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Tang Y, Xiao Y, Yang F, Gao X, Zhu X, Qiao G. Association between dietary vitamin A intake and risk of cardiometabolic multimorbidity. Sci Rep 2024; 14:16656. [PMID: 39030396 PMCID: PMC11271594 DOI: 10.1038/s41598-024-67723-1] [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: 05/07/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024] Open
Abstract
The association between vitamin A and single cardiometabolic diseases has been extensively studied, but the relationship between dietary vitamin A intake and the risk of cardiometabolic multimorbidity (CMM) has not been studied. Therefore, the present study was conducted to explore the association with CMM risk by analyzing different sources of vitamin A. This study utilized 13,603 subjects aged ≥ 18 years from 1997 to 2015 from the China Health and Nutrition Survey (CHNS). Dietary intake was calculated from 3 consecutive 24-h dietary recalls combined with a house hold food inventory. CMM is defined as the development of at least two cardiometabolic diseases. After a median follow-up of 9.0 years, there were 1050 new cases of CMM. The risk of CMM was significantly lower in those with higher vitamin A intake (Q1 vs Q5 HR 0.66, 95% CI 0.54-0.81). β-carotene (Q1 vs Q5 HR 0.82, 95% CI 0.66-1.02) and retinol (Q1 vs Q5 HR 0.59, 95% CI 0.48-0.73) intake had a similarly negative correlation. Using restricted cubic spline found an L-shaped relationship between retinol intake and CMM (p non-linear < 0.001). Negative associations were also found in specific CMD groups (hypertension, cardiovascular disease, stroke and diabetes). Dietary intake of vitamin A was negatively associated with CMM risk, and this protective effect was more pronounced in patients with cardiovascular disease. There was an L-shaped association between retinol intake and CMM risk.
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Affiliation(s)
- Yudi Tang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yao Xiao
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, Hubei, China
- Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, 430061, Hubei, China
- Hubei Academy of Traditional Chinese Medicine, Wuhan, 430074, Hubei, China
| | - Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xiaolian Gao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinhong Zhu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.
| | - Guiyuan Qiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.
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Dong T, Lin W, Zhou Q, Yang Y, Liu X, Chen J, Liu H, Zhang C. Association of adiposity indicators with cardiometabolic multimorbidity risk in hypertensive patients: a large cross-sectional study. Front Endocrinol (Lausanne) 2024; 15:1302296. [PMID: 38577567 PMCID: PMC10991765 DOI: 10.3389/fendo.2024.1302296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
Background Cardiometabolic multimorbidity (CMM) has emerged as a prominent public health concern. Hypertensive patients are prone to develop comorbidities. Moreover, the accumulation of visceral adipose tissue is the main cause for the development of cardiometabolic diseases. The cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and Chinese visceral adiposity index (CVAI) not only assess adipose tissue mass but also reflect adipose tissue dysfunction. So far, no study has been reported to evaluate the association of CMI, LAP, VAI, and CVAI with CMM risk in hypertensive patients. Therefore, this study aimed to assess the association between these adiposity indicators and the risk of CMM among Chinese hypertensive patients. Methods In this cross-sectional study, a total of 229,287 hypertensive patients aged 35 years and older were included from the National Basic Public Health Service Project. All participants underwent a face-to-face questionnaire survey, physical examination, and the collection of fasting venous blood samples. Multivariable logistic regression models were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic curve was utilized to evaluate the identification ability for CMM. Results After adjusting for confounders, each 1-standard deviation increase in CMI, LAP, VAI, and CVAI was associated with a 14%, 8%, 12%, and 54% increased risk of CMM, respectively. When comparing the highest quartile of these indicators with the lowest quartile, individuals in the highest quartile of CMM, LAP, VAI, and CVAI had a 1.39-fold (95% CI 1.30, 1.48), 1.28-fold (95% CI 1.19, 1.37), 1.37-fold (95% CI 1.29, 1.46), and 2.56-fold (95% CI 2.34, 2.79) increased risk of CMM after adjusting for potential confounders. Notably, a nonlinear association was observed for CMI, LAP, and VAI with the risk of CMM (all P nonlinearity < 0.001). CVAI exhibited the highest area under the receiver operating characteristic curve (AUC) among all the included adiposity indices in this analysis. Conclusion This study indicated the significant positive association of CMI, LAP, VAI, and CVAI with the risk of CMM in hypertensive patients. Among these indicators, CVAI demonstrated the most robust performance in predicting CMM risk and may serve as a valuable tool for identifying CMM risk in Chinese hypertensive patients.
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Affiliation(s)
- Ting Dong
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiquan Lin
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Qin Zhou
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yunou Yang
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Xiangyi Liu
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jiamin Chen
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Hui Liu
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Caixia Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Song G, Li W, Ma Y, Xian Y, Liao X, Yang X, Zhang H, Cade JE. Nutrient intake and risk of multimorbidity: a prospective cohort study of 25,389 women. BMC Public Health 2024; 24:696. [PMID: 38439008 PMCID: PMC10913224 DOI: 10.1186/s12889-024-18191-9] [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: 10/09/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Multimorbidity is becoming an increasingly serious public health challenge in the aging population. The impact of nutrients on multimorbidity remains to be determined and was explored using data from a UK cohort study. METHOD Our research analysis is mainly based on the data collected by the United Kingdom Women's Cohort Study (UKWCS), which recruited 35,372 women aged 35-69 years at baseline (1995 to 1998), aiming to explore potential associations between diet and chronic diseases. Daily intakes of energy and nutrients were estimated using a validated 217-item food frequency questionnaire at recruitment. Multimorbidity was assessed using the Charlson comorbidity index (CCI) through electronic linkages to Hospital Episode Statistics up to March 2019. Cox's proportional hazards models were used to estimate associations between daily intakes of nutrients and risk of multimorbidity. Those associations were also analyzed in multinomial logistic regression as a sensitivity analysis. In addition, a stratified analysis was conducted with age 60 as the cutoff point. RESULTS Among the 25,389 participants, 7,799 subjects (30.7%) were confirmed with multimorbidity over a median follow-up of 22 years. Compared with the lowest quintile, the highest quintile of daily intakes of energy and protein were associated with 8% and 12% increased risk of multimorbidity respectively (HR 1.08 (95% CI 1.01, 1.16), p-linearity = 0.022 for energy; 1.12 (1.04, 1.21), p-linearity = 0.003 for protein). Higher quintiles of daily intakes of vitamin C and iron had a slightly lowered risk of multimorbidity, compared to the lowest quintile. A significantly higher risk of multimorbidity was found to be linearly associated with higher intake quintiles of vitamin B12 and vitamin D (p-linearity = 0.001 and 0.002, respectively) in Cox models, which became insignificant in multinomial logistic regression. There was some evidence of effect modification by age in intakes of iron and vitamin B1 associated with the risk of multimorbidity (p-interaction = 0.006 and 0.025, respectively). CONCLUSIONS Our findings highlight a link between nutrient intake and multimorbidity risk. However, there is uncertainty in our results, and more research is needed before definite conclusions can be reached.
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Affiliation(s)
- Ge Song
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Weimin Li
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Yanfen Ma
- Department of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Yao Xian
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Xia Liao
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Xueliang Yang
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China
| | - Huifeng Zhang
- Department of Clinical Nutrition, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, 710061, Xi'an, China.
- School of Food Science and Nutrition, University of Leeds, LS2 9AT, Leeds, UK.
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, LS2 9AT, Leeds, UK
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Gu D, Wang D, Zhu Q, Luo L, Zhang T. Prevalence of dyslipidemia and associated factors in sedentary occupational population from Shanghai: a cross-sectional study. Arch Public Health 2024; 82:21. [PMID: 38331828 PMCID: PMC10854172 DOI: 10.1186/s13690-024-01245-0] [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: 08/13/2023] [Accepted: 01/27/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Dyslipidemia is a major risk factor for cardiovascular diseases, but its prevalence and determinants among sedentary occupational population are poorly understood. This study aimed to investigate the prevalence and associated factors for dyslipidemia among a sedentary occupational population in Shanghai, China. METHODS We collected data from 35,950 sedentary occupational workers on their demographics, social, medical, and family history, lifestyle, anthropometry, and biochemistry. We used the 2016 Chinese guideline for the management of dyslipidemia in adults to define dyslipidemia and its subtypes. We performed multivariate logistic regression to examine the factors associated with dyslipidemia. RESULTS The prevalence of dyslipidemia was 29.10%, with 15.86% for high triglycerides (TG), 6.43% for high total cholesterol (TC), 5.37% for high low-density lipoprotein cholesterol (LDL-C), and 14.68% for low high-density lipoprotein cholesterol (HDL-C). Men had a significantly higher prevalence of dyslipidemia than women (39.64% vs. 12.43%, P < 0.01). Factors associated with dyslipidemia included older age, being married, longer sedentary time while resting, frequent intake of animal viscera, current smoking, hypertension, diabetes, and obesity. Current drinking was associated with a 1.24 times higher prevalence of high TG (P < 0.01). Current smokers were less likely to have low HDL-C than non-smokers. CONCLUSIONS Our present study, in a population of 35,950 sedentary occupational workers from Shanghai, demonstrated a prevalence of dyslipidemia, but lower than in other previous studies without the limitation of occupational characteristics. Prevention and control measures for dyslipidemia should take into account the characteristics and related factors for this population group.
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Affiliation(s)
- Dongxing Gu
- Department of Information Center, Huadong Sanatorium, Wuxi, 214065, China
| | - Dandan Wang
- School of Public Health, Fudan University, 130 Dong'an Rd, Xuhui District, Shanghai, 200032, China
| | - Qinzhong Zhu
- Department of Information Center, Huadong Sanatorium, Wuxi, 214065, China
| | - Li Luo
- School of Public Health, Fudan University, 130 Dong'an Rd, Xuhui District, Shanghai, 200032, China
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, 200032, China
| | - Tiantian Zhang
- School of Public Health, Fudan University, 130 Dong'an Rd, Xuhui District, Shanghai, 200032, China.
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Hu Y, Wang Z, He H, Pan L, Tu J, Shan G. Prevalence and patterns of multimorbidity in China during 2002-2022: A systematic review and meta-analysis. Ageing Res Rev 2024; 93:102165. [PMID: 38096988 DOI: 10.1016/j.arr.2023.102165] [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: 10/31/2022] [Revised: 11/20/2023] [Accepted: 12/07/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Multimorbidity is common, particularly among elderly people. Restructuring health service systems to better manage this public health issue requires knowledge regarding disease prevalence and patterns. We quantified the epidemiology characteristics of multimorbidity among adults in China to inform policy-making and resource allocation. METHODS We searched 10 databases for studies (January 2000-October 2023) reporting primary epidemiological multimorbidity data for adults in China. We included observational studies; we excluded duplicate publications and studies investigating a single comorbidity pattern, focused on specific population categories, using medical insurance reimbursement data, and with unclear/incomplete data. We assessed risk of bias using the STROBE checklist and estimated heterogeneity among studies. The prevalence was pooled using the random-effects method and sample size as weight. FINDINGS Of 13,998 records retrieved, 67 studies (30 in English, 37 in Chinese) were included. The prevalence (95% confidence interval) of multimorbidity was 25.4% (15.1%, 35.7%) among Chinese adults. Among 42 studies reporting age-specific prevalence, multimorbidity prevalence increased rapidly with age: 3.3% (0%, 15.2%) for age 18-29 years, 5.9% (0%, 12.9%) for 30-44 years, 17.6% (6.1%, 29.1%) for 45-59 years, 32.4% (16.1%, 48.7%) for 60-69 years, 38.5% (23.6%, 53.4%) for 70-79 years, and 40.2% (20.8%, 59.6%) for age ≥ 80 years. Overall prevalence of multimorbidity has increased in recent years, with regional disparity. The most common patterns included hypertension with hearing impairment (10.4% [95% CI: 4.3%, 16.5%]), dyslipidemia (8.9% [4.1%, 13.6%]), and diabetes (8.7% [3.7%, 13.8%]). CONCLUSION Multimorbidity was present nearly one in four Chinese adults, with hypertensive diseases and other comorbidities being the most-observed pattern; the prevalence increased rapidly with increased age. There is huge variation in the prevalence of multimorbidity across China. Coordinated, comprehensive strategies are urgently needed to control the ongoing impact of multimorbidity.
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Affiliation(s)
- Yaoda Hu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, No. 5, DongDanSanTiao, DongCheng District, Beijing 100005, China
| | - Zixing Wang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, No. 5, DongDanSanTiao, DongCheng District, Beijing 100005, China
| | - Huijing He
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, No. 5, DongDanSanTiao, DongCheng District, Beijing 100005, China
| | - Li Pan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, No. 5, DongDanSanTiao, DongCheng District, Beijing 100005, China
| | - Ji Tu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, No. 5, DongDanSanTiao, DongCheng District, Beijing 100005, China
| | - Guangliang Shan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, No. 5, DongDanSanTiao, DongCheng District, Beijing 100005, China.
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