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  • Oxford University Press (OUP)  (19)
  • Yu, Canqing  (19)
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  • Oxford University Press (OUP)  (19)
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  • 1
    Online Resource
    Online Resource
    Importance of healthy lifestyle factors and ideal cardiovascular health metrics for risk of heart failure in Chinese adults
    Oxford University Press (OUP) ; 2022
    In:  International Journal of Epidemiology Vol. 51, No. 2 ( 2022-05-09), p. 567-578
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 51, No. 2 ( 2022-05-09), p. 567-578
    Abstract: The relative importance of healthy lifestyle factors and cardiovascular health metrics for the risk of heart failure is uncertain in Chinese populations. We aimed to compare the strength of associations between healthy lifestyle factors and ideal cardiovascular health metrics in the risk of heart failure in middle-aged Chinese adults. Methods A healthy lifestyle score (HLS) was constructed using smoking, drinking, physical activity, diet, body mass index and waist circumference, and compared with a more comprehensive set of metrics that included cardiovascular-disease risk biomarkers (blood pressure, blood glucose and blood lipids) in addition to the HLS. This broader set of factors [called ‘ideal cardiovascular health metrics’ (ICVHMs)] was evaluated in 487 197 participants in the China Kadoorie Biobank. Results A total of 4208 incident cases of heart failure were recorded during a median follow-up of 10 years. Both HLS [hazard ratio (HR), 0.88; 95% confidence interval (CI), 0.85, 0.91] and ICVHMs (0.87: 0.84, 0.89) were inversely associated with risk of heart failure (P  & lt; 0.001 for linear trend). Compared with participants with 0–1 HLS, the multivariable-adjusted HR of those with 4–5 HLS was 0.68 (0.59, 0.77). Compared with participants with 0–2 ICVHMs, the adjusted HR (95% CIs) of those who had 7–8 ICVHMs was 0.47 (0.36, 0.60). ICVHMs were more strongly predictive of risk of heart failure (area under curve, 0.61 vs 0.58, P  & lt; 0.001) than healthy lifestyle factors alone. Conclusions Higher levels of healthy lifestyle factors and ICVHMs were each inversely associated with heart failure, and lifestyle factors combined with cardiometabolic factors improved the prediction of heart failure compared with healthy lifestyle factors alone.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyab236
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1494592-7
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  • 2
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    Online Resource
    PCSK9 genetic variants and risk of vascular and non-vascular diseases in Chinese and UK populations
    Oxford University Press (OUP) ; 2024
    In:  European Journal of Preventive Cardiology ( 2024-01-10)
    Details
    In: European Journal of Preventive Cardiology, Oxford University Press (OUP), ( 2024-01-10)
    Abstract: Lowering low-density lipoprotein cholesterol (LDL-C) through PCSK9 inhibition represents a new therapeutic approach to preventing and treating cardiovascular disease (CVD). Phenome-wide analyses of PCSK9 genetic variants in large biobanks can help to identify unexpected effects of PCSK9 inhibition. Methods and results In the prospective China Kadoorie Biobank, we constructed a genetic score using three variants at the PCSK9 locus associated with directly measured LDL-C [PCSK9 genetic score (PCSK9-GS)]. Logistic regression gave estimated odds ratios (ORs) for PCSK9-GS associations with CVD and non-CVD outcomes, scaled to 1 SD lower LDL-C. PCSK9-GS was associated with lower risks of carotid plaque [n = 8340 cases; OR = 0.61 (95% confidence interval: 0.45–0.83); P = 0.0015] , major occlusive vascular events [n = 15 752; 0.80 (0.67–0.95); P = 0.011], and ischaemic stroke [n = 11 467; 0.80 (0.66–0.98); P = 0.029] . However, PCSK9-GS was also associated with higher risk of hospitalization with chronic obstructive pulmonary disease [COPD: n = 6836; 1.38 (1.08–1.76); P = 0.0089] and with even higher risk of fatal exacerbations amongst individuals with pre-existing COPD [n = 730; 3.61 (1.71–7.60); P = 7.3 × 10−4] . We also replicated associations for a PCSK9 variant, reported in UK Biobank, with increased risks of acute upper respiratory tract infection (URTI) [pooled OR after meta-analysis of 1.87 (1.38–2.54); P = 5.4 × 10−5] and self-reported asthma [pooled OR of 1.17 (1.04–1.30); P = 0.0071] . There was no association of a polygenic LDL-C score with COPD hospitalization, COPD exacerbation, or URTI. Conclusion The LDL-C-lowering PCSK9 genetic variants are associated with lower risk of subclinical and clinical atherosclerotic vascular disease but higher risks of respiratory diseases. Pharmacovigilance studies may be required to monitor patients treated with therapeutic PCSK9 inhibitors for exacerbations of respiratory diseases or respiratory tract infections. Lay summary Genetic analyses of over 100 000 participants of the China Kadoorie Biobank, mimicking the effect of new drugs intended to reduce cholesterol by targeting the PCSK9 protein, have identified potential severe effects of lower PCSK9 activity in patients with existing respiratory disease.
    Type of Medium: Online Resource
    ISSN: 2047-4873 , 2047-4881
    URL: Article
    DOI: 10.1093/eurjpc/zwae009
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2646239-4
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  • 3
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    Online Resource
    Prenatal famine exposure, adulthood obesity patterns and risk of type 2 diabetes
    Oxford University Press (OUP) ; 2018
    In:  International Journal of Epidemiology Vol. 47, No. 2 ( 2018-04-01), p. 399-408
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 47, No. 2 ( 2018-04-01), p. 399-408
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyx228
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
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  • 4
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    Lifestyle, cardiometabolic disease, and multimorbidity in a prospective Chinese study
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal Vol. 42, No. 34 ( 2021-09-07), p. 3374-3384
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 42, No. 34 ( 2021-09-07), p. 3374-3384
    Abstract: The potential difference in the impacts of lifestyle factors (LFs) on progression from healthy to first cardiometabolic disease (FCMD), subsequently to cardiometabolic multimorbidity (CMM), and further to death is unclear. Methods and results  We used data from the China Kadoorie Biobank of 461 047 adults aged 30–79 free of heart disease, stroke, and diabetes at baseline. Cardiometabolic multimorbidity was defined as the coexistence of two or three CMDs, including ischaemic heart disease (IHD), stroke, and type 2 diabetes (T2D). We used multi-state model to analyse the impacts of high-risk LFs (current smoking or quitting because of illness, current excessive alcohol drinking or quitting, poor diet, physical inactivity, and unhealthy body shape) on the progression of CMD. During a median follow-up of 11.2 years, 87 687 participants developed at least one CMD, 14 164 developed CMM, and 17 541 died afterwards. Five high-risk LFs played crucial but different roles in all transitions from healthy to FCMD, to CMM, and then to death. The hazard ratios (95% confidence intervals) per one-factor increase were 1.20 (1.19, 1.21) and 1.14 (1.11, 1.16) for transitions from healthy to FCMD, and from FCMD to CMM, and 1.21 (1.19, 1.23), 1.12 (1.10, 1.15), and 1.10 (1.06, 1.15) for mortality risk from healthy, FCMD, and CMM, respectively. When we further divided FCMDs into IHD, ischaemic stroke, haemorrhagic stroke, and T2D, we found that LFs played different roles in disease-specific transitions even within the same transition stage. Conclusion  Assuming causality exists, our findings emphasize the significance of integrating comprehensive lifestyle interventions into both health management and CMD management.
    Type of Medium: Online Resource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehab413
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2001908-7
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  • 5
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    Circulating proteins and risk of pancreatic cancer: a case-subcohort study among Chinese adults
    Oxford University Press (OUP) ; 2022
    In:  International Journal of Epidemiology Vol. 51, No. 3 ( 2022-06-13), p. 817-829
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 51, No. 3 ( 2022-06-13), p. 817-829
    Abstract: Pancreatic cancer has a very poor prognosis. Biomarkers that may help predict or diagnose pancreatic cancer may lead to earlier diagnosis and improved survival. Methods The prospective China Kadoorie Biobank (CKB) recruited 512 891 adults aged 30–79 years during 2004–08, recording 702 incident cases of pancreatic cancer during 9 years of follow-up. We conducted a case-subcohort study measuring 92 proteins in 610 cases and a subcohort of 623 individuals, using the OLINK immuno-oncology panel in stored baseline plasma samples. Cox regression with the Prentice pseudo-partial likelihood was used to estimate adjusted hazard ratios (HRs) for risk of pancreatic cancer by protein levels. Results Among 1233 individuals (including 610 cases), several chemokines, interleukins, growth factors and membrane proteins were associated with risk of pancreatic cancer, with adjusted HRs per 1 standard deviation (SD) of 0.86 to 1.86, including monocyte chemotactic protein 3 (MCP3/CCL7) {1.29 [95% CI (confidence interval) (1.10, 1.51)]}, angiopoietin-2 (ANGPT2) [1.27 (1.10, 1.48)] , interleukin-18 (IL18) [1.24 (1.07, 1.43)] and interleukin-6 (IL6) [1.21 (1.06, 1.38)] . Associations between some proteins [e.g. matrix metalloproteinase-7 (MMP7), hepatocyte growth factor (HGF) and tumour necrosis factor receptor superfamily member 9 [TNFRSF9)] and risk of pancreatic cancer were time-varying, with higher levels associated with higher short-term risk. Within the first year, the discriminatory ability of a model with known risk factors (age, age squared, sex, region, smoking, alcohol, education, diabetes and family history of cancer) was increased when several proteins were incorporated (weighted C-statistic changed from 0.85 to 0.99; P for difference = 4.5 × 10–5), although only a small increase in discrimination (0.77 to 0.79, P = 0.04) was achieved for long-term risk. Conclusions Several plasma proteins were associated with subsequent diagnosis of pancreatic cancer. The potential clinical utility of these biomarkers warrants further investigation.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyab274
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 6
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    Pneumonia hospitalizations and the subsequent risk of incident ischaemic cardiovascular disease in Chinese adults
    Oxford University Press (OUP) ; 2021
    In:  International Journal of Epidemiology Vol. 50, No. 5 ( 2021-11-10), p. 1698-1707
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 50, No. 5 ( 2021-11-10), p. 1698-1707
    Abstract: Acute respiratory infections have been associated with a transient increase in cardiovascular risk. However, whether such an association persists beyond 1 month and the potential modifying effect of cardiovascular risk factors on such an association are less well established. Methods The China Kadoorie Biobank enrolled 512 726 participants aged 30–79 years from 10 areas across China during 2004–2008. By the end of 2017, a total of 5444 participants with new-onset ischaemic heart disease (IHD) and 4846 with ischaemic stroke (IS) who also had at least a record of hospitalization for pneumonia during follow-up were included. We used a self-controlled case-series method and calculated the age- and season-adjusted relative incidences (RIs) and 95% confidence intervals (CIs) for ischaemic cardiovascular disease (CVD) after pneumonia. Results The risk of ischaemic CVD increased during days 1–3 after pneumonia hospitalization, with an RI (95% CI) of 4.24 (2.92–6.15) for IHD and 1.85 (1.02–3.35) for IS. The risk gradually reduced with longer duration since pneumonia hospitalization but remained elevated until days 92–365 for IHD (1.23, 1.12–1.35) and days 29–91 for IS (1.25, 1.05–1.48). Pre-existing cardiovascular risk factors amplified the associations between pneumonia and ischaemic CVD risks, such as chronic obstructive pulmonary disease for both IHD and IS, and diabetes and smoking for IHD (all Pinteraction  & lt; 0.05). Besides, the risk of ischaemic CVD was also higher among the participants aged ≥70 years (Pinteraction  & lt; 0.001 for IHD and 0.033 for IS). Conclusion Among middle-aged and older Chinese adults, pneumonia hospitalization was associated with both short- and long-term increases in ischaemic CVD risk for ≤1 year.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyab039
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 7
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    Solid fuels for cooking and tobacco use and risk of major chronic liver disease mortality: a prospective cohort study of 0.5 million Chinese adults
    Oxford University Press (OUP) ; 2020
    In:  International Journal of Epidemiology Vol. 49, No. 1 ( 2020-02-01), p. 45-55
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 49, No. 1 ( 2020-02-01), p. 45-55
    Abstract: Harmful substances in solid fuel and tobacco smoke are believed to enter the bloodstream via inhalation and to be metabolized in the liver, leading to chronic liver damage. However, little is known about the independent and joint effects of solid fuel use and smoking on risks of chronic liver disease (CLD) mortality. Methods During 2004–08, ∼0.5 million adults aged 30–79 years were recruited from 10 areas across China. During a 10-year median follow-up, 2461 CLD deaths were recorded. Multivariable Cox regression yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the individual associations of self-reported long-term cooking fuel and tobacco use with major CLD death. Results Overall, 49% reported solid fuel use and 26% smoked regularly. Long-term solid fuel use for cooking and current smoking were associated with higher risks of CLD deaths, with adjusted HRs of 1.26 (95% CI, 1.02–1.56) and 1.28 (1.13–1.44), respectively. Compared with never-smoking clean fuel users, the HRs were 1.41 (1.10–1.82) in never-smoking solid fuel users, 1.55 (1.17–2.06) in regular-smoking clean fuel users and 1.71 (1.32–2.20) in regular-smoking solid fuels users. Individuals who had switched from solid to clean fuels (1.07, 0.90–1.29; for median 14 years) and ex-regular smokers who stopped for non-medical reasons (1.16, 0.95–1.43; for median 10 years) had no evidence of excess risk of CLD deaths compared with clean fuel users and never-regular smokers, respectively. Conclusions Among Chinese adults, long-term solid fuel use for cooking and smoking were each independently associated with higher risks of CLD deaths. Individuals who had stopped using solid fuels or smoking had lower risks.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyz216
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 8
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    222Long-term mortality after early famine exposure: findings from the China Kadoorie Biobank
    Oxford University Press (OUP) ; 2021
    In:  International Journal of Epidemiology Vol. 50, No. Supplement_1 ( 2021-09-01)
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 50, No. Supplement_1 ( 2021-09-01)
    Abstract: Previous studies suggested that increased risks of chronic diseases in China might be attributable to early experience of the Chinese Great Famine during last century, but the reliable evidence for adult mortality was rare. This study is to investigate the association of early famine exposure with death risks in the middle age. Methods A number of 94 051 participants from China Kadoorie Biobank were categorized as non-famine births (born between 10/1/1956 and 9/30/1958, and 10/1/1962 and 9/30/1964) and famine births (born between 10/1/1959 and 9/30/1961). The outcomes were total and cause specific mortality. Cox regression was used to estimate hazard ratio (HR) for famine exposure. Results During a median 10.2 years of follow-up, we documented 2802 total deaths in all participants. Prenatal famine exposure was only associated with the risks of ischemic heart disease (IHD) mortality in adulthood (310 deaths, HR [95% CI]: 1.34 [1.02, 1.75] ), compared with non-famine births. We also observed the association of famine with total mortality (HR [95% CI]: 1.42 [1.12, 1.7 8]) in daily alcohol drinkers, but not in non-daily drinkers (P for interaction: 0.025). Conclusions This study indicated that early famine exposure was associated with an increased death risk of heart disease and such risk may be modified by adult alcohol consumption. Key messages Early Chinese famine experience might impact adult IHD deaths. Coexistence of early famine experience and adult alcohol consumption was associated with higher risks of total mortality.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyab168.434
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 9
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    Adherence to a healthy lifestyle and the risk of type 2 diabetes in Chinese adults
    Oxford University Press (OUP) ; 2017
    In:  International Journal of Epidemiology Vol. 46, No. 5 ( 2017-10-01), p. 1410-1420
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 46, No. 5 ( 2017-10-01), p. 1410-1420
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyx074
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
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  • 10
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    Adherence to Healthy Lifestyle and Attenuation of Biological Aging in Middle-Aged and Older Chinese Adults
    Oxford University Press (OUP) ; 2021
    In:  The Journals of Gerontology: Series A Vol. 76, No. 12 ( 2021-11-15), p. 2232-2241
    Details
    In: The Journals of Gerontology: Series A, Oxford University Press (OUP), Vol. 76, No. 12 ( 2021-11-15), p. 2232-2241
    Abstract: Little is known about the effects of lifestyle modification on biological aging in population-based studies of middle-aged and older adults. Method We examined the individual and joint associations of multiple lifestyle factors with accelerated biological aging measured by change in frailty index (FI) over 8 years in a prospective study of Chinese adults. Data were obtained on 24 813 participants in the China Kadoorie Biobank on lifestyle factors and frailty status at baseline and at 8 years after baseline. Adherence to healthy lifestyle factors included nonsmoking or quitting smoking for reasons other than illness, avoidance of heavy alcohol consumption, daily intake of fruit and vegetables, being physically active, body mass index of 18.5–23.9 kg/m2, and waist-to-hip ratio of & lt;0.90 (men)/0.85 (women). FI was constructed separately at baseline and resurvey using 25 age- and health-related items. Results Overall, 8 760 (35.3%) individuals had a worsening frailty status. In multivariable-adjusted logistic regression analyses, adherence to healthy lifestyle was associated with a lower risk of worsening frailty status. Compared with robust participants maintaining 0–1 healthy lifestyle factors, the corresponding odds ratios (95% CIs) were 0.93 (0.83–1.03), 0.75 (0.67–0.84), 0.68 (0.60–0.77), and 0.55 (0.46–0.65) for robust participants with 2, 3, 4, and 5–6 healthy lifestyle factors. The decreased risk of frailty status worsening by adherence to healthy lifestyle factors was similar in both middle-aged and older adults, and in both robust and prefrail participants at baseline. Conclusions Adherence to a healthy lifestyle may attenuate the rate of change in biological aging in middle-aged and older Chinese adults.
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glab213
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2043927-1
    SSG: 12
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