Yu
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Jieming Zhong
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
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Zhu Y, Lu JM, Yu ZB, Li D, Wu MY, Shen P, Lin HB, Wang JB, Chen K. Intra-individual variability of total cholesterol is associated with cardiovascular disease mortality: A cohort study. Nutr Metab Cardiovasc Dis 2019; 29:1205-1213. [PMID: 31383502 DOI: 10.1016/j.numecd.2019.07.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 05/22/2019] [Accepted: 07/08/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS The relationship between serum total cholesterol (TC) and mortality remains inconsistent. Additionally, intra-individual variability of cholesterol has been of increasing interest as a new indicator for health outcomes. We aimed to examine the association between TC and its variability and risk of mortality. METHODS AND RESULTS We performed a retrospective cohort study with 122,645 individuals aged over 40 years in Ningbo, China. The intra-individual variability was calculated using four metrics including standard deviation, coefficient variation, variation independent of mean and average successive variability. Hazard ratios and 95% confidence intervals were estimated for the associations of baseline and variability in TC with risk of mortality by Cox proportional hazards regression models. During 591,585.3 person-years of follow-up, 4563 deaths (including 1365 from cardiovascular disease, 788 from stroke and 1514 from cancer) occurred. A U-shaped association was observed for baseline TC level and risk of total, cardiovascular and cancer mortality, with lowest mortality at 5.46 mmol/L, 5.04 mmol/L and 5.51 mmol/L, respectively. As compared with subjects with TC variability in the lowest quartile, individuals in the highest quartile had 21% higher risk of all-cause mortality (HR = 1.21, 95% CI: 1.05 to 1.40), and 41% higher risk of CVD mortality (HR = 1.41, 95%CI: 1.10 to 1.81). CONCLUSION Both too low and too high baseline TC level were associated with higher risk of total, cardiovascular disease and cancer mortality. Variability of TC could be a risk factor of total and CVD mortality, independent of mean TC level. Future studies are needed to confirm these findings.
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Affiliation(s)
- Yao Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jie-Ming Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Zhe-Bin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Die Li
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Meng-Yin Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China
| | - Peng Shen
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Hong-Bo Lin
- Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, China
| | - Jian-Bing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China; Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China.
| | - Kun Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, China; Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China; Cancer Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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15
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Stefler D, Roever L. Hypertension and consequent mortality risk in China. J Epidemiol Community Health 2018; 72:1071-1072. [PMID: 30228174 DOI: 10.1136/jech-2018-211430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 08/23/2018] [Indexed: 01/04/2023]
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