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Jin Y, Zhai ZW, Sun LT, Xia PD, Hu H, Jiang CQ, Zhao BC, Qu H, Qian Q, Dai Y, Yao HW, Wang ZJ, Han JG. [Construction of a model based on multipoint full-layer puncture biopsy for predicting pathological complete response after neoadjuvant therapy for locally advanced rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2024; 27:403-411. [PMID: 38644246 DOI: 10.3760/cma.j.cn441530-20240101-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective: To investigate the value of transanal multipoint full-layer puncture biopsy (TMFP) in predicting pathological complete response (pCR) after neoadjuvant radiotherapy and chemotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and to establish a predictive model for providing clinical guidance regarding the treatment of LARC. Methods: In this multicenter, prospective, cohort study, we collected data on 110 LARC patients from four hospitals between April 2020 and March 2023: Beijing Chaoyang Hospital of Capital Medical University (50 patients), Beijing Friendship Hospital of Capital Medical University (41 patients), Qilu Hospital of Shandong University (16 patients), and Zhongnan Hospital of Wuhan University (three patients). The patients had all received TMFP after completing standard nCRT. The variables studied included (1) clinicopathological characteristics; (2) clinical complete remission (cCR) and efficacy of TMFP in determining pCR after NCRT in LARC patients; and (3) hospital attended, sex, age, clinical T- and N-stages, distance between the lower margin of the tumor and the anal verge, baseline and post-radiotherapy serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA)19-9 concentrations, chemotherapy regimen, use of immunosuppressants with or without radiotherapy, radiation therapy dosage, interval between surgery and radiotherapy, surgical procedure, clinical T/N stage after radiotherapy, cCR, pathological results of TMFP, puncture method (endoscopic or percutaneous), and number and timing of punctures. Single-factor and multifactorial logistic regression analysis were used to determine the factors affecting pCR after NCRT in LARC patients. A prediction model was constructed based on the results of multivariat analysis and the performance of this model evaluated by analyzing subject work characteristics (ROC), calibration, and clinical decision-making (DCA) curves. pCR was defined as complete absence of tumor cells on microscopic examination of the surgical specimens of rectal cancer (including lymph node dissection) after NCRT, that is, ypT0+N0. cCR was defined according to the Chinese Neoadjuvant Rectal Cancer Waiting Watch Database Study Collaborative Group criteria after treatment, which specify an absence of ulceration and nodules on endoscopy; negative rectal palpation; no tumor signals on rectal MRI T2 and DWI sequences; normal serum CEA concentrations, and no evidence of recurrence on pelvic computed tomography/magnetic resonance imaging. Results: Of the 110 patients, 45 (40.9%) achieved pCR after nCRT, which was combined with immune checkpoint inhibitors in 34 (30.9%). cCR was diagnosed before puncture in 38 (34.5%) patients, 43 (39.1%) of the punctures being endoscopic. There were no complications of puncture such as enterocutaneous fistulae, vaginal injury, prostatic injury, or presacral bleeding . Only one (2.3%) patient had a small amount of blood in the stools, which was relieved by anal pressure. cCR had a sensitivity of 57.8% (26/45) for determining pCR, specificity of 81.5% (53/65), accuracy of 71.8% (79/110), positive predictive value 68.4% (26/38), and negative predictive value of 73.6% (53/72). In contrast, the sensitivity of TMFP pathology in determining pCR was 100% (45/45), specificity 66.2% (43/65), accuracy 80.0% (88/110), positive predictive value 67.2% (45/67), and negative predictive value 100.0% (43/43). In this study, the sensitivity of TMFP for pCR (100.0% vs. 57.8%, χ2=24.09, P<0.001) was significantly higher than that for cCR. However, the accuracy of pCR did not differ significantly (80.0% vs. 71.8%, χ2=2.01, P=0.156). Univariate and multivariate logistic regression analyses showed that a ≥4 cm distance between the lower edge of the tumor and the anal verge (OR=7.84, 95%CI: 1.48-41.45, P=0.015), non-cCR (OR=4.81, 95%CI: 1.39-16.69, P=0.013), and pathological diagnosis by TMFP (OR=114.29, the 95%CI: 11.07-1180.28, P<0.001) were risk factors for pCR after NCRT in LARC patients. Additionally, endoscopic puncture (OR=0.02, 95%CI: 0.05-0.77, P=0.020) was a protective factor for pCR after NCRT in LARC patients. The area under the ROC curve of the established prediction model was 0.934 (95%CI: 0.892-0.977), suggesting that the model has good discrimination. The calibration curve was relatively close to the ideal 45° reference line, indicating that the predicted values of the model were in good agreement with the actual values. A decision-making curve showed that the model had a good net clinical benefit. Conclusion: Our predictive model, which incorporates TMFP, has considerable accuracy in predicting pCR after nCRT in patients with locally advanced rectal cancer. This may provide a basis for more precisely selecting individualized therapy.
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Affiliation(s)
- Y Jin
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Z W Zhai
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - L T Sun
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - P D Xia
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H Hu
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - C Q Jiang
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - B C Zhao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - H Qu
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Q Qian
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Y Dai
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H W Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Dai J, Zhou FX, Xu H, Jiang CQ, Wang WB, Jiang HG, Wang QY, Wang Y, Xia L, Wu H, Peng J, Wei Y, Luo M, Tang F, Yang L, Hu H, Huang TH, Jiang DZ, Wang DJ, Wang XY. Efficacy and Safety of High-Dose Vitamin C Combined with Total Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer (HCCSC R02 Study). Int J Radiat Oncol Biol Phys 2023; 117:e291-e292. [PMID: 37785075 DOI: 10.1016/j.ijrobp.2023.06.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Forpatients with locally advanced rectal cancer (LARC), the standard treatment is fluoropyrimidine (FU) -based neoadjuvant chemoradiotherapy (NCRT) combined with curative surgery. The CAO/ARO/AIO-04 trial and FORWARC trial reported that the addition of oxaliplatin to FU -based NCRT contributed to improve pathologic complete response (pCR), nevertheless, increased the acute therapeutic toxicity. Some studies showed that vitamin C (VitC) had potential benefits on anti-tumor therapy and anti-inflammatory response. Therefore, we conducted this HCCSC R02 study to explore the efficacy and safety of adding a high-dose intravenous VitC to mFOLFOX6/XELOX -based NCRT in LARC. MATERIALS/METHODS HCCSCR02 study was designed as a prospective, single-center phase II trial, which including pts aged 18-75 years with stage II/III rectal adenocarcinoma, distance from anus ≤12cm. The enrollment criteria included: staged with MRI as cT3/cT4 or cN1/2, or mesorectal fascia involvement (MRF+), or difficult to preserve the anus. Patients with glucose-6-phosphate dehydrogenase enzyme(G6PD) deficiency were excluded. Pelvic intensity modulated radiation therapy (IMRT) was given in 45-50.4Gy/25-28 fractions. Concurrently, two cycles of chemotherapy (mFOLFOX6 or XELOX) were administered during IMRT, as well as intravenous VitC (24g) delivered daily after the end of each radiation therapy. Additional 2-3 cycles of mFOLFOX6 / XELOX were adopted between the completion of radiotherapy and surgery. The primary endpoint was pCR rate. The secondary endpoints included radiation-related toxicities, overall survival (OS) and disease-free survival (DFS). This study is still recruiting. RESULTS From May 15, 2021 to Feb 8, 2023, 19 pts were recruited and finished all the scheduled NCRT, of which the proportion of cT4, cT3, cN2, cN1 were 31.6%, 63.2%, 52.6%, 36.8%, respectively. In addition, 10 pts (52.6%) were diagnosed as MRF+ initially, and 8 pts (42.1%) had a lower primary tumor(≤5cm) who were considered difficult for anal preservation before NCRT. All subjects enrolled were confirmed to be proficient mismatch repair (pMMR). As a result, 18 pts underwent a total mesorectal excision (TME) all with R0-resection, and 8 pts were evaluated as pCR (44.4%, 8/18, confidence interval: 0.246-0.663), 11 as major pathological response rate (MPR) (61.6%, 11/18), respectively. The anus preservation rate in patients with lower diseases was 87.5% (7/8). One case accepted a watch-and-wait strategy because of clinical complete response (cCR). Overall, grade 3 toxicities were observed in 4 pts, including 3 leucopenia (15.8%, 3/19), 2 neutropenia (10.5%, 2/19) and 1 diarrhea (5.3%, 1/19). No grade 4 adverse event was observed. CONCLUSION The addition of high-dose VitC to the mFOLFOX6/XELOX-based NCRT in LARC showed a promising pCR, well tolerance, particularly low rate of diarrhea, thus warrants further investigation. CLINICAL TRIAL INFORMATION NCT04801511.
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Affiliation(s)
- J Dai
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - F X Zhou
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - H Xu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - C Q Jiang
- Department of Colorectal and Anal Surgery, Low Rectal Cancer Diagnosis and Treatment Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - W B Wang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - H G Jiang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Q Y Wang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Y Wang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - L Xia
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - H Wu
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - J Peng
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Y Wei
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - M Luo
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - F Tang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - L Yang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - H Hu
- Department of Colorectal and Anal Surgery, Low Rectal Cancer Diagnosis and Treatment Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - T H Huang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - D Z Jiang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - D J Wang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - X Y Wang
- Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
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Han JG, Sun LT, Zhai ZW, Xia PD, Hu H, Zhang D, Jiang CQ, Zhao BC, Qu H, Qian Q, Dai Y, Yao HW, Wang ZJ. [The value of transanal multipoint full-layer puncture biopsy in determining the response degree of rectal cancer following neoadjuvant therapy: a prospective multicenter study]. Zhonghua Wai Ke Za Zhi 2023; 61:768-774. [PMID: 37491169 DOI: 10.3760/cma.j.cn112139-20230417-00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Objective: To verify the feasibility and accuracy of the transanal multipoint full-layer puncture biopsy (TMFP) technique in determining the residual status of cancer foci after neoadjuvant therapy (nCRT) in rectal cancer. Methods: Between April 2020 and November 2022, a total of 78 patients from the Beijing Chaoyang Hospital of Capital Medical University, the Beijing Friendship Hospital of Capital Medical University, the Qilu Hospital of Shandong University, the Zhongnan Hospital of Wuhan University with advanced rectal cancer received TMFP after nCRT participated in this prospective multicenter trial. There were 53 males and 25 females, aged (M(IQR)) 61 (13) years (range: 35 to 77 years). The tumor distance from the anal verge was 5 (3) cm (range: 2 to 10 cm). The waiting time between nCRT and TMFP was 73 (26) days (range: 33 to 330 days). 13-point transanal puncture was performed with a 16 G tissue biopsy needle with the residual lesion as the center. The specimens were submitted for independent examination and the complications of the puncture were recorded. The consistency of TMFP and radical operation specimen was compared. The consistency of TMPF with clinical remission rates for the diagnosis of complete pathological remission was compared by sensitivity, specificity, negative predictive value, positive predictive value and accuracy. Statistical analysis between groups was performed using the χ2 analysis, and a paired χ2 test was used to compare diagnostic validity. Results: Before TMFP, clinical complete response (cCR) was evaluated in 27 cases. Thirty-six cases received in vivo puncture, the number of punctures in each patient was 13 (8) (range: 4 to 20), 24 cases of tumor residue were found in the puncture specimens. The sensitivity to judgment (100% vs. 60%, χ2=17.500, P<0.01) and accuracy (88.5% vs. 74.4%, χ2=5.125, P=0.024) of TMFP for the pathologic complete response (pCR) were significantly higher than those of cCR. Implement TMFP based on cCR judgment, the accuracy increased from 74.4% to 92.6% (χ2=4.026, P=0.045). The accuracy of the in vivo puncture was 94.4%, which was 83.3% of the in vitro puncture (χ2=1.382, P=0.240). Overall, the accuracy of TMFP improved gradually with an increasing number of cases (χ2=7.112, P=0.029). Conclusion: TMFP is safe and feasible, which improves the sensitivity and accuracy of rectal cancer pCR determination after nCRT, provides a pathological basis for cCR determination, and contributes to the safe development of the watch and wait policy.
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Affiliation(s)
- J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - L T Sun
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z W Zhai
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - P D Xia
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H Hu
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - D Zhang
- Department of Clinical Epidemiology Laboratory, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - C Q Jiang
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - B C Zhao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - H Qu
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Q Qian
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Y Dai
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H W Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Metcalf C, Klein SL, Read JM, Riley S, Cummings D, Guan Y, Kwok KO, Huachen Z, Jiang CQ, Lam TH, Lessler J. Survival at older ages: are greater influenza antibody titers protective? Med Hypotheses 2023; 178:111135. [PMID: 37744025 PMCID: PMC10512879 DOI: 10.1016/j.mehy.2023.111135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Antibodies are a core element of the immune system's defense against infectious diseases. We hypothesize that antibody titres might therefore be an important predictor of survival in older individuals. This is important because biomarkers that robustly measure survival have proved elusive, despite their potential utility in health care settings. We present evidence supporting the hypothesis that influenza antibody titres are associated with overall survival of older individuals, and indicate a role for biological sex in modulating this association. Since antibody titres can be modulated by vaccination, these results have important implications for public health policy on influenza control in aging populations.
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Affiliation(s)
- Cje Metcalf
- Dept of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - S L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J M Read
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, UK
| | - S Riley
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Dat Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Yi Guan
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
- Guangzhou No. 12 Hospital, Guangzhou, Guangdong, China
| | - K O Kwok
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Z Huachen
- School of Public Health, University of Hong Kong, Hong Kong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - C Q Jiang
- Guangzhou No. 12 Hospital, Guangzhou, Guangdong, China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - J Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Wei SC, Liu C, Chen M, Cai YH, Wu XH, Chen ML, Zhang JX, Xiang D, Liu ZC, Jiang CQ, Shi J, Wu KC, Dong WG. [Effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease: a multicenter study]. Zhonghua Nei Ke Za Zhi 2023; 62:1000-1006. [PMID: 37528039 DOI: 10.3760/cma.j.cn112138-20220818-00603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Objective: To investigate the effects of biologics on psychological status and quality of life in patients with inflammatory bowel disease (IBD). Methods: A cross-sectional survey was conducted in 42 hospitals in 22 provinces (autonomous regions and municipalities directly under the central government) from September 2021 to May 2022. General clinical information and the use of biologics were obtained from adult patients diagnosed with IBD who voluntarily participated in the study. Psychological status was evaluated using the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Inflammatory Bowel Disease Questionnaire (IBDQ) assessment tools. Counts were analyzed via the Chi-square test, and datasets that were not normally distributed were analyzed via nonparametric tests. P<0.05 was considered statistically significant. Results: A total of 2 478 valid questionnaires were collected. The GAD-7 score of the biologics group was significantly lower than that of the non-use group [6 (2, 9) vs. 7 (3, 10), Z=-3.49, P<0.001]. IBDQ scores [183 (158, 204) vs. 178 (152, 198), Z=-4.11, P<0.001], intestinal symptom scores [61 (52, 67) vs. 58 (49, 65), Z=-5.41, P<0.001], systemic symptom scores [28 (24, 32) vs. 27 (23, 31), Z=-2.37, P=0.018], emotional ability scores [69 (58, 77) vs. 67 (56, 75), Z=-3.58, P<0.001] and social ability scores [26 (22, 29) vs. 25 (22, 29), Z=-2.52, P=0.012] in the biologics group were significantly higher than in the non-use group. GAD-7 scores [5 (2, 9) vs. 6 (3, 10), Z=-3.50, P<0.001] and PSQI scores [6 (4, 9) vs. 6 (4, 9), Z=-2.55, P=0.011] were significantly lower in the group using infliximab than in the group not using it. IBDQ scores were significantly higher in patients using vedolizumab than in those not using it [186 (159, 205) vs. 181 (155, 201), Z=-2.32, P=0.021] and were also significantly higher in the group treated with adalimumab than in the group not treated with adalimumab [187 (159, 209) vs. 181 (155, 201), Z=-2.16, P=0.030]. However, ustekinumab had no significant effect on any of the scores. Conclusion: The use of biologics is strongly associated with improvements in anxiety status and quality of life in IBD patients.
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Affiliation(s)
- S C Wei
- Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing 210029, China
| | - C Liu
- Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China
| | - M Chen
- Department of Gastroenterology, Xijing Hospital, Air Force Medical University, Xi'an 710032, China
| | - Y H Cai
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an 710032, China
| | - X H Wu
- Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China
| | - M L Chen
- Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China
| | - J X Zhang
- Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China
| | - D Xiang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Z C Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - C Q Jiang
- Department of Clinical Psychology, Beijing Anding Hospital, Capital Medical University, Beijing l00088, China
| | - J Shi
- Department of Medical Psychology, Chinese People's Liberation Army Rocket Army Characteristic Medical Center, Beijing l00088, China
| | - K C Wu
- Department of Gastroenterology, Xijing Hospital, Air Force Medical University, Xi'an 710032, China
| | - W G Dong
- Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China
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Wu YJ, Zhang WS, Zhu F, Zhu T, Jin YL, Pan J, Jiang CQ. [Study on the relationship between the age at natural menopause and postmenopausal metabolic syndrome]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:433-437. [PMID: 36922179 DOI: 10.3760/cma.j.cn112150-20220601-00560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
To explore the relationship between the early or delayed age at natural menopause and metabolic syndrome (MS) in women. A total of 4 734 natural menopausal women who completed the baseline survey from November 2017 to January 2020 in the Guangzhou Middle-aged and Elderly Chronic Disease Prospective Cohort Study were selected in this cross-sectional study. Data on general demographic characteristics, disease history and female physiological health indicators were collected. Logistic regression model and restricted cubic spline curve were used to analyze the relationship between the age at natural menopause and MS. The results showed that the mean age of the subjects was (60±6) years old. The median (Q1,Q3) age at natural menopause was 50 (49, 52) years old, and the prevalence of MS was 14.8%(699/4 734). After adjusting for confounders, the age at natural menopause was closely related to MS in an approximate"U"shape. Compared with the group of normal age at natural menopause, the early age at menopause (OR=1.52, 95%CI: 1.12-2.06) and delayed age at menopause (OR=1.77, 95%CI: 1.36-2.30) had a higher risk of MS. In the group with time since menopause ≤6 years and 7-9 years, the risk of MS in the group with delayed age at menopause was 2.40 times (95%CI: 1.54-3.75) and 2.19 times (95%CI: 1.11-4.31) higher than that in the group with normal menopausal age, respectively. In conclusion, the early and delayed age at natural menopause increased the risk of MS. The increased risk of MS in delayed age at natural menopause mainly occurred within 10 years since menopause.
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Affiliation(s)
- Y J Wu
- Department of Molecular Epidemiology, Guangzhou Twelfth People's Hospital,Guangzhou 510620,China School of Public Health,Guangzhou Medical University,Guangzhou 511436,China
| | - W S Zhang
- Department of Molecular Epidemiology, Guangzhou Twelfth People's Hospital,Guangzhou 510620,China
| | - F Zhu
- Department of Molecular Epidemiology, Guangzhou Twelfth People's Hospital,Guangzhou 510620,China
| | - T Zhu
- Department of Molecular Epidemiology, Guangzhou Twelfth People's Hospital,Guangzhou 510620,China
| | - Y L Jin
- Department of Molecular Epidemiology, Guangzhou Twelfth People's Hospital,Guangzhou 510620,China
| | - J Pan
- Department of Molecular Epidemiology, Guangzhou Twelfth People's Hospital,Guangzhou 510620,China
| | - C Q Jiang
- Department of Molecular Epidemiology, Guangzhou Twelfth People's Hospital,Guangzhou 510620,China
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Zhang P, Jiang CQ, Xiong ZG, Zheng YB, Fu YF, Li XM, Pang DF, Liao XF, Tong X, Zhu HM, Yang ZH, Gong GW, Yin XP, Li DL, Li HJ, Chen HL, Jiang XF, He ZJ, Lu YJ, Shuai XM, Gao JB, Cai KL, Tao KX. [Diagnosis and treatment status of perioperative anemia in patients with gastrointestinal neoplasms: a multi-center study in Hubei Province]. Zhonghua Wai Ke Za Zhi 2022; 60:32-38. [PMID: 34954944 DOI: 10.3760/cma.j.cn112139-20210405-00160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ2 test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.
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Affiliation(s)
- P Zhang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - C Q Jiang
- Department of Colorectal Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Z G Xiong
- Department of Gastrointestinal Surgery, HuBei Cancer Hospital, Wuhan 430079, China
| | - Y B Zheng
- Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Y F Fu
- Department of Gastrointestinal Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - X M Li
- Department of Gastrointestinal Surgery, Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, Huangshi 435000, China
| | - D F Pang
- Department of Gastrointestinal Surgery, Jingzhou Central Hospital, Jingzhou 434020, China
| | - X F Liao
- Department of General Surgery, Xiangyang Central Hospital, Hubei College of Liberal Arts and Sciences, Xiangyang 441021, China
| | - X Tong
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - H M Zhu
- Department of Gastrointestinal Surgery, People's Hospital of Macheng, Huanggang 438300, China
| | - Z H Yang
- Department of Gastiointestinal Surgery, Institute of Digestive Disease, China Three Gorges University, Yichang Central People's Hospital, Yichang 443000, China
| | - G W Gong
- Department of Gastrointestinal Surgery, Xiaogan Hospital of Wuhan University of Science and Technology, Xiaogan 432600, China
| | - X P Yin
- Department of Gastrointestinal Surgery Ⅱ Ward, Xianning Central Hospital, Hubei University of Science and Technology, Xianning 437100, China
| | - D L Li
- Department of Gastrointestinal Surgery, Xishui People's Hospital, Huanggang 438200, China
| | - H J Li
- Department of General Surgery, the First People's Hospital of Zaoyang, Xiangyang 441200, China
| | - H L Chen
- Department of General Surgery, Affiliated Hospital of Hubei Institute for Nationalities, Enshi 445000, China
| | - X F Jiang
- Department of Gastrointestinal Surgery, the First People's Hospital of Jingzhou, Jingzhou 434000, China
| | - Z J He
- Department of Gastrointestinal Surgery, Renmin Hospital of Hubei University of Medicine, Shiyan 442200, China
| | - Y J Lu
- Department of Gastrointestinal Surgery, Huanggang Central Hospital, Huanggang 438000, China
| | - X M Shuai
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - J B Gao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - K L Cai
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - K X Tao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Ge ST, Wen HX, Zuo LG, Li SQ, Chen DL, Zhu PS, Jiang CQ, Luo J, Liu ML. [Clinical efficacy of transabdominal preperitoneal prosthesis based on inverted "T" peritoneotomy for lumbar hernia]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:1103-1106. [PMID: 34923796 DOI: 10.3760/cma.j.cn441530-20201208-00651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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9
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Jiang CQ, Wang Z, Zhou D, Zhang SM, Yu ZQ, Chen G. [Clinical diagnosis and treatment analysis of 553 cases of acoustic neuroma in a single center]. Zhonghua Yi Xue Za Zhi 2021; 101:2077-2080. [PMID: 34275242 DOI: 10.3760/cma.j.cn112137-20201228-03485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the relationship between microsurgery and prognosis of acoustic neuroma. Methods: A total of 553 acoustic neuroma surgical cases admitted to the First Affiliated Hospital of Soochow University from January 1, 1986 to September 30, 2016, were collected retrospectively. They were divided into 1986-1995 group, 1996-2005 group, and 2006-2016 group. The general information, tumor size, preoperative hospital stay, total hospital stay, operation time, intraoperative blood transfusion, use of neuroelectrophysiological monitoring, internal auditory canal wall grinding, tumor resection degree, postoperative facial nerve function rating (House-Brackmann grading), discharge status, and quality of life assessment KPS of patients were statistically analyzed. Results: Compared with the 1986-1995 group and the 1996-2005 group, the average age of patients in the 2006-2016 group ((52.9±13.3) years) was larger but the overall tumor volume ((3.7±0.8) cm) was smaller, and preoperative hospital stay ((4.9±1.9) days), the total hospital stay ((19.4±6.4) days) was significantly reduced, the operation time ((4.6±1.0) hours) was shortened, the intraoperative blood transfusion rate (18.5%) was significantly reduced, the intraoperative neuroelectrophysiological monitoring utilization rate (8.9%), and the internal auditory canal rate (12.7%) was higher. While increasing the tumor total resection and near total resection rate (89.2%), it further improved the postoperative facial nerve function retention rate (71.5%), and significantly increased the discharge cure rate (88.5%) (P<0.05). At the same time, the postoperative quality of life assessment good rate (KPS≥60 points) and excellent rate (KPS≥80 points) of the patients in the 2006-2016 group increased significantly, reaching 94.2% and 45.8% (P<0.05). Conclusion: The maturity of microsurgery techniques and the use of intraoperative neuroelectrophysiological monitoring can shorten the treatment cycle of patients with acoustic neuroma, increase the tumor resection rate and postoperative facial nerve function retention rate, and effectively improve the quality of life of patients after surgery.
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Affiliation(s)
- C Q Jiang
- Department of Surgery, District 6,Suzhou Xiangcheng People's Hospital, Suzhou 215131, China
| | - Z Wang
- Department of Surgery, District 11, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - D Zhou
- Department of Surgery, District 11, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - S M Zhang
- Department of Surgery, District 11, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Z Q Yu
- Department of Surgery, District 11, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - G Chen
- Department of Surgery, District 11, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
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Zhong GB, Jiang CQ, Yu XS, Liu ZD, Wang WL, Xu RD. Long noncoding RNA SNHG8 promotes the proliferation of osteosarcoma cells by downregulating miR-542-3p. J BIOL REG HOMEOS AG 2020; 34:517-524. [PMID: 32450677 DOI: 10.23812/20-97-61] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Small nucleolar RNA host genes (SNHGs) as a subset of long noncoding RNAs (lncRNAs) have critical roles in the pathogenesis of multiple malignancies, however, the role and molecular mechanisms of lncRNA SNHG8 in osteosarcoma (OS) remain unclear. In the present study, the correlation of SNHG8 or miR-542-3p with clinicopathological elements and prognosis in OS patents was estimated by TCGA cohort. Cell viability and invasion were assessed by MTT and Transwell assays. The interplay between SNHG8 and miR-542-3p was affirmed by a luciferase report assay. The effects of SNHG8 on miR-542-3p expression were examined in MG-63 and SW-1353 cells by qRT-PCR analysis. The results showed that incremental expression of SNHG8 or reduced expression of miR-542-3p was related to poor survival and tumor recurrence in OS patients. Overexpressing SNHG8 accelerated the growth and invasion of MG-63 cells, but silencing SNHG8 harbored an opposite effect in SW-1353 cells. Additionally, SNHG8 could negatively regulate miR-542-3p expression and bind with miR-542-3p, which attenuated SNHG8 induced cell proliferation. Taken together, these findings indicate that lncRNA SNHG8 promotes the proliferation of OS cells by downregulating miR-542-3p.
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Affiliation(s)
- G B Zhong
- Baoshan Branch, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University. Shanghai, China
| | - C Q Jiang
- Department of Orthopaedics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - X S Yu
- Department of Orthopaedics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Z D Liu
- Department of Orthopaedics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - W L Wang
- Department of Orthopaedics, South Campus, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - R D Xu
- Department of Orthopaedics, South Campus, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Xu F, Zhang YC, Hu H, Xu M, Huang MF, Qian Q, Jiang CQ, Ding Z. [Analysis on the efficacy and safety of reconstruction of mesenteric superior and inferior artery to increase the blood supply of ileal type D pouch]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:83-86. [PMID: 31958937 DOI: 10.3760/cma.j.issn.1671-0274.2020.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Zhou Y, Jiang CQ, Qian Q, Zhang W, Wang XW, Zhang L, Yu XQ, Ding Z, Gong ZL, You SP. [A rare case of spontaneous transvaginal evisceration]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:1085-1086. [PMID: 31770841 DOI: 10.3760/cma.j.issn.1671-0274.2019.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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13
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Zuo LG, Ge ST, Wang X, Zhu YK, Liu ZH, Yang YT, Jiang CQ, Li SQ, Liu ML. [Analysis on prognosis and influencing factors of postoperative low anterior resection syndrome for rectal cancer patients undergoing laparoscopic anus-preserving radical resection]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:573-578. [PMID: 31238637 DOI: 10.3760/cma.j.issn.1671-0274.2019.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the prognosis and influencing factors of postoperative low anterior resection syndrome (LARS) for rectal cancer patients undergoing laparoscopic sphincter-preserving radical resection. Methods: A retrospective case-control study was used in this study. Clinical data of 268 rectal cancer patients undergoing laparoscopic sphincter-preserving radical resection at Department of Gastrointestinal Surgery of The First Affiliated Hospital of Bengbu Medical College from January 2016 to January 2018 were retrospectively collected. Inclusion criteria: (1) operation procedure was total mesorectal excision (TME) and sphincter-preserving radical resection; (2) rectal cancer was confirmed by postoperative pathology; (3) age of patient was ≥ 18 years old. Exclusion criteria: (1) patient who had history of pelvic surgery and pelvic fractures, which would affect the anorectal function; (2) patient who had history of preoperative chronic constipation and irritable bowel syndrome, which would affect defecation; (3) patient who developed postoperative complications, such as anastomotic leakage, which would affect defecation function; (4) patient who received long-term use of drugs, which would affect the function of gastrointestinal tract or anus; (5) patient suffered from mental illness, who was unable to communicate properly; (6) patient who was lack of clinical data or had incomplete clinical data. Patients were followed up at 3, 6 and 12 months postoperatively, and LARS was diagnosed and graded according to the LARS score scale. The LARS score ranged from 0 to 42 points, and 0 to 20 was difined as no LARS, 21 to 29 was mild LARS, and 30 to 42 was severe LARS. LARS score >20 points at any time point was defined as postoperative LARS. Severe LARS transferring into mild LARS and mild LARS transferring into no LARS was defined as symptom improvement. Incidence and outcomes of LARS were evaluated. The factors associated with LARS outcomes were analyzed using χ(2) test and logistic regression model. Results: A total of 268 patients were enrolled. The incidence of LARS was 42.9% (115/268), 32.5% (87/268) and 20.1% (54/268) at 3, 6, and 12 months postoperatively respectively, and no new case of LARS was found after 3 months postoperatively. The incidence of mild LARS was 25.7% (69/268), 17.2% (46/268) and 8.6% (23/268) at 3, 6, and 12 months postoperatively respectively, and mild LARS incidence at 6 months was significantly lower than that at 3 months (χ(2)=5.857, P=0.016), and was significantly higher than that at 12 months (χ(2)=8.799, P=0.003). The incidence of severe LARS was 17.2% (46/268), 15.3% (41/268) and 11.6% (31/268) at 3, 6, and 12 months postoperatively respectively, without significant difference among 3 time points (all P>0.05). The improvement rate within one year after surgery in patients with mild LARS diagnosed at 3 months was significantly higher than that in patients with severe LARS (88.4% vs. 32.6%, χ(2)=38.340, P<0.001). Univariate analysis showed that female, distance from anastomosis to anal verge < 5 cm and tumor diameter ≥ 5 cm were associated with unsatisfied LARS outcomes (all P<0.05). Logistic regression analysis showed that distance from anastomosis to anal verge <5 cm was an independent risk factor for LARS outcome (OR=3.589, 95% CI: 1.163 to 2.198, P<0.001). Conclusions: The incidence of LARS after laparoscopic sphincter-preserving radical resection decreases with time. The improvement rate within postoperative 1-year of severe LARS is lower than that of mild LARS. Low anastomotic position may lead to impaired improvement of LARS.
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Affiliation(s)
- L G Zuo
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, Bengbu Medical College, Anhui Bengbu 233004, China; Key Laboratory of Tissue Transplantation of Anhui Province, Bengbu Medical College Anhui Bengbu 233030, China
| | - S T Ge
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, Bengbu Medical College, Anhui Bengbu 233004, China; Key Laboratory of Tissue Transplantation of Anhui Province, Bengbu Medical College Anhui Bengbu 233030, China
| | - X Wang
- Department of Clinical Medicine, Bengbu Medical College, Anhui Bengbu 233030, China
| | - Y K Zhu
- Department of Clinical Medicine, Bengbu Medical College, Anhui Bengbu 233030, China
| | - Z H Liu
- Department of Clinical Medicine, Bengbu Medical College, Anhui Bengbu 233030, China
| | - Y T Yang
- Department of Clinical Medicine, Bengbu Medical College, Anhui Bengbu 233030, China
| | - C Q Jiang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, Bengbu Medical College, Anhui Bengbu 233004, China
| | - S Q Li
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, Bengbu Medical College, Anhui Bengbu 233004, China
| | - M L Liu
- Department of Gastrointestinal Surgery, the First Affiliated Hospital, Bengbu Medical College, Anhui Bengbu 233004, China
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Shen ZM, Jiang CQ, Zhang WS, Xu L, Jin YL, Zhu T, Zhu F, Lam DQ. [Mediating effect of hemoglobin and hematocrit on the association between alcohol consumption and blood pressure among middle-aged and elderly male residents in Guangzhou]. Zhonghua Xin Xue Guan Bing Za Zhi 2018; 46:701-705. [PMID: 30293376 DOI: 10.3760/cma.j.issn.0253-3758.2018.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the mediating effect of hemoglobin (Hb) and hematocrit (HCT) on the association between alcohol consumption and blood pressure, and provide evidence for the prevention and control of alcohol-attributed hypertension. Methods: 1 091 male (age >50 years old) participants with drinking habit were selected from the Guangzhou biobank cohort study (GBCS). Mediation analysis was used to evaluate the mediating effect of Hb and HCT on the association of alcohol consumption (unit/day) with systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure(PP) and mean arterial pressure (MAP). Results: After adjusting for age, body mass index, education level, personal annual income, smoking, occupation and physical activity, the associations of alcohol consumption with SBP, DBP, PP and MAP were partly mediated by Hb, the proportion of mediating effect was 11.8% (95%CI 4.8%-24.7%), 15.3% (95%CI 6.5%-32.0%), 8.4% (95%CI 2.2%-22.5%) and 13.5% (95%CI 5.9%-27.5%), respectively. The associations of alcohol consumption with SBP, DBP, and MAP were also partly mediated by HCT, the proportion of mediating effect was 6.3% (95%CI 1.0%-16.0%), 8.7% (95%CI 1.4%-21.4%), and 7.5% (95%CI 1.0%-18.6%), respectively. Conclusion: There is a significant mediating effect of Hb and HCT on the association between alcohol consumption and blood pressure. Besides efforts on alcohol control, the potential effects of alcohol-induced increase on Hb and HCT, which might also increase the blood pressure, need to be considered to achieve optimal monitoring and prevention of alcohol-related hypertension.
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Affiliation(s)
- Z M Shen
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
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Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
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Hu Q, Jiang CQ, Zhang WS, Cheng JJ, Xu L, Jin YL, Shen ZM, Zhu F, Lam DQ. [Association between body weight change during early and middle adulthood and the risk of type 2 diabetes in middle aged and elderly population]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38:1699-1702. [PMID: 29294590 DOI: 10.3760/cma.j.issn.0254-6450.2017.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population. Methods: Based on the Guangzhou Biobank Cohort Study (GBCS), 28 736 residents aged ≥50 years were included in Guangzhou. Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population. Adjustments on age, smoking, alcohol consumption, physical activity, education level, occupation, district of residence and body mass index etc., were made. Results: The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women, with the prevalence rates of diabetes as 13.1% and 13.7% in men and women, respectively. Compared to those with stable body weight, the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend<0.01). Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83, 95%CI:1.99-4.02) and women (OR=3.13, 95%CI: 2.47-3.96). Compared to those who reached the highest weight at age 20, those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes, with OR being 5.32 (95%CI: 1.92-14.8) in men and 3.41 (95%CI: 2.49-4.67) in women, respectively. Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women. Conclusion: Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population. The detrimental effect of obesity on diabetes might become significantly visible in the next decades.
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Affiliation(s)
- Q Hu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - C Q Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - W S Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - J J Cheng
- Department of Public Health and Epidemiology, University of Birmingham, Birmingham B15 2TT, UK
| | - L Xu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Y L Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - Z M Shen
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - F Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - D Q Lam
- Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong 999077, China
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Xu L, Lam TH, Jiang CQ, Zhang WS, Jin YL, Zhu T, Zhu F, Thomas GN, Cheng KK. Adiposity and incident diabetes within 4 years of follow-up: the Guangzhou Biobank Cohort Study. Diabet Med 2017; 34:1400-1406. [PMID: 28477424 DOI: 10.1111/dme.13378] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 01/19/2023]
Abstract
AIM Whether different adiposity measures predict incident diabetes differentially in general Chinese populations is unclear. We investigated this in Chinese people aged 50+ years in the Guangzhou Biobank Cohort Study. METHODS Waist circumference and BMI were measured at baseline, and fasting glucose was measured at both baseline and follow-up examinations. Incident diabetes was defined as fasting glucose ≥ 7.0 mmol/l, glucose after 2-h oral glucose tolerance test ≥ 11.1 mmol/l, and/or self-reported physician-diagnosed diabetes during the follow-up period. RESULTS Of 15 752 people without diabetes at baseline from 2003 to 2008, 1779 (11.3%) developed incident diabetes during the follow-up from 2008 to 2012 (mean = 3.6 years, sd = 1.0). After mutually adjusting each other and adjusting for other potential confounders, waist circumference showed a higher predictive value than BMI. The odds ratio (OR) (95% confidence interval (CI) was 1.50 (95% CI 1.37-1.64) for a 1 sd increment in waist circumference and 1.21 (95% CI 1.11-1.33), for a 1 sd increment in BMI. Similarly, after mutual adjustment, abdominal obesity was associated with an almost twofold odds of incident diabetes (OR 1.93, 95% CI 1.71-2.17), which was higher than that for general obesity (OR 1.76, 95% CI 1.50-2.06). The area under receiver operating characteristic curve (AUC) for waist circumference was higher than that for BMI [AUC = 0.676 (95% CI 0.660-0.686) vs. 0.665 (95% CI 0.651-0.678), P = 0.02]. CONCLUSION Abdominal obesity predicted incident diabetes in older people better than general obesity. Our findings may be an early warning signal for local government or public health practitioners to develop and investigate more effective intervention programmes for diabetes, and should also be disseminated to the public to pay more attention to this important public health issue.
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Affiliation(s)
- L Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong
- School of Public Health, the University of Hong Kong, Hong Kong
| | - T H Lam
- School of Public Health, the University of Hong Kong, Hong Kong
- Guangzhou 12th Hospital, Guangzhou, China
| | - C Q Jiang
- School of Public Health, the University of Hong Kong, Hong Kong
| | - W S Zhang
- Guangzhou 12th Hospital, Guangzhou, China
| | - Y L Jin
- Guangzhou 12th Hospital, Guangzhou, China
| | - T Zhu
- Guangzhou 12th Hospital, Guangzhou, China
| | - F Zhu
- Guangzhou 12th Hospital, Guangzhou, China
| | - G N Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Shen J, Jiang CQ, Yan YF, Liu BR, Zu CL. Effect of increased UV-B radiation on carotenoid accumulation and total antioxidant capacity in tobacco (Nicotiana tabacum L.) leaves. Genet Mol Res 2017; 16:gmr-16-01-gmr.16018438. [PMID: 28290611 DOI: 10.4238/gmr16018438] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
Carotenoids are important components of plant antioxidant systems, which protect photosystems from photooxidative destruction during ultraviolet-B (UV-B) exposure. The influence of carotenoids on total antioxidant capacity (TAC) of plants has rarely been studied. In this study, tobacco (Nicotiana tabacum L., 'K326') seedlings exposed to UV-B radiation were used in order to evaluate the effects of ambient levels of UV-B radiation on carotenoid accumulation. The aim was to investigate whether carotenoids could enhance TAC as a means of UV protection. Our results showed that leaf carotenoid content in the low UV-B exposure (+9.75 μW/cm2) plants was approximately 8% higher than that observed in control plants at 2-8 days of exposure. At high UV-B exposure (+20.76 μW/cm2), the carotenoid content increased rapidly after 1 day's exposure (10.41% higher than the control), followed by a return to the content as in control plants. Furthermore, carotenoid content positively correlated with TAC (P = 0.024). These results suggest that carotenoids have antioxidant properties and play an important role in the antioxidant system. UV-B exposure increased the carotenoid synthesis capability of plants. The plants could deplete the carotenoids to scavenge excess ROS at high UV-B radiation levels, which protects the tobacco plant from oxidative damage caused by UV-B stress.
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Affiliation(s)
- J Shen
- Tobacco Research Institute, Anhui Academy of Agricultural Sciences, Hefei City, Anhui Province, China
| | - C Q Jiang
- Tobacco Research Institute, Anhui Academy of Agricultural Sciences, Hefei City, Anhui Province, China
| | - Y F Yan
- Tobacco Research Institute, Anhui Academy of Agricultural Sciences, Hefei City, Anhui Province, China
| | - B R Liu
- Tobacco Research Institute, Anhui Academy of Agricultural Sciences, Hefei City, Anhui Province, China
| | - C L Zu
- Tobacco Research Institute, Anhui Academy of Agricultural Sciences, Hefei City, Anhui Province, China
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19
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Hu Q, Jiang CQ, Zhang WS, Cheng JJ, Xu L, Jin YL, Rao SL, Zheng HQ, Lam DQ. [Correlation between body fat percentage and general obesity indexes in middle aged and old people in Guangzhou]. Zhonghua Liu Xing Bing Xue Za Zhi 2016; 37:1341-1344. [PMID: 27765122 DOI: 10.3760/cma.j.issn.0254-6450.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine the correlation between body fat percentage (BFP) and general obesity indexes, including body mass index (BMI), waist circumference (WC) and waist to hip ratio (WHR) and calculate the corresponding BFP cutoff values in the middle aged and old people in Guangzhou. The corresponding cut-point of optimal body fat percentage for Guangzhou older population. Methods: Based on the Guangzhou Biobank Cohort Study (GBCS), 3 490 relatively healthy Guangzhou residents aged ≥50 years were selected and were randomly divided into 2 groups. The equations between BFP and BMI, WC, WHR were set up with Curve fitting analysis in one group. The multiple regression analysis was undertaken to establish predictive equations between BFP and BMI, WC, WHR with stepwise model for adding gender, age, physical activity, drinking and smoking. Then, the optimal cut-points of BFP corresponding to BMI, WC and WHR to reflect the degree of obesity were calculated. The equations were then validated with another group. Results: BFP increased with the increase of WHR, WC and BMI. BMI was a better predictor of body fat percentage than WC and WHR. The final regression equation was BFP=(-23.47 -8.87×sex) +2.94× (BMI) - 0.024 × (BMI)2,the coefficient of determination was 0.805. Based on the equation, the BFP corresponding to overweight/obesity (24 kg/m2≤BMI<28 kg/m2) were 24.3% ≤BFP<31.1% in men and 33.2%≤BFP<40.0% in women, respectively. BMI had a better consistency with BFP in identify obesity compared with WC and WHR, obtained the area of ROC 0.909 in men and 0.919 in women respectively. The sensitivity and specificity were 70.3% and 85.5% in men; and 75.2% and 93.0% in women respectively. Conclusion: BFP has a better correlation with BMI. The study results indicated that BFP for middle aged and old males and females in Guangzhou corresponding to overweight/obesity (BMI≥24 kg/m2) were <24.0% and <33.0% respectively.
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Affiliation(s)
- Q Hu
- Molecular Epidemiology Research Center, the 12th Affiliated Hospital of Guangzhou Medical University, Guangzhou 510620, China
| | - C Q Jiang
- Molecular Epidemiology Research Center, the 12th Affiliated Hospital of Guangzhou Medical University, Guangzhou 510620, China
| | - W S Zhang
- Molecular Epidemiology Research Center, the 12th Affiliated Hospital of Guangzhou Medical University, Guangzhou 510620, China
| | - J J Cheng
- Department of Public Health and Epidemiology, University of Birmingham, UK
| | - L Xu
- Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong 999077, China
| | - Y L Jin
- Molecular Epidemiology Research Center, the 12th Affiliated Hospital of Guangzhou Medical University, Guangzhou 510620, China
| | - S L Rao
- Molecular Epidemiology Research Center, the 12th Affiliated Hospital of Guangzhou Medical University, Guangzhou 510620, China
| | - H Q Zheng
- Molecular Epidemiology Research Center, the 12th Affiliated Hospital of Guangzhou Medical University, Guangzhou 510620, China
| | - D Q Lam
- Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong 999077, China
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20
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Jiang CQ, Chan YH, Xu L, Jin YL, Zhu T, Zhang WS, Cheng KK, Lam TH. Smoking and serum vitamin D in older Chinese people: cross-sectional analysis based on the Guangzhou Biobank Cohort Study. BMJ Open 2016; 6:e010946. [PMID: 27338881 PMCID: PMC4932269 DOI: 10.1136/bmjopen-2015-010946] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Studies on serum vitamin D in smokers showed conflicting results. We examined the association of smoking status with serum vitamin D in older Chinese men, taking advantage of a community-based sample with natural exposure to vitamin D. DESIGN Cross-sectional study based on the Guangzhou Biobank Cohort Study (GBCS). SETTING Community-based sample from the Guangzhou Biobank Cohort Study. PARTICIPANTS 612 male participants aged 50+years recruited from 2009 to 2011. RESULTS The mean (SD) of vitamin D concentration was 58.3 (17.2), 57.0 (15.0) and 54.7 (15.4) nmol/L for never, former and current smokers, respectively. Adjusted for multiple confounders, vitamin D decreased from never to former, then to current smokers (P for trend 0.02). Compared to never smokers, current smokers had lower serum concentrations of vitamin D, and the concentrations decreased with the increasing number of cigarettes per day (-3.11 (95% CI -9.05 to 2.82), -3.29 (-8.3 to 1.72) and -4.61 (-8.89 to -0.33) for 1-9, 10-19 and 20+cigarettes per day, respectively; p for trend 0.01), duration of smoking (-1.39 (-6.09 to 3.30) and -5.39 (-9.42 to -1.35) for 1-39 and 40+years, respectively; p for trend 0.008) as well as pack-years (-2.89 (-6.78 to 1.01) and -5.58 (-10.48 to -0.67) for 1-39 and 40+pack-years, respectively; p for trend 0.009). Longer duration of quitting smoking was associated with higher vitamin D than was current smoking (P for trend 0.04). CONCLUSIONS Current smokers had lower vitamin D than never smokers, and the association showed a dose-response pattern.
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Affiliation(s)
- C Q Jiang
- Guangzhou No 12 Hospital, Guangzhou, China
| | - Y H Chan
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China
| | - L Xu
- School of Public Health, the University of Hong Kong, Hong Kong, China
| | - Y L Jin
- Guangzhou No 12 Hospital, Guangzhou, China
| | - T Zhu
- Guangzhou No 12 Hospital, Guangzhou, China
| | - W S Zhang
- Guangzhou No 12 Hospital, Guangzhou, China
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - T H Lam
- Division of Cardiology, Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China
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21
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Chen W, Jiang CQ, Qian Q, Ding Z, Liu ZS. Antiperistaltic Side-to-Side Ileorectal Anastomosis is Associated with a Better Short-Term Fecal Continence and Quality of Life in Slow Transit Constipation Patients. Dig Surg 2015; 32:367-74. [PMID: 26302872 DOI: 10.1159/000437234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 06/24/2015] [Indexed: 12/10/2022]
Abstract
BACKGROUND Surgical treatment of refractory slow transit constipation (STC) is traditionally performed using end-to-side ileorectal anastomosis (SE-IRA) with total abdominal colectomy (TAC). Antiperistaltic side-to-side (SS) IRA is suggested to be a superior approach. Employing a well-characterized cohort of STC patients, we compared the postoperative outcomes of the 2 surgical approaches. METHODS A total of 42 patients underwent TAC for refractory idiopathic STC. Twenty patients were treated using traditional SE-IRA whereas 22 patients were treated using SS-IRA. Patients were evaluated at 3 and 6 months as well as at 1 and 2 years after surgery. Both groups were compared for patient characteristics, perioperative data and quality of life. Cleveland Clinic Incontinence Score (CCIS) and Gastrointestinal Quality of Life Index (GQILI) were adopted for evaluating postoperative recovery. RESULTS Both study groups were comparable with respect to general patient characteristics, disease severity and post-operative complications. Fewer than 30% of all patients reported substantial dissatisfaction with surgical outcomes in both the groups. The SS-IRA group was associated with a lower postoperative CCIS (p < 0.05) and a better GQILI (p < 0.05) than that of the SE-IRA group during early follow-up examinations. CONCLUSION In this study, SS-IRA was superior to traditional SE-IRA for the treatment of STC with respect to post-operative outcomes, and especially during early follow-up.
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Affiliation(s)
- Wei Chen
- Department of Colorectal Anal Surgery, Zhongnan Hospital, Wuhan University, Wuhan, PR China
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22
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Xu L, Jiang CQ, Schooling CM, Zhang WS, Cheng KK, Lam TH. Liver enzymes and incident diabetes in China: a prospective analysis of 10 764 participants in the Guangzhou Biobank Cohort Study. J Epidemiol Community Health 2015; 69:1040-4. [PMID: 26139641 DOI: 10.1136/jech-2015-205518] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/08/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Impaired liver function has been shown to be associated with incident diabetes. The independent role of the different liver enzymes, including γ-glutamyltransferase (GGT), alanine transaminase (ALT) and aspartate transaminase (AST), has not been addressed properly, taking into account their high collinearity. We used partial least squares (PLS) regression to identify the contribution of ALT, AST and GGT, which appears causally associated with diabetes as a validation factor, to incident diabetes in a South China population where liver impairment and diabetes are common. METHODS Participants were from the Guangzhou Biobank Cohort Study recruited in 2003-2008, with follow-up re-examination up to the end of 2012. Multivariable generalised linear models and PLS were used to examine the adjusted associations of ALT, AST and GGT with diabetes. Incident diabetes was defined as self-reported diabetes, and/or initiation of hypoglycaemia medication or insulin during follow-up, or fasting glucose ≥7.0 mmol/L, or 2 h oral glucose tolerance test, glucose ≥11.1 mmol/L at follow-up examination. RESULTS In 10 764 Chinese participants aged ≥50 years with no diabetes at baseline, 1228 (11.4%) developed diabetes during the median 4 years of follow-up. Using PLS, the risk for incident diabetes was higher by 18% (95% CI 8% to 27%) per 1 SD increment in log-ALT, and expectedly higher by 36% (95% CI 26% to 52%) for log-GGT, adjusted for age, sex, education, smoking, alcohol, physical activity, waist circumference and body mass index. Similarly adjusted, no association for log-AST (relative risk 0.92, 95% CI 0.85 to 1.01) was found. CONCLUSIONS ALT but not AST was associated with incident diabetes. Further experimental studies are needed to confirm the causal association and clarify the underlying mechanisms.
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Affiliation(s)
- L Xu
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - C Q Jiang
- Guangzhou No 12 Hospital, Guangzhou, China
| | - C M Schooling
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong CUNY School of Public Health and Hunter College, New York, USA
| | - W S Zhang
- Guangzhou No 12 Hospital, Guangzhou, China
| | - K K Cheng
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - T H Lam
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
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Jagielski AC, Jiang CQ, Xu L, Taheri S, Zhang WS, Cheng KK, Lam TH, Thomas GN. Glycaemia is associated with cognitive impairment in older adults: the Guangzhou Biobank Cohort Study. Age Ageing 2015; 44:65-71. [PMID: 25005262 DOI: 10.1093/ageing/afu088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population. METHODS the Guangzhou Biobank Cohort Study included 27,971 individuals (50-96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured. RESULTS after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00-1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73-1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI -0.03 to -0.002) and 0.03 in MMSE score (P = 0.114, 95% CI -0.06-0.01). CONCLUSIONS an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range.
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Affiliation(s)
- A C Jagielski
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Birmingham and Black Country NIHR CLAHRC, Birmingham, UK
| | - C Q Jiang
- Guangzhou Number 12 People's Hospital, Guangzhou, China
| | - L Xu
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - S Taheri
- Birmingham and Black Country NIHR CLAHRC, Birmingham, UK Department of Medicine, Weill Cornell Medical College in New Youk, NY, USA Department of Medicine, Weill Cornell Medical College in Qatar, Doha, Qatar Department of Medicine, King's College London, London, UK
| | - W S Zhang
- Guangzhou Number 12 People's Hospital, Guangzhou, China
| | - K K Cheng
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - T H Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - G N Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK Mannheim Medical Faculty, Institute of Public Health, Social and Preventive Medicine, University of Heidelberg, Mannheim 68135, Germany
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Zhong Y, Jiang CQ, Cheng KK, Zhang WS, Liu B, Jin YL, Lam TH, Leung GM, Schooling CM. Height, its components, and coagulability among older Chinese: the Guangzhou biobank cohort study. Am J Hum Biol 2014; 26:603-8. [PMID: 24909113 DOI: 10.1002/ajhb.22568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/21/2014] [Accepted: 05/12/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The causal role of some cardiovascular risk factors, such as HDL cholesterol, has been increasingly challenged and attention is returning to all elements of Virchow's triad, i.e., hypercoagulability (including viscosity) as well as endothelial function and blood flow. We examined the life course origins of coagulability. METHODS We used multivariable linear regression to assess whether childhood influences, proxied by height and its components, were associated with hematocrit (Hct), hemoglobin (HGB), and other hematological parameters in 28,595 older Chinese adults (mean age = 61.8 years) from the Guangzhou Biobank Cohort Study. RESULTS Adjusted for age, sex, and recruitment phase, leg length was negatively associated with platelets (PLT) (-0.83 × 10(9) /l per centimeter (cm), 95% confidence interval (CI) -1.01 to -0.65). Sitting height and height were positively associated with Hct (0.05% per cm, 95% CI 0.04-0.07 for sitting height; 0.02% per cm, 95% CI 0.01-0.02 for height), HGB (0.21 g/l per cm, 95% CI 0.17-0.25; 0.07 g/l per cm, 95% CI 0.04-0.09) and negatively associated with PLT (-1.2 × 10(9) /l per cm, 95% CI -1.4 to -1.0; -0.83 × 10(9) /l per cm, 95% CI -0.95 to -0.70). Further adjustment for potential confounders did little to change the estimates. CONCLUSIONS For the first time we provide anthropometric evidence for the different roles of prepubertal and pubertal influences in relation to Hct and HGB. Whether factors that promote leg growth but reduce growth of sitting height may help to prevent cardiovascular events, via effects on hypercoagulability or viscosity, overall or in specific subgroups, remains to be determined.
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Affiliation(s)
- Y Zhong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
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Zhao J, Jiang CQ, Lam TH, Liu B, Cheng KK, Kavikondala S, Zhang WS, Leung GM, Schooling CM. Genetically predicted 17β-estradiol and systemic inflammation in women: a separate-sample Mendelian randomisation analysis in the Guangzhou Biobank Cohort Study. J Epidemiol Community Health 2014; 68:780-5. [DOI: 10.1136/jech-2013-203451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Au Yeung SL, Jiang CQ, Zhang WS, Lam TH, Cheng KK, Leung GM, Schooling CM. Systematic differences among never, occasional and moderate alcohol users in southern China, and its use in alcohol research: a cross-sectional study. J Epidemiol Community Health 2013; 67:1054-60. [PMID: 23969348 DOI: 10.1136/jech-2013-202807] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Western observational studies show moderate alcohol use, compared with never use, positively associated with health. Moderate users differ systematically from others, making these observations vulnerable to confounding. Observations from other contexts may help distinguish whether these associations are confounded. To assess whether southern Chinese would provide a more suitable setting to examine the association of moderate alcohol use with health, we compared never alcohol users with moderate alcohol users and occasional users in this setting. METHODS We used age-adjusted multinomial regression to assess sex-stratified associations of alcohol use (never, occasional (<1 occasion/week), moderate (≤140 g ethanol/week for women and ≤210 g for men)) with health attributes and indicators in the Guangzhou Biobank Cohort Study (2003-2008) (n=26 361). RESULTS Among men, moderate alcohol users, when compared with never users, had slightly lower socioeconomic position and unhealthier lifestyle. Conversely, occasional alcohol users, when compared with never users, had higher socioeconomic position and healthier lifestyle. Among women, when compared with never users, both occasional and moderate users had higher socioeconomic position and healthier lifestyle. However, all alcohol users for both sexes, when compared with never users, were more likely to be ever smokers and to be exposed to secondhand smoke. CONCLUSIONS Observations in alcohol epidemiology may be affected by confounding due to contextually specific systematic differences. Results from a particular setting should not be interpreted as causal unless they are verified in different populations and, preferably, in non-observational studies.
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Affiliation(s)
- S L Au Yeung
- Li Ka Shing Faculty of Medicine, Lifestyle and Lifecourse Epidemiology Group, School of Public Health, The University of Hong Kong, , Hong Kong, China
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Abstract
OBJECTIVE Deep brain stimulating (DBS) is a rapidly developing therapy that can treat many refractory neurological diseases. However, the traditional DBS electrodes which are made of Pt-Ir alloy may induce severe field distortions in magnetic resonance imaging (MRI) which leads to artifacts that will lower the local image quality and cause inconvenience or interference. A novel DBS electrode made from carbon nanotube yarns (CNTYs) is brought up to reduce the artifacts. This study is therefore to evaluate the artifact properties of the novel electrode. APPROACH We compared its MR artifact characteristics with the Pt-Ir electrode in water phantom, including its artifact behaviors at different orientations as well as at various off-center positions, using both spin echo (SE) and gradient echo (GE) sequences, and confirmed its performance in vivo. MAIN RESULTS The results in phantom showed that the CNTY electrode artifacts reduced as much as 62% and 74% on GE and SE images, respectively, compared to the Pt-Ir one. And consistent behaviors were confirmed in vivo. The susceptibility difference was identified as the dominant cause in producing artifacts. SIGNIFICANCE Employing the CNTY electrode may generate much less field distortion in the vicinity, improve local MR image quality and possibly be beneficial in various aspects.
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Affiliation(s)
- C Q Jiang
- Institute of Man-Machine and Environmental Engineering, School of Aerospace, Tsinghua University, Beijing, People's Republic of China
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Au Yeung SL, Jiang CQ, Cheng KK, Liu B, Zhang WS, Lam TH, Leung GM, Schooling CM. Evaluation of moderate alcohol use and cognitive function among men using a Mendelian randomization design in the Guangzhou biobank cohort study. Am J Epidemiol 2012; 175:1021-8. [PMID: 22302076 DOI: 10.1093/aje/kwr462] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Observational studies usually show that moderate alcohol use is associated with better cognitive function. Such studies are vulnerable to residual confounding arising from systematic differences between moderate alcohol users and others. A Mendelian randomization study carried out in a suitable population, such as southern Chinese men, in which alcohol use is low to moderate and is influenced by genotype, offers an alternative and superior approach for clarifying the causal effect of moderate alcohol use on cognitive function. The authors used aldehyde dehydrogenase 2 (ALDH2) genotype (AA, GA, or GG) as an instrumental variable in 2-stage least squares analysis to obtain unbiased estimates of the relation of alcohol consumption (measured in alcohol units (10 g ethanol) per day) with cognitive function, assessed from delayed 10-word recall score (n = 4,707) and Mini-Mental State Examination (MMSE) score (n = 2,284), among men from the Guangzhou Biobank Cohort Study (2003-2008). ALHD2 genotype was strongly associated with alcohol consumption, with an F statistic of 71.0 in 2-stage least squares analysis. Alcohol consumption was not associated with delayed 10-word recall score (-0.03 words per alcohol unit, 95% confidence interval: -0.18, 0.13) or MMSE score (0.06 points per alcohol unit, 95% confidence interval: -0.22, 0.34). Moderate alcohol use is unlikely to be cognitively protective.
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Affiliation(s)
- S L Au Yeung
- Lifestyle and Lifecourse Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
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Kavikondala S, Jiang CQ, Zhang WS, Cheng KK, Lam TH, Leung GM, Schooling CM. Intergenerational influences on diabetes in a developing population: the Guangzhou Biobank Cohort Study. Am J Hum Biol 2011; 23:747-54. [PMID: 21987430 DOI: 10.1002/ajhb.21206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 06/07/2011] [Accepted: 06/13/2011] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Intergenerational "mismatch" and/or growth conditions may be relevant to the epidemic of diabetes in developing populations. In a rapidly developing southern Chinese population, we tested whether maternal environment, proxied by maternal literacy, or family socio-economic position (SEP), proxied by paternal literacy, were associated with fasting glucose and diabetes. To assess if intergenerational mismatch contributed, we tested whether the associations varied by life course SEP. METHODS In 19,818 older (≥50 years) adults from the Guangzhou Biobank Cohort Study (phases 2 and 3), we used censored and logistic regression to assess the associations of maternal and paternal literacy with fasting glucose, elevated fasting glucose and diabetes and whether these associations varied by sex, age or life course SEP. RESULTS Maternal, but not paternal, literacy was negatively associated with fasting plasma glucose (β-coefficient -0.06 mmol/l, 95% confidence interval (CI) -0.11 to -0.01) and elevated fasting glucose (odds ratio (OR) 0.92, 95% CI 0.86-0.99) adjusted for age, sex, study phase, life course SEP, childhood growth, adiposity, number of offspring, and birth order. Associations of maternal and paternal literacy with fasting glucose, elevated fasting glucose and diabetes did not vary by sex, age or life course SEP. CONCLUSION Offspring of literate mothers had lower risk for impaired glucose tolerance than offspring of illiterate mothers. Being raised by literate mothers may increase the likelihood of children with higher SEP and lower long-term disease risk, or better maternal conditions over generations may be associated with lower fasting glucose.
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Affiliation(s)
- S Kavikondala
- Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, China
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Phillips AC, Jiang CQ, Thomas GN, Lin JM, Yue XJ, Cheng KK, Jin YL, Zhang WS, Lam TH. White blood cell subsets are associated with carotid intima-media thickness and pulse wave velocity in an older Chinese population: the Guangzhou Biobank Cohort Study. J Hum Hypertens 2011; 26:485-92. [PMID: 21654852 DOI: 10.1038/jhh.2011.58] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cross-sectional associations between white blood cell (WBC) count, lymphocyte and granulocyte numbers, and carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (PWV) were examined in a novel older Chinese community sample. A total of 817 men and 760 women from a sub-study of the Guangzhou Biobank Cohort Study had a full blood count measured by an automated hematology analyzer, carotid IMT by B-mode ultrasonography and brachial-ankle PWV by a non-invasive automatic waveform analyzer. Following adjustment for confounders, WBC count (β=0.07, P<0.001) and granulocyte (β=0.07, P<0.001) number were significantly positively related to PWV, but not lymphocyte number. Similarly, WBC count (β=0.08, P=0.03), lymphocyte (β=0.08, P=0.002) and granulocyte (β=0.03, P=0.04) number were significantly positively associated with carotid IMT, but only the association with lymphocyte count survived correction for other cardiovascular risk factors. In conclusion, higher WBC, particularly lymphocyte and granulocyte, count could be used, respectively, as markers of cardiovascular disease risk, measured through indicators of atherosclerosis and arterial stiffness. The associations for WBC count previously observed by others were likely driven by higher granulocytes; an index of systemic inflammation.
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Affiliation(s)
- A C Phillips
- School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK.
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Schooling CM, Jiang CQ, Lam TH, Zhang WS, Cheng KK, Leung GM. Childhood meat eating and inflammatory markers: the Guangzhou Biobank Cohort Study. BMC Public Health 2011; 11:345. [PMID: 21595911 PMCID: PMC3121633 DOI: 10.1186/1471-2458-11-345] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 05/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We hypothesized that socio-economic development could, via nutritionally driven levels of pubertal sex-steroids, promote a pro-inflammatory state among men but not women in developing countries. We tested this hypothesis, using recalled childhood meat eating as a proxy for childhood nutrition, in southern China. METHODS We used multivariable linear regression in the Guangzhou Biobank Cohort Study phase 3 (2006-8) to examine the adjusted associations of recalled childhood meat eating, <1/week (n = 5,023), about once per week (n = 3,592) and almost daily (n = 1,252), with white blood cell count and its differentials among older (≥ 50 years) men (n = 2,498) and women (n = 7,369). RESULTS Adjusted for age, childhood socio-economic position, education and smoking, childhood meat eating had sex-specific associations with white blood cell count and lymphocyte count, but not granulocyte count. Men with childhood meat eating almost daily compared to <1/week had higher white blood cell count (0.33 109/L, 95% confidence interval (CI) 0.10 to 0.56) and higher lymphocyte count (0.16 109/L, 95% CI 0.07 to 0.25). Adjustment for obesity slightly attenuated these associations. CONCLUSION If confirmed, this hypothesis implies that economic development and the associated improvements in nutrition at puberty may be less beneficial among men than women; consistent with the widening sex differentials in life expectancy with economic development.
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Affiliation(s)
- C M Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Schooling CM, Jiang CQ, Lam TH, Cowling BJ, Au Yeung SL, Zhang WS, Cheng KK, Leung GM. Estimated birth weight and adult cardiovascular risk factors in a developing southern Chinese population: a cross sectional study. BMC Public Health 2010; 10:270. [PMID: 20492733 PMCID: PMC2887395 DOI: 10.1186/1471-2458-10-270] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Accepted: 05/24/2010] [Indexed: 02/02/2023] Open
Abstract
Background Birth weight is negatively associated with cardiovascular diseases and diabetes, but the associations are less well-established in developing populations where birth weight is often unavailable. We studied the association of birth weight and cardiovascular risk, using birth rank as an instrumental variable, in Southern China. Methods We used published data on birth weight by birth rank from an appropriate population and baseline data from the Guangzhou Biobank Cohort Study phases 2 & 3 (2005-8) to examine the adjusted associations, using instrumental variable analysis, of birth weight with clinically measured cardiovascular risk factors and the metabolic syndrome in older (≥ 50 years) men (n = 5,051) and women (n = 13,907). Results Estimated birth weight was associated with lower blood pressure (systolic -0.25 mm Hg 95% confidence interval (CI), -0.53 to 0.03 and diastolic -0.33 mm Hg 95% CI -0.48 to -0.18 per standard deviation higher birth weight), but had little association with glucose, lipids, waist-hip ratio, body mass index or the metabolic syndrome, adjusted for age, sex, early environment and number of offspring. Conclusion Birth weight may impact blood pressure; however associations of birth weight with other cardiovascular risk factors may not be related to foetal exposures, but speculatively could be an historical co-incidence, with corresponding implications for prevention.
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Affiliation(s)
- C M Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Xu L, Jiang CQ, Lam TH, Yue XJ, Lin JM, Cheng KK, Liu B, Li Jin Y, Zhang WS, Thomas GN. Arterial stiffness and left-ventricular diastolic dysfunction: Guangzhou Biobank Cohort Study-CVD. J Hum Hypertens 2010; 25:152-8. [PMID: 20428193 DOI: 10.1038/jhh.2010.44] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, is an established cardiovascular risk factor of ventricular stiffening. We studied the association of baPWV with left-ventricular (LV) diastolic function in a sub-study of the Guangzhou Biobank Cohort Study. In all, 378 Chinese subjects with a normal ejection fraction (>50%) had baPWV measurement by a noninvasive automatic waveform analyser, carotid intima-medial thickness (IMT) measurement by B-mode ultrasonography and cardiac diastolic function assessment by echocardiography. After adjusting for age, both baPWV and IMT were associated with LV mass index, posterior wall end-diastolic thickness and inter-ventricular end-diastolic thickness, but only baPWV was associated with deceleration time, atrial flow velocity and E/A ratio. Multivariable linear regression model showed that baPWV and mean arterial pressure, but not IMT, were significantly associated with E/A ratio (β=-0.02, P=0.03 and β=-0.36, P=0.02, respectively). The receiver operator characteristic curve showed that baPWV was better than pulse pressure or mean arterial pressure to detect LV diastolic dysfunction (E/A<1.0). Our study suggested that increased baPWV might be an independent risk factor or marker for diastolic dysfunction. Early detection of an intervention on increased baPWV may be important for prevention of cardiac diastolic dysfunction.
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Affiliation(s)
- L Xu
- Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong, PR China
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Schooling CM, Jiang CQ, Zhang WS, Lam TH, Cheng KK, Leung GM. Visceral adiposity would be expected to predict incident diabetes better in women than men. Diabetologia 2010; 53:393-5. [PMID: 19937223 DOI: 10.1007/s00125-009-1613-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Accepted: 10/29/2009] [Indexed: 12/01/2022]
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Fielding R, Leung GM, Lam WWT, Jiang CQ, Sitthi-Amorn C, Ahn LV, Lu YM, Zhang WS. A pan-Asian survey of risk perception, attitudes and practices associated with live animal markets. Hong Kong Med J 2009; 15 Suppl 6:17-20. [PMID: 19801712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Affiliation(s)
- R Fielding
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
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Lam KBH, Jordan RE, Jiang CQ, Thomas GN, Miller MR, Zhang WS, Lam TH, Cheng KK, Adab P. Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study. Eur Respir J 2009; 35:317-23. [PMID: 19574332 DOI: 10.1183/09031936.00024709] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is some evidence that chronic obstructive pulmonary disease (COPD) and metabolic syndrome may be related, perhaps through systemic inflammation, which is common to both. However, the association between the two conditions has not yet been clearly shown. The present study involved 7,358 adults aged > or =50 yrs from a population-based survey who underwent spirometry, a structured interview and measurement of fasting metabolic marker levels. Airflow obstruction (forced expiratory volume in 1 s/forced vital capacity ratio of less than the lower limit of normal) was present in 6.7%, and the International Diabetes Federation metabolic syndrome criteria were met by 20.0%. The risk of metabolic syndrome was higher in those with airflow obstruction than in those without (odds ratio (OR) 1.47; 95% confidence interval (CI) 1.12-1.92), after controlling for potential confounders. Of the five components of metabolic syndrome, only central obesity was significantly associated with airflow obstruction (OR 1.43; 95% CI 1.09-1.88) after adjusting for body mass index. A similar association was observed in both never and current smokers. In this Chinese sample, airflow obstruction was associated with metabolic syndrome, and, in particular, its central obesity component. This may help explain the increased risk of cardiovascular diseases in COPD, and so could guide future clinical practice.
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Affiliation(s)
- K-B H Lam
- Guangzhou Number 12 People's Hospital, No. 1 Tianqiang Lu, Huangpu Da Dao Xi, Guangzhou 510620, People's Republic of China
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Lam KBH, Jiang CQ, Thomas G, Arora T, Zhang WS, Taheri S, Adab P, Lam TH, Cheng KK. Abstract: P1342 INCREASED RISK OF TYPE 2 DIABETES WITH NAPPING: THE GUANGZHOU BIOBANK COHORT STUDY (GBCS). ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71359-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Liao QY, Lam WWT, Dang VT, Jiang CQ, Udomprasertgul V, Fielding R. What causes H5N1 avian influenza? Lay perceptions of H5N1 aetiology in South East and East Asia. J Public Health (Oxf) 2009; 31:573-81. [PMID: 19423546 DOI: 10.1093/pubmed/fdp043] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health education to reduce population poultry exposures has limited effect. Lay beliefs about H5N1 highly pathogenic avian influenza (HPAI) causes could provide insights helpful for improving public health interventions. METHODS Qualitative interviews of poultry farmers, retailers, market stall holders and consumers in Hong Kong (n = 20), Guangzhou (n = 25), Vietnam (n = 38) and Thailand (n = 40) were conducted using purposive sampling and analysed using ethnographic principles. RESULTS Each location produced three comparable themes: 'viruses': HPAI exemplified a periodic, natural, disease process therefore, deserving little concern. For some, science had 'discovered' something long known to farmers and lived with for generations. Others believe the virus to be new. Viral ecology was reasonably well understood among farmers, but less so by retailers and consumers; 'husbandry practices' included poor hygiene, overcrowding and industrial farming, modern commercial feed and veterinary drugs; 'vulnerability factors' included uncontrollable 'external' explanations involving the weather, seasonal changes, bird migrations and pollution. CONCLUSIONS Lay explanations were generally ecologically consistent. Nonetheless, beliefs that HPAI is a normal, recurrent process, external factors and roles of industrialized poultry rearing countered health worker claims of H5N1 seriousness for smallholders. These causal beliefs incorporate contemporary models of H5N1 ecology, but in a manner that contradicts public health efforts at control.
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Affiliation(s)
- Q Y Liao
- Department of Community Medicine, HKU, 5/F, Faculty of Medicine Building, Health Behaviour Research Group, School of Public Health, Pokfulam, Hong Kong, China
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Schooling CM, Jiang CQ, Heys M, Zhang WS, Adab P, Cheng KK, Lam TH, Leung GM. Are height and leg length universal markers of childhood conditions? The Guangzhou Biobank cohort study. J Epidemiol Community Health 2009; 62:607-14. [PMID: 18559443 DOI: 10.1136/jech.2007.065003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In developed western populations longer legs have been shown to be a marker of better early childhood conditions. In the first generations to experience the epidemiologic transition and associated economic development, epigenetic constraints on growth might preclude improved childhood conditions from increasing leg growth or height. DESIGN, SETTING AND PARTICIPANTS Multivariable linear regression was used to assess the association of parental growth environment, proxied by parental literacy, and childhood conditions, proxied by parental possessions, with leg length, sitting height and height in a cross-sectional sample from 2005-6 of 9998 Chinese people aged at least 50 years from phase 2 of the Guangzhou Biobank Cohort Study. MAIN RESULTS Adjusted for age and sex, the association of childhood conditions with leg length and height varied with parental literacy (interaction p values <0.01 and 0.03), but not for sitting height (p value 0.43), with statistically significant trends (p values <0.01) for parental possessions to be associated with longer legs and greater height only in the offspring of two literate parents where legs were longer by 0.56 cm (95% CI 0.27 to 0.86) and height greater by 1.16 cm (95% CI 0.74 to 1.58) for participants with most, compared with least, parental possessions in childhood. CONCLUSIONS Epigenetic influences originating in earlier generations may constrain growth during the infancy and/or childhood phases in very recently developed populations. Neither height nor leg length should be assumed to be consistent proxies of early life environment with corresponding implications for economic history, the aetiology of some chronic diseases and the monitoring of population health.
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Affiliation(s)
- C M Schooling
- Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Schooling CM, Jiang CQ, Lam TH, Zhang WS, Cheng KK, Leung GM. Alcohol use and fasting glucose in a developing southern Chinese population: the Guangzhou Biobank Cohort Study. J Epidemiol Community Health 2008; 63:121-7. [PMID: 18930980 DOI: 10.1136/jech.2008.077602] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND In observational studies, mainly from Western Caucasian populations, moderate alcohol use has been shown to be associated with a lower risk of diabetes. However, whether the protection is due to the attributes of alcohol or to those of moderate alcohol users is difficult to disentangle. A population with a different distribution of alcohol consumption and diabetes prevalence from Western populations was studied as a counterfactual comparison. METHODS Baseline data from the Guangzhou Biobank Cohort Study phases 1 and 2 (2003-6) were used to examine the adjusted associations, using multivariable censored linear regression, of alcohol use with fasting blood glucose in older (> or =50 years) men (n = 5740) and women (n = 14 274) from southern China. Moderate alcohol use was defined as weekly drinking of < or =210 g alcohol in men and < or =140 g in women. The expected associations of alcohol with high-density lipoprotein (HDL) cholesterol and blood pressure were also checked. RESULTS Moderate alcohol users had very similar fasting glucose levels to never users, adjusted for age, sex, socioeconomic status, smoking and physical activity. In contrast, moderate alcohol users had higher HDL-cholesterol by 0.05 mmol/litre (95% CI 0.02 to 0.07). Excessive (more than moderate) alcohol users had higher fasting glucose. CONCLUSIONS In an understudied population with a different pattern of alcohol use from the populations usually studied, the biologically expected effects of moderate alcohol use were seen, but there was little effect on fasting glucose. Although cross-sectional studies cannot be conclusive, this pattern of findings, if confirmed, suggests that moderate alcohol use may not affect fasting glucose, although excessive use may be a risk factor.
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Affiliation(s)
- C M Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Schooling CM, Jiang CQ, Heys M, Zhang WS, Lao XQ, Adab P, Cowling BJ, Thomas GN, Cheng KK, Lam TH, Leung GM. Is leg length a biomarker of childhood conditions in older Chinese women? The Guangzhou Biobank Cohort Study. J Epidemiol Community Health 2008; 62:160-6. [PMID: 18192605 DOI: 10.1136/jech.2006.058917] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In developed western populations longer legs have been shown to be a biomarker of better early childhood conditions. It was hypothesised that in transitioning populations better childhood conditions may bring forward puberty and thus decrease leg length, counteracting the overall positive effect of a favourable childhood environment on leg growth. DESIGN Structural equation modelling was used to assess the interrelationship of age, education, father's job, age of menarche and leg length in a cross-sectional sample of 7273 Chinese women aged at least 50 years from the Guangzhou Biobank Cohort Study. RESULTS Leg length had no significant association with education or father's occupation on bivariable testing. After including age of menarche in the model, education was associated with longer legs (0.45 cm longer per 10 years of education, 95% CI 0.20 to 0.71). Education was also associated with younger age of menarche (1.21 years younger per 10 years of education, 95% CI 1.09 to 1.34), which was in turn associated with shorter legs (0.23 cm shorter per year of menarche earlier, 95% CI 0.18 to 0.27). CONCLUSIONS In older Chinese women leg length is not a universal biomarker of childhood conditions, when proxied by her educational level and father's occupation. Nutritionally driven epigenetic influences operating over generations may constrain growth in very recently developed populations. Given the impact of childhood conditions on health, and the dearth of long-term records outside the industrialised world, a greater understanding of the influences on growth in the developing world is required.
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Affiliation(s)
- C M Schooling
- Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong SAR, China
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Schooling CM, Jiang CQ, Lam TH, Zhang WS, Cheng KK, Leung GM. Life-course origins of social inequalities in metabolic risk in the population of a developing country. Am J Epidemiol 2008; 167:419-28. [PMID: 18056924 DOI: 10.1093/aje/kwm329] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In countries that have been industrialized for a long time, but not always elsewhere, low socioeconomic position (SEP) is associated with ischemic heart disease in men. The authors hypothesized that socioeconomic development could, via pubertal sex steroids, promote an atherogenic lipid profile and body shape in men but not in women. Therefore, they examined the associations of SEP with ischemic heart disease risk in a developing-country population. The authors used multivariable regression to examine the associations of SEP with the metabolic syndrome and its components in 9,746 Chinese adults aged >/=50 years from the Guangzhou Biobank Cohort Study, phase 2, recruited in 2005-2006. After adjustment for age, smoking, alcohol use, and physical activity, high SEP at each of three life stages, proxied by parental possesions in childhood, education, and longest held-occupation, was inversely associated with the metabolic syndrome in women but not in men. Higher SEP in men was associated with lower pulse pressure and fasting plasma glucose level but also with greater waist circumference and a lower high density lipoprotein cholesterol level. With socioeconomic development, diet-related hormonal changes at puberty may outweigh the usual protective effect of social advantage in men, with corresponding implications for boys currently undergoing the nutrition transition in the developing world.
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Affiliation(s)
- C M Schooling
- Department of Community Medicine and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Lao XQ, Thomas GN, Jiang CQ, Zhang WS, Yin P, Adab P, Lam TH, Cheng KK. c-Reactive protein and the metabolic syndrome in older Chinese: Guangzhou Biobank Cohort Study. Atherosclerosis 2007; 194:483-9. [PMID: 17010351 DOI: 10.1016/j.atherosclerosis.2006.08.061] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Revised: 08/23/2006] [Accepted: 08/24/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the association between serum c-reactive protein (CRP) concentration and the metabolic syndrome (MS) using the International Diabetes Federation Metabolic Syndrome Guidelines (April, 2005) definition in an older Chinese population. METHODS Three thousand and fourteen men and 7275 women aged 50-85 years were recruited and received a full medical check-up including measurement of blood pressure, obesity indices, fasting total, LDL-, HDL-cholesterol, triglycerides, glucose and c-reactive protein. Data describing socioeconomic and lifestyle factors was also collected. RESULTS Vascular risk factors including waist circumference, weight gain and waist gain since the age of 18, body mass index, waist-hip-ratio, triglyceride, HDL-cholesterol, and systolic and diastolic blood pressures were positively associated with CRP in both men and women (p from <0.001 to 0.016). Compared to those without MS components, adjusted odds ratios for having elevated CRP increased in those with the MS or its components compared those without MS or components (all p<0.001), except for the low HDL-cholesterol in both genders and raised fasting glucose in men. Similarly, the risk of elevated CRP increased with escalating MS components even after adjustment of a range of potential confounders. CONCLUSIONS There is a strong relationship between CRP and the constellation of MS components and associated vascular risk in this older Chinese population.
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Affiliation(s)
- X Q Lao
- Department of Community Medicine, School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
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Thomas GN, Lao XQ, Jiang CQ, McGhee SM, Zhang WS, Adab P, Lam TH, Cheng KK. Implications of increased weight and waist circumference on vascular risk in an older Chinese population: the Guangzhou Biobank Cohort Study. Atherosclerosis 2007; 196:682-8. [PMID: 17765903 DOI: 10.1016/j.atherosclerosis.2007.07.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 07/12/2007] [Accepted: 07/17/2007] [Indexed: 11/22/2022]
Abstract
BACKGROUND The relationships between weight and waist on vascular risk are well described, but the long-term impact of these parameters is less clearly defined, particularly in Chinese populations. METHODS Ten thousand four hundred and ten older subjects (50-85 years) were recruited and blood pressure, anthropometric, and fasting vascular risk factors measured. Socioeconomic and demographic data, including self-reported weight and waist gain since 18 years. The association of weight and waist gain with these vascular risk factors was analysed. RESULTS Weight, and particularly waist gain were associated with a more adverse vascular risk factor profile, with the most adverse profile associated with gains in both weight and waist. Anthropometric gains were associated with increased risk even in non-obese subjects (p<0.05). Even after adjustment for a range of demographic and socioeconomic factors, waist gain was associated with additional risk of having the metabolic syndrome and its components and self-reported vascular disease in those centrally obese subjects (p<0.05 for all). CONCLUSION Increased weight and waist increased the level of vascular risk factors and self-reported disease in both non-obese and obese subjects. The high prevalence of vascular risk factors in this population forewarns of a major developing health burden in the rapidly modernising 1.2 billion Chinese population.
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Affiliation(s)
- G Neil Thomas
- Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
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Yin P, Jiang CQ, Cheng KK, Lam TH, Lam KH, Miller MR, Zhang WS, Thomas GN, Adab P. Passive smoking exposure and risk of COPD among adults in China: the Guangzhou Biobank Cohort Study. Lancet 2007; 370:751-7. [PMID: 17765524 DOI: 10.1016/s0140-6736(07)61378-6] [Citation(s) in RCA: 189] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in China, where the population is also exposed to high levels of passive smoking, yet little information exists on the effects of such exposure on COPD. We examined the relation between passive smoking and COPD and respiratory symptoms in an adult Chinese population. METHODS We used baseline data from the Guangzhou Biobank Cohort Study. Of 20 430 men and women over the age of 50 recruited in 2003-06, 15,379 never smokers (6497 with valid spirometry) were included in this cross-sectional analysis. We measured passive smoking exposure at home and work by two self-reported measures (density and duration of exposure). Diagnosis of COPD was based on spirometry and defined according to the GOLD guidelines. FINDINGS There was an association between risk of COPD and self-reported exposure to passive smoking at home and work (adjusted odds ratio 1.48, 95% CI 1.18-1.85 for high level exposure; equivalent to 40 h a week for more than 5 years). There were significant associations between reported respiratory symptoms and increasing passive smoking exposure (1.16, 1.07-1.25 for any symptom). INTERPRETATION Exposure to passive smoking is associated with an increased prevalence of COPD and respiratory symptoms. If this association is causal, we estimate that 1.9 million excess deaths from COPD among never smokers could be attributable to passive smoking in the current population in China. Our findings provide strong evidence for urgent measures against passive smoking in China.
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Affiliation(s)
- P Yin
- Department of Public Health and Epidemiology, University of Birmingham, UK
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Huxley R, Jamrozik K, Lam TH, Barzi F, Ansary-Moghaddam A, Jiang CQ, Suh I, Woodward M. Impact of smoking and smoking cessation on lung cancer mortality in the Asia-Pacific region. Am J Epidemiol 2007; 165:1280-6. [PMID: 17369610 DOI: 10.1093/aje/kwm002] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cigarette smoking is becoming increasingly common in Asia while quitting remains rare, in part because of a lack of knowledge about the risks of smoking. This study compared the risk of death from lung cancer associated with smoking habits in Australia and New Zealand and in Asia by using data from the Asia Pacific Cohort Studies Collaboration: 31 studies involving 480,125 individuals. Cox regression models were used. The hazard ratios for lung cancer mortality associated with current smoking were, for men, 2.48 (95% confidence interval (CI): 1.99, 3.11) in Asia versus 9.87 (95% CI: 6.04, 16.12) in Australia and New Zealand; p for homogeneity <0.0001. For women, the corresponding estimates were 2.35 (95% CI: 1.29, 4.28) in Asia versus 19.33 (95% CI: 10.0, 37.3) in Australia and New Zealand; p for homogeneity <0.0001. Quitting was beneficial in both regions; the hazard ratios for former compared with current smokers were 0.69 (95% CI: 0.53, 0.92) in Asia and 0.30 (95% CI: 0.22, 0.41) in Australia and New Zealand. The lesser effect in Asia was partly explained by the fewer number of cigarettes smoked and the shorter duration of follow-up in Asian studies. These results suggest that tobacco control policies in Asia should not solely concentrate on preventing the uptake of smoking but also attend to cessation.
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Affiliation(s)
- R Huxley
- Nutrition and Lifestyle Division, The George Institute for International Health, University of Sydney, Sydney, New South Wales, Australia.
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Lao XQ, Thomas GN, Jiang CQ, Zhang WS, Yin P, Adab P, Lam TH, Cheng KK. Association of the metabolic syndrome with vascular disease in an older Chinese population: Guangzhou Biobank Cohort Study. J Endocrinol Invest 2006; 29:989-96. [PMID: 17259796 DOI: 10.1007/bf03349212] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the prevalence of the metabolic syndrome (MS) and relative associations with vascular disease in an older Chinese population using the US National Cholesterol Education Program: Adult Treatment Panel (NCEP: ATP III) and International Diabetes Federation (IDF) definitions. DESIGN Cross-sectional study. SUBJECTS A total of 3035 men and 7291 women aged 50 to 85 yr recruited from Guangzhou, China. MEASUREMENTS All participants received a full medical check-up including measurement of blood pressure, obesity indices, fasting total, LDL-, HDL-cholesterol, triglycerides (TG) and glucose levels. Demographic information and self-reported history of physician-diagnosed coronary heart disease (CHD), stroke and myocardial infarction (MI) were collected through standardized interview. RESULTS The estimates under the two definitions differed substantially, with the age standardized prevalence of MS 15.57% using the NCEP: ATP III definition and 25.81% using the IDF definition. Among all participants, 80.23% were similarly classified using both definitions. The association between self-reported CHD, stroke and MI and the MS defined by the IDF definition was stronger than that by the NCEP: ATP III. CONCLUSIONS The IDF compared to the ATP III definition shows a stronger association with the MS and associated vascular disease in Chinese. The prevalence of the MS is alarmingly high in this older Chinese population. Comprehensive strategies are needed for prevention and treatment of the MS to reduce the increased societal burden of cardiovascular disease in China.
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Affiliation(s)
- X Q Lao
- Department of Community Medicine, School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
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Lao XQ, Thomas GN, Jiang CQ, Zhang WS, Yin P, Schooling M, Heys M, Leung GM, Adab P, Cheng KK, Lam TH. Parity and the metabolic syndrome in older Chinese women: the Guangzhou Biobank Cohort Study. Clin Endocrinol (Oxf) 2006; 65:460-9. [PMID: 16984238 DOI: 10.1111/j.1365-2265.2006.02615.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine whether parity or gravidity contributes to the development of the metabolic syndrome (MS). METHODS The first phase of the Guangzhou Biobank Cohort Study recruited 7352 women and 3065 men aged 50-93 years in 2003-4. Data on the number of live births and pregnancies, other reproduction-associated factors and socioeconomic and lifestyles factors were collected by standardized interview. The MS components were determined through physical examination and measurement of fasting blood samples. MS was identified if waist circumference was >or= 90 cm for men or >or= 80 cm for women, plus any two of: (a) raised triglyceride (TG) level (1.7 mmol/l) or specific treatment for this lipid abnormality; (b) reduced high density lipoprotein (HDL)-cholesterol (< 1.03 mmol/l in males or < 1.29 mmol/l in females) or specific treatment for this lipid abnormality; (c) raised blood pressure (BP, systolic BP >or= 130 mmHg or diastolic BP >or= 85 mmHg) or hypertension therapy; and (d) raised fasting glucose (>or= 5.6 mmol/l) or previously diagnosed type 2 diabetes. RESULTS Before adjustment for potential confounders, we found associations between the number of births and lifestyle and socioeconomic factors in both sexes. However, in women, but not in men, body mass index (BMI), waist-hip ratio, triglyceride and glucose were positively associated with the number of birth after adjusting for a range of potential confounders. The age-adjusted prevalence of the MS increased with the number of births and pregnancies in women, but the gradient for birth was steeper than that for pregnancies [odds ratio change per birth 1.16, 95% confidence interval (CI) 1.11-1.22, P < 0.001; odds ratio change per pregnancy 1.11, 95% CI 1.06-1.16, P < 0.001], although attenuating the association adjustment did not affect the significance of these findings. There was no association in men with regard to the number of their partners' live births given the same analysis and similar shared living background with the women. CONCLUSION Higher parity or gravidity was associated with a consistent increase in the risk of MS in Chinese women. As the association persisted after adjustment for lifestyle factors and there was no association between the risk of MS and the number of births associated with the partners of the males, the association in women may represent a biological response to pregnancy.
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Affiliation(s)
- X Q Lao
- Department of Community Medicine, School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong
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Thomas GN, Jiang CQ, Lao XQ, McGhee SM, Zhang WS, Schooling CM, Adab P, Lam TH, Cheng KK. Snoring and vascular risk factors and disease in a low-risk Chinese population: the Guangzhou Biobank Cohort Study. Sleep 2006; 29:896-900. [PMID: 16895256 DOI: 10.1093/sleep/29.7.896] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVE Snoring is a common condition, but data describing the relationship between snoring and vascular disease is very limited in Asian populations. We therefore describe the association between snoring and vascular disease and associated risk factors. DESIGN Cross-sectional study of baseline data from the Guangzhou Biobank Cohort Study. SETTING Community-based elderly association from Guangzhou, China. PARTICIPANTS 10413 Chinese subjects (50-85 years of age). MEASUREMENTS Self-reported snoring status and frequency and frequency of daytime tiredness were collected by questionnaire, as were demographic and socioeconomic data, disease histories, and potential confounders, such as smoking and alcohol consumption. Anthropometry, blood pressure, and fasting glucose and lipid profile were also measured. RESULTS Self-reported snoring frequency was identified in 8325 (80.0%) subjects, with 51.6% reporting that they snored, of whom 15.5% were daily snorers. Increasing prevalence of snoring showed a clear positive relationship with cardiovascular risk factors, including age, obesity, blood pressure, and lipid levels (p < .001 for all). The prevalence of self-reported vascular-disease history was low but significantly associated with increasing snoring frequency. Logistic regression showed that snoring frequency was an independent predictor of vascular-disease history (odds ratios [95% confidence intervals] 1.68 [1.32-2.13] for daily snorers compared with the never-snorer reference group), of the metabolic syndrome (2.16 [1.88-2.49]) and each of its components (hypertension [1.37 (1.20-1.56)], and of dyslipidemia [1.22 (1.07-1.40)], central obesity [2.39 (2.08-2.76)], and diabetes [1.30 (1.09-1.56)]) after adjustment for potential confounders. CONCLUSION Increasing snoring frequency was associated with an increasing prevalence of risk factors and self-reported vascular disease. Snoring may a useful marker for increased risk of vascular disease.
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Affiliation(s)
- G Neil Thomas
- Department of Community Medicine, and School of Public Health, The University of Hong Kong, Pokfulam
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Jiang CQ, Wang B, Yu CF, Xiao LW, Liu WW, Jiao SH, Liu YY, Lao XQ, Lam TH. Dysbaric osteonecrosis by X-ray and CT scan in Chinese divers. Undersea Hyperb Med 2005; 32:169-74. [PMID: 16119308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To compare the results of X-ray and CT scan for dysbaric osteonecrosis in Chinese divers. METHODS Both shoulders, hips and knees of 66 asymptomatic divers with diving duration of more than one year were examined by X-ray and CT scan. RESULTS The most frequent locations of dysbaric osteonecrosis were the upper femurs, followed by the upper humerus, lower femurs and upper tibias, and the most frequent radiographic lesions were calcification spots and cystic changes. Of the lesions detected, 38% (27/71) and 42% (95/229) werejuxta-articular of the femoral and humeral heads by X-ray and CT respectively. The detection rates of dysbaric necrosis (juxta- and/or other lesions) of X-ray and CT scan were 42.4% (95% confidence interval: 30.5%-54.3%) and 81.8% (95% CI: 72.4%-91.2%) respectively (p<0.05). If CT scan was used as the gold standard, the sensitivity of X-ray was 100% and the specificity was 31.6%. CONCLUSION CT scan showed a higher detection rate of dysbaric necrosis than X-ray. We recommend that CT scan be used for early diagnosis of dysbaric osteonecrosis.
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Affiliation(s)
- C Q Jiang
- Guangzhou Occupational Disease Prevention & Treatment Centre, Guangzhou 510620, China
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