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  • 1
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 80, No. 3 ( 2023-03), p. 640-649
    Abstract: High blood pressure (BP) is highly prevalent in patients with chronic kidney disease. However, the thresholds to initiate BP-lowering treatment in this population are unclear. We aimed to examine the associations between BP levels and clinical outcomes and provide evidence on potential thresholds to initiate BP-lowering therapy in people with chronic kidney disease. Methods: This nationwide, multicenter, prospective cohort study included 12 523 chronic kidney disease participants without antihypertensive therapy in mainland China. Participants were followed up during 2011 to 2016 for cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, hospitalized or treated heart failure, and cardiovascular death) and renal events (≥20% decline in the estimated glomerular filtration rate, end-stage kidney disease, and renal death). Results: Overall, 652 cardiovascular events and 1268 renal events occurred during 43 970 person-years of follow-up. We observed a positive and linear relationship between systolic BP and risks of cardiovascular and renal events down to 90 mm Hg, as well as between diastolic BP and risks of renal events down to 50 mm Hg. A J-shaped trend was noted between diastolic BP and risks of cardiovascular events, but a linear relationship was revealed in participants 〈 60 years ( P for interaction 〈 0.001). A significant increase in the risk of cardiovascular and renal outcomes was observed at systolic BP ≥130 mm Hg (versus 90–119 mm Hg) and at diastolic BP ≥90 mm Hg (versus 50–69 mm Hg). Conclusions: In people with chronic kidney disease, a higher systolic BP/diastolic BP level (≥130/90 mm Hg) is significantly associated with a greater risk of cardiovascular and renal events, indicating potential thresholds to initiate BP-lowering treatment.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 2
    In: Journal of Diabetes, Wiley, Vol. 13, No. 12 ( 2021-12), p. 987-997
    Abstract: 2型糖尿病的诊断年龄在全球及中国呈年轻化的趋势。目前较少研究糖尿病诊断年龄与白蛋白尿患病风险的相关性。本研究拟探讨糖尿病诊断年龄是否为白蛋白尿风险相关的独立危险因素。 方法 我们使用了来自中国大陆207961名研究对象的全国多中心研究数据。从年龄、性别和研究中心匹配的非糖尿病人群中随机选择正常对照, 另外对已诊断糖尿病患者的病程进行匹配, 最终共有31366 名新诊断2型糖尿病患者和 31366名正常对照, 及7490名已诊断2型糖尿病和7490名正常对照纳入分析。使用多元Logistic回归分析在不同糖尿病诊断年龄层中2型糖尿病患者与正常对照患白蛋白尿的风险。 结果 虽然年龄越大, 白蛋白尿患病风险越高, 但是2型糖尿病患者与正常对照组白蛋白尿的比值比随着诊断年龄的增加而降低。与正常对照组相比, 年龄 〈 50、50‐59、60‐69 或≥70 岁诊断为糖尿病的患者经过多变量校正后白蛋白尿风险仍然增加, 新诊断糖尿病分别增加了 81%、60%、45% 和 33%, 已诊断糖尿病分别增加了 135%、121%、90% 和 58%。 结论 在中国成人中, 2型糖尿病诊断年龄越低, 其白蛋白尿风险升高越明显。
    Type of Medium: Online Resource
    ISSN: 1753-0393 , 1753-0407
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2485432-3
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  • 3
    In: Diabetes & Metabolism, Elsevier BV, Vol. 49, No. 2 ( 2023-03), p. 101420-
    Type of Medium: Online Resource
    ISSN: 1262-3636
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2049824-X
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  • 4
    In: The Lancet Regional Health - Western Pacific, Elsevier BV, Vol. 20 ( 2022-03), p. 100350-
    Type of Medium: Online Resource
    ISSN: 2666-6065
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 3052289-4
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  • 5
    In: Circulation: Cardiovascular Quality and Outcomes, Ovid Technologies (Wolters Kluwer Health), Vol. 15, No. 9 ( 2022-09)
    Abstract: Many studies demonstrate a J-shaped association between blood pressure and cardiovascular diseases (CVDs), but the findings are plagued by confounding from other traditional cardiovascular risk factors (CVRFs). Our aims were to examine the associations of systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels with CVD in individuals without major CVRFs and whether there were thresholds for the association. Methods: In the 4C study (China Cardiometabolic Disease and Cancer Cohort), 36 042 CVRF-free participants without CVD, diabetes, dyslipidemia, hypertension, or smoking were identified during 2011 to 2012. Among CVRF-free participants, 17 476 CVRF-preferable individuals with better glycemic (fasting glucose, 〈 110 mg/dL; 2-hour post-load glucose, 〈 140 mg/dL) and lipid profile (total cholesterol, 〈 200 mg/dL; LDL [low-density lipoprotein] cholesterol, 〈 130 mg/dL) were selected. The total person-years of follow-up for CVRF-free subjects and CVRF-preferable subjects were 130 147 and 63 573 person-years, respectively. Information on the development of major CVDs was collected during 2014 to 2016. Cox proportional hazard models were performed to estimate the risks for incident CVD by SBP and DBP groups, respectively. Results: We found that both baseline SBP and DBP presented significantly linear associations with CVD risks in CVRF-free and CVRF-preferable participants. There is significant increase in the CVD risk among CVRF-free participants with baseline SBP level of 110 to 119 mm Hg (hazard ratio, 1.79 [95% CI, 1.19–2.71]), 120 to 129 mm Hg (hazard ratio, 2.03 [95% CI, 1.36–3.03] ), and 130 to 139 mm Hg (hazard ratio, 2.15 [95% CI, 1.40–3.28]) compared with SBP 〈 110 mm Hg. Significant increases were also observed for DBP level of 80 to 89 mm Hg (hazard ratio, 1.43 [95% CI, 1.03–1.97]) compared with DBP 〈 70 mm Hg. Similar results were observed in CVRF-preferable participants. Conclusions: SBP and DBP with levels currently considered normal were significantly and linearly associated with incident CVD without thresholds above 110/70 mm Hg among Chinese adults without major CVRFs.
    Type of Medium: Online Resource
    ISSN: 1941-7713 , 1941-7705
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2453882-6
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  • 6
    In: International Journal of Cancer, Wiley, Vol. 150, No. 7 ( 2022-04), p. 1091-1100
    Abstract: Biomarkers for early detection of pancreatic cancer are in urgent need. To explore systematic circulating metabolites unbalance and identify potential biomarkers for pancreatic cancer in prospective Chinese cohorts, we conducted an untargeted metabolomics study in subjects with incident pancreatic cancer and matched controls (n = 192) from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. We characterized 998 metabolites in baseline serum and calculated 156 product‐to‐precursor ratios based on the KEGG database. The identified metabolic profiling revealed systematic metabolic network disorders before pancreatic cancer diagnosis. Forty‐Five metabolites or product‐to‐precursor ratios showed significant associations with pancreatic cancer ( P   〈  .05 and FDR  〈  0.1), revealing abnormal metabolism of amino acids (especially alanine, aspartate and glutamate), lipids (especially steroid hormones), vitamins, nucleotides and peptides. A novel metabolite panel containing aspartate/alanine (OR [95% CI]: 1.97 [1.31‐2.94] ), androstenediol monosulfate (0.69 [0.49‐0.97]) and glycylvaline (1.68 [1.04‐2.70] ) was significantly associated with risk of pancreatic cancer. Area under the receiver operating characteristic curves (AUCs) was improved from 0.573 (reference model of CA 19‐9) to 0.721. The novel metabolite panel was validated in an independent cohort with AUC improved from 0.529 to 0.661. These biomarkers may have a potential value in early detection of pancreatic cancer.
    Type of Medium: Online Resource
    ISSN: 0020-7136 , 1097-0215
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 218257-9
    detail.hit.zdb_id: 1474822-8
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  • 7
    In: Diabetes Care, American Diabetes Association, Vol. 43, No. 8 ( 2020-08-01), p. 1902-1909
    Abstract: We aim to investigate the impact of ideal cardiovascular health metrics (ICVHMs) on the association between famine exposure and adulthood diabetes risk. RESEARCH DESIGN AND METHODS This study included 77,925 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study who were born around the time of the Chinese Great Famine and free of diabetes at baseline. They were divided into three famine exposure groups according to the birth year, including nonexposed (1963–1974), fetal exposed (1959–1962), and childhood exposed (1949–1958). Relative risk regression was used to examine the associations between famine exposure and ICVHMs on diabetes. RESULTS During a mean follow-up of 3.6 years, the cumulative incidence of diabetes was 4.2%, 6.0%, and 7.5% in nonexposed, fetal-exposed, and childhood-exposed participants, respectively. Compared with nonexposed participants, fetal-exposed but not childhood-exposed participants had increased risks of diabetes, with multivariable-adjusted risk ratios (RRs) (95% CIs) of 1.17 (1.05–1.31) and 1.12 (0.96–1.30), respectively. Increased diabetes risks were observed in fetal-exposed individuals with nonideal dietary habits, nonideal physical activity, BMI ≥24.0 kg/m2, or blood pressure ≥120/80 mmHg, whereas significant interaction was detected only in BMI strata (P for interaction = 0.0018). Significant interactions have been detected between number of ICVHMs and famine exposure on the risk of diabetes (P for interaction = 0.0005). The increased risk was observed in fetal-exposed participants with one or fewer ICVHMs (RR 1.59 [95% CI 1.24–2.04]), but not in those with two or more ICVHMs. CONCLUSIONS The increased risk of diabetes associated with famine exposure appears to be modified by the presence of ICVHMs.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
    detail.hit.zdb_id: 1490520-6
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  • 8
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 107, No. 1 ( 2022-01-01), p. e84-e94
    Abstract: Diabetes, hypertension and dyslipidemia accelerates the incidence of cardiovascular disease (CVD) events. However, data regarding the association between main cardiometabolic morbidities such as diabetes, hypertension, and dyslipidemia and the subsequent risk of CVD events in Chinese adults are still limited. Objective To investigate the associations between individual and combined cardiometabolic morbidities and incident cardiovascular events in Chinese adults. Methods Baseline data were obtained from a prospective, nationwide, and population-based cohort study in China during 2011–2012. A total of 133 572 participants aged ≥40 years were included in the study. The main outcome measures were CVD events. Results Compared with participants without diabetes, hypertension and dyslipidemia, participants with only diabetes (hazard ratio [HR], 1.58; 95% CI, 1.32-1.90) or only hypertension (2.04; 1.82-2.28) exhibited significantly higher risk for CVD events, while participants with only dyslipidemia (0.97; 0.84-1.12) exhibited no significantly higher risk for CVD events. When analyzed collectively, participants with diabetes plus hypertension (HR, 2.67; 95% CI, 2.33-3.06), diabetes plus dyslipidemia (1.57; 1.32-1.87), and hypertension plus dyslipidemia (2.12; 1.88-2.39) exhibited significantly higher risk for CVD. Moreover, participants with the combination of diabetes, hypertension, and dyslipidemia exhibited the highest risk for CVD events (HR, 3.06; 95% CI, 2.71-3.46). Multivariable-adjusted HRs (95% CIs) for CVD associated with diabetes based on fasting glucose ≥7.0 mmol/L, oral glucose tolerance test 2-hour glucose ≥11.1 mmol/L, and hemoglobin A1c ≥6.5% were 1.64 (1.51-1.78), 1.57 (1.45-1.69), and 1.54 (1.42-1.66), respectively; associated with hypertension based on systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg were 1.89 (1.76-2.03) and 1.74 (1.60-1.88), respectively; associated with dyslipidemia based on total cholesterol ≥6.22 mmol/L, low-density lipoprotein cholesterol ≥4.14 mmol/L, high-density lipoprotein cholesterol & lt;1.04 mmol/L, and triglycerides ≥2.26 mmol/L were 1.18 (1.08-1.30), 1.30 (1.17-1.44), 1.00 (0.92-1.09), and 1.10 (1.01-1.20), respectively. Conclusion Diabetes, hypertension and dyslipidemia showed additive associations with the risk of CVD events in middle-aged and elderly Chinese adults.
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    RVK:
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2022
    detail.hit.zdb_id: 2026217-6
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  • 9
    In: Liver International, Wiley, Vol. 42, No. 12 ( 2022-12), p. 2683-2695
    Abstract: Lack of physical activity and excessive sitting time contributed to ectopic fat accumulation, especially in the liver. Previous studies have illustrated the harm of sedentary behaviour and the benefits of physical activity on fatty liver disease. We aimed to explore the association between the behaviour patterns and the risk of metabolic dysfunction‐associated fatty liver disease (MAFLD) using isotemporal substitution model to examine the effect of replacing one behaviour to another while keeping the total time and other behaviours fixed among Chinese middle‐aged and elderly population. Methods This study included 161 147 participants aged ≥40 years old from the nationwide, population‐based cohort of the REACTION study. The International Physical Activity Questionnaire was used to measure self‐reported time for sleeping, sitting, walking and moderate‐to‐vigorous physical activity (MVPA). MAFLD was defined by evidence of fatty liver index (FLI) ≥ 60 in addition to one of the following three patterns, namely overweight/obesity, presence of diabetes, or evidence of metabolic dysregulation. Isotemporal substitution models using logistic regression models to evaluate the association of replacement of different behaviour patterns with each other and the risk of MAFLD. Results Substitution of 60 minutes per day of sleeping, walking or total MVPA for sitting was associated with a 2%–8% reduction of MAFLD risk in overall participants. In employed individuals, replacing sitting time with occupational MVPA or nonoccupational MVPA both could bring benefits to liver steatosis. Stratified analysis found that replacing 60 minutes of sitting time with an equivalent time of other behaviour pattern could reduce approximately 8% of the risk among MAFLD participants with metabolic abnormalities. Such a relationship might be explained by the important mediated role of metabolic elements, such as waist circumference, body mass index, triglycerides and homoeostasis model assessment of insulin resistance. Furthermore, replacing sitting with MVPA showed a stronger association among participants who got enough sleep (sleep duration ≥7 hours per day). Conclusion Replacing sitting with other behaviour patterns could reduce the prevalence of MAFLD, and such substitution effect was much remarkably in individuals with abnormal metabolic status. Observably, obese individuals were more likely to benefit from appropriate changes in behaviour patterns. Moreover, the analysis of sleep duration stratification appealed that the adequacy of individual sleep duration also had a significant impact on the substitution effect. It is worth noting that adjusting the time allocation of behaviour patterns might have a beneficial impact on liver‐metabolic health, and these findings might help us better recognize the importance of reasonable arrangement of behaviour patterns according to the individual's situation.
    Type of Medium: Online Resource
    ISSN: 1478-3223 , 1478-3231
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2124684-1
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  • 10
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 5, No. 7 ( 2016-07-06)
    Abstract: Chronic kidney disease ( CKD ) increases cardiovascular disease ( CVD ) risk. However, the association of mildly reduced kidney function with CVD risk is unclear. Methods and Results This study investigated the association of estimated glomerular filtration rate ( eGFR ) with prevalent CVDs, 10‐year Framingham risk for coronary heart disease ( CHD ), and 10‐year risk of atherosclerotic cardiovascular diseases ( ASCVD ) in 239 832 participants from the baseline of the Risk Evaluation of cA ncers in Chinese diabeTic Individuals: a lON gitudinal study. With an interviewer‐assisted questionnaire, we collected information on CVD , including reported CHD , stroke, or myocardial infarction. Chronic Kidney Disease–Epidemiology Collaboration ( CKD ‐ EPI ) equation was used to calculate eGFR . Compared with individuals with normal eGFR (≥90 mL/min per 1.73 m 2 ), those with decreased eGFR (75–89, 60–74, and 〈 60 mL/min per 1.73 m 2 ) had higher risk of prevalent obesity, diabetes mellitus, hypertension, and dyslipidemia in both men and women ( P for trend all 〈 0.001). Moreover, a significantly higher 10‐year Framingham risk for CHD and 10‐year risk for ASCVD was observed in both men and women with mildly decreased eGFR (60–89 mL/min per 1.73 m 2 ). Conclusions Even mildly reduced eGFR (under 90 mL/min per 1.73 m 2 ) is associated with elevated 10‐year Framingham risk for CHD and 10‐year ASCVD risk among Chinese adults.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2653953-6
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