Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a populat...Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.展开更多
Assessing individual risks of healthy aging using biomarkers and identifying associated factors have become important areas of research.In this study,we conducted a literature review of relevant publications between 2...Assessing individual risks of healthy aging using biomarkers and identifying associated factors have become important areas of research.In this study,we conducted a literature review of relevant publications between 2018 and 2023 in both Chinese and English databases.Previous studies have predominantly used single biomarkers,such as C-reactive protein,or focused on specific life course stages and factors such as socioeconomic status,mental health,educational levels,and unhealthy lifestyles.By summarizing the progress in this field,our study provides valuable insights and future directions for promoting healthy aging from a life course perspective.展开更多
Exercise intervention at the early stage of type 2 diabetes mellitus(T2DM)can aid in the maintenance of blood glucose homeostasis and prevent the development of macrovascular and microvascular complications.However,th...Exercise intervention at the early stage of type 2 diabetes mellitus(T2DM)can aid in the maintenance of blood glucose homeostasis and prevent the development of macrovascular and microvascular complications.However,the exercise-regulated pathways that prevent the development of T2DM remain largely unclear.In this study,two forms of exercise intervention,treadmill training and voluntary wheel running,were conducted for high-fat diet(HFD)-induced obese mice.We observed that both forms of exercise intervention alleviated HFD-induced insulin resistance and glucose intolerance.Skeletal muscle is recognized as the primary site for postprandial glucose uptake and for responsive alteration beyond exercise training.Metabolomic profiling of the plasma and skeletal muscle in Chow,HFD,and HFD-exercise groups revealed robust alterations in metabolic pathways by exercise intervention in both cases.Overlapping analysis identified nine metabolites,including beta-alanine,leucine,valine,and tryptophan,which were reversed by exercise treatment in both the plasma and skeletal muscle.Transcriptomic analysis of gene expression profiles in the skeletal muscle revealed several key pathways involved in the beneficial effects of exercise on metabolic homeostasis.In addition,integrative transcriptomic and metabolomic analyses uncovered strong correlations between the concentrations of bioactive metabolites and the expression levels of genes involved in energy metabolism,insulin sensitivity,and immune response in the skeletal muscle.This work established two models of exercise intervention in obese mice and provided mechanistic insights into the beneficial effects of exercise intervention on systemic energy homeostasis.展开更多
The recommendation encouraging patients with cancer to keep a normal body mass index(BMI)is largely extrapolated from data on risk of developing cancer.We tested the prospective association between peri-diagnostic(wit...The recommendation encouraging patients with cancer to keep a normal body mass index(BMI)is largely extrapolated from data on risk of developing cancer.We tested the prospective association between peri-diagnostic(within 1 year post-diagnosis)BMI and all-cause mortality in patients with incident cancers.During 7.2 years of follow-up,42%(48,340)of the 114430 patients with cancer died.Spline analysis revealed that compared with a BMI of 22.5,a BMI lower than 22.5 was associated with increased risk of all-cause mortality across 24 cancer types.A BMI higher than 22.5 was associated with reduced all-cause mortality,while a non-linear association was observed;the lowest risk was found at a BMI of 29.6–34.2,and the risk started to return to and above unity at very high BMI values.The reduced mortality risk of high BMI was observed in 23 of 24 cancer types and maintained after attempts to remove potential selection bias,confounding by smoking and comorbidities,and reserve causality.展开更多
Owing to the susceptibility of conventional observational studies to confounding factors and reverse causation,the causal association between cardiac function and frailty is unclear.We aimed to investigate whether car...Owing to the susceptibility of conventional observational studies to confounding factors and reverse causation,the causal association between cardiac function and frailty is unclear.We aimed to investigate whether cardiac function has causal effects on frailty.In this study,a two-sample Mendelian randomization(MR)study was conducted using genetic variants associated with cardiac function assessed by magnetic resonance imaging phenotypes as instrumental variables.Genetic variants asso-ciated with cardiac function by magnetic resonance imaging(including seven cardiac function phenotypes)and the frailty index(FI)were obtained from two large genome-wide association studies.MR estimates from each genetic instrument were combined using inverse variance weighted(IVW),weighted median,and MR‒Egger regression methods.We found that the increase in genetically determined stroke volume(beta-0.13,95%CI-0.16 to-0.10,p=1.39E-6),rather than other cardiac phenotypes,was associated with lower FI in MR analysis of IVW after Bonferroni correction.Sensitivity analyses examining potential bias caused by pleiotropy or reverse causality revealed similar findings(e.g.,intercept[SE],-0.008[0.011],p=0.47 by MR‒Egger intercept test).The leave-one-out analysis indicated that the association was not driven by single nucleotide polymorphisms.No evidence of heterogeneity was found among the genetic variants(e.g.,MR‒Egger:Q statistic=14.4,p=0.156).In conclusion,we provided evidence that improved cardiac function could contribute to reducing FI.These findings support the hypothesis that enhancing cardiac function could be an effective prevention strategy for frailty.展开更多
Emerging epidemiological studies suggest that long-term ozone(O_(3))exposure may increase the risk of mortality,while pre-existing evidence is mixed and has been generated predominantly in North America and Europe.In ...Emerging epidemiological studies suggest that long-term ozone(O_(3))exposure may increase the risk of mortality,while pre-existing evidence is mixed and has been generated predominantly in North America and Europe.In this study,we investigated the impact of long-term O_(3)exposure on all-cause mortality in a national cohort in China.A dynamic cohort of 20882 participants aged40 years was recruited between 2011 and 2018 from four waves of the China Health and Retirement Longitudinal Study.A Cox proportional hazard regression model with time-varying exposures on an annual scale was used to estimate the mortality risk associated with warm-season(Aprile September)O_(3)exposure.The annual average level of participant exposure to warm-season O_(3)concentrations was 100 mg m^(-3)(range:61 e142 mg m^(-3)).An increase of 10 mg m^(-3)in O_(3)was associated with a hazard ratio(HR)of 1.18(95%confidence interval[CI]:1.13e1.23)for all-cause mortality.Compared with the first exposure quartile of O_(3),HRs of mortality associated with the second,third,and highest exposure quartiles were 1.09(95%CI:0.95e1.25),1.02(95%CI:0.88e1.19),and 1.56(95%CI:1.34e1.82),respectively.A J-shaped concentration eresponse associationwas observed,revealing a non-significant increase in risk below a concentration of approximately 110 mg m^(-3).Low-temperature-exposure residents had a higher risk of mortality associated with long-term O_(3)exposure.This study expands current epidemiological evidence from China and reveals that high-concentration O_(3)exposure curtails the long-term survival of middle-aged and older adults.展开更多
Dear Editor,Given the systemic and substantial health consequences of smoking and the significant cancer risk from smoking[1,2],it is expected that cancer patients would quit smoking after cancer diagnosis.However,the...Dear Editor,Given the systemic and substantial health consequences of smoking and the significant cancer risk from smoking[1,2],it is expected that cancer patients would quit smoking after cancer diagnosis.However,the smoking rate among cancer survivors is only slightly lower than that among the general population[3,4],and 64%of smokers diagnosed with cancer continued to smoke even after they learned they had cancer[5].In addition,some former smokers may resume smoking after surviving cancer[6].A number of previous studies have investigated the association between smoking and clinical outcomes in cancer patients[1,7–10].Nevertheless,most studies were conducted in smoking-related cancers,and evidence for non-smoking-related cancers is limited.There is an urgent need for more convincing evidence showing the harms of smoking and the benefits of smoking cessation to promote smoking cessation in cancer patients and survivors.We systematically studied the associations of smoking status,smoking intensity,age at initiation,and smoking cessation at cancer diagnosis with all-cause mortality in a prospective cohort of 128,423 cancer patients across 23 cancer types from the MD Anderson Cancer Patients and Survivors Cohort.展开更多
基金supported by the National Key R&D Program of China(2021YFC2501500)National Natural Science Foundation of China(82171476)。
文摘Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.
基金Supported by Grants from the National Natural Science Foundation of China(72374180)the Soft Science Research Program of Zhejiang Province(2023KXCX-KT011)+1 种基金the Fundamental Research Funds for the Central Universities,the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province(2020E10004)Zhejiang University Global Partnership Fund.
文摘Assessing individual risks of healthy aging using biomarkers and identifying associated factors have become important areas of research.In this study,we conducted a literature review of relevant publications between 2018 and 2023 in both Chinese and English databases.Previous studies have predominantly used single biomarkers,such as C-reactive protein,or focused on specific life course stages and factors such as socioeconomic status,mental health,educational levels,and unhealthy lifestyles.By summarizing the progress in this field,our study provides valuable insights and future directions for promoting healthy aging from a life course perspective.
基金supported by grants from the National Key Research and Development Program of China(2018YFA0800403 and 2021YFC2701903)the Training Program of the Major Research Plan of the National Natural Science Foundation of China(91857110)+5 种基金the National Natural Science Foundation of China(81670740,82100904,and 32000817)the National Natural Science Fund for Excellent Young Scholars of China(81722012)Zhejiang Provincial Natural Science Foundation of China(LZ21H070001 and LQ21C110001)the Innovative Institute of Basic Medical Sciences of Zhejiang University,the Fundamental Research Funds for the Central Universities,the Construction Fund of Medical Key Disciplines of Hangzhou,Hangzhou Science and Technology Bureau(20150733Q13 and ZD20200129)the Construction Fund of Key Medical Disciplines of Hangzhou(OO20200055)the K.C.Wong Education Foundation.
文摘Exercise intervention at the early stage of type 2 diabetes mellitus(T2DM)can aid in the maintenance of blood glucose homeostasis and prevent the development of macrovascular and microvascular complications.However,the exercise-regulated pathways that prevent the development of T2DM remain largely unclear.In this study,two forms of exercise intervention,treadmill training and voluntary wheel running,were conducted for high-fat diet(HFD)-induced obese mice.We observed that both forms of exercise intervention alleviated HFD-induced insulin resistance and glucose intolerance.Skeletal muscle is recognized as the primary site for postprandial glucose uptake and for responsive alteration beyond exercise training.Metabolomic profiling of the plasma and skeletal muscle in Chow,HFD,and HFD-exercise groups revealed robust alterations in metabolic pathways by exercise intervention in both cases.Overlapping analysis identified nine metabolites,including beta-alanine,leucine,valine,and tryptophan,which were reversed by exercise treatment in both the plasma and skeletal muscle.Transcriptomic analysis of gene expression profiles in the skeletal muscle revealed several key pathways involved in the beneficial effects of exercise on metabolic homeostasis.In addition,integrative transcriptomic and metabolomic analyses uncovered strong correlations between the concentrations of bioactive metabolites and the expression levels of genes involved in energy metabolism,insulin sensitivity,and immune response in the skeletal muscle.This work established two models of exercise intervention in obese mice and provided mechanistic insights into the beneficial effects of exercise intervention on systemic energy homeostasis.
基金supported in part by theCenter for Translational and Public Health Genomics,the University of Texas MD Anderson Cancer Centerthe State of Texas Tobacco Settlement Funds for Patient History Database+2 种基金Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province(2020E10004)Leading Innovative and Entrepreneur TeamIntroduction Programof Zhejiang(2019R01007)and Key Research and Development Program of Zhejiang Province(2020C03002).
文摘The recommendation encouraging patients with cancer to keep a normal body mass index(BMI)is largely extrapolated from data on risk of developing cancer.We tested the prospective association between peri-diagnostic(within 1 year post-diagnosis)BMI and all-cause mortality in patients with incident cancers.During 7.2 years of follow-up,42%(48,340)of the 114430 patients with cancer died.Spline analysis revealed that compared with a BMI of 22.5,a BMI lower than 22.5 was associated with increased risk of all-cause mortality across 24 cancer types.A BMI higher than 22.5 was associated with reduced all-cause mortality,while a non-linear association was observed;the lowest risk was found at a BMI of 29.6–34.2,and the risk started to return to and above unity at very high BMI values.The reduced mortality risk of high BMI was observed in 23 of 24 cancer types and maintained after attempts to remove potential selection bias,confounding by smoking and comorbidities,and reserve causality.
基金supported by National Key Research and Development Programme of China(2018YFC2000400,2018YFC2000400-3,2018YFC2002000)Shanghai Municipal Science and Technology Major Project(2017SHZDZX01).
文摘Owing to the susceptibility of conventional observational studies to confounding factors and reverse causation,the causal association between cardiac function and frailty is unclear.We aimed to investigate whether cardiac function has causal effects on frailty.In this study,a two-sample Mendelian randomization(MR)study was conducted using genetic variants associated with cardiac function assessed by magnetic resonance imaging phenotypes as instrumental variables.Genetic variants asso-ciated with cardiac function by magnetic resonance imaging(including seven cardiac function phenotypes)and the frailty index(FI)were obtained from two large genome-wide association studies.MR estimates from each genetic instrument were combined using inverse variance weighted(IVW),weighted median,and MR‒Egger regression methods.We found that the increase in genetically determined stroke volume(beta-0.13,95%CI-0.16 to-0.10,p=1.39E-6),rather than other cardiac phenotypes,was associated with lower FI in MR analysis of IVW after Bonferroni correction.Sensitivity analyses examining potential bias caused by pleiotropy or reverse causality revealed similar findings(e.g.,intercept[SE],-0.008[0.011],p=0.47 by MR‒Egger intercept test).The leave-one-out analysis indicated that the association was not driven by single nucleotide polymorphisms.No evidence of heterogeneity was found among the genetic variants(e.g.,MR‒Egger:Q statistic=14.4,p=0.156).In conclusion,we provided evidence that improved cardiac function could contribute to reducing FI.These findings support the hypothesis that enhancing cardiac function could be an effective prevention strategy for frailty.
基金supported by the Youth Fund Project of Humanities and Social Sciences Research of the Ministry of Education(Grant No.21YJCZH229).
文摘Emerging epidemiological studies suggest that long-term ozone(O_(3))exposure may increase the risk of mortality,while pre-existing evidence is mixed and has been generated predominantly in North America and Europe.In this study,we investigated the impact of long-term O_(3)exposure on all-cause mortality in a national cohort in China.A dynamic cohort of 20882 participants aged40 years was recruited between 2011 and 2018 from four waves of the China Health and Retirement Longitudinal Study.A Cox proportional hazard regression model with time-varying exposures on an annual scale was used to estimate the mortality risk associated with warm-season(Aprile September)O_(3)exposure.The annual average level of participant exposure to warm-season O_(3)concentrations was 100 mg m^(-3)(range:61 e142 mg m^(-3)).An increase of 10 mg m^(-3)in O_(3)was associated with a hazard ratio(HR)of 1.18(95%confidence interval[CI]:1.13e1.23)for all-cause mortality.Compared with the first exposure quartile of O_(3),HRs of mortality associated with the second,third,and highest exposure quartiles were 1.09(95%CI:0.95e1.25),1.02(95%CI:0.88e1.19),and 1.56(95%CI:1.34e1.82),respectively.A J-shaped concentration eresponse associationwas observed,revealing a non-significant increase in risk below a concentration of approximately 110 mg m^(-3).Low-temperature-exposure residents had a higher risk of mortality associated with long-term O_(3)exposure.This study expands current epidemiological evidence from China and reveals that high-concentration O_(3)exposure curtails the long-term survival of middle-aged and older adults.
基金supported in part by the State of Texas Tobacco Settlement Funds for Patient History Database,Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province(2020E10004)Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang(2019R01007)Key Research and Development Program of Zhejiang Province(2020C03002).
文摘Dear Editor,Given the systemic and substantial health consequences of smoking and the significant cancer risk from smoking[1,2],it is expected that cancer patients would quit smoking after cancer diagnosis.However,the smoking rate among cancer survivors is only slightly lower than that among the general population[3,4],and 64%of smokers diagnosed with cancer continued to smoke even after they learned they had cancer[5].In addition,some former smokers may resume smoking after surviving cancer[6].A number of previous studies have investigated the association between smoking and clinical outcomes in cancer patients[1,7–10].Nevertheless,most studies were conducted in smoking-related cancers,and evidence for non-smoking-related cancers is limited.There is an urgent need for more convincing evidence showing the harms of smoking and the benefits of smoking cessation to promote smoking cessation in cancer patients and survivors.We systematically studied the associations of smoking status,smoking intensity,age at initiation,and smoking cessation at cancer diagnosis with all-cause mortality in a prospective cohort of 128,423 cancer patients across 23 cancer types from the MD Anderson Cancer Patients and Survivors Cohort.
