A total of 1 116 middle-aged and elderly men and 1 442 postmenopausal women were recruited in this study. Whether bisphenol A exposure was associated with circulating sex hormone concentrations was studied. Univariate...A total of 1 116 middle-aged and elderly men and 1 442 postmenopausal women were recruited in this study. Whether bisphenol A exposure was associated with circulating sex hormone concentrations was studied. Univariate analysis revealed that the urinary bisphenol A concentration was negatively correlated with the serum levels of luteinizing hormone （B=-0.061, P〈0.0001） and follicle-stimulating hormone （B=-0.086, P〈0.0001） in men, and with the serum levels of follicle-stimulating hormone （B=-0.037, P=0.018） and sex hormone-binding globulin （B=-0.043, P=0.006） in women. However, no significant association was observed between the serum levels of urinary bisphenol A and circulating sex hormone after adjustment for the potential confounders.展开更多
Objective This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease(CKD)in Shanghai community residents.Methods We used data from a cohort study of co...Objective This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease(CKD)in Shanghai community residents.Methods We used data from a cohort study of community residents who participated in three examinations in 2008,2009,and 2013,respectively.Fasting plasma glucose(FPG)level,blood pressure(BP),and lipid levels were determined in 2,109 participants at all three visits,and CKD was evaluated between the second and the third visits.Visit-to-visit variabilities in metabolic factors were described by coefficients of variation(CV)at three visits.A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV.CKD was defined as the estimated glomerular filtration rate<60 mL/min per 1.73 m2 or urinary albumin-to-creatinine ratio≥30 mg/g.Results A total of 200(9.5%)participants had CKD at the third visit.Compared with the lowest quartile of CV,the highest quartile was associated with a 70%increased risk of CKD for FPG[odds ratio,OR=1.70;95%confidence interval(CI)1.06–2.72],62%for systolic BP(OR=1.62,95%CI 1.04–2.50),and 85%for low-density lipoprotein cholesterol(OR=1.85,95%CI 1.23–2.80).Furthermore,the risk of CKD increased significantly with an increasing variability score.Compared with participants with score 0,participants with scores of 1,2,and 3 were associated with 58%(OR=1.58,95%CI 1.08–2.32),121%(OR=2.21,95%CI 1.40–3.49),and 548%(OR=6.48,95%CI 3.18–13.21)higher risks of CKD,respectively.Conclusion The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.展开更多
Diabetes has become a serious public health concern worldwide,and China is the epidemic center.In China,the prevalence of type 2 diabetes(T2D)was 11.6%among adults aged≥18 years[1].Cardiovascular disease(CVD)occurs e...Diabetes has become a serious public health concern worldwide,and China is the epidemic center.In China,the prevalence of type 2 diabetes(T2D)was 11.6%among adults aged≥18 years[1].Cardiovascular disease(CVD)occurs earlier and with greater severity in patients with T2D than in individuals without T2D[2].Thus,potential risk factors for screening T2D are needed to prevent such poor clinical outcomes.展开更多
Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the ris...Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases （ASCVD） among 8,252 participants aged 〉 40 years without diabetes from Jiading district, Shanghai, China.Results Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid （all P trend 〈 0.05）. Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia （all P trend 〈 0.05）. A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios （ORs） [95% confidence intervals （C/s）] for the highest quartiles for high Framingham risk were 3.00 （2.00-4.50） in men and 2.95 （1.08-8.43） in women. The multivariate adjusted ORs （95% C/s） for the highest quartile for high ASCVD risk were 1.93 [1.17-3.17） in men and 4.53 （2.57-7.98） in women.Conclusion Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dystipidemia, 10-year Framingham risk for coronary heart disease, and lO-year risk for ASCVD among Chinese adults without diabetes.展开更多
This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease （PAD） among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine ...This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease （PAD） among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine （FT3）, free thyroxin （FT4）, thyroid-stimulating hormone （TSH）, and thyroid antibodies were measured.展开更多
Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional a...Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.展开更多
Objective The association between lipoprotein(a)[Lp(a)] levels and metabolic syndrome(MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between L...Objective The association between lipoprotein(a)[Lp(a)] levels and metabolic syndrome(MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort. Methods A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS. Results In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS(30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio(OR) for prevalent MetS [multivariate-adjusted OR 0.45(95% confidence interval 0.39-0.51);P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups. Conclusion Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.展开更多
Objective To update the estimated prevalence rates of smoking and examine major metabolic diseases associated with smoking status in Chinese adults. Methods Using a complex, multistage, probability sampling design, we...Objective To update the estimated prevalence rates of smoking and examine major metabolic diseases associated with smoking status in Chinese adults. Methods Using a complex, multistage, probability sampling design, we recruited a nationally representative sample of 98,658 Chinese adults aged ≥18 years in 2010. Information on current, former, never, and passive smoking status was obtained using a standard questionnaire. All estimates were weighted to represent the overall Chinese adult population. Results The estimated proportion of current smokers was 28.3% for Chinese adults aged _〉18 years. The corresponding values of former and passive smokers were 5.1% and 21.4%, respectively. Additionally, former smokers were found to have a less favorable metabolic risk profile among all categories of smoking status in both men and women. The prevalence of metabolic diseases such as diabetes and hypertension also increased with a greater number of smoking pack-years in men. Conclusion The prevalences of current smoking and passive smoking remain high in Chinese adults.展开更多
Objective To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35–74 years.Methods Data for this study were derived from the China Chronic Diseases and Behavioral Ri...Objective To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35–74 years.Methods Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey.Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China.A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes,with participants nested within districts/counties.Results A total of 69,332 participants aged 35–74 years,from 158 districts/counties were included in the analysis.Concentrations of selenium in soil varied greatly across the 158 districts/counties,with a median concentration of 0.219 mg/kg(IQR:0.185–0.248).The results showed that both Quartile 1(0.119–0.185 mg/kg)and Quartile 4(0.249–0.344 mg/kg)groups were positively associated with diabetes compared to a soil selenium concentration of 0.186–0.219 mg/kg(Quartile 2),crude odds ratios(ORs)(95%CI)were 1.227(1.003–1.502)and 1.280(1.048–1.563).The P values were 0.045 and 0.013,for Quartile 1 and Quartile 4 groups,respectively.After adjusting for all confounding factors of interest,the Quartile 1 group became non-significant,and the Quartile 4 group had an adjusted OR(95%CI)of 1.203(1.018–1.421)relative to the reference group(Quartile 2),the P values was 0.030.No significant results were seen for the Quartile 3 group(0.220–0.248 mg/kg)compared to the reference group.Conclusion Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35–74 years.展开更多
Objective To study the relationship between resting heart rate and blood lipid level. Methods A total of 9 415 subjects aged≥40 years were included in the present study. Their resting heart rate was monitored and th...Objective To study the relationship between resting heart rate and blood lipid level. Methods A total of 9 415 subjects aged≥40 years were included in the present study. Their resting heart rate was monitored and their serum levels of triglyceride （TG）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C） and high density lipoprotein cholesterol （HDL-C） were measured to define dyslipidemia according to the 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Results The subjects were divided into group A with their resting heart rate〈70 beats/min, group B with their resting heart rate=70-79 beats/min, group C with their resting heart rate=80-89 beats/min, and group D with their resting heart rate≥90 beats/min. High TG, TC, and LDL-C were presented across the resting heart rate （Ptrend〈0.01）. Multiple logistic regression analysis revealed that the risk of high TG and TC was higher in subjects with their resting heart rate≥90 beats/min than in those with their resting heart rate〈70 beats/min （OR=1.42;95%CI：1.16-1.74 and OR=1.33;95%CI：1.09-1.64, respectively）. Conclusion Elevated resting heart rate is associated with high TG and TC in middle-aged and elderly Chinese subjects.展开更多
Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore...Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.展开更多
Objective Ideal cardiovascular health(CVH) could predict a lower risk of developing cardiovascular diseases. This study was conducted to investigate the association between ideal CVH and subclinical atherosclerosis in...Objective Ideal cardiovascular health(CVH) could predict a lower risk of developing cardiovascular diseases. This study was conducted to investigate the association between ideal CVH and subclinical atherosclerosis in a population cohort of Chinese adults aged ≥ 40 years. Methods This study was designed as a cross-sectional analysis of 8,395 participants who had complete data at baseline and a prospective analysis of 4,879 participants who had complete data at 4.3 years of follow-up. Ideal CVH metrics were defined according to the American Heart Association. Subclinical atherosclerosis was evaluated by plaques in carotid arteries, carotid intima-media thickness(CIMT), brachial-ankle pulse wave velocity(baPWV), and urinary albumin-to-creatinine ratio(UACR). Results Both the prevalence and incidence of atherosclerosis measures were found to be decreased with increasing numbers of ideal CVH metrics at baseline(all P values for trend < 0.01). The levels of CIMT and UACR at follow-up showed an inverse and significant association with the numbers of ideal CVH metrics at baseline(both P values for trend < 0.05) but a borderline significant association with baPWV(P for trend = 0.0505). Taking participants with 0-1 ideal metric as reference, we found that participants with 5-6 ideal metrics had significantly lower risks of developing carotid plaques(odds ratio, OR = 0.46; 95% confidence interval, CI 0.27-0.79), increased CIMT(OR = 0.60; 95% CI 0.42-0.84), and increased baPWV(OR = 0.57; 95% CI 0.34-0.97) after full adjustments. A significant interactive effect of age and CVH was detected on CIMT and baPWV progression(both P values for interaction < 0.05). Conclusion The numbers of ideal CVH metrics showed a significant and inverse association with the risk of developing subclinical atherosclerosis in middle-aged and elderly Chinese adults, whereas its dose-response effect was attenuated in individuals aged ≥ 60 years and partially weakened in male participants.展开更多
Objective Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease(NAFLD).Peripheral artery disease(PAD)and liver fibrosis share many common metabolic dysfunctions.We aimed to explore ...Objective Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease(NAFLD).Peripheral artery disease(PAD)and liver fibrosis share many common metabolic dysfunctions.We aimed to explore the association between PAD and risk of fibrosis deterioration in NAFLD patients.Methods The study recruited 1,610 NAFLD patients aged≥40 years from a well-defined community at baseline in 2010 and followed up between August 2014 and May 2015.Fibrosis deterioration was defined as the NAFLD fibrosis score(NFS)status increased to a higher category at the follow-up visit.PAD was defined as an ankle-brachial index of<0.90 or>1.40.Results During an average of 4.3 years’follow-up,618 patients progressed to a higher NFS category.PAD was associated with 92%increased risk of fibrosis deterioration[multivariable-adjusted odds ratio(OR):1.92,95%confidence interval(CI):1.24,2.98].When stratified by baseline NFS status,the OR for progression from low to intermediate or high NFS was 1.74(95%CI:1.02,3.00),and progression from intermediate to high NFS was 2.24(95%CI:1.05,4.80).There was a significant interaction between PAD and insulin resistance(IR)on fibrosis deterioration(P for interaction=0.03).As compared with non-PAD and non-IR,the coexistence of PAD and IR was associated with a 3.85-fold(95%CI:2.06,7.18)increased risk of fibrosis deterioration.Conclusion PAD is associated with an increased risk of fibrosis deterioration in NAFLD patients,especially in those with IR.The coexistence of PAD and IR may impose an interactive effect on the risk of fibrosis deterioration.展开更多
Metabolic syndrome(MetS) is a cluster of metabolic disorders including obesity, hypertension, hyperglycemia, elevated triglyceride levels, and low high-density lipoprotein cholesterol(HDL-C) levels. In recent years, t...Metabolic syndrome(MetS) is a cluster of metabolic disorders including obesity, hypertension, hyperglycemia, elevated triglyceride levels, and low high-density lipoprotein cholesterol(HDL-C) levels. In recent years, the prevalence of MetS[1]has increased dramatically worldwide.展开更多
Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of...Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of left and right BaPWV was analyzed. BaPWV was defined as high when it was31 752.5 cm/s （the upper quartile） either side. Results The BaPWV and its elevated percentage progressively increased across the quartiles of the serum calcium level （P〈0.05）. The prevalence of elevated BaPWV was significantly higher in subjects of the second, third and highest quartiles than in those of the lowest quartile （26.9%, 28.4%, and 33.2%vs 23.7%, P=0.0116, P=0.0004, and P〈0.0001）. Logistic regression analysis revealed that the risk of elevated BaPWV was 1.32- fold higher in subjects of the highest quartile than in those of the lowest quartile （OR=1.32, 95%CI：1.08-1.60）. Conclusion The elevated serum calcium level is related to an elevated BaPWV and a higher risk of arterial stiffness, independent of conventional risk factors, in middle-aged and elderly Chinese subjects.展开更多
Objective The association between neutrophil-to-lymphocyte ratio(NLR)with subclinical macrovascular and microvascular diseases has been less investigated.We sought to examine the association between NLR and new-onset ...Objective The association between neutrophil-to-lymphocyte ratio(NLR)with subclinical macrovascular and microvascular diseases has been less investigated.We sought to examine the association between NLR and new-onset subclinical macrovascular and microvascular abnormalities in the Chinese population.Methods From a community cohort,we included 6,430 adults aged≥40 years without subclinical macrovascular and microvascular diseases at baseline.We measured subclinical macrovascular and microvascular abnormalities separately using the ankle-brachial index(ABI),brachial-ankle pulse wave velocity(baPWV),and albuminuria.Results During a mean follow-up of 4.3 years,110 participants developed incident abnormal ABI,746 participants developed incident elevated baPWV,and 503 participants developed incident albuminuria.Poisson regression analysis indicated that NLR was significantly associated with an increased risk of newonset abnormal ABI,elevated baPWV,and albuminuria.Compared to overweight/obese participants,we found a much stronger association between NLR and subclinical vascular abnormalities in participants with normal weight.Furthermore,we found an interaction between the NLR and body mass index(BMI)on the risk of new-onset abnormal ABI(P for interaction:0.01).Conclusion NLR was associated with subclinical macrovascular and microvascular diseases in the Chinese population.Furthermore,in participants with normal weight,the association between NLR and subclinical vascular abnormalities was much stronger.展开更多
Serum fetuin-A levels are reportedly elevated in hyperthyroidism. However, there are few relevant epidemiologic studies. We conducted a cross-sectional study in Songnan community, China in 2009 to investigate the asso...Serum fetuin-A levels are reportedly elevated in hyperthyroidism. However, there are few relevant epidemiologic studies. We conducted a cross-sectional study in Songnan community, China in 2009 to investigate the association between serum fetuin-A concentrations and thyroid function. A total of 2,984 participants aged 40 years and older were analyzed. Multivariable linear regression analysis revealed that serum fetuin-A concentra- tions were positively associated with log （free triiodothyronine） and were inversely associated with log （thyroid peroxidase antibody） after adjustment （both P 〈 0.05）. Compared with the participants in the lowest tertile of free triiodo- thyronine and free thyroxine level, those in the highest tertile had higher fetuin-A concentrations. Additionally, high serum fetuin-A concentrations were related to high thyroid function （odds ratio 1.27, 95% confidence interval 1.01-1.61）, after adjustment for conventional risk factors.展开更多
Nonalcoholic fatty liver disease(NAFLD)is known for its insidious onset and chronic nature,which have jeopardized the health and life of 29.2%of adults in China[1].In 2020,metabolic dysfunctionassociated fatty liver d...Nonalcoholic fatty liver disease(NAFLD)is known for its insidious onset and chronic nature,which have jeopardized the health and life of 29.2%of adults in China[1].In 2020,metabolic dysfunctionassociated fatty liver disease(MAFLD),a more accurate nomenclature to replace NAFLD,was put forward in an international consensus of experts involving 22 countries[2].In China,at least 300 million people will suffer from MAFLD by 2030,which will be a heavy burden on national health[3].展开更多
基金supported by the grants from Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health(1994DP131044)National Natural Science Foundation of China(No.81170739,81170719,81270877,81222008,81200563)+3 种基金Shanghai New Excellent Youth Program(XYQ2011009)Shanghai Health Bureau(2011293)Shanghai Committee of Science and Technology(12PJ1407700)EFSD-CDS-Lilly Program for Collaborative Research between China and Europe(2011)
文摘A total of 1 116 middle-aged and elderly men and 1 442 postmenopausal women were recruited in this study. Whether bisphenol A exposure was associated with circulating sex hormone concentrations was studied. Univariate analysis revealed that the urinary bisphenol A concentration was negatively correlated with the serum levels of luteinizing hormone （B=-0.061, P〈0.0001） and follicle-stimulating hormone （B=-0.086, P〈0.0001） in men, and with the serum levels of follicle-stimulating hormone （B=-0.037, P=0.018） and sex hormone-binding globulin （B=-0.043, P=0.006） in women. However, no significant association was observed between the serum levels of urinary bisphenol A and circulating sex hormone after adjustment for the potential confounders.
基金the grants from the National Key R&D Program of China[2017YFC1310700,2016YFC1305600,2018YFC1311800,2016YFC0901200]the National Natural Science Foundation of China[81870560,81700764,81561128019]+4 种基金the Shanghai Municipal Government[18411951800]the Shanghai Shenkang Hospital Development Center[SHDC12019101]the Shanghai Jiaotong University School of Medicine[DLY201801]the Ruijin Hospital[2018CR002]the Shanghai Municipal Education Commission[HJWR20196619]。
文摘Objective This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease(CKD)in Shanghai community residents.Methods We used data from a cohort study of community residents who participated in three examinations in 2008,2009,and 2013,respectively.Fasting plasma glucose(FPG)level,blood pressure(BP),and lipid levels were determined in 2,109 participants at all three visits,and CKD was evaluated between the second and the third visits.Visit-to-visit variabilities in metabolic factors were described by coefficients of variation(CV)at three visits.A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV.CKD was defined as the estimated glomerular filtration rate<60 mL/min per 1.73 m2 or urinary albumin-to-creatinine ratio≥30 mg/g.Results A total of 200(9.5%)participants had CKD at the third visit.Compared with the lowest quartile of CV,the highest quartile was associated with a 70%increased risk of CKD for FPG[odds ratio,OR=1.70;95%confidence interval(CI)1.06–2.72],62%for systolic BP(OR=1.62,95%CI 1.04–2.50),and 85%for low-density lipoprotein cholesterol(OR=1.85,95%CI 1.23–2.80).Furthermore,the risk of CKD increased significantly with an increasing variability score.Compared with participants with score 0,participants with scores of 1,2,and 3 were associated with 58%(OR=1.58,95%CI 1.08–2.32),121%(OR=2.21,95%CI 1.40–3.49),and 548%(OR=6.48,95%CI 3.18–13.21)higher risks of CKD,respectively.Conclusion The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.
基金the National Natural Science Foundation of China[Grant/Award Number 81870604]Ministry of Science and Technology of the People's Republic of China[Grand/Award Number 2016YFC1304904]Yuhong Chen was supported by the Shanghai Shenkang Hospital Development Center for improving the control of type 2 diabetes in the suburbs of Shanghai[16CR4020A].
文摘Diabetes has become a serious public health concern worldwide,and China is the epidemic center.In China,the prevalence of type 2 diabetes(T2D)was 11.6%among adults aged≥18 years[1].Cardiovascular disease(CVD)occurs earlier and with greater severity in patients with T2D than in individuals without T2D[2].Thus,potential risk factors for screening T2D are needed to prevent such poor clinical outcomes.
基金supported by Grants from the Ministry of Science and Technology of the People’s Republic of China[2016YFC1305202,2016YFC1305601,2016YFC0901201,2016YFC1304904]the National Natural Science Foundation of China[81670795]
文摘Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases （ASCVD） among 8,252 participants aged 〉 40 years without diabetes from Jiading district, Shanghai, China.Results Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid （all P trend 〈 0.05）. Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia （all P trend 〈 0.05）. A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios （ORs） [95% confidence intervals （C/s）] for the highest quartiles for high Framingham risk were 3.00 （2.00-4.50） in men and 2.95 （1.08-8.43） in women. The multivariate adjusted ORs （95% C/s） for the highest quartile for high ASCVD risk were 1.93 [1.17-3.17） in men and 4.53 （2.57-7.98） in women.Conclusion Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dystipidemia, 10-year Framingham risk for coronary heart disease, and lO-year risk for ASCVD among Chinese adults without diabetes.
基金supported by the National Natural Science Foundation of China(No.81370960 and 81670795)the Ministry of Science and Technology(No.2015BAI12B14,2015BAI12B02,2016YFC0901200,and 2016YFC1305202)
文摘This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease （PAD） among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine （FT3）, free thyroxin （FT4）, thyroid-stimulating hormone （TSH）, and thyroid antibodies were measured.
基金supported by the grants from National Key R&D Program of China [2017YFC1310700,2016YFC1305600]the National Natural Science Foundation of China [81622011,81561128019]+2 种基金the Shanghai Municipal Commission of Health and Family Planning [15GWZK0802]the'Gaofeng Gaoyuan Program for Clinical Scientists'from Shanghai Jiao-Tong University School of Medicine [20161301,20161307]Dr.Yu Xu was supported by the'Outstanding Young Talent Program'from Shanghai Municipal Government
文摘Objective The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease(CVD) risk in Chinese adults. Methods We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography(CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score(FRS) and the 10-year atherosclerotic cardiovascular disease(ASCVD) risk score. Results Among the 549 participants, 267(48.6%) had no coronary plaques, 201(36.6%) had noncalcified coronary plaques, and 81(14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio(OR) 2.41; 95% confidence interval(CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score(OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. Conclusion Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.
基金supported by grants from the Ministry of Science and Technology of the People’s Republic of China [2016YFC1305202]Shanghai Sailing Program [17YF1416800]+1 种基金supported by the ‘Chenxing Plan’ of Shanghai Jiaotong University,Shuguang Program [15SG15]Gaofeng Clinical Medicine Grant Support [20152202] from Shanghai Municipal Education Commission
文摘Objective The association between lipoprotein(a)[Lp(a)] levels and metabolic syndrome(MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort. Methods A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS. Results In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS(30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio(OR) for prevalent MetS [multivariate-adjusted OR 0.45(95% confidence interval 0.39-0.51);P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups. Conclusion Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.
基金supported by the Chinese Ministry of Financesupported by the grants 2013BAI09B13 from the National Clinical Research Center for Metabolic Diseases+1 种基金2015CB553601 from the National Basic Research Program of China(973 Program)81321001,81130016,81561128019 from the National Natural Science Foundation of China
文摘Objective To update the estimated prevalence rates of smoking and examine major metabolic diseases associated with smoking status in Chinese adults. Methods Using a complex, multistage, probability sampling design, we recruited a nationally representative sample of 98,658 Chinese adults aged ≥18 years in 2010. Information on current, former, never, and passive smoking status was obtained using a standard questionnaire. All estimates were weighted to represent the overall Chinese adult population. Results The estimated proportion of current smokers was 28.3% for Chinese adults aged _〉18 years. The corresponding values of former and passive smokers were 5.1% and 21.4%, respectively. Additionally, former smokers were found to have a less favorable metabolic risk profile among all categories of smoking status in both men and women. The prevalence of metabolic diseases such as diabetes and hypertension also increased with a greater number of smoking pack-years in men. Conclusion The prevalences of current smoking and passive smoking remain high in Chinese adults.
基金National Key Research and Development Programme[2018YFC1315305]China CDC’s Scientific Research Project[JY18-2-22]China CDC’s Public Health and Emergency Response Mechanism Programme[131031001000150001]。
文摘Objective To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35–74 years.Methods Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey.Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China.A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes,with participants nested within districts/counties.Results A total of 69,332 participants aged 35–74 years,from 158 districts/counties were included in the analysis.Concentrations of selenium in soil varied greatly across the 158 districts/counties,with a median concentration of 0.219 mg/kg(IQR:0.185–0.248).The results showed that both Quartile 1(0.119–0.185 mg/kg)and Quartile 4(0.249–0.344 mg/kg)groups were positively associated with diabetes compared to a soil selenium concentration of 0.186–0.219 mg/kg(Quartile 2),crude odds ratios(ORs)(95%CI)were 1.227(1.003–1.502)and 1.280(1.048–1.563).The P values were 0.045 and 0.013,for Quartile 1 and Quartile 4 groups,respectively.After adjusting for all confounding factors of interest,the Quartile 1 group became non-significant,and the Quartile 4 group had an adjusted OR(95%CI)of 1.203(1.018–1.421)relative to the reference group(Quartile 2),the P values was 0.030.No significant results were seen for the Quartile 3 group(0.220–0.248 mg/kg)compared to the reference group.Conclusion Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35–74 years.
基金supported by grants from the Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health(1994DP131044)National Nature Science Foundation of China(81170739,81170719,81270877,81222008)+1 种基金Shanghai New Excellent Youth Program(XYQ2011009)the Shanghai Health Bureau Grant(2011293)
文摘Objective To study the relationship between resting heart rate and blood lipid level. Methods A total of 9 415 subjects aged≥40 years were included in the present study. Their resting heart rate was monitored and their serum levels of triglyceride （TG）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C） and high density lipoprotein cholesterol （HDL-C） were measured to define dyslipidemia according to the 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Results The subjects were divided into group A with their resting heart rate〈70 beats/min, group B with their resting heart rate=70-79 beats/min, group C with their resting heart rate=80-89 beats/min, and group D with their resting heart rate≥90 beats/min. High TG, TC, and LDL-C were presented across the resting heart rate （Ptrend〈0.01）. Multiple logistic regression analysis revealed that the risk of high TG and TC was higher in subjects with their resting heart rate≥90 beats/min than in those with their resting heart rate〈70 beats/min （OR=1.42;95%CI：1.16-1.74 and OR=1.33;95%CI：1.09-1.64, respectively）. Conclusion Elevated resting heart rate is associated with high TG and TC in middle-aged and elderly Chinese subjects.
基金supported by grants from the Ministry of Science and Technology of the People’s Republic of China[grant nos.2016YFC1305600,2016YFC1305202,2016YFC1304904,2017YFC1310700,2018YFC1311800]the National Natural Science Foundation of China[grant nos.81970706,81970691,81970728,81800683]。
文摘Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.
基金supported by the grants from National Key R&D Program of China [2016YFC1305600,2017YFC1310700,2016YFC0901200,2016YFC1304904]the National Natural Science Foundation of China [81561128019,81622011]+4 种基金the Shanghai Municipal Commission of Health and Family Planning [15GWZK0802]the Three-year Action Plan on Public Health [15GWZK0802]the ‘Gaofeng Gaoyuan Program for Clinical Scientists’ from Shanghai Jiao Tong University School of Medicine [20161301,20161307]supported by the ‘Shanghai Outstanding Academic Leader Program’supported by the ‘Outstanding Young Talent Program’ from Shanghai Municipal Government
文摘Objective Ideal cardiovascular health(CVH) could predict a lower risk of developing cardiovascular diseases. This study was conducted to investigate the association between ideal CVH and subclinical atherosclerosis in a population cohort of Chinese adults aged ≥ 40 years. Methods This study was designed as a cross-sectional analysis of 8,395 participants who had complete data at baseline and a prospective analysis of 4,879 participants who had complete data at 4.3 years of follow-up. Ideal CVH metrics were defined according to the American Heart Association. Subclinical atherosclerosis was evaluated by plaques in carotid arteries, carotid intima-media thickness(CIMT), brachial-ankle pulse wave velocity(baPWV), and urinary albumin-to-creatinine ratio(UACR). Results Both the prevalence and incidence of atherosclerosis measures were found to be decreased with increasing numbers of ideal CVH metrics at baseline(all P values for trend < 0.01). The levels of CIMT and UACR at follow-up showed an inverse and significant association with the numbers of ideal CVH metrics at baseline(both P values for trend < 0.05) but a borderline significant association with baPWV(P for trend = 0.0505). Taking participants with 0-1 ideal metric as reference, we found that participants with 5-6 ideal metrics had significantly lower risks of developing carotid plaques(odds ratio, OR = 0.46; 95% confidence interval, CI 0.27-0.79), increased CIMT(OR = 0.60; 95% CI 0.42-0.84), and increased baPWV(OR = 0.57; 95% CI 0.34-0.97) after full adjustments. A significant interactive effect of age and CVH was detected on CIMT and baPWV progression(both P values for interaction < 0.05). Conclusion The numbers of ideal CVH metrics showed a significant and inverse association with the risk of developing subclinical atherosclerosis in middle-aged and elderly Chinese adults, whereas its dose-response effect was attenuated in individuals aged ≥ 60 years and partially weakened in male participants.
基金Grants from the Ministry of Science and Technology of China[2018YFC1311705,2016YFC1305600,and 2016YFC1304904]the National Natural Science Foundation of China[81770842,81941017,and 81870604]+1 种基金the Shanghai Science and Technology Commission[YDZX20173100004881]the Shanghai Shen-Kang Hospital Development Center[SHDC12016202]。
文摘Objective Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease(NAFLD).Peripheral artery disease(PAD)and liver fibrosis share many common metabolic dysfunctions.We aimed to explore the association between PAD and risk of fibrosis deterioration in NAFLD patients.Methods The study recruited 1,610 NAFLD patients aged≥40 years from a well-defined community at baseline in 2010 and followed up between August 2014 and May 2015.Fibrosis deterioration was defined as the NAFLD fibrosis score(NFS)status increased to a higher category at the follow-up visit.PAD was defined as an ankle-brachial index of<0.90 or>1.40.Results During an average of 4.3 years’follow-up,618 patients progressed to a higher NFS category.PAD was associated with 92%increased risk of fibrosis deterioration[multivariable-adjusted odds ratio(OR):1.92,95%confidence interval(CI):1.24,2.98].When stratified by baseline NFS status,the OR for progression from low to intermediate or high NFS was 1.74(95%CI:1.02,3.00),and progression from intermediate to high NFS was 2.24(95%CI:1.05,4.80).There was a significant interaction between PAD and insulin resistance(IR)on fibrosis deterioration(P for interaction=0.03).As compared with non-PAD and non-IR,the coexistence of PAD and IR was associated with a 3.85-fold(95%CI:2.06,7.18)increased risk of fibrosis deterioration.Conclusion PAD is associated with an increased risk of fibrosis deterioration in NAFLD patients,especially in those with IR.The coexistence of PAD and IR may impose an interactive effect on the risk of fibrosis deterioration.
基金supported by the Ministry of Science and Technology of the People's Republic of China [Grant Number 2016YFC1305202]the National Natural Science Foundation of China [Grant Numbers 81670795 and 81700764]+2 种基金the Shanghai Municipal Education Commission [Grant Numbers 15SG15 and 20152202]the Shanghai Municipal Health Commission [Grant Number 201740040]the Shanghai Sailing Program [Grant Numbers 18YF1419900 and 17YF1416800]
文摘Metabolic syndrome(MetS) is a cluster of metabolic disorders including obesity, hypertension, hyperglycemia, elevated triglyceride levels, and low high-density lipoprotein cholesterol(HDL-C) levels. In recent years, the prevalence of MetS[1]has increased dramatically worldwide.
基金supported by the Key Laboratory for Endocrine and Metabolic Diseases,Ministry of Health(1994DP131044)National Nature Science Foundation of China(81170739,81170719,81222008,81370960)+3 种基金Shanghai New Excellent Youth Program(XYQ2011009)Shanghai Health Bureau(2011293)EFSD-CDS-Lilly Program for Collaborative Research between China and Europe(2011)Shanghai Shen Kang Hospital Development Center(SHDC12012301)
文摘Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of left and right BaPWV was analyzed. BaPWV was defined as high when it was31 752.5 cm/s （the upper quartile） either side. Results The BaPWV and its elevated percentage progressively increased across the quartiles of the serum calcium level （P〈0.05）. The prevalence of elevated BaPWV was significantly higher in subjects of the second, third and highest quartiles than in those of the lowest quartile （26.9%, 28.4%, and 33.2%vs 23.7%, P=0.0116, P=0.0004, and P〈0.0001）. Logistic regression analysis revealed that the risk of elevated BaPWV was 1.32- fold higher in subjects of the highest quartile than in those of the lowest quartile （OR=1.32, 95%CI：1.08-1.60）. Conclusion The elevated serum calcium level is related to an elevated BaPWV and a higher risk of arterial stiffness, independent of conventional risk factors, in middle-aged and elderly Chinese subjects.
基金supported by the grants from the National Key R&D Program of China[2017YFC1310700,2016YFC1305600,2016YFC0901200,2016YFC1305202,2016YFC1304904,2018YFC1311800,2018YFC1311705]the National Natural Science Foundation of China[81870560,81561128019,81621061,81700764,81941017,81770842]+9 种基金the Chinese Academy of Medical Sciences[2018PT32017,2019PT330006]the Shanghai Municipal Government[18411951800]the Shanghai Shenkang Hospital Development Center[SHDC12019101]Shanghai Municipal Commission of Health and Family Planning[20174Y0014]National Major Scientific and Technological Special Project for“Significant New Drugs Development”[2017ZX09304007]Shanghai Rising-Star Program[21QA1408100]the Scientific and Technological Committee of Shanghai[19411964200]Innovative research team of high-level local universities in Shanghaithe Shanghai Jiaotong University School of Medicine[DLY201801,20161301,20161307]the Ruijin Hospital[2018CR002]。
文摘Objective The association between neutrophil-to-lymphocyte ratio(NLR)with subclinical macrovascular and microvascular diseases has been less investigated.We sought to examine the association between NLR and new-onset subclinical macrovascular and microvascular abnormalities in the Chinese population.Methods From a community cohort,we included 6,430 adults aged≥40 years without subclinical macrovascular and microvascular diseases at baseline.We measured subclinical macrovascular and microvascular abnormalities separately using the ankle-brachial index(ABI),brachial-ankle pulse wave velocity(baPWV),and albuminuria.Results During a mean follow-up of 4.3 years,110 participants developed incident abnormal ABI,746 participants developed incident elevated baPWV,and 503 participants developed incident albuminuria.Poisson regression analysis indicated that NLR was significantly associated with an increased risk of newonset abnormal ABI,elevated baPWV,and albuminuria.Compared to overweight/obese participants,we found a much stronger association between NLR and subclinical vascular abnormalities in participants with normal weight.Furthermore,we found an interaction between the NLR and body mass index(BMI)on the risk of new-onset abnormal ABI(P for interaction:0.01).Conclusion NLR was associated with subclinical macrovascular and microvascular diseases in the Chinese population.Furthermore,in participants with normal weight,the association between NLR and subclinical vascular abnormalities was much stronger.
基金supported by grants 2015CB553601 from the National Basic Research Program of China(973 Program)201502007 from the Ministry of Health+3 种基金2015BAI12B14 from the Ministry of Science and Technology81622011,81321001,81390350,81130016,and 81561128019 from the National Natural Science Foundation of Chinasupported by the Pujiang Talent Program(15PJD027)from the Science and Technology Commission of Shanghai Municipalitythe Gaofeng Gaoyuan Program for Clinical Scientists(20161307)from Shanghai Jiao-Tong University School of Medicine
文摘Serum fetuin-A levels are reportedly elevated in hyperthyroidism. However, there are few relevant epidemiologic studies. We conducted a cross-sectional study in Songnan community, China in 2009 to investigate the association between serum fetuin-A concentrations and thyroid function. A total of 2,984 participants aged 40 years and older were analyzed. Multivariable linear regression analysis revealed that serum fetuin-A concentra- tions were positively associated with log （free triiodothyronine） and were inversely associated with log （thyroid peroxidase antibody） after adjustment （both P 〈 0.05）. Compared with the participants in the lowest tertile of free triiodo- thyronine and free thyroxine level, those in the highest tertile had higher fetuin-A concentrations. Additionally, high serum fetuin-A concentrations were related to high thyroid function （odds ratio 1.27, 95% confidence interval 1.01-1.61）, after adjustment for conventional risk factors.
基金supported by the Shanghai Science and Technology Commission[19411964200]National Natural Science Foundation of China[81930021,81970728,81970691,82170819,and 21904084]+4 种基金Shanghai Outstanding Academic Leaders Plan[20XD1422800]Chinese Academy of Medical Sciences[2018PT32017 and 2019PT330006]Shanghai Medical and Health Development Foundation[DMRFP_I_01]Clinical Research Plan of SHDC[SHDC2020CR3064B]Science and Technology Committee of Shanghai[20Y11905100]
文摘Nonalcoholic fatty liver disease(NAFLD)is known for its insidious onset and chronic nature,which have jeopardized the health and life of 29.2%of adults in China[1].In 2020,metabolic dysfunctionassociated fatty liver disease(MAFLD),a more accurate nomenclature to replace NAFLD,was put forward in an international consensus of experts involving 22 countries[2].In China,at least 300 million people will suffer from MAFLD by 2030,which will be a heavy burden on national health[3].
