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Liu Q, Si F, Wu Y, Yu J. Association between transitions in metabolic health and colorectal cancer across categories of body size phenotype: a prospective cohort study. Obesity (Silver Spring) 2024; 32:1948-1957. [PMID: 39169802 DOI: 10.1002/oby.24122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE We aimed to investigate the associations of changes in metabolic health across categories of body size phenotype with the risk of colorectal cancer in a community-based prospective cohort. METHODS In the current study, a total of 70,987 participants were included. Changes in metabolic health across categories of body size phenotype were assessed between the health examination for the first time in the years 2006 through 2009 and a 2010/2011 health examination. A multivariate Cox proportional hazards model was used to assess the associations of changes in metabolic health across body size phenotype categories with risk of colorectal cancer. RESULTS During the median follow-up time of 11.04 years, 428 (0.60%) participants developed colorectal cancer. Compared with metabolically healthy normal-weight (MHNW) participants who remained MH, the risk of colorectal cancer was increased by 144% (95% CI: 1.21-4.95) for participants with metabolically healthy obesity (MHO) who converted to a metabolically unhealthy (MU) phenotype. Participants who were MU at baseline were still at increased risk of colorectal cancer, regardless of obesity status. CONCLUSIONS The MHO phenotype was a dynamic status over time, and converting to MU during follow-up and being initially MU were associated with having an increased risk of colorectal cancer, regardless of degree of obesity and body size phenotype.
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Affiliation(s)
- Qian Liu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Fei Si
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Yuntao Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Jing Yu
- Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, China
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Huang L, Liu Y, Geng T, Zhang N, Sun L, Wu S, Gao X. Healthy Sleep Pattern, Metabolic Diseases, and Risk of Stroke: The Kailuan Cohort Study. Nat Sci Sleep 2024; 16:1169-1178. [PMID: 39131166 PMCID: PMC11314433 DOI: 10.2147/nss.s468522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/16/2024] [Indexed: 08/13/2024] Open
Abstract
Background Sleep complaints were reported to be associated with stroke, however, the evidence on the association between healthy sleep pattern and stroke risk in Chinese is limited. Objective The aim of this study was to investigate the association between healthy sleep pattern and stroke in Chinese, and the influence of metabolic diseases on the association. Methods A total of 11,851 participants from the Kailuan study in China without stroke at baseline were included. We calculated a healthy sleep score according to four sleep factors, and defined the low-risk groups as follows: no insomnia, no excessive daytime sleepiness, no frequent snoring, and sleep 7-8h/d. Each low-risk sleep factor was assigned a score of 1. Cox proportional hazard models were used to assess the association between healthy sleep score and stroke. Mediation analysis was used to estimate the role of metabolic diseases (obesity, diabetes, and hypertension) in the healthy sleep score-stroke association. Results During a mean follow-up period of 7.7 years, 504 cases of stroke were identified. A higher healthy sleep score was associated with a lower risk of stroke in a dose-response manner (P-trend=0.03). The adjusted hazard ratio (HR) for participants with a healthy sleep score of 4 versus ≤2 was 0.75 (95% confidence interval [CI]: 0.56, 0.96). In addition, obesity, diabetes, and hypertension collectively explained 21.9% (95% CI: 17.2, 26.5) of the association between healthy sleep score and stroke. Conclusion Adherence to healthy sleep pattern was associated with a lower risk of stroke, and the favorable association was partially mediated by metabolic diseases.
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Affiliation(s)
- Lili Huang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, People’s Republic of China
| | - Yesong Liu
- Department of Neurology, Kailuan General Hospital, Tangshan, People’s Republic of China
| | - Tingting Geng
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, People’s Republic of China
| | - Nannan Zhang
- Department of Neurology, Kailuan General Hospital, Tangshan, People’s Republic of China
| | - Liang Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, People’s Republic of China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, People’s Republic of China
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, People’s Republic of China
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Wu Z, Chen S, Tao X, Liu H, Sun P, Richards AM, Tan HC, Yu Y, Yang Q, Wu S, Zhou X. Risk and effect modifiers for poor glycemic control among the chinese diabetic adults on statin therapy: the kailuan study. Clin Res Cardiol 2024; 113:1219-1231. [PMID: 38265512 DOI: 10.1007/s00392-024-02381-x] [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: 09/26/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Limited studies have investigated the association between statin therapy and poor glycemic control, especially in the Chinese diabetic population. METHODS Two prospective diabetes cohorts were drawn from the Kailuan Cohort. In Cohort 1, linear regression models were used to evaluate the association between statin therapy and glycated hemoglobin (HbA1c) level change. In Cohort 2, new user design and conditional logistic models were used to assess associations between statin initiation and poor glycemic control which was a composite outcome comprised of hypoglycemic agent escalation and new-onset hyperglycemia. RESULTS Among 11,755 diabetic patients with medication information, 1400 statin users and 1767 statin nonusers with repeated HbA1c measurements were included in Cohort 1 (mean age: 64.6 ± 10.0 years). After a median follow-up of 3.02 (1.44, 5.00) years, statin therapy was associated with higher HbA1c levels (β: 0.20%; 95%CI: 0.05% to 0.34%). In Cohort 2, 1319 pairs of matched cases/controls were included (mean age: 61.6 ± 9.75 years). After a median follow-up of 4.87 (2.51, 8.42) years, poor glycemic control occurred in 43.0% of statin new users and 31.8% of statin nonusers (OR: 1.69; 95% CI: 1.32 to 2.17; P < 0.001). The statin-associated poor glycemic control risk was significantly higher among patients with lower body mass index (Pint = 0.089). Furthermore, a nonlinear association was observed between statin therapy duration and poor glycemic control (P = 0.003). CONCLUSIONS Among Chinese diabetic adults, statin therapy was associated with a higher level of HbA1c, and a higher risk of hypoglycemic agent escalation and new-onset hyperglycemia, especially among those who had lower body mass index levels and longer statin therapy duration.
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Affiliation(s)
- Zhaogui Wu
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhuadong Street, Lubei District, TangshanHebei, 063001, China
| | - Xixi Tao
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Hangkuan Liu
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Pengfei Sun
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Arthur Mark Richards
- Cardiovascular Research Institute, National University Health System, 14 Medical Drive, Singapore, 117599, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive (MD6), Singapore, 117597, Singapore
| | - Huay Cheem Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive (MD6), Singapore, 117597, Singapore
- Department of Cardiology, National University Heart Centre, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore
| | - Ying Yu
- Department of Pharmacology and Tianjin Key Laboratory of Inflammatory Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300070, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China.
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhuadong Street, Lubei District, TangshanHebei, 063001, China.
| | - Xin Zhou
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China.
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Dong Y, Chen S, Yu Y, Li W, Xu Z, Du J, Huang S, Wu S, Cai Y. Association between Urine Specific Gravity as a Measure of Hydration Status and Risk of Type 2 Diabetes: The Kailuan Prospective Cohort Study. Nutrients 2024; 16:1643. [PMID: 38892576 PMCID: PMC11174895 DOI: 10.3390/nu16111643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/07/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Diabetes, especially type 2 diabetes (T2D), poses an unprecedented challenge to global public health. Hydration status also plays a fundamental role in human health, especially in people with T2D, which is often overlooked. This study aimed to explore the longitudinal associations between hydration status and the risk of T2D among the Chinese population. This study used data from the large community-based Kailuan cohort, which included adults who attended physical examinations from 2006 to 2007 and were followed until 2020. A total of 71,526 participants who eventually met the standards were divided into five hydration-status groups based on their levels of urine specific gravity (USG). Multivariable and time-dependent Cox proportional hazards models were employed to evaluate the associations of baseline and time-dependent hydration status with T2D incidence. Restricted cubic splines (RCS) analysis was used to examine the dose-response relationship between hydration status and the risk of T2D. Over a median 12.22-year follow-up time, 11,804 of the participants developed T2D. Compared with the optimal hydration-status group, participants with dehydration and severe dehydration had a significantly increased risk of diabetes, with adjusted hazard ratios (95% CI) of 1.30 (1.04-1.63) and 1.38 (1.10-1.74). Time-dependent analyses further confirmed the adverse effects of impending dehydration, dehydration, and severe dehydration on T2D incidence by 16%, 26%, and 33% compared with the reference group. Inadequate hydration is significantly associated with increased risks of T2D among Chinese adults. Our findings provided new epidemiological evidence and highlighted the potential role of adequate hydration status in the early prevention of T2D development.
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Affiliation(s)
- Yinqiao Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan 063000, China;
| | - Yaohui Yu
- School of Public Health, North China University of Science and Technology, Tangshan 063210, China;
| | - Wenjuan Li
- School of Clinical Medicine, North China University of Science and Technology, Tangshan 063210, China;
| | - Zhongqing Xu
- Department of General Practice, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China;
| | - Juan Du
- Endocrinology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China;
| | - Shan Huang
- Endocrinology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China;
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan 063000, China;
| | - Yong Cai
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
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Nie T, Huang S, Yang Y, Hu A, Wang J, Cheng Z, Liu W. A review of the world's salt reduction policies and strategies - preparing for the upcoming year 2025. Food Funct 2024; 15:2836-2859. [PMID: 38414443 DOI: 10.1039/d3fo03352j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Excessive consumption of dietary sodium is a significant contributor to non-communicable diseases, including hypertension and cardiovascular disease. There is now a global consensus that regulating salt intake is among the most cost-effective measures for enhancing public health. More than half of the countries worldwide have implemented multiple strategies to decrease salt consumption. Nevertheless, a report on sodium intake reduction published by the World Health Organization revealed that the world is off-track to meet its targeted reduction of 30% by 2025. The global situation regarding salt reduction remains concerning. This review will center on domestic and international salt reduction policies, as well as diverse strategies, given the detrimental effects of excessive dietary salt intake and the existing global salt intake scenario. Besides, we used visualization software to analyze the literature related to salt reduction research in the last five years to explore the research hotspots in this field. Our objective is to enhance public awareness regarding the imperative of reducing salt intake and promoting the active implementation of diverse salt reduction policies.
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Affiliation(s)
- Ting Nie
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Siqi Huang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Yuxin Yang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Anna Hu
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Jianing Wang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Zeneng Cheng
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
| | - Wenjie Liu
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, China.
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Shimozuru Y, Matsushima Y, Ochi M, Itoh H, Hachisuka A, Saeki S. Survey of patients with stroke in the Kitakyushu Area, Japan: a 12-year retrospective analysis of the critical pathway. J Stroke Cerebrovasc Dis 2024; 33:107525. [PMID: 38171185 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107525] [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: 05/21/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES We aimed to clarify the incidence, clinical profile, outcome, and activities of daily living of patients with stroke using the Kitakyushu clinical pathway database and to investigate the characteristics of patients with stroke in the Kitakyushu medical area in Japan. MATERIALS AND METHODS The clinical data of patients with stroke registered in the Kitakyushu database between April 1, 2009 and December 31, 2021 were retrospectively examined. The National Institutes of Health Stroke Scale was used to classify stroke severity. A descriptive analysis of basic variables, including age, stroke type, length of hospital stay, and activities of daily living, according to stroke severity was conducted. RESULTS There were 7,487 acute care hospital patients and 5,441 rehabilitation hospital patients. Compared with patients in similar cities in Japan, patients in the Kitakyushu area tended to be older at the time of stroke onset with a higher proportion of cases of hemorrhagic stroke. Length of hospital stay in both acute and rehabilitation hospitals increased with stroke severity. The Functional Independence Measure gain was highest in patients with moderate disability. CONCLUSIONS Compared with patients in similar cities in Japan, in the Kitakyushu area, patients with stroke were older and the proportion of patients with hemorrhagic stroke was higher. Stroke rehabilitation therapy is effective for patients with moderately severe stroke.
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Affiliation(s)
- Yukihiro Shimozuru
- Graduate School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
| | - Yasuyuki Matsushima
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Mitsuhiro Ochi
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Hideaki Itoh
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Akiko Hachisuka
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Satoru Saeki
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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Chen YP, Wang M, Fang X, Liya A, Zhang H, Blank I, Zhu H, Liu Y. Odorants Identified in Chinese Dry-Cured Ham Contribute to Salty Taste Enhancement. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:613-624. [PMID: 38156454 DOI: 10.1021/acs.jafc.3c05848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Jinhua dry-cured ham (JDH) is a traditional fermented Chinese meat product. We studied the dynamic sensory and emotional profiles of JDHs obtained by five preparation methods and the corresponding release of sodium ions (Na+), potassium ions (K+), and volatile organic compounds (VOCs) during oral processing. The VOCs with salty taste enhancement abilities were screened based on the correlations of VOCs with salty flavor and concentration of Na and K ions with salty flavor. A trained sensory panel evaluated the saltiness enhancements of selected VOCs by using static and dynamic sensory methods. The results revealed that Na+, K+, and selected VOCs were mainly released during 0-10 s of the chewing process. The release of Na+ and K+ in JDH residue samples exhibited consistently decreasing trends, while in saliva, their concentrations increased. The VOCs showing a high correlation with Na+ and K+ and salty flavor have saltiness enhancement abilities in both NaCl solutions and NaCl + MSG mixtures. Odor-induced saltiness was pronounced at low salt concentrations (0.2% NaCl). The investigation demonstrated 16 VOCs exhibiting saltiness enhancement abilities, including 4 pyrazines, 5 acids, 4 sulfur-containing compounds, and 3 other compounds. The sensory evaluation suggested pyrazines and sulfur-containing compounds as good saltiness enhancers. 2-Furfuryl mercaptan significantly enhanced the salty sensation in the NaCl + MSG solutions when compared with MSG alone (p < 0.05). This research provides evidence that certain odorants identified in JDHs exhibit salty-enhancing properties, indicating their potential for salt reduction at the industrial level.
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Affiliation(s)
- Yan Ping Chen
- Department of Food Science & Technology, School of Agriculture & Biology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Mengni Wang
- Department of Food Science & Technology, School of Agriculture & Biology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xiaolei Fang
- Department of Food Science & Technology, School of Agriculture & Biology, Shanghai Jiao Tong University, Shanghai 200240, China
- College of Food and Health, Zhejiang Agriculture and Forestry University, Hangzhou 311300, China
| | - A Liya
- Department of Food Science & Technology, School of Agriculture & Biology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Haihua Zhang
- College of Food and Health, Zhejiang Agriculture and Forestry University, Hangzhou 311300, China
| | - Imre Blank
- Zhejiang Yiming Food Co., Ltd., Jiuting Center, Huting North Street No. 199, Shanghai 201600, China
| | - Hanyue Zhu
- Guangdong Provincial Key Laboratory of Intelligent Food Manufacturing, Foshan University, Foshan 528225, Guangdong, China
| | - Yuan Liu
- Department of Food Science & Technology, School of Agriculture & Biology, Shanghai Jiao Tong University, Shanghai 200240, China
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Tian X, Feng J, Chen S, Zhang Y, Zhang X, Xu Q, Wang P, Wu S, Wang A. Baseline and longitudinal cardiovascular health using Life's Essential 8 metrics with the risk of incident hypertension. Clin Exp Hypertens 2023; 45:2271190. [PMID: 37983187 DOI: 10.1080/10641963.2023.2271190] [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: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE The quantification of cardiovascular health (CVH) was updated by the American Heart Association recently by using the "Life's Essential 8" (LE8) score. We aimed to investigate the associations of baseline and longitudinal CVH status measured by the new LE8 score (except for blood pressure) with the risk of hypertension. METHODS A total of 52 990 participants with complete data on LE8 metrics and without hypertension were enrolled from the Kailuan study, Tangshan, China. The associations of incident hypertension with the overall baseline, time-updated, and time-varying CVH score (ranging 0 [lowest] to 100 [highest]), and each component of LE8, were assessed by Cox regressions. RESULTS During a median follow-up of 10.73 years 28 380 cases of incident hypertension were identified. The risk of hypertension attenuated with increased CVH score (Ptrend < 0.0001), the hazard ratios (HRs) in high CVH versus low CVH group was 0.54 (95% confidence interval [CI], 0.51-0.57) for baseline CVH, 0.47 (95% CI, 0.45-0.50) for time-updated CVH, and 0.59 (95% CI, 0.55-0.63) for time-varying CVH. The predictive value of CVH in predicting hypertension improved by using LE8 than using Life's Simple 7 metrics. Among LE8 components, body mass index score was the strongest risk factor for hypertension. Subgroup analyses showed that the benefit of a higher CVH score on hypertension was more prominent in young adults and in women (Pinteraction < 0.05). CONCLUSIONS A higher CVH score assessed by new LE8 is associated with a lower risk of subsequent hypertension, especially young adults and women.
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Affiliation(s)
- Xue Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jingxuan Feng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qin Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Penglian Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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Shen Y, Liu H, Meng X, Gao A, Liu Y, Ma W, Liang H, Hu F. The causal effects between gut microbiota and hemorrhagic stroke: a bidirectional two-sample Mendelian randomization study. Front Microbiol 2023; 14:1290909. [PMID: 38188561 PMCID: PMC10770845 DOI: 10.3389/fmicb.2023.1290909] [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: 09/11/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
Background Recent studies have suggested that the composition of gut microbiota (GM) may change after intracerebral hemorrhage. However, the causal inference of GM and hemorrhagic stroke is unknown. Mendelian Randomization (MR) is an effective research method that removes confounding factors and investigates the causal relationship between exposure and outcome. This study intends to explore the causal relationship between GM and hemorrhagic stroke with the help of MR. Methods Univariable and multivariable MR analyses were performed using summary statistics of the GM (n = 18,340) in the MiBioGen consortium vs. the FinnGen consortium R9 summary statistics (intracerebral hemorrhage, subarachnoid hemorrhage, and nontraumatic intracranial hemorrhage). Causal associations between gut microbiota and hemorrhagic stroke were analyzed using inverse variance weighted, MR-Egger regression, weighted median, weighted mode, simple mode, and MR-PRESSO. Cochran's Q statistic, MR-Egger regression, and leave-one-out analysis were used to test for multiplicity and heterogeneity of instrumental variables. Separate reverse MR analyses were performed for microbiota found to be causally associated with hemorrhagic stroke in the forward MR analysis. Also, multivariate MR analyses were conducted after incorporating common confounders. Results Based on the results of univariable and multivariate MR analyses, Actinobacteria (phylum) (OR, 0.80; 95%CI, 0.66-0.97; p = 0.025) had a protective effect against hemorrhagic stroke, while Rikenellaceae RC9 gut group (genus) (OR, 0.81; 95%CI, 0.67-0.99; p = 0.039) had a potential protective effect. Furthermore, Dorea (genus) (OR, 1.77; 95%CI, 1.27-2.46; p = 0.001), Eisenbergiella (genus) (OR, 1.24; 95%CI, 1.05-1.48; p = 0.013) and Lachnospiraceae UCG008 (genus) (OR, 1.28; 95%CI, 1.01-1.62; p = 0.041) acted as potential risk factors for hemorrhagic stroke. The abundance of Dorea (genus) (β, 0.05; 95%CI, 0.002 ~ 0.101; p = 0.041) may increase, and that of Eisenbergiella (genus) (β, -0.072; 95%CI, -0.137 ~ -0.007; p = 0.030) decreased after hemorrhagic stroke according to the results of reverse MR analysis. No significant pleiotropy or heterogeneity was detected in any of the MR analyses. Conclusion There is a significant causal relationship between GM and hemorrhagic stroke. The prevention, monitoring, and treatment of hemorrhagic stroke through GM represent a promising avenue and contribute to a deeper understanding of the mechanisms underlying hemorrhagic stroke.
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Affiliation(s)
- Yingjie Shen
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hao Liu
- Clinical Laboratory of Molecular Biology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiangyi Meng
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Aili Gao
- School of Life Science, Northeast Agricultural University, Harbin, China
| | - Yansong Liu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Ma
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongsheng Liang
- NHC Key Laboratory of Cell Transplantation, Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, China
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10
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Liu Y, Lin L, Tao B, Ding X, Chen S, Wang G, Shi J, Huang Z, Yu J, Yang N, Wu S, Li Y. The effect of adverse pregnancy outcomes on vascular aging in young women: the Kailuan study. J Hum Hypertens 2023; 37:969-976. [PMID: 36750628 DOI: 10.1038/s41371-023-00805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 01/05/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023]
Abstract
Adverse pregnancy outcomes (APOs) are at increased future cardiovascular risk and require effective risk mitigation. However, data regarding appropriate postpartum screening for young women with APOs are lacking. We aimed to investigate the association between APOs and vascular aging by the determination of high pulse wave velocity (PWV) in young women. Women who gave birth from 1990 to 2020 and underwent brachial-ankle pulse wave velocity (baPWV) assessments in the postpartum period were recruited. We excluded women with age ≥50 years at the baPWV assessment or missing postpartum health examinations. The history of APOs including hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, and low birth weight were assessed by medical records. High PWV was defined as baPWV above the 90th percentile for different age group. Multivariable Logistic regression was used to evaluate the association of APOs and high PWV. 3193 participants were included in the analysis, including 912 (28.6%) individuals with APOs. The prevalence of high PWV in the non-APO group and the APOs group were 7.19% (164) and 13.9% (127), respectively (P < 0.05). Compared with non-APO group, the OR (95% CI) of APOs group was 1.67 (1.29-2.16). The risks in the 20-29, 30-39, and 40-49 age groups were 2.51 (1.13-5.59), 1.83 (1.30-2.59), and 1.35 (0.82-2.21) (P for trend <0.05). We conclude that APOs are risk factors of vascular aging for young women and the risk decreased with increasing age. BaPWV should be an important indicator for preventive cardiovascular risk management in young women with APOs. Clinical trial registration: Registration number ChiCTR-TNRC-11001489, http://www.chictr.org.cn/showproj.aspx?proj=8050 .
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Affiliation(s)
- Yan Liu
- Department of Graduate School, Tianjin Medical University, No. 22 Meteorological Terrace Road, Heping District, Tianjin, 300070, China
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Liming Lin
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Boni Tao
- Tianjin Binhai New Area Center for Disease Control and Prevention, No. 575 Jiashun Road, Binhai New Area, Tianjin, 300450, China
| | - Xiong Ding
- School of Public Health, North China University of Science and Technology, Tangshan, 063000, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Jihong Shi
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Zhe Huang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Jiaxin Yu
- Department of Cardiology, Tangshan Worker's Hospital, No.27 Culture Road, Tangshan, 063000, China
| | - Ning Yang
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, 300457, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China.
| | - Yuming Li
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, 300457, China.
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Ma J, Lee YK. Examining the Association between Cigarette Smoking Quantity and Subjective Salt Taste Preference and Salt-Related Eating Behavior. Korean J Fam Med 2023; 44:335-341. [PMID: 37647943 PMCID: PMC10667072 DOI: 10.4082/kjfm.23.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Smoking can reduce taste sensitivity, the ability to sense various tastes, and diet quality and can increase the incidence of diseases such as hypertension. This study aimed to analyze the association between the smoking amount, subjective salt preference, and salt-related eating behaviors. METHODS Data of more than 16 million individuals from the Korean Community Health Survey were used. Forest plots were drawn to compare the cumulative odds ratios of salt taste preference and salt-related eating behaviors, adjusted for sex, age, body mass index, education level, household income, marital status, and drinking status at various smoking levels. RESULTS Subjective salt preference and salt-related eating behaviors increased with smoking amount; the adjusted odds ratios (AORs) for smoking >20 cigarettes were higher than those for smoking <20 cigarettes. For daily smokers, the AOR was 1.27 (95% confidence interval [CI], 1.22-1.31) for 1-5 cigarettes per day and 1.68 (95% CI, 1.65-1.71) for 16-20 cigarettes per day (P<0.001). Smokers were more likely to have more frequent salt-related eating behaviors than nonsmokers. CONCLUSION The subjective salt preference of smokers was higher than that of nonsmokers. Additionally, smokers used salt or soy sauce and dipped fried food in soy sauce more frequently than nonsmokers, which was also related to smoking amount.
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Affiliation(s)
- Jian Ma
- Department of Food Science & Nutrition, Kyungpook National University, Daegu, Korea
| | - Yeon-Kyung Lee
- Department of Food Science & Nutrition, Kyungpook National University, Daegu, Korea
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12
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Ren TJ, Zhang K, Li WJ, Ren ST, Huang YZ, Yang N, Wu SL, Li YM. Body mass index, neck circumference, and hypertension: a prospective cohort study. Front Cardiovasc Med 2023; 10:1269328. [PMID: 37849941 PMCID: PMC10578437 DOI: 10.3389/fcvm.2023.1269328] [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: 07/29/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023] Open
Abstract
Objective This study aimed to investigate the association between BMI combined with neck circumference and the risk of hypertension. Methods We selected participants from the Kailuan study in 2014 who were normotensive as our research subjects. We compared the risk of hypertension among individuals in group 1 (non-obese with low neck circumference), group 2 (non-obese with high neck circumference), group 3 (obese with low neck circumference), and group 4 (obese with high neck circumference). Results After a median observation period of 3.86 years, hypertension occurred in 13,383 participants. Subjects in Group 2, 3, and 4 had significantly higher risks of hypertension compared to Group 1, with hazard ratios (HRs) of 1.066 (95% CI: 1.025, 1.110), 1.322 (95% CI: 1.235, 1.415), and 1.422 (95% CI: 1.337, 1.512), respectively. Additionally, adding BMI to a conventional model had a greater incremental effect on predicting hypertension compared to adding neck circumference alone. However, considering both BMI and neck circumference together further improved the prediction of hypertension. Conclusion Individuals with both high BMI and high neck circumference face a higher risk of hypertension. Moreover, BMI is a superior predictor of hypertension risk compared to neck circumference, but using both of these measures can further enhance the accuracy of hypertension risk prediction.
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Affiliation(s)
- Tao-jun Ren
- Clinical School of Cardiovascular Disease, Tianjin Medical University, Tianjin, China
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Kun Zhang
- Clinical School of Cardiovascular Disease, Tianjin Medical University, Tianjin, China
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Wen-juan Li
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Shu-tang Ren
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Yun-zhou Huang
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Ning Yang
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Shou-ling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yu-ming Li
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
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Li M, Zhao L, Zhang L, Li P, Zhang X, Wang C, Li X, Wu S, Sun L. Factors influencing normal blood pressure maintenance in young adults. J Clin Hypertens (Greenwich) 2023; 25:725-736. [PMID: 37461269 PMCID: PMC10423756 DOI: 10.1111/jch.14702] [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: 05/09/2023] [Revised: 06/15/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023]
Abstract
Despite an alarming increase in the prevalence of hypertension among Chinese young adults, longitudinal studies investigating factors that affect the maintenance of normal blood pressure (BP) in this population are lacking. Our study aimed to address this knowledge gap. A total of 7100 participants from the Kailuan Study who had normal BP and were aged <30 years at their first physical examination between 2006 and 2016 were included in this study. Cox proportional hazards regression models were used to assess hazard ratios (HR), and 95% confidence intervals (CI) were calculated to assess the associations between influencing factors and the maintenance of normal BP in young adults. Analyses were stratified by sex. During the follow-up period (mean, 7.98 years), 1921 participants (27.06%) maintained normal BP. Higher education levels (HR, 1.11; 95% CI, 1.00-1.22), low salt intake (HR, 1.25; 95% CI, 1.04-1.51), being underweight (HR, 1.16; 95% CI, 1.02-1.31), and having normal weight (HR, 1.19; 95% CI, 1.01-1.39), normal blood glucose (HR, 1.22; 95% CI, 1.02-1.46), and no family history of hypertension (HR, 1.65; 95% CI, 1.41-1.92) at baseline were found to be associated with maintaining normal BP. Compared with female smokers, female non-smokers had 1.68 times higher odds of maintaining normal BP. This study identified factors that influence the maintenance of normal BP in the young population in China. This information can assist clinicians in establishing comprehensive and effective primary prevention measures for hypertension.
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Affiliation(s)
- Man Li
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
- School of clinical medicineNorth China University of Science and TechnologyTangshanHebeiChina
| | - Lei Zhao
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
| | - Li Zhang
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
| | - Peng Li
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
| | - Xiaoling Zhang
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
| | - Chong Wang
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
| | - Xinyuan Li
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
| | - Shouling Wu
- Department of CardiologyKailuan HospitalTangshanChina
| | - Lixia Sun
- Department of EmergencyThe Affiliated Hospital of North China University of Science and TechnologyTangshanChina
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Abstract
Since 2015, stroke has become the leading cause of death and disability in China, posing a significant threat to the health of its citizens as a major chronic non-communicable disease. According to the China Stroke High-risk Population Screening and Intervention Program, an estimated 17.8 million [95% confidence interval (CI) 17.6-18.0 million] adults in China had experienced a stroke in 2020, with 3.4 million (95% CI 3.3-3.5 million) experiencing their first-ever stroke and another 2.3 million (95% CI 2.2-2.4 million) dying as a result. Additionally, approximately 12.5% (95% CI 12.4-12.5%) of stroke survivors were left disabled, as defined by a modified Rankin Scale score greater than 1, equating to 2.2 million (95% CI 2.1-2.2 million) stroke-related disabilities in 2020. As the population ages and the prevalence of risk factors like diabetes, hypertension, and hyperlipidemia continues to rise and remains poorly controlled, the burden of stroke in China is also increasing. A large national epidemiological survey initiated by the China Hypertension League in 2017 showed that the prevalence of hypertension was 24.7%; the awareness, treatment, and control rates in hypertensive patients were: 60.1%, 42.5%, and 25.4%, respectively. A nationally representative sample of the Chinese mainland population showed that the weighted prevalence of total diabetes diagnosed by the American Diabetes Association criteria was 12.8%, suggesting there are 120 million adults with diabetes in China, and the awareness, treatment, and control rates in diabetic patients were: 43.3%, 49.0%, and 49.4%, respectively. The "Sixth National Health Service Statistical Survey Report in 2018" showed that the proportion of the obese population in China was 37.4%, an increase of 7.2 points from 2013. Data from 1599 hospitals in the Hospital Quality Monitoring System and Bigdata Observatory Platform for Stroke of China (BOSC) showed that a total of 3,418,432 stroke cases [mean age ± standard error (SE) was (65.700 ± 0.006) years, and 59.1% were male] were admitted during 2020. Of those, over 80% (81.9%) were ischemic stroke (IS), 14.9% were intracerebral hemorrhage (ICH) strokes, and 3.1% were subarachnoid hemorrhage (SAH) strokes. The mean ± SE of hospitalization expenditures was Chinese Yuan (CNY) (16,975.6 ± 16.3), ranging from (13,310.1 ± 12.8) in IS to (81,369.8 ± 260.7) in SAH, and out-of-pocket expenses were (5788.9 ± 8.6), ranging from (4449.0 ± 6.6) in IS to (30,778.2 ± 156.8) in SAH. It was estimated that the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion, of which the patient pays approximately CNY 19.8 billion. In-hospital death/discharge against medical advice rate was 9.2% (95% CI 9.2-9.2%), ranging from 6.4% (95% CI 6.4-6.5%) for IS to 21.8% for ICH (95% CI 21.8-21.9%). From 2019 to 2020, the information about 188,648 patients with acute IS receiving intravenous thrombolytic therapy (IVT), 49,845 patients receiving mechanical thrombectomy (MT), and 14,087 patients receiving bridging (IVT + MT) were collected through BOSC. The incidence of intracranial hemorrhage during treatment was 3.2% (95% CI 3.2-3.3%), 7.7% (95% CI 7.5-8.0%), and 12.9% (95% CI 12.3-13.4%), respectively. And in-hospital death/discharge against medical advice rate was 8.9% (95% CI 8.8-9.0%), 16.5% (95% CI 16.2-16.9%), and 16.8% (95% CI 16.2-17.4%), respectively. A prospective nationwide hospital-based study was conducted at 231 stroke base hospitals (Level III) from 31 provinces in China through BOSC from January 2019 to December 2020 and 136,282 stroke patients were included and finished 12-month follow-up. Of those, over 86.9% were IS, 10.8% were ICH strokes, and 2.3% were SAH strokes. The disability rate [% (95% CI)] in survivors of stroke at 3-month and 12-month was 14.8% (95% CI 14.6-15.0%) and 14.0% (95% CI 13.8-14.2%), respectively. The mortality rate [% (95% CI)] of stroke at 3-month and 12-month was 4.2% (95% CI 4.1-4.3%) and 8.5% (95% CI 8.4-8.6%), respectively. The recurrence rate [% (95% CI)] of stroke at 3-month and 12-month was 3.6% (95% CI 3.5-3.7%) and 5.6% (95% CI 5.4-5.7%), respectively. The Healthy China 2030 Stroke Action Plan was launched as part of this review, and the above data provide valuable guidelines for future stroke prevention and treatment efforts in China.
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Affiliation(s)
- Wen-Jun Tu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Long-De Wang
- School of Public Health, Peking University, Beijing, 100191, China.
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Liu Q, Cui H, Chen S, Zhang D, Huang W, Wu S. Association of baseline Life's Essential 8 score and trajectories with carotid intima-media thickness. Front Endocrinol (Lausanne) 2023; 14:1186880. [PMID: 37334294 PMCID: PMC10272710 DOI: 10.3389/fendo.2023.1186880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023] Open
Abstract
Objective We aimed to examine the association between the baseline Life's Essential 8 (LE8) score and LE8 score trajectories with the continuous carotid intima-media thickness (cIMT) as well as the risk of high cIMT. Methods The Kailuan study has been an ongoing prospective cohort study since 2006. A total of 12,980 participants who completed the first physical examination and cIMT detection at follow-up without a history of CVD and missing data on the component of LE8 metrics in or before 2006 were finally included in the analysis. The LE8 score trajectories were developed from 2006 to 2010 using trajectory modeling of the SAS procedure Proc Traj. The measurement and result review of the cIMT were performed by specialized sonographers using standardized methods. According to quintiles of baseline LE8 score, participants were categorized into five groups: Q1, Q2, Q3, Q4, and Q5. Similarly, based on their LE8 score trajectories, they were classified into four groups: very low-stable group, low-stable group, median-stable group, and high-stable group. In addition to continuous cIMT measurement, we determined the high cIMT based on the age (by 5 years) and sex-specific 90th percentile cut point. To address aims 1 and 2, the association between baseline/trajectory groups and continuous cIMT/high cIMT was assessed by using SAS proc genmod to calculate β, relative risk (RR), and 95% confidence intervals (CI). Results A total of 12,980 participants were finally included in aim 1, and 8,758 participants met aim 2 of the association between LE8 trajectories and cIMT/high cIMT. Compared with the Q1 group, the continuous cIMT for Q2, Q3, Q4, and Q5 groups were thinner; the other groups had a lower risk of high cIMT. For aim 2, the results indicated that compared with a very low-stable group, the cIMT for the low-stable group, the median-stable group, and the high-stable group were thinner (-0.07 mm [95% CI -0.10~0.04 mm], -0.10 mm [95% CI -0.13~-0.07 mm], -0.12 mm [95% CI -0.16~-0.09 mm]) and had a lower risk of high cIMT. The RR (95% CI) for high cIMT was 0.84 (0.75~0.93) in the low-stable group, 0.63 (0.57~0.70) in the median-stable group, 0.52 (0.45~0.59) in the high-stable group. Conclusions In summary, our study revealed that high baseline LE8 scores and LE8 score trajectories were associated with lower continuous cIMT and attenuated risk of high cIMT.
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Affiliation(s)
- Qian Liu
- Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Haozhe Cui
- School of Medicine, Nankai University, Tianjin, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Dongyan Zhang
- Ultrasound Medicine Department, Kailuan General Hospital, Tangshan, China
| | - Wei Huang
- Ultrasound Medicine Department, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
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Zhou H, Ding X, Wu S, Yan J, Cao J. Association of cardiovascular health score trajectory and risk of subsequent cardiovascular disease in non-diabetic population: a cohort study. BMC Public Health 2023; 23:1043. [PMID: 37264382 DOI: 10.1186/s12889-023-15569-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/30/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Diabetes is an important risk factor for cardiovascular disease (CVD), but in the non-diabetic population, high glucose values within the normal range are also positively associated with CVD risk. There is a lack of concern for people without diabetes and evidence is lacking regarding the association between changes in cardiovascular health score (CVHS) and CVD risk in the non-diabetic population. METHODS The current study included 37,970 non-diabetic participants free of CVD events in or before 2010 from the Kailuan Study and calculated CVHS according to the overall status of 7 cardiovascular health metrics between the 2006 and 2010 waves. Latent mixture models were used to explore the subgroups with different development trends included in the context of the Kailuan non-diabetic population and to identify the trajectory of each subgroup. The outcomes of the current study were CVD events, including myocardial infarction and stroke. CVHS trajectory was developed to predict subsequent CVD risk from 2010 to 2020. The Cox proportional hazard model was established to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of CVD across different trajectory patterns. RESULTS Five distinct CVHS trajectory patterns were identified, including low-stable pattern (n = 2835), moderate-increasing pattern (n = 3492), moderate-decreasing pattern (n = 7526), high-stable I pattern (n = 17,135), and high-stable II pattern (n = 6982). Compared with the low-stable pattern, participants with the high-stable II pattern had a lower subsequent risk of CVD (HR = 0.22, 95%CI = 0.18-0.28); In stratification analysis, the lower risk for CVD was observed in females (HR = 0.10, 95%CI = 0.05-0.23, P for interaction < 0.05) and those aged < 60 years (HR = 0.16, 95%CI = 0.11 to 0.22, P for interaction < 0.05). CONCLUSIONS CVHS trajectory patterns were associated with an altered CVD risk in the non-diabetic population. When stratified by age and sex, the association was stronger in young adults and females.
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Affiliation(s)
- Hui Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xiong Ding
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Jin Yan
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jianyun Cao
- Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Ma J, Lee YK. The effects of cigarette smoking and alcohol drinking on salty taste preferences based on Korean Community Health Survey data. Nutr Res Pract 2023; 17:487-502. [PMID: 37266114 PMCID: PMC10232194 DOI: 10.4162/nrp.2023.17.3.487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/01/2022] [Accepted: 09/01/2022] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES Excessive sodium intake, cigarette smoking, and alcohol consumption are risk factors for a wide range of diseases. This study aimed to determine whether smokers and drinkers are more likely to enjoy their food with more salt, and whether the combination of smoking and drinking is associated with salty taste preferences. SUBJECTS/METHODS This study analyzed the data of over 16 million Koreans from two four-year Korean Community Health Survey cycles (i.e., 2010 to 2013 and 2014 to 2017). The respondents' preferences for salty foods (i.e., their salt intake levels, whether they added salt or soy sauce to foods served on the table, and whether they dipped fried foods in salt or soy sauce), and the odds ratio (OR) of their preference were examined among smokers and drinkers when adjusted for sex, age, body mass index, educational level, household income, marital status, and cigarette smoking or alcohol consumption status. RESULTS Cigarette smoking and alcohol consumption were correlated with the consumption of salty food. Based on the adjusted model, cigarette smokers and alcohol drinkers preferred adding salt or soy sauce or dipping fried foods in soybean more than non-smokers and non-drinkers. In addition, people who smoked and consumed alcohol reported a more significant stacking effect regarding the salty taste preference. CONCLUSION This large population-based study found that both cigarette smoking and alcohol consumption were correlated with salty taste preferences, which may cause excessive sodium intake.
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Affiliation(s)
- Jian Ma
- Department of Food Science & Nutrition, Kyungpook National University, Daegu 41566, Korea
| | - Yeon-Kyung Lee
- Department of Food Science & Nutrition, Kyungpook National University, Daegu 41566, Korea
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18
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Kou C, Zhao X, Fan X, Lin X, Wang Q, Yu J. Dietary sodium/potassium intake and cognitive impairment in older patients with hypertension: Data from NHANES 2011-2014. J Clin Hypertens (Greenwich) 2023. [PMID: 37183770 DOI: 10.1111/jch.14667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
This study aimed to assess the relationship between dietary sodium/potassium intake and cognition in elderly individuals with hypertension. We designed a cross-sectional study based on the 2011-2014 National Health and Nutrition Examination Survey (NHANES) 2011-2014. A multivariable-logistic regression analysis was performed to analyze the relationship between sodium/potassium intake and cognitive impairment. Restricted cubic spline (RCS) based on regression analysis to assess the nonlinear dose-response relationship between dietary sodium intake and cognitive performance. Out of the 2276 participants included in this study, 1670 patients had hypertension. Compared with the lowest quartile of dietary sodium intake, the lowest weighted odds ratio of cognitive impairment in DSST was observed in Q4 (OR = 0.45, 0.29-0.70), and a similar trend was observed in AFT (OR = 0.34, 0.18-0.65). After adjusting the covariates, the lowest weighted multivariable-adjusted OR of cognitive impairment in DSST were also observed in Q4 (OR = 0.47, 0.26-0.84) compared with the lowest quartile of dietary sodium intake. The RCS results showed that dietary sodium intake was U-shaped and associated with the risk of cognitive impairment in the DSST (Pnon-linearity = 0.0067). In addition, no significant association was observed between dietary potassium intake and different dimensions of cognitive performance. In conclusion, excessively high and low low dietary sodium were associated with impairment of specific processing speed, sustained attention, and working memory for elderly patients with hypertension in the United States. However, no association was observed between dietary potassium intake and cognition.
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Affiliation(s)
- Chengkun Kou
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xu Zhao
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xin Fan
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xin Lin
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Qiongying Wang
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Jing Yu
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Liu D, Zhang Q, Xing S, Wei F, Li K, Zhao Y, Zhang H, Gong G, Guo Y, Liu Z. Excessive salt intake accelerates the progression of cerebral small vessel disease in older adults. BMC Geriatr 2023; 23:263. [PMID: 37131130 PMCID: PMC10155382 DOI: 10.1186/s12877-023-03877-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 03/07/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND It is unclear whether excessive salt intake accelerates the progression of cerebral small vessel disease (CSVD). The major objective of this study was to investigate the harmful effect of excessive salt intake on the progression of CSVD in older individuals. METHODS Between May 2007 and November 2010, 423 community-dwelling individuals aged 60 years and older were recruited from the Shandong area, China. Salt intake was estimated using 24-hour urine collection for 7 consecutive days at baseline. Participants were classified into low, mild, moderate and high groups according to the salt intake estimation. CSVD including white matter hyperintensities (WMHs), lacunes, microbleeds and an enlarged perivascular space (EPVS) were determined using brain magnetic resonance imaging. RESULTS During an average of five years of follow-up, the WMH volume and WMH-to-intracranial ratio were increased in the four groups. However, the increasing trends in the WMH volume and WMH-to-intracranial ratio were significantly faster in the higher salt intake groups compared with the lower salt intake groups (Padjusted < 0.001). The cumulative hazard ratios of new-incident WMHs (defined as those with Fazekas scale scores ≥ 2), new-incident lacunes, microbleeds or an EPVS, as well as composites of CSVD, were respectively 2.47, 2.50, 3.33, 2.70 and 2.89 for the mild group; 3.72, 3.74, 4.66, 4.01 and 4.49 for the moderate group; and 7.39, 5.82, 7.00, 6.40 and 6.61 for the high group, compared with the low group after adjustment for confounders (Padjusted < 0.001). The risk of new-incident WMHs, lacunes, microbleeds or an EPVS, and composites of CSVD was significantly increased with each 1-standard-deviation increment in salt intake (Padjusted < 0.001). CONCLUSION Our data indicates that excessive salt intake is an important and independent contributor to the progression of CVSD in older adults.
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Affiliation(s)
- Di Liu
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, China
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, China
| | - Qin Zhang
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, China
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, China
| | - Shasha Xing
- Department of Geriatrics, the Third Hospital of Lixia District, Jinan, Shandong, 250100, China
| | - Fang Wei
- Department of Cardiology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250013, China
| | - Ke Li
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, China
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, China
| | - Yingxin Zhao
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, China
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, China
| | - Hua Zhang
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, China
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, China
| | - Gary Gong
- The Russel H. Morgan Department of Radiology and Radiological Sciences, the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Yuqi Guo
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, China
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, China
| | - Zhendong Liu
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, China.
- School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, China.
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Yang L, Yue Q, Fang F, Zhang Y, Liu P, Zhang Z, Wang G, Chen S, Wu S, Yang X. Effect of dual residual risk of cholesterol and inflammation on all-cause mortality in patients with cardiovascular disease. Cardiovasc Diabetol 2023; 22:96. [PMID: 37095492 PMCID: PMC10127069 DOI: 10.1186/s12933-023-01826-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Randomized controlled trials confirm that risks of residual cholesterol and residual inflammation remains in patients with cardiovascular disease (CVD) even after lipid-lowering therapy. This study aims to investigate the association between dual residual risk of cholesterol and inflammation and all-cause mortality in a real-world population with CVD. METHODS Patients with a CVD history who first took statins between 1 January 2010 and 31 December 2017 in the Kailuan Study were selected as study participants. According to low-density lipoprotein cholesterol (LDL-C) and hypersensitive C-reactive protein levels, patients were divided into those with no residual risk, residual inflammatory risk (RIR), residual cholesterol risk (RCR), and residual cholesterol and inflammatory risk (RCIR). Cox proportional hazard model was conducted to determine hazard ratio (HR) of all-cause mortality for RIR, RCR, and RCIR. Stratified analysis was conducted according to good medication adherence and 75% of the percentage LDL-C decline, high SMART 2 risk score, and blood pressure and blood glucose at standard levels. RESULTS After 6.10 years of follow-up, 377 all-cause deaths occurred in 3509 participants (mean age 63.69 ± 8.41 years, 86.78% men). After adjusting for related risk factors, the HR and (95% confidence interval [CI]) of all-cause mortality in the RIR, RCR, and RCIR was 1.63 (1.05, 2.52), 1.37 (0.98, 1.90), and 1.75 (1.25, 2.46), compared with no residual risk. Similar associations were observed in participants with moderate or low statin compliance, a lower percentage of LDL-C decline, high SMART 2 risk score, uncontrolled blood pressure, and uncontrolled blood glucose, in the RCIR had a 1.66-fold, 2.08-fold, 1.69-fold, 2.04-fold, and 2.05-fold higher risk of all-cause mortality, respectively, than the reference. CONCLUSION Risks of residual cholesterol and residual inflammation remain in patients with CVD after receiving statins, and their combined effect significantly increases the risk of all-cause mortality. Here, this increased risk was dependent on statin compliance, LDL-C reduction, SMART 2 risk score, and blood pressure and blood glucose control.
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Affiliation(s)
- Ling Yang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Qing Yue
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Fang Fang
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research On Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Yinggen Zhang
- Department of Nuclear Medicine, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China
| | - Peipei Liu
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Zihao Zhang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China.
| | - Xiuhong Yang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China.
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research On Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China.
- School of Public Health, Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research On Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China.
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Lu T, Zhang W, Jiang C, Jin Y, Zhu T, Zhu F, Xu L. Association of Salt Intake with Muscle Strength and Physical Performance in Middle-Aged to Older Chinese: The Guangzhou Biobank Cohort Study. Nutrients 2023; 15:nu15030516. [PMID: 36771223 PMCID: PMC9919999 DOI: 10.3390/nu15030516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Older people have higher amounts of sodium accumulation in skeletal muscles than younger people, indicating the possible role of salt intake on muscular and physical function. This large population-based cross-sectional study examined the association of salt intake with muscle strength and physical performance in 4867 participants with an average age of 60.4 (standard deviation = 7.7) years. Information on salt intake was collected from self-reports. Absolute and relative grip strength (AGS and RGS), timed up-and-go test (TUGT), and falls were considered the indicators of muscle strength and physical performance. Linear and logistic regression were used to examine the associations of salt intake with AGS, RGS, TUGT score, and falls, adjusting for demographic and lifestyle factors, body mass index, self-rated health, and self-reported hypertension. Higher salt intake was independently associated with lower grip strength and a higher TUGT score. Versus light salt intake, the adjusted β (95% confidence interval (CI)) of AGSmax, RGSmax, and TUGT scores in those with salty taste were -0.53 (-0.97, -0.08) kg, -0.04 (-0.06, -0.02) kg per kg/m2, and 0.08 (0.02, 0.14) s, respectively. A non-significant association was found between salt intake and falls. In sex-stratification analysis, the association remained in women but became non-significant in men. Our results suggest that avoiding high-salt diets may play a role in preserving muscle strength and physical function in the elderly, especially in women.
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Affiliation(s)
- Tingyu Lu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Weisen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou 510620, China
- Correspondence: (W.Z.); (L.X.); Tel.: +86-20-38665762 (W.Z.); +86-20-87335523 (L.X.); Fax: 86-20-87330446 (L.X.)
| | - Chaoqiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou 510620, China
| | - Yali Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou 510620, China
| | - Tong Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou 510620, China
| | - Feng Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou 510620, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Correspondence: (W.Z.); (L.X.); Tel.: +86-20-38665762 (W.Z.); +86-20-87335523 (L.X.); Fax: 86-20-87330446 (L.X.)
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Huang Z, Chen Z, Wang X, Ding X, Cai Z, Li W, Cai Z, Lan Y, Chen G, Fang W, Wu S, Chen Y. Association of Cardiovascular Health Score Trajectory With Incident Myocardial Infarction in Hypertensive Patients. Hypertension 2022; 79:2622-2630. [PMID: 36082672 DOI: 10.1161/hypertensionaha.122.19633] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The association between changes in cardiovascular health score (CHS) over time and myocardial infarction (MI) risk in hypertensive patients remains unclear. METHOD This was a prospective study comprising 17 374 hypertensive patients from the Kailuan study cohort who underwent 3 surveys and were identified to be free of MI, stroke, or cancer from 2006 to 2010. CHS consisted of 7 cardiovascular health metrics (plasma glucose, total cholesterol, blood pressure, smoking, body mass index, physical activity, salt intake), ranging from 0 (worst) to 13 (best) in the study. CHS trajectories were developed during 2006 to 2010 to predict the MI risk from 2010 to 2020. Additionally, the Cox proportional hazard model was established to calculate the hazard ratio and 95% CI of incident MI in different trajectory groups. RESULT This study identified the 5 CHS trajectories from 2006 to 2010: low-stable (n=1161; range, 4.7-4.5), moderate-decreasing (n=3928; decreased from 6.9 to 6.0), moderate-increasing (n=1014; increased from 5.6 to 7.8), high-stable I (n=7940; range, 8.1-8.2), and high-stable II (n=3331; range, 9.2-9.7). During the median follow-up of 10.04 years, 288 incident MI cases were identified. After adjusting for potential confounders, compared with low-stable group, the hazard ratio and 95% CI of MI were 0.24 (0.15-0.40) for high-stable II, 0.36 (0.24-0.54) for high-stable I, 0.46 (0.25-0.83) for moderate-increasing, and 0.61 (0.41-0.90) for moderate-decreasing, respectively. CONCLUSIONS In hypertensive patients, high-stable CHS or improvement in CHS is associated with a lower risk of incident MI, when compared with low-stable CHS trajectory over time.
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Affiliation(s)
- Zegui Huang
- Shantou University Medical College, China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China]
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, the Netherlands (Z. Chen)
| | - Xianxuan Wang
- Shantou University Medical College, China (Z.H., X.W., Zhiwei Cai, W.F.)
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China (Z.H., X.W., Zefeng Cai, Y.L., W.F., Y.C.)
| | - Xiong Ding
- School of Public Health, Wuhan University, China (X.D.)
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China (Z.H., X.W., Zefeng Cai, Y.L., W.F., Y.C.)
| | - Weijian Li
- Department of Cardiology, Shenzhen Luohu People's Hospital, China (W.L.)
| | - Zhiwei Cai
- Shantou University Medical College, China (Z.H., X.W., Zhiwei Cai, W.F.)
| | - Yulong Lan
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China (Z.H., X.W., Zefeng Cai, Y.L., W.F., Y.C.)
| | - Guanzhi Chen
- China Medical University, Shenyang, China (G.C.)
| | - Wei Fang
- Shantou University Medical College, China (Z.H., X.W., Zhiwei Cai, W.F.)
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China (Z.H., X.W., Zefeng Cai, Y.L., W.F., Y.C.)
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China
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Effects of indoor and outdoor temperatures on blood pressure and central hemodynamics in a wintertime longitudinal study of Chinese adults. J Hypertens 2022; 40:1950-1959. [PMID: 35969204 DOI: 10.1097/hjh.0000000000003198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We aimed to estimate the effects of indoor and outdoor temperature on wintertime blood pressure (BP) among peri-urban Beijing adults. METHODS We enrolled 1279 adults (ages: 40-89 years) and conducted measurements in two winter campaigns in 2018-2019 and 2019-2020. Study staff traveled to participant homes to administer a questionnaire and measure brachial and central BP. Indoor temperature was measured in the 5 min prior to BP measurement. Outdoor temperature was estimated from regional meteorological stations. We used multivariable mixed-effects regression models to estimate the within-individual and between-individual effects of indoor and outdoor temperatures on BP. RESULTS Indoor and outdoor temperatures ranged from 0.0 to 28 °C and -14.3 to 6.4 °C, respectively. In adjusted models, a 1 °C increase in indoor temperature was associated with decreased SBP [-0.4 mmHg, 95% confidence interval (CI): -0.7 to -0.1 (between-individual; brachial and central BP); -0.5 mmHg, 95% CI: -0.8 to -0.2 (within-individual, brachial BP); -0.4 mmHg, 95% CI: -0.7 to -0.2 (within-individual, central BP)], DBP [-0.2 mmHg, 95% CI:-0.4 to -0.03 (between-individual); -0.3 mmHg, 95% CI: -0.5 to -0.04 (within-individual)], and within-individual pulse pressure [-0.2 mmHg, 95% CI: -0.4 to -0.04 (central); -0.3 mmHg, 95% CI: -0.4 to -0.1 (brachial)]. Between-individual SBP estimates were larger among participants with hypertension. There was no evidence of an effect of outdoor temperature on BP. CONCLUSION Our results support previous findings of inverse associations between indoor temperature and BP but contrast with prior evidence of an inverse relationship with outdoor temperature. Wintertime home heating may be a population-wide intervention strategy for high BP and cardiovascular disease in China.
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Liu T, Zhang Q, Xiao X, Wang Y, Ma X, Song M, Zhang Q, Cao L, Shi H. High salt intake combined with hypertension elevated the risk of primary liver cancer: a prospective cohort study. Front Oncol 2022; 12:916583. [PMID: 35992793 PMCID: PMC9382678 DOI: 10.3389/fonc.2022.916583] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/06/2022] [Indexed: 01/02/2023] Open
Abstract
Background Hypertension and high-salt intake may act synergistically to increase the risk of primary liver cancer (PLC). We prospectively examined the joint effect of hypertension and salt intake on the risk of PLC incidence. Methods A total of 92,978 participants were included in the final analyses. The study population was divided into 4 groups according to the presence or absence of hypertension and salt intake. Cox proportional hazards regression models were used to evaluate the association of hypertension and/or high-salt intake with the risk of incident cancers. The CAUSALMED procedure was used to perform the mediation analyses. Results During a median follow-up of 12.69 years, a total of 418 incident cancer cases were identified. Hypertension was a risk factor for PLC in women but not in men. High salt intake was associated with an elevated risk of PLC in men. A significant interaction between salt intake and hypertension was found for the risk of PLC (P for interaction=0.045). Compared with Group 1 (hypertension-, high salt intake-), participants in Group 2 (hypertension-, high salt intake+) and Group 4 (hypertension+, high salt intake+) were associated with an elevated risk of PLC with the corresponding multivariate HRs (95%CIs) of 1.73(0.96,3.10) and 1.96(1.09,3.53) respectively. No significant mediation effect was found for the association between hypertension, salt intake and PLC risk. Conclusions The combination of high salt intake and hypertension could significantly increase the risk of PLC. It may be reasonable to recommend a low-salt intake to prevent and control the prevalence of PLC and hypertension. Trial registration Kailuan study, ChiCTR–TNRC–11001489. Registered 24 August, 2011-Retrospectively registered, https://www.chictr.org.cn/showprojen.aspx?proj=8050
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Affiliation(s)
- Tong Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Qingsong Zhang
- Department of General Surgery, Kailuan General Hospital, Tangshan, China
| | - Xiaoli Xiao
- Department of Gynecology, Aerospace Center Hospital, Beijing, China
| | - Yiming Wang
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, China
| | - Xiangming Ma
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, China
| | - Mengmeng Song
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Liying Cao
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, China
- *Correspondence: Hanping Shi, ; Liying Cao,
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- *Correspondence: Hanping Shi, ; Liying Cao,
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Huang Z, Ding X, Yue Q, Wang X, Chen Z, Cai Z, Li W, Cai Z, Chen G, Lan Y, Wu W, Wu S, Chen Y. Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study. Cardiovasc Diabetol 2022; 21:141. [PMID: 35897017 PMCID: PMC9331781 DOI: 10.1186/s12933-022-01577-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/19/2022] [Indexed: 02/05/2023] Open
Abstract
Background It has been suggested that the baseline triglyceride-glucose (TyG) index, a simple surrogate measure for insulin resistance, is significantly associated with the occurrence of stroke. Nevertheless, the impact of longitudinal patterns of TyG on the stroke risk in hypertensive patients is still unknown. Hence, this study aimed to investigate the association between TyG index trajectory and stroke risk among hypertensive patients. Methods This prospective study included 19,924 hypertensive patients from the Kailuan Study who underwent three waves survey and were free of myocardial infarction, cancer and stroke before or during 2010. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2], and latent mixed modelling was used to identify the trajectory of TyG during the exposure period (2006–2010). Furthermore, the Cox proportional hazard models were applied to estimate the hazard ratio (HR) and 95% confidence interval (CI) for incident stroke of different trajectory groups. Results Five distinct TyG trajectory were identified during 2006–2010: low-stable (n = 2483; range, 8.03–8.06), moderate low-stable (n = 9666; range, 8.58–8.57), moderate high-stable (n = 5759; range, 9.16–9.09), elevated-stable (n = 1741; range, 9.79–9.75), and elevated-increasing (n = 275; range, 10.38–10.81). During the median follow-up of 9.97 years, 1,519 cases of incident stroke were identified, including 1,351 with ischemic stroke and 215 with hemorrhage stroke. After adjusting for confounding variables, the HR and 95% CI of stroke were 2.21 (1.49,3.28) for the elevated-increasing group, 1.43 (1.13,1.83) for the elevated-stable group, 1.35 (1.10,1.64) for the moderate high-stable group, 1.26 (1.06,1.52) for the moderate low-stable group, respectively, when compare with the low-stable group. Similar results were observed in ischemic stroke, but a significant association was not found between TyG trajectory and risk of hemorrhage stroke. Conclusion A long-term elevated TyG index in hypertensive patients is associated with an increased risk of stroke, especially ischemic stroke. This finding implies that regular monitoring of TyG index may assist in identifying individuals at a higher risk of stroke among patients with hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01577-7.
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Affiliation(s)
- Zegui Huang
- Shantou University Medical College, Shantou, China, Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Xiong Ding
- School of Public Health, Wuhan University, Wuhan, China
| | - Qing Yue
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xianxuan Wang
- Shantou University Medical College, Shantou, China.,Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Weijian Li
- Shantou University Medical College, Shantou, China.,Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Zhiwei Cai
- Shantou University Medical College, Shantou, China.,Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | | | - Yulong Lan
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Road, Tangshan, 063000, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
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Association between Perceived Salt Intake and Arterial Stiffness. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9072082. [PMID: 35845930 PMCID: PMC9279047 DOI: 10.1155/2022/9072082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/30/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
To explore the association of perceived salt intake (SI) level with arterial stiffness in the community population in northern China. We enrolled participants who completed the health questionnaire, physical examination, and brachial-ankle pulse wave velocity (baPWV) test during 2010-2019 and divided them into <6 g (low SI), 6-10 g (medium SI), and >10 g (high SI) groups based on their daily SI. The influence of SI on baPWV was analyzed using the multivariate logistic regression model. A total of 36324 subjects, aged (49.10 ± 12.57) years with a male to female ratio of 25934 : 10390, met the inclusion criteria and were enrolled. The average baPWV was (1527.73 ± 355.61) cm/s. Logistic regression analysis showed that after adjusting for other confounders, daily SI>10 g (high SI) was a risk factor for arterial stiffness (baPWV ≥1400 cm/s), with the odds ratio (95% confidence interval [CI]) of 1.17 (1.04-1.31). High SI is independently associated with arterial stiffness.
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Zhou YF, Wang Y, Wang G, Zhou Z, Chen S, Geng T, Zhang YB, Wang Y, Chen JX, Pan A, Wu S. Association Between Statin Use and Progression of Arterial Stiffness Among Adults With High Atherosclerotic Risk. JAMA Netw Open 2022; 5:e2218323. [PMID: 35713899 PMCID: PMC9206193 DOI: 10.1001/jamanetworkopen.2022.18323] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IMPORTANCE Limited studies have investigated the association between statin use and progression of arterial stiffness, a key player in the pathophysiology of cardiovascular disease. OBJECTIVE To examine the association between statin use and progression of arterial stiffness in Chinese adults with high atherosclerotic risk measured by brachial-ankle pulse wave velocity (baPWV). DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study enrolled 5105 adults with high atherosclerotic risk from the Kailuan General Hospital from 2010 to 2020. Data were analyzed from February 2021 to April 2022. EXPOSURES Statin use information was retrieved from electronic medical records from 2010 to 2020, and statin users were those who have been prescribed any statin medications at least 6 months before baPWV measurements. Statin users were 1:1 matched with non-statin users by propensity score method. MAIN OUTCOMES AND MEASURES Progression of baPWV was assessed using the absolute difference between baseline and follow-up baPWV, divided by the follow-up time in years. Multivariable linear regression models were used to estimate the association between statin use and arterial stiffness. RESULTS Among 5105 adults with assessment of baPWV (mean [SD] age: 60.8 [9.7] years; 3842 [75.3%] men and 1263 [24.7%] women), 1310 statin users were matched with 1310 non-statin users (mean [SD] age, 63.2 [9.3] years). Compared with non-statin users, statin users were associated with significantly lower baPWV at baseline (difference: -33.6 cm/s; 95% CI, -62.1 to -5.1 cm/s). Among 1502 adults with repeated assessment of baPWV, 410 statin users were matched with 410 non-statin users (mean [SD] age, 62.9 [9.2] years). Compared with non-statin users, statin users had significantly slower progression of baPWV (difference, -23.3 cm/s per year; 95% CI, -40.6 to -6.0 cm/s per year) during a mean (SD) follow-up of 4.8 (2.7) years. A significantly slower progression of baPWV was observed in continuous statin users (difference, -24.2 cm/s per year; 95% CI, -42.2 to -6.3 cm/s per year) and high adherent users (difference, -39.7 cm/s per year; 95% CI, -66.9 to -12.4 cm/s per year), but not in discontinued users (difference, -17.3 cm/s per year; 95% CI, -52.4 to 17.8 cm/s per year) and low adherent users (difference, -17.9 cm/s per year; 95% CI, -36.5 to 0.7 cm/s per year), compared with non-statin users. CONCLUSIONS AND RELEVANCE In this cohort study, statin use was associated with slower progression of arterial stiffness in Chinese adults with high atherosclerotic risk.
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Affiliation(s)
- Yan-Feng Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanxiu Wang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
| | - Tingting Geng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Bo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun-Xiang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China
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Zuo Y, Li H, Chen S, Tian X, Mo D, Wu S, Wang A. Joint association of modifiable lifestyle and metabolic health status with incidence of cardiovascular disease and all-cause mortality: a prospective cohort study. Endocrine 2022; 75:82-91. [PMID: 34345980 DOI: 10.1007/s12020-021-02832-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/18/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to identify the joint associations of modifiable lifestyle and metabolic factors with the incidences of cardiovascular disease and all-cause mortality. METHODS We recruited 94,831 participants (men, 79.76%; median age, 51.60 [43.47-58.87]) without a history of cardiovascular disease from the Kailuan study during 2006 and 2007 and followed them until a cardiovascular disease event, or death occurred, or until December 31, 2017. Baseline metabolic health status was assessed using Adult Treatment Panel III criteria, and details of the lifestyles of the participants were recorded using a self-reported questionnaire. We used Cox proportional hazards models to evaluate the joint associations. RESULTS During a median follow-up of 11.03 years, we recorded 6590 cardiovascular disease events and 9218 all-cause mortality. Participants with the most metabolic risk components and the least healthy lifestyle had higher risk of cardiovascular disease (hazard ratio 2.06 [95% confidence interval (CI) 1.77-2.39]) and mortality (HR 1.53 [95% CI 1.31-1.78]), than participants with fewer metabolic risk components and the healthiest lifestyle. Compared with those in participants with the healthiest lifestyle, the HRs for cardiovascular disease in participants with the least healthy lifestyle were 1.26 (95% CI 1.17-1.37), 1.16 (95% CI 1.03-1.31), and 1.07 (95% CI 0.90-1.27) for those with low, medium, and high metabolic risk, respectively. CONCLUSION Healthy lifestyle is associated with a lower risk of cardiovascular disease and there is no significant interaction between metabolic risk and a healthy lifestyle. Therefore, a healthy lifestyle should be promoted, even for people with high metabolic risk.
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Affiliation(s)
- Yingting Zuo
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Haibin Li
- Department of Cardiac Surgery, Heart Center, and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xue Tian
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Dapeng Mo
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Ma J, Lee YK. Sodium content changes between 2015 and 2019 in restaurant menu items selected for sodium reduction in Daegu. Nutr Res Pract 2022; 16:537-548. [PMID: 35919291 PMCID: PMC9314199 DOI: 10.4162/nrp.2022.16.4.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/17/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND/OBJECTIVES South Korea has been conducting the Sodium Reduction Restaurant Project since 2015 to reduce sodium contents in restaurant menus. The purpose of this study was to analyze changes in the sodium content of menus as determined by the Daegu Sodium Reduction Restaurant Project between 2015 and 2019. MATERIALS/METHODS Intervention was aimed at reducing the sodium contents of over 10% of menu items in participating restaurants. On-site inspections and evaluations were conducted using a checklist, and reductions in sodium contents were determined by analyzing the salinities and sodium contents of menus after intervention. RESULTS Post-intervention salinities and sodium contents were significantly lower than baseline values in 2016 (P < 0.001), 2017 (P < 0.001), 2018 (P < 0.001), and 2019 (P < 0.001). However, sodium contents and salinities differences before and after intervention were not significant in 2015. Sodium contents of more than 20% of menu items offered by restaurants that participated in the Sodium Reduction Restaurant Project for 2 yrs starting in 2016 declined by 28.9%. On the other hand, the sodium reduction rate achieved by restaurants that participated for 4 yrs from 2015 reached 55.4%. The percentage of restaurants that participated in the project increased annually, though some failed to be designated as Sodium Reduction Restaurants because they did not meet sodium reduction rate requirements. CONCLUSIONS Positive correlations were found between duration of participation in the project and sodium reduction and designation rates. Sustainable long-term support at the national level is required to expand the project to other regions.
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Affiliation(s)
- Jian Ma
- Department of Food Science & Nutrition, Kyungpook National University, Daegu 41566, Korea
| | - Yeon-Kyung Lee
- Department of Food Science & Nutrition, Kyungpook National University, Daegu 41566, Korea
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Kim HJ, Lee YK, Koo H, Shin MJ. Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction. Nutr Res Pract 2022; 16:S70-S88. [PMID: 35651840 PMCID: PMC9127518 DOI: 10.4162/nrp.2022.16.s1.s70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/25/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022] Open
Abstract
Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake–response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.
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Affiliation(s)
- Hyun Ja Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Yeon-Kyung Lee
- Department of Food Science and Nutrition, Kyungpook National University, Daegu 41566, Korea
| | - Hoseok Koo
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul 04551, Korea
| | - Min-Jeong Shin
- School of Biosystems and Biomedical Sciences, College of Health Science, Korea University, Seoul 02841, Korea
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31
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Chen H, Chen G, Zhang L, Wu W, Li W, Wang X, Yan X, Chen Y, Wu S. Estimated pulse wave velocity can predict the incidence of new-onset atrial fibrillation: A 11-year prospective study in a Chinese population. Front Cardiovasc Med 2022; 9:912573. [PMID: 36072866 PMCID: PMC9443485 DOI: 10.3389/fcvm.2022.912573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Arterial stiffness, a risk factor for atrial fibrillation (AF), is rarely applied in clinical practice because of the difficulty and high cost of its measurement. Estimated pulse wave velocity (ePWV) is a simple, reproducible, and non-invasive index of arterial stiffness. This study was to assess the predictive value of ePWV for the risk of new-onset AF. METHODS Subjects were selected from the Kailuan cohort study population who underwent initial physical examination between 2006 and 2008. A total of 96,561 subjects were ultimately included in the final analysis. ePWV was divided into four groups according to quartiles. The Kaplan-Meier method was used to calculate the cumulative incidence of AF. A Cox regression model was used to assess the predictive value of estimated arterial stiffness for new-onset AF. RESULTS Mean age of subjects was 51.47 ± 9.68 years, while 76,968 (79.65%) were male and 19,663 (20.35%) were female. During mean follow-up period of 11.77 years, 1,215 AF events occurred. Results of the Kaplan-Meier analysis showed that the incidence of new-onset AF increased with increase in ePWV. Cox regression analysis showed that in the total population, the incidence of new-onset AF was 1.64, 1.90, and 2.64 times higher in the medium, medium-high, and high ePWV groups, respectively, compared with the low ePWV group. When stratified according to sex, ePWV had higher predictive value in the female population. CONCLUSIONS Increased ePWV increases the incidence of new-onset AF, and may promote application of more aggressive primary prevention. TRIAL REGISTRY NAME Risk factors and intervention for cardiology, cerebrovascular and related disease (Kailuan Study); URL: http://www.chictr.org.cn/showproj.aspx?proj=8050; Registration number: ChiCTR-TNRC-11001489.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College, Shantou, China
- Department of Cardiology, First Hospital of Medical College of Shantou University, Shantou, China
| | | | - Liling Zhang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Weijian Li
- Shantou University Medical College, Shantou, China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xianxuan Wang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xiuzhu Yan
- School of Foreign Language, Guangdong Polytechnic Normal University, Guangzhou, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
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Stevens D, Lane DA, Harrison SL, Lip GYH, Kolamunnage-Dona R. Modelling of longitudinal data to predict cardiovascular disease risk: a methodological review. BMC Med Res Methodol 2021; 21:283. [PMID: 34922465 PMCID: PMC8684210 DOI: 10.1186/s12874-021-01472-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/15/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The identification of methodology for modelling cardiovascular disease (CVD) risk using longitudinal data and risk factor trajectories. METHODS We screened MEDLINE-Ovid from inception until 3 June 2020. MeSH and text search terms covered three areas: data type, modelling type and disease area including search terms such as "longitudinal", "trajector*" and "cardiovasc*" respectively. Studies were filtered to meet the following inclusion criteria: longitudinal individual patient data in adult patients with ≥3 time-points and a CVD or mortality outcome. Studies were screened and analyzed by one author. Any queries were discussed with the other authors. Comparisons were made between the methods identified looking at assumptions, flexibility and software availability. RESULTS From the initial 2601 studies returned by the searches 80 studies were included. Four statistical approaches were identified for modelling the longitudinal data: 3 (4%) studies compared time points with simple statistical tests, 40 (50%) used single-stage approaches, such as including single time points or summary measures in survival models, 29 (36%) used two-stage approaches including an estimated longitudinal parameter in survival models, and 8 (10%) used joint models which modelled the longitudinal and survival data together. The proportion of CVD risk prediction models created using longitudinal data using two-stage and joint models increased over time. CONCLUSIONS Single stage models are still heavily utilized by many CVD risk prediction studies for modelling longitudinal data. Future studies should fully utilize available longitudinal data when analyzing CVD risk by employing two-stage and joint approaches which can often better utilize the available data.
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Affiliation(s)
- David Stevens
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK.,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK. .,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK.,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L7 8TX, UK.,Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ruwanthi Kolamunnage-Dona
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
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Chen H, Wu W, Fang W, Chen Z, Yan X, Chen Y, Wu S. Does an increase in estimated pulse wave velocity increase the incidence of hypertension? J Hypertens 2021; 39:2388-2394. [PMID: 34261958 DOI: 10.1097/hjh.0000000000002945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE As a risk indicator of hypertension, arterial stiffness is difficult to measure. Thus, we aimed to evaluate the association between estimated pulse wave velocity (ePWV) as a convenient indicator and the incidence of hypertension. METHODS The Kailuan cohort was selected for statistical analysis and 54 849 individuals were included in the final cohort. Multiple linear regression was used to analyse the correlation between ePWV and mean SBP (SBP_m) measured at five time points over a 10-year period and between ePWV and mean DBP (DBP_m) measured at five time points over a 10-year period. Logistic regression was used to analyse the effect of estimated arterial stiffness on hypertension. RESULTS The mean age of individuals was 48.44 ± 9.32 years, and 41 419 individuals (75.51%) were male. A multiple linear regression analysis showed that ePWV was positively correlated with both SBP_m and DBP_m. For every 1 cm/s increase in ePWV, SBP_m and DBP_m increased by 5.60 and 2.12 mmHg, respectively. A logistic regression analysis showed that in the total cohort, the incidence of hypertension in populations with moderate, moderate-high and high ePWV values was 3.03, 5.44 and 7.87-times higher, respectively, compared with individuals with low ePWV values. ePWV had a higher predictive value in female and middle age population compared with male and the eldly population grouped by sex and age respectively. CONCLUSION ePWV positively correlates with both SBP_m and DBP_m, and an increase in ePWV is associated with an increase in the incidence of hypertension.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College
- Department of Cardiology, First Hospital of Medical College of Shantou University
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Wei Fang
- Shantou University Medical College
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Xiuzhu Yan
- School of Foreign Language, Guangdong Polytechnic Normal University, Guangzhou, Guangdong, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
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Ding X, Li J, Wu Y, Yang P, Zhao D, Yuan X, Chen S, Luo X, Li Y, Wu S. Ideal Cardiovascular Health Metrics Modify the Association Between Exposure to Chinese Famine in Fetal and Cardiovascular Disease: A Prospective Cohort Study. Front Cardiovasc Med 2021; 8:751910. [PMID: 34805306 PMCID: PMC8599955 DOI: 10.3389/fcvm.2021.751910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022] Open
Abstract
Background: No study has explored the modification effect of ideal cardiovascular health metrics (ICVHMs) on the association between famine exposure and risk of cardiovascular disease (CVD) so far. We aim to examine the effect of ICVHMs on the association between exposure to famine early in life and the risk of CVD in adulthood. Methods: A total of 61,527 participants free of CVD were included in this study from the Kailuan Study. All participants were divided into three groups, included nonexposed, fetal-exposed, and childhood-exposed groups. Cox regression was used to estimate the effect of famine exposure and ICVHMs on CVD risk. Results: After a median of 13.0 (12.7–13.2) years follow-up, 4,814 incident CVD cases were identified. Compared with nonexposed participants, the CVD risk increased in participants with fetal famine exposure (hazard ratio [HR]: 1.21; 95% CI: 1.07–1.37), but not in childhood famine-exposed participants. After stratifying by the number of ICVHMs, the increased CVD risk associated with fetal famine exposure was only observed in participants with less ICVHMs ( ≤ 2) (HR: 1.30; 95% CI: 1.11–1.52, P for interaction=0.008), but disappeared in those with three or more ICVHMs. The modified effect of ICVHMs was sex specific (P for sex interaction = 0.031). Conclusions: Exposing to famine in the fetal period could increase the risk of CVD in late life; however, ICVHMs might modify the effect of famine exposure on CVD risk, especially in men.
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Affiliation(s)
- Xiong Ding
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Jinfeng Li
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Ying Wu
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Peng Yang
- Department of Neurosurgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Dandan Zhao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xiaojie Yuan
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Xiaoyan Luo
- Department of Emergency, Kailuan General Hospital, Tangshan, China
| | - Yun Li
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
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Zhao J, Liu S, Yan J, Zhu X. The Impact of Gut Microbiota on Post-Stroke Management. Front Cell Infect Microbiol 2021; 11:724376. [PMID: 34712621 PMCID: PMC8546011 DOI: 10.3389/fcimb.2021.724376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Junyi Zhao
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Siyu Liu
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Jingyi Yan
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Xinzhou Zhu
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
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36
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Chen YP, Wang M, Blank I, Xu J, Chung HY. Saltiness-Enhancing Peptides Isolated from the Chinese Commercial Fermented Soybean Curds with Potential Applications in Salt Reduction. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:10272-10280. [PMID: 34436886 DOI: 10.1021/acs.jafc.1c03431] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Salt is very important for human health and food seasoning. Recently, several peptides isolated from natural food products have been reported exhibiting a salty taste or a saltiness-enhancing function. In this investigation, taste-active peptides occurring in commercial Chinese fermented soybean curd were isolated and identified using ultrafiltration, gel permeation chromatography, ion-exchange chromatography, and nano-LC/Q-TOF MS/MS. The salty taste-enhancing function of the target fractions was confirmed by both a rat taste cell model and/or human sensory evaluation. Four decapeptides were found as taste-active compounds. Among them, peptide E (EDEGEQPRPF) was the most potent saltiness-enhancing peptide: 0.4 mg/mL in 50 mmol/L NaCl solution could increase its salty perception equivalent to the salt level of 63 mmol/L NaCl reference solution. The sequence of the peptide has been found in the α'-subunit of β-conglycinin [Glycine max]. The remaining peptides V (VGPDDDEKSW), DD (DEDEQPRPIP), and DG (DEGEQPRPFP) showed umami and kokumi tastes as well as a weak saltiness-enhancing sensation. These findings suggest that the decapeptide EDEGEQPRPF could be a possible alternative to partially reduce the amount of sodium intake without compromising for saltiness.
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Affiliation(s)
- Yan Ping Chen
- Department of Food Science and Technology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, China
- Food and Nutritional Sciences Programme, School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Mengni Wang
- Department of Food Science and Technology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Imre Blank
- Zhejiang Yiming Food Co, LTD, Jiuting Center, Huting North Street No.199, Shanghai 201600, China
| | - Jiaojiao Xu
- Food and Nutritional Sciences Programme, School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, United States
| | - Hau Yin Chung
- Food and Nutritional Sciences Programme, School of Life Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
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A comparison of carotid atherosclerosis in symptomatic patients between 2002-2005 and 2012-2015 cohorts using multi-contrast magnetic resonance vessel wall imaging. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2021; 18:623-630. [PMID: 34527028 PMCID: PMC8390937 DOI: 10.11909/j.issn.1671-5411.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare the morphological and compositional characteristics of carotid plaques in two cohorts (2002−2005 and 2012−2015) of Chinese patients using magnetic resonance vessel wall imaging. METHODS Symptomatic patients with carotid atherosclerotic plaques who underwent carotid vessel wall magnetic resonance imaging between 2002−2005 and 2012−2015 were retrospectively recruited. Plaque morphology [including mean wall area, wall thickness, and maximum normalized wall index (NWI)] and composition [including calcification, intraplaque hemorrhage, and lipid-rich necrotic core (LRNC)] in symptomatic carotid arteries were evaluated and compared between patients in these two time periods. RESULTS A total of 258 patients, including 129 patients in the 2002−2005 cohort and 129 patients in the 2012−2015 cohort, were recruited. Statin use (49.6%vs. 32.6%, P = 0.004) and hypertension (76.0% vs. 62.8%, P = 0.015) were significantly more common in the 2012–2015 cohort than in the 2002−2005 cohort. Patients in the 2012−2015 cohort also exhibited significantly low plaque burden parameters (allP < 0.05), as well as a lower prevalence (68.2% vs. 89.9%, P < 0.001) and volume percentages of LRNC (11.2% ± 14.2% vs. 25.7% ± 17.7%, P < 0.001). These differences remained significant after adjustment for clinical factors. The differences in the volume percentages of LRNC also remained significant after an additional adjustment for maximum NWI ( P < 0.001).
CONCLUSIONS Patients in the 2012−2015 cohort had a lower plaque burden and volume percentages of LRNC in symptomatic carotid arteries than those in the 2002−2005 cohort. These findings indicate that carotid plaques in the recent cohort had a lower severity and vulnerability.
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Li Y, Lyu Y, Huang J, Huang K, Yu J. Transcriptome sequencing reveals high-salt diet-induced abnormal liver metabolic pathways in mice. BMC Gastroenterol 2021; 21:335. [PMID: 34454434 PMCID: PMC8397858 DOI: 10.1186/s12876-021-01912-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/19/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Although salt plays an important role in maintaining the normal physiological metabolism of the human body, many abnormalities in the liver caused by a high-salt diet, especially with normal pathological results, are not well characterized. METHODS Eight-week-old female C57BL/6 mice were randomly divided into a normal group and a high salt group. These groups were then fed with normal or sodium-rich chow (containing 6% NaCl) for 6 weeks. Liver injury was evaluated, and the influences of a high-salt diet on the liver were analyzed by transcriptome sequencing at the end of week 6. RESULTS We found that although no liver parenchymal injury could be found after high-salt feeding, many metabolic abnormalities had formed based on transcriptome sequencing results. GO and KEGG enrichment analyses of differentially expressed genes revealed that at least 15 enzymatic activities and the metabolism of multiple substances were affected by a high-salt diet. Moreover, a variety of signaling and metabolic pathways, as well as numerous biological functions, were involved in liver dysfunction due to a high-salt diet. This included some known pathways and many novel ones, such as retinol metabolism, linoleic acid metabolism, steroid hormone biosynthesis, and signaling pathways. CONCLUSIONS A high-salt diet can induce serious abnormal liver metabolic activities in mice at the transcriptional level, although substantial physical damage may not yet be visible. This study, to our knowledge, was the first to reveal the impact of a high-salt diet on the liver at the omics level, and provides theoretical support for potential clinical risk evaluation, pathogenic mechanisms, and drug design for combating liver dysfunction. This study also provides a serious candidate direction for further research on the physiological impacts of high-salt diets.
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Affiliation(s)
- Yanping Li
- Department of Gastroenterology, Civil Aviation General Hospital, No. 1, Gaojingjia, Chaoyang District, China
| | - Yufei Lyu
- Beijing Institute of Biotecnology, No. 20, Dongda Street, Fengtai District, Beijing, China
| | - Jing Huang
- Beijing Institute of Biotecnology, No. 20, Dongda Street, Fengtai District, Beijing, China
| | - Kun Huang
- Department of Gastroenterology, Civil Aviation General Hospital, No. 1, Gaojingjia, Chaoyang District, China.
| | - Jiufei Yu
- Department of Gastroenterology, Civil Aviation General Hospital, No. 1, Gaojingjia, Chaoyang District, China.
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Judge C, O’Donnell MJ, Hankey GJ, Rangarajan S, Chin SL, Rao-Melacini P, Ferguson J, Smyth A, Xavier D, Lisheng L, Zhang H, Lopez-Jaramillo P, Damasceno A, Langhorne P, Rosengren A, Dans AL, Elsayed A, Avezum A, Mondo C, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Diaz R, Yusoff K, Yusufali A, Oguz A, Wang X, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Yusuf S. Urinary Sodium and Potassium, and Risk of Ischemic and Hemorrhagic Stroke (INTERSTROKE): A Case-Control Study. Am J Hypertens 2021; 34:414-425. [PMID: 33197265 PMCID: PMC8057138 DOI: 10.1093/ajh/hpaa176] [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] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/27/2020] [Accepted: 11/10/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although low sodium intake (<2 g/day) and high potassium intake (>3.5 g/day) are proposed as public health interventions to reduce stroke risk, there is uncertainty about the benefit and feasibility of this combined recommendation on prevention of stroke. METHODS We obtained random urine samples from 9,275 cases of acute first stroke and 9,726 matched controls from 27 countries and estimated the 24-hour sodium and potassium excretion, a surrogate for intake, using the Tanaka formula. Using multivariable conditional logistic regression, we determined the associations of estimated 24-hour urinary sodium and potassium excretion with stroke and its subtypes. RESULTS Compared with an estimated urinary sodium excretion of 2.8-3.5 g/day (reference), higher (>4.26 g/day) (odds ratio [OR] 1.81; 95% confidence interval [CI], 1.65-2.00) and lower (<2.8 g/day) sodium excretion (OR 1.39; 95% CI, 1.26-1.53) were significantly associated with increased risk of stroke. The stroke risk associated with the highest quartile of sodium intake (sodium excretion >4.26 g/day) was significantly greater (P < 0.001) for intracerebral hemorrhage (ICH) (OR 2.38; 95% CI, 1.93-2.92) than for ischemic stroke (OR 1.67; 95% CI, 1.50-1.87). Urinary potassium was inversely and linearly associated with risk of stroke, and stronger for ischemic stroke than ICH (P = 0.026). In an analysis of combined sodium and potassium excretion, the combination of high potassium intake (>1.58 g/day) and moderate sodium intake (2.8-3.5 g/day) was associated with the lowest risk of stroke. CONCLUSIONS The association of sodium intake and stroke is J-shaped, with high sodium intake a stronger risk factor for ICH than ischemic stroke. Our data suggest that moderate sodium intake-rather than low sodium intake-combined with high potassium intake may be associated with the lowest risk of stroke and expected to be a more feasible combined dietary target.
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Affiliation(s)
- Conor Judge
- Department of Medicine, NUI Galway, Galway, Ireland
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
- Wellcome Trust Health Research Board Irish Clinical Academic Training (ICAT), Dublin, Ireland
| | - Martin J O’Donnell
- Department of Medicine, NUI Galway, Galway, Ireland
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Graeme J Hankey
- School of Medicine and Pharmacology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Sumathy Rangarajan
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Siu Lim Chin
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Purnima Rao-Melacini
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Andrew Smyth
- Department of Medicine, NUI Galway, Galway, Ireland
| | - Denis Xavier
- Department of Medicine, St John’s Medical College and Research Institute, Bangalore, India
| | - Liu Lisheng
- Department of Medicine, National Center of Cardiovascular Disease, Beijing, China
| | - Hongye Zhang
- Department of Medicine, Beijing Hypertension League Institute, Beijing, China
| | - Patricio Lopez-Jaramillo
- Department of Medicine, Instituto de Investigaciones MASIRA, Universidad de Santander, Bucaramanga, Colombia
| | | | - Peter Langhorne
- Department of Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow, Scotland, UK
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Antonio L Dans
- College of Medicine, University of Philippines, Manila, Philippines
| | - Ahmed Elsayed
- Department of Surgery, Al Shaab Teaching Hospital, Khartoum, Sudan
| | - Alvaro Avezum
- Department of Medicine, International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Charles Mondo
- Department of Medicine, Kiruddu National Referral Hospital, Kampala, Uganda
| | | | - Anna Czlonkowska
- Department of Medicine, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Nana Pogosova
- Department of Medicine, National Medical Research Center of Cardiology, Moscow, Russia
| | | | - Rafael Diaz
- Department of Medicine, Estudios Clínicos Latino America (ECLA), Instituto Cardiovascular de Rosario (ICR), Rosario, Argentina
| | - Khalid Yusoff
- Department of Medicine, Universiti Teknologi MARA, Selayang, Selangor and UCSI University, Kuala Lumpur, Malaysia
| | - Afzalhussein Yusufali
- Department of Medicine, Hatta Hospital, Dubai Health Authority/Dubai Medical College, Dubai, UAE
| | - Aytekin Oguz
- Department of Internal Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Xingyu Wang
- Department of Medicine, Beijing Hypertension League Institute, Beijing, China
| | - Fernando Lanas
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Okechukwu S Ogah
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adesola Ogunniyi
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Helle K Iversen
- Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - German Malaga
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Shahram Oveisgharan
- Department of Medicine, Rush Alzheimer Disease Research Center in Chicago, Chicago, Illinois, USA
| | - Fawaz Al Hussain
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Salim Yusuf
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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Cai F, Dong WY, Jiang JX, Chen XL, Wang Y, Deng CY, Zhang QY. Estimation of salt intake assessed by 24-h urinary sodium level among adults speaking different dialects from the Chaoshan region of southern China. Public Health Nutr 2021; 24:290-298. [PMID: 32347195 PMCID: PMC10195506 DOI: 10.1017/s136898001900507x] [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: 07/03/2019] [Revised: 11/25/2019] [Accepted: 12/06/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Dietary salt intake may vary depending on different lifestyles. We aimed to estimate the different salt intakes and evaluate the knowledge and self-awareness about salt among people speaking the Teochew, Teochew-Hakka and Hakka dialects in the Chaoshan region of southern China. DESIGN The study followed a cluster sampling of residents in Chaoshan region. General characteristics, lifestyles, health status as well as knowledge and self-awareness related to salt intake were investigated using a questionnaire. Anthropometric variables as well as Na and K excretion in a 24-h urine collection were measured. SETTING Chaoshan region of China. PARTICIPANTS Four hundred fifteen adults who spoke only one of these three dialects. RESULTS The salt intake of adults who spoke the Teochew, Teochew-Hakka and Hakka dialects was 7·19 (interquartile range (IQR) 5·29-10·17), 9·03 (IQR 6·62-11·54) and 10·12 (IQR 7·61-12·82) g/d, respectively, with significant differences between Teochew and Teochew-Hakka speakers and between Teochew and Hakka speakers (both P < 0·05). The Na:K ratio for adults who spoke the three dialects was 3·00 (IQR 2·00-4·11), 3·50 (IQR 2·64-4·82) and 4·52 (IQR 3·35-5·97), respectively, and differed significantly among the groups (all P < 0·05). Multiple linear regression analysis showed increased Na:K ratio associated with hypertension (β = 0·71, P = 0·043) in Hakka speakers. Knowledge and self-awareness about salt intake were poor in this population. CONCLUSIONS Salt intake was closely related to lifestyles and was higher than the upper limit (5 g/d) recommended by the WHO in adults of Chaoshan, especially those speaking the Hakka dialect.
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Affiliation(s)
- Fen Cai
- Department of Nosocomial Infection Management, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Wen-Ya Dong
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Jia-Xin Jiang
- Lianshang Town Health Hospital of Chenghai District, Shantou, Guangdong, China
| | - Xiao-Li Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Yue Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Chang-Yu Deng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Qing-Ying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Corresponding author: Email
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Zhang X, Liu Y, Li S, Lichtenstein AH, Chen S, Na M, Veldheer S, Xing A, Wang Y, Wu S, Gao X. Alcohol consumption and risk of cardiovascular disease, cancer and mortality: a prospective cohort study. Nutr J 2021; 20:13. [PMID: 33522924 PMCID: PMC7852289 DOI: 10.1186/s12937-021-00671-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
Background Studies regarding whether light to moderate alcohol consumption is associated with a lower risk of cardiovascular diseases (CVD) have generated mixed results. Further, few studies have examined the potential impact of alcohol consumption on diverse disease outcomes simultaneously. We aimed to prospectively study the dose-response association between alcohol consumption and risk of CVD, cancer, and mortality. Methods This study included 83,732 adult Chinese participants, free of CVD and cancer at baseline. Participants were categorized into 6 groups based on self-report alcohol consumption: 0, 1–25, 26–150, 151–350, 351–750, and > 750 g alcohol/wk. Incident cases of CVD, cancers, and mortality were confirmed by medical records. Hazard ratios (HRs) for the composite risk of these three outcomes, and each individual outcome, were calculated using Cox proportional hazard model. Results During a median follow-up of 10.0 years, there were 6411 incident cases of CVD, 2947 cancers and 6646 deaths. We observed a J-shaped relation between alcohol intake and risk of CVD, cancer, and mortality, with the lowest risk at 25 g/wk., which is equivalent to ~ 2 servings/wk. Compared to consuming 1–25 g/wk., the adjusted HR for composite outcomes was 1.38 (95% confidence interval (CI):1.29–1.49) for non-drinker, 1.15 (95% CI: 1.04–1.27) for 26–150 g/wk., 1.22 (95% CI: 1.10–1.34) for 151–350 g/wk., 1.33 (95% CI: 1.21–1.46) for 351–750 g/wk., and 1.57 (95% CI: 1.30–1.90) for > 750 g/wk., after adjusting for age, sex, lifestyle, social economic status, and medication use. Conclusions Light alcohol consumption at ~ 25 g/wk was associated with lower risk of CVD, cancer, and mortality than none or higher consumption in Chinese adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00671-y.
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Affiliation(s)
- Xinyuan Zhang
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA
| | - Yan Liu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Shanshan Li
- Slone Epidemiology Center, Boston University School of Medicine, Boston, USA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA
| | - Susan Veldheer
- Department of Family and Community Medicine and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, USA
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Yanxiu Wang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China.
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA.
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Blanco-Metzler A, Núñez-Rivas H, Vega-Solano J, Montero-Campos MA, Benavides-Aguilar K, Cubillo-Rodríguez N. Household Cooking and Eating out: Food Practices and Perceptions of Salt/Sodium Consumption in Costa Rica. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031208. [PMID: 33572878 PMCID: PMC7908278 DOI: 10.3390/ijerph18031208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 01/01/2023]
Abstract
This research aims to study the food practices and perceptions related to excessive consumption of salt/sodium when cooking and eating outside the home in a study population representing the wide intergenerational and sociocultural diversity of Costa Rica. Key communities from around the country, cultural experts, and key informants were selected. Four qualitative research techniques were applied. Data was systematized based on the Social Ecological Model. Women are generally in charge of cooking and family food purchases. Salt is perceived as a basic ingredient, used in small amounts that can be reduced-but not eliminated-when cooking. Changes in food preparations and emotions associated with the consumption of homemade food with salt were identified. The population likes to eat out, where the establishments selected depend mainly on age group and income. Beyond cultural and geographical differences, age aspects are suggested as being the main differentiators, in terms of use of salt, seasonings, and condiments in the preparation of food at home, the recipes prepared, and the selection of establishments in which to eat out. The deeply rooted values and meanings associated with salt in food indicate that the implementation of salt reduction strategies in Costa Rica is challenging.
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Affiliation(s)
- Adriana Blanco-Metzler
- Costa Rican Institute of Research and Teaching in Nutrition and Health (INCIENSA), Tres Ríos 4-2250, Costa Rica; (H.N.-R.); (J.V.-S.); (M.A.M.-C.); (K.B.-A.)
- Correspondence: ; Tel.: +506-22799911
| | - Hilda Núñez-Rivas
- Costa Rican Institute of Research and Teaching in Nutrition and Health (INCIENSA), Tres Ríos 4-2250, Costa Rica; (H.N.-R.); (J.V.-S.); (M.A.M.-C.); (K.B.-A.)
| | - Jaritza Vega-Solano
- Costa Rican Institute of Research and Teaching in Nutrition and Health (INCIENSA), Tres Ríos 4-2250, Costa Rica; (H.N.-R.); (J.V.-S.); (M.A.M.-C.); (K.B.-A.)
| | - María A. Montero-Campos
- Costa Rican Institute of Research and Teaching in Nutrition and Health (INCIENSA), Tres Ríos 4-2250, Costa Rica; (H.N.-R.); (J.V.-S.); (M.A.M.-C.); (K.B.-A.)
| | - Karla Benavides-Aguilar
- Costa Rican Institute of Research and Teaching in Nutrition and Health (INCIENSA), Tres Ríos 4-2250, Costa Rica; (H.N.-R.); (J.V.-S.); (M.A.M.-C.); (K.B.-A.)
| | - Nazareth Cubillo-Rodríguez
- Project Consultant, International Development Research Centre (IDRC), Llorente de Tibas 11303, Costa Rica;
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Chen H, Chen Y, Wu W, Cai Z, Chen Z, Yan X, Wu S. Total cholesterol, arterial stiffness, and systolic blood pressure: a mediation analysis. Sci Rep 2021; 11:1330. [PMID: 33446746 PMCID: PMC7809132 DOI: 10.1038/s41598-020-79368-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 12/07/2020] [Indexed: 02/05/2023] Open
Abstract
On the basis of 45,092 participants (mean age of 54.04 ± 13.09 years) from the Kailuan study, this study was performed to explore the relationships among total cholesterol (TC), brachial-ankle pulse wave velocity (BaPWV), and systolic blood pressure (SBP) and quantify their separate effects. The correlations among TC, SBP, and BaPWV were analyzed using multivariate linear regression models. Mediation analysis was performed to determine whether the effect of TC on SBP can be explained by arterial stiffness. Multivariate linear regression analysis showed that for every one standard deviation increase in TC and BaPWV, SBP increased by 0.33 mmHg and 0.044 mmHg, respectively; for every one standard deviation increase in TC, BaPWV increased by 5.34 cm/s. Mediation analysis showed that the TC-induced SBP elevation was mediated by arterial stiffness in more than half of the whole cohort (indirect effect, 0.73; percent mediated, 54.5%). Furthermore, the TC-induced SBP elevation was mediated by arterial stiffness in less than half of the males (indirect effect, 0.70; percent mediated, 47.9%); however, the results were not statistically significant in females. In conclusion, TC and BaPWV are positively correlated with SBP, whereas TC is positively correlated with BaPWV. Almost half of the increase in SBP contributed to TC is mediated by arterial stiffness.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College, Shantou, 515041, Guangdong, China
- Department of Cardiology, First Hospital of Medical College of Shantou University, Shantou, 515041, Guangdong, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China.
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zefeng Cai
- Shantou University Medical College, Shantou, 515041, Guangdong, China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Xiuzhu Yan
- School of Foreign Language, Guangdong Polytechnic Normal University, Guangzhou, 510000, Guangdong, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, 063001, China.
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Zhang Q, Ma X, Xing J, Shi H, Yang R, Jiao Y, Chen S, Wu S, Zhang S, Sun X. Serum Uric Acid Is a Mediator of the Association Between Obesity and Incident Nonalcoholic Fatty Liver Disease: A Prospective Cohort Study. Front Endocrinol (Lausanne) 2021; 12:657856. [PMID: 34054728 PMCID: PMC8158156 DOI: 10.3389/fendo.2021.657856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/19/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Obesity has been demonstrated to show a consistent link with the increased possibility of nonalcoholic fatty liver disease (NAFLD). Since both serum uric acid (SUA) and obesity are essential components of metabolic syndrome (MetS), it is uncertain whether the incidence of NAFLD results from serum uric acid, obesity, or other potential factors based on previous studies. PATIENTS AND METHODS This study enrolled 16,839 participants with no history of alcohol consumption and no fatty liver disease in 2010. All participants completed a survey which included health and lifestyle questionnaires, and underwent physical examination, ultrasonography, and laboratory examinations of blood samples. After the four-year follow up, 5,104 (30.31%) participants were diagnosed with NAFLD. The associations between SUA, BMI or obesity, and incident NAFLD were assessed by multivariate linear regression, logistic regression analysis, and mediation analysis, respectively. RESULTS By adjusting demographic and serum characteristics, linear correlation coefficients between obesity and SUA were 20.26 [95% confidence interval (CI)]: 15.74, 24.77), 13.31 (95% CI: 6.63, 19.99) and 22.21 (95% CI: 16.41, 28.02) in the total population, and in the female and male groups, respectively. The odds ratios were 2.49 (95% CI: 1.61, 3.87) in the total population, 5.71 (95% CI: 2.25, 14.45) in the female group and 1.99 (95% CI: 1.15, 3.45) in the male group for the correlation between obesity and incident NAFLD. The mediation analysis showed that SUA contributed to 10.03%, 0.58%, and 12.54% of obesity-related NAFLD development in the total population, females and males, respectively. CONCLUSION The findings showed mediation linkages of both obesity and SUA with the incident NAFLD. The role of SUA as a mediator constitutes clinical significance that should be recognized and considered.
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Affiliation(s)
- Qian Zhang
- Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
- Clinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaoqian Ma
- Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
| | - Jie Xing
- Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
| | - Haiyun Shi
- Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
| | - Runkuan Yang
- Department of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Yue Jiao
- Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Shutian Zhang
- Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
| | - Xiujing Sun
- Department of Gastroenterology, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China
- *Correspondence: Xiujing Sun,
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Tao B, Yang P, Wang C, Du W, Shen P, Wu Y, Ding X, Chen S, Wu S, Li Y. Fetal exposure to the Great Chinese Famine and risk of ischemic stroke in midlife. Eur J Neurol 2020; 28:1244-1252. [PMID: 33263194 DOI: 10.1111/ene.14661] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Epidemiological studies have reported an association between famine exposure and increased risk of cardiovascular disease. However, it is unclear whether fetal exposure to the Great Chinese Famine of 1959 to 1961 was associated with risk of ischemic stroke in midlife. METHODS A total of 17,787 participants of the Kailuan study, who were free of cardiovascular disease and cancer at baseline (2006) were enrolled in the study. All participants were divided into three groups: unexposed (born between 1 October 1962 and 30 September 1964, used as the reference group in current analyses), fetal exposure (born between 1 October 1959 and 30 September 1961), and early childhood exposure (born between 1 October 1956 and 30 September 1958). Incident ischemic stroke cases between 2006 and 2017 were confirmed by review of medical records. Cox proportional hazards regression was applied to analyze the effect of fetal famine exposure on ischemic stroke risk. RESULTS During the mean (10.4 ± 2.2) years of follow-up, 547 incident ischemic stroke cases were identified. After adjustment for potential confounders, the hazard ratio (HR) for ischemic stroke was 1.45, and the 95% confidence interval (CI) was 1.14, 1.84 for fetal famine-exposed compared with unexposed individuals. Similar associations were observed in men (adjusted HR: 1.40; 95% CI: 1.08, 1.80) and overweight individuals (adjusted HR: 1.56; 95% CI: 1.18, 2.07), but not in their counterparts. The results of the early childhood-exposed group were similar to the above. CONCLUSIONS Our findings support an association between fetal malnutrition and higher risk of ischemic stroke in adulthood.
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Affiliation(s)
- Boni Tao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Peng Yang
- Department of Neurosurgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Cun Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Wei Du
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Peixuan Shen
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Ying Wu
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xiong Ding
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yun Li
- School of Public Health, North China University of Science and Technology, Tangshan, China
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Chen H, Chen Y, Wu W, Chen Z, Cai Z, Chen Z, Yan X, Wu S. Prolonged hyperlipidemia exposure increases the risk of arterial stiffness in young adults: a cross-sectional study in a cohort of Chinese. BMC Public Health 2020; 20:1091. [PMID: 32652962 PMCID: PMC7353800 DOI: 10.1186/s12889-020-09211-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 07/05/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hyperlipidemia is associated with arterial stiffness. Herein, We examined the effect of prolonged exposure to hyperlipidemia on the risk of arterial stiffness in young adults. METHODS A study cohort (35-55 years old) that received health check-ups in the Kailuan study (2014-2016) were assessed. Hyperlipidemia was defined as a low-density lipoprotein cholesterol ≥160 mg/dL according to the Chinese Guidelines for the Management of Dyslipidemia in Adults. Subjects were divided into three groups based on the number of years with hyperlipidemia: normal (0 years), low exposure (1-5 years), and high exposure (5-10 years) groups. Arterial stiffness was defined as brachial-ankle pulse wave velocity > 1400 cm/s. For all subjects and subjects that did not meet statin treatment criteria under guidelines, logistics regression was used to analyze the effect of prolonged hyperlipidemia exposure on arterial stiffness in different age groups. RESULTS Among 12,431 subjects, the mean age was 46.42 ± 5.34 years with 9000 men (72.4%). Brachial-ankle pulse wave velocity gradually increased with increased exposure duration. Logistic regression analysis showed that hyperlipidemia exposure was a risk factor for arterial stiffness in the low (1.22 times) and high (1.49 times) exposure groups compared with the normal group. In the different age groups, the risk of arterial stiffness increased with the duration of hyperlipidemia exposure, apart for the 35-40-year-old population. The effect of hyperlipidemia exposure duration on arterial stiffness in young adults that did not meet statin treatment criteria under guidelines was similar to the general population. CONCLUSIONS Prolonged exposure to hyperlipidemia in young adults increases the risk of arterial stiffness. Young adults with this condition may benefit from more aggressive primary prevention. TRIAL REGISTRATION Name of the registry: Risk factors and intervention for cardiology, cerebrovascular and related disease (Kailuan Study) Trial registration number: CHiCTR-TNC1100 1489 Date of registration: Aug 24, 2011 URL of trial registry record: http://www.chictr.org.cn/showproj.aspx?proj=8050.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College, NO.22 Xinling Road, Jinping District, Shantou City, 515041 Guangdong Province China
- Department of Cardiology, First Hospital of Medical College of Shantou University, NO.57 Changping Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
- School of Foreign Language, Guangdong Polytechnic Normal University, NO.293 Zhongshan Avenue West, Tianhe District, Guangzhou, 510665 Guangdong China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Zekai Chen
- Shantou University Medical College, NO.22 Xinling Road, Jinping District, Shantou City, 515041 Guangdong Province China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Zefeng Cai
- Shantou University Medical College, NO.22 Xinling Road, Jinping District, Shantou City, 515041 Guangdong Province China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69 Dongxia North Road, Jinping District, Shantou City, 515041 Guangdong Province China
| | - Xiuzhu Yan
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, NO.57 Xinhua East Road, Lubei District, Tangshan City, 063001 Hebei Province China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, NO.57 Xinhua East Road, Lubei District, Tangshan City, 063001 Hebei Province China
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Sun M, Cui H, Liang M, Wang W, Wang Y, Liu X, Liu S, Cao L. Perceived dietary salt intake and the risk of primary liver cancer: a population-based prospective study. J Hum Nutr Diet 2020; 33:833-840. [PMID: 32548912 DOI: 10.1111/jhn.12761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although a high-salt diet is associated with high risk of chronic diseases such as hypertension, stroke and cardiovascular disease, little is known about the relationship between a high-salt diet and the risk of primary liver cancer (PLC). Consequently, we prospectively assessed the association of high perceived salt intake with the risk of PLC in the Kailuan Study. METHODS In total, 97 006 participants who were healthy adults or free living adults at the baseline (2006) were included in the present study. The data of perceived salt intake were collected via questionnaire and classified into three categories: <6 g day-1 for low salt intake, 6-10 g day-1 for intermediate salt intake, >10 g day-1 for high-salt intake. PLC including hepatocellular carcinoma and intrahepatic cholangiocarcinoma (excluding liver metastasis), and was confirmed by review of medical records. We used a Cox proportional hazards model to analyse the association between high perceived salt diet and the risk of PLC after adjusting for possible confounders, including age, gender, body mass index, high sensitivity-C-reactive protein, low-density lipoprotein-cholesterol, total cholesterol, triglycerides, alanine aminotransferase, HbsAg positive, cirrhosis, fatty liver, hypertension, diabetes, drinking status, smoking status and physical exercise. RESULTS During the follow-up period of 1 113 816 person-years, 397 PLC events were diagnosed. After adjusting for most potential confounders, subjects in intermediate salt intake and high salt intake had a multivariable hazard ratio and 95% confidence interval of 1.49 (0.97-2.29) and 1.98 (1.22-3.22) (P for trend = 0.0042), respectively, compared to low salt intake. CONCLUSIONS A higher perceived salt intake was associated with a higher risk of PLC.
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Affiliation(s)
- M Sun
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.,Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - H Cui
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.,Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - M Liang
- Department of Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.,Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - W Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - Y Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - X Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - S Liu
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
| | - L Cao
- Department of Hepatobiliary Surgery, Kailuan General Hospital Affiliated to North China University of Science and Technology, Tangshan, Hebei, China
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Park CY, Jo G, Lee J, Singh GM, Lee JT, Shin MJ. Association between dietary sodium intake and disease burden and mortality in Koreans between 1998 and 2016: The Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2020; 14:501-518. [PMID: 33029290 PMCID: PMC7520563 DOI: 10.4162/nrp.2020.14.5.501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/23/2019] [Accepted: 02/28/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES Sodium intake is positively associated with blood pressure, which may increase the risk for cardiovascular disease (CVD). Therefore, we assessed the disease burden of CVD attributable to sodium intakes above 2,000 mg/day and prospectively investigated the association between dietary/urinary sodium levels and the risk of all-cause and CVD-mortality using the Korea National Health and Nutrition Examination Survey (KNHNES). SUBJECTS/METHODS A total of 68,578 and 33,113 participants were included for comparative risk assessment (CRA) analysis and mortality analysis, respectively, and mean follow-up time for mortality was 5.4 years. CRA analysis was used to quantify attributable incidences of stroke, ischemic heart disease (IHD), and deaths attributable to sodium intake between 1998 and 2016. Cox proportional hazard regression model was used to determine the association between sodium intake and all-cause and CVD-mortality. RESULTS Mean dietary sodium intake decreased over time, reaching 3,647 mg/day in 2016. Similarly, the population attributable fractions of stroke and IHD, and the number of CVD-associated deaths attributable to high sodium intake/excretion also decreased. In terms of association with mortality, when participants were grouped into quartiles (Q) by energy-adjusted sodium intake, those in Q2 had a lower risk of all-cause mortality than those in Q1 with lower intakes. The risk of CVD-associated mortality was higher only in females with high sodium intake in Q4 than those in Q1. CONCLUSIONS This nationwide data indicates that, in line with previous studies of multiple cohorts, both low and high sodium intakes may be associated with an increased risk of mortality; therefore, the optimal sodium intake for Koreans needs to be revised.
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Affiliation(s)
- Clara Yongjoo Park
- Department of Food and Nutrition, Human Ecology Research Institute, Chonnam National University, Gwangju 61186, Korea
| | - Garam Jo
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Korea
| | - Juhee Lee
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Korea
| | - Gitanjali M Singh
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA 02111, USA
| | - Jong-Tae Lee
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Korea
| | - Min-Jeong Shin
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Korea
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Association of Newly Found Asymptomatic Intracranial Artery Stenosis and Ideal Cardiovascular Health Metrics in Chinese Community Population. Sci Rep 2020; 10:7200. [PMID: 32350306 PMCID: PMC7190703 DOI: 10.1038/s41598-020-63927-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/25/2020] [Indexed: 12/28/2022] Open
Abstract
In the general population, there is a strong inverse relationship between the number of ideal cardiovascular health (CVH) metrics and the total incidence of cardiovascular diseases and stroke. However, the prevalence of ideal CVH is extremely low and there are few studies on its association with newly found asymptomatic intracranial arterial stenosis (AICAS). Therefore, we performed this prospective study to assess the relationship between the newly found AICAS and ideal CVH metrics in the Chinese community population. Seven ideal CVH metrics of 3,475 participants in the Asymptomatic Polyvascular Abnormalities Community study (APAC) conducted in China (1,962 men and 1,513 women between the ages of 45 and 75 years) were collected. Based on the occurrence of newly found AICAS, all participants were divided into the AICAS group and non-ICAS group. Prevalence of ideal CVH metrics was compared between the two groups. Logistic regression was used to estimate the association of newly found AICAS with ideal CVH metrics. The result was the number of ideal CVH metrics was strongly associated with age, gender, education levels and family income (each P < 0.0001). Among the seven CVH metrics total cholesterol (TC) was the only one showing significant difference between the newly found AICAS group and non-ICAS group in our 2 years observation. Participants with less ideal CVH metrics (≤3) were associated with significantly higher prevalence of AICAS than those with more (>3) ideal CVH metrics (OR, 1.27; P = 0.045). Furthermore, less (≤3) ideal CVH metrics was markedly associated with higher incidence of AICAS for all participants, younger participants (<60 years) (OR, 1.34; P = 0.046) and men participants (OR, 1.53; P = 0.032) after adjustment for gender, age, education level, family income and stroke history. Thus we conclude that participants with newly found AICAS have high prevalence of total cholesterol status, and Individuals with low ideal CVH metrics (≤3) are associated with significantly higher prevalence of asymptomatic ICAS, especially in high-risk population of young and men participants. Therefore, primordial prevention of stroke should also focus on those high-risk populations.
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Dai H, Li F, Bragazzi NL, Wang J, Chen Z, Yuan H, Lu Y. Distinct developmental trajectories of body mass index and diabetes risk: A 5-year longitudinal study of Chinese adults. J Diabetes Investig 2020; 11:466-474. [PMID: 31454166 PMCID: PMC7078171 DOI: 10.1111/jdi.13133] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/08/2019] [Accepted: 08/25/2019] [Indexed: 12/24/2022] Open
Abstract
AIMS/INTRODUCTION This longitudinal study aimed to explore whether distinct developmental trajectories of body mass index (BMI) would be predictive of diabetes risk in general Chinese adults. MATERIALS AND METHODS A total of 4,519 participants aged >18 years who were free of diabetes in 2011 (baseline of the current analysis) were enrolled in this study. All participants completed a medical examination every year during 2011-2016, and BMI levels were measured two to six (average 5.6) times. Group-based trajectory modeling was applied to identify BMI trajectories over time. New-onset diabetes was confirmed in 2016. RESULTS During 2011-2016, four distinct BMI trajectories were identified according to BMI range and changing pattern over time: "low" (19.6%), "moderate" (33.4%), "moderate-high" (33.4%) and "high" (13.6%). A total of 168 (3.7%) new-onset diabetes cases were confirmed in 2016. Compared with the "low" BMI trajectory, participants in the "high" BMI trajectory were at significantly higher risk for new-onset diabetes (adjusted relative risk 3.24, 95% confidence interval 1.27-8.24). Notably, BMI trajectories based on the first four or three annual BMI tests yielded similar results. By contrast, no significant correlation was found between categories of baseline BMI and new-onset diabetes in 2016 after multivariate adjustment. CONCLUSIONS The present results show that distinct BMI trajectories, even identified using just four or three annual BMI tests, are significantly associated with new-onset diabetes. Monitoring BMI trajectories over time might provide an important approach to identify subpopulations at higher risk for developing diabetes.
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Affiliation(s)
- Haijiang Dai
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
- Center for Disease ModelingDepartment of Mathematics and StatisticsYork UniversityTorontoOntarioCanada
| | - Fei Li
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Nicola Luigi Bragazzi
- Center for Disease ModelingDepartment of Mathematics and StatisticsYork UniversityTorontoOntarioCanada
| | - Jiangang Wang
- Department of Health ManagementThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Zhiheng Chen
- Department of Health ManagementThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Hong Yuan
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Yao Lu
- Center of Clinical PharmacologyThe Third Xiangya HospitalCentral South UniversityChangshaHunanChina
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