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  • 11
    Online-Ressource
    Online-Ressource
    Gestational hyperglycemia and the risk of cardiovascular diseases among elderly Chinese women: Findings from the REACTION study
    Wiley ; 2021
    In:  Journal of Diabetes Vol. 13, No. 12 ( 2021-12), p. 949-959
    Details
    In: Journal of Diabetes, Wiley, Vol. 13, No. 12 ( 2021-12), p. 949-959
    Kurzfassung: 妊娠高血糖会增加以后患糖尿病的风险。然而，与妊娠高血糖相关的未来心血管疾病(Cardiovascular diseases, CVD)的风险仍然不确定。本研究旨在探讨妊娠高血糖对中国老年女性后续心血管疾病风险的影响及其可能的影响因素。 方法 我们在中国2型糖尿病患者恶性肿瘤发生风险的流行病学(REACTION)研究的老年妇女中开展了一项病例对照研究。研究纳入82名妊娠高血糖女性及410名按年龄和研究中心匹配的对照女性。心血管疾病信息(包括冠心病、中风和心肌梗死)通过调查员辅助的标准化问卷收集。 结果 有妊娠高血糖的女性更容易发生糖尿病 [比值比(Odd ratio, OR)，2.51； 95%可信区间(Confidence interval, CI)，1.50‐4.18] 和CVD(OR，1.98； 95%CI，1.05‐3.74)。即使没有进展为 2 型糖尿病，妊娠高血糖也与 CVD 风险增加相关(OR，2.88；95%CI，1.18‐7.00)。然而，亚组分析表明，与没有妊娠期高血糖或高血压的女性相比，同时有妊娠期高血糖和高血压的女性患心血管疾病的风险更高(OR，3.98；95%CI，1.65‐9.58)，而CVD风险在单纯有妊娠高血糖的女性中没有显著变化(OR，2.15；95%CI，0.71‐6.57)。分层分析表明，在超重/肥胖、缺乏体力活动或饮食不健康的人群中，妊娠高血糖会显著增加CVD风险。 结论 在中国老年女性中，妊娠期高血糖与晚年 CVD 风险增加有关。这种关联与是否发展为糖尿病无关，而可能会受到生活方式和高血压的影响。
    Materialart: Online-Ressource
    ISSN: 1753-0393 , 1753-0407
    URL: Issue
    URL: Article
    DOI: 10.1111/jdb.v13.12
    DOI: 10.1111/1753-0407.13222
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2485432-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 12
    Online-Ressource
    Online-Ressource
    Data_Sheet_1.docx
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-7-26)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-7-26)
    Kurzfassung: Whether longitudinal changes in metabolic status influence the effect of kidney stones on cardiovascular disease (CVD) remains unclarified. We investigated the modification effect of status changes in metabolic syndrome (MetS) in the association of kidney stones with risk of incident CVD events. Methods We performed a prospective association and interaction study in a nationwide cohort including 129,172 participants aged ≥ 40 years without CVDs at baseline and followed up for an average of 3.8 years. Kidney stones information was collected by using a questionnaire and validated by medical records. The repeated biochemical measurements were performed to ascertain the metabolic status at both baseline and follow-up. Results 4,017 incident total CVDs, 1,413 coronary heart diseases (CHDs) and 2,682 strokes were documented and ascertained during follow-up. Kidney stones presence was significantly associated with 44%, 70% and 31% higher risk of CVDs, CHDs and stroke, respectively. The stratified analysis showed significant associations were found in the incident and sustained MetS patients, while no significant associations were found in the non-MetS at both baseline and follow-up subjects or the MetS remission ones, especially in women. For the change status of each single component of the MetS, though the trends were not always the same, the associations with CVD were consistently significant in those with sustained metabolic disorders, except for the sustained high blood glucose group, while the associations were consistently significant in those with incident metabolic disorders except for the incident blood pressure group. We also found a significant association of kidney stone and CVD or CHD risk in the remain normal glucose or triglycerides groups; while the associations were consistently significant in those with incident metabolic disorders except for the incident blood pressure group. We also found a significant association of kidney stone and CVD or CHD risk in the remain normal glucose or triglycerides groups. Conclusions A history of kidney stones in women with newly developed MetS or long-standing MetS associated with increased risk of CVD. The mechanisms link kidney stones and CVD risk in the metabolic and non-metabolic pathways were warranted for further studies.
    Materialart: Online-Ressource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2022.923981
    DOI: 10.3389/fcvm.2022.923981.s001
    Sprache: Unbekannt
    Verlag: Frontiers Media SA
    Publikationsdatum: 2022
    ZDB Id: 2781496-8
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 13
    Online-Ressource
    Online-Ressource
    The Impact of Spousal Diabetes Status and Ideal Cardiovascular Health Metrics on Risk of Incident Diabetes: A Nationwide Prospective Cohort Study
    Elsevier BV ; 2022
    In:  SSRN Electronic Journal
    Details
    In: SSRN Electronic Journal, Elsevier BV
    Materialart: Online-Ressource
    ISSN: 1556-5068
    URL: Article
    DOI: 10.2139/ssrn.4307639
    Sprache: Englisch
    Verlag: Elsevier BV
    Publikationsdatum: 2022
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 14
    Online-Ressource
    Online-Ressource
    Table_1.docx
    Frontiers Media SA ; 2021
    In:  Frontiers in Endocrinology Vol. 12 ( 2021-10-4)
    Details
    In: Frontiers in Endocrinology, Frontiers Media SA, Vol. 12 ( 2021-10-4)
    Kurzfassung: Nationwide studies focusing on the impact of early-onset type 2 diabetes and obesity on the development of cardiovascular diseases (CVD) are limited in China. We aimed to investigate the association between age at diagnosis of type 2 diabetes and the risk of CVD, and to further examine the modifying effect of obesity on this association among Chinese adults. Methods This study included 23,961 participants with previously diagnosed diabetes from a large nationwide population-based cohort study across mainland China. With an interviewer-assisted questionnaire, we collected detailed information on CVDs. Logistic regression analysis was used to evaluate the risk of CVDs associated with age at diagnosis of diabetes. Results Compared with patients with late-onset diabetes (≥60 years), those with earlier-onset diabetes had increased risks for CVD, with adjusted ORs (95% CIs) of 1.72 (1.36-2.17), 1.52 (1.31-1.75) and 1.33 (1.19-1.48) for patients diagnosed aged & lt;40, 40-49 and 50-59 years, respectively. Each 5-year earlier age at diagnosis of type 2 diabetes was significantly associated with 14% increased risk of CVD (OR, 1.14; 95%CI, 1.11-1.18). This association was more prominent for patients with obesity than those with normal body mass index (BMI). Significant interaction was detected between age at diagnosis and BMI categories on CVD risk ( P for interaction=0.0457). Conclusion Early-onset type 2 diabetes was significantly associated with higher risk of CVD, and this association was more prominent among patients with obesity.
    Materialart: Online-Ressource
    ISSN: 1664-2392
    URL: Article
    URL: Article
    DOI: 10.3389/fendo.2021.717069
    DOI: 10.3389/fendo.2021.717069.s001
    Sprache: Unbekannt
    Verlag: Frontiers Media SA
    Publikationsdatum: 2021
    ZDB Id: 2592084-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 15
    Online-Ressource
    Online-Ressource
    Examining the Linear Association Between Blood Pressure Levels and Cardiovascular Diseases in the Absence of Major Risk Factors in China
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation: Cardiovascular Quality and Outcomes Vol. 15, No. 9 ( 2022-09)
    Details
    In: Circulation: Cardiovascular Quality and Outcomes, Ovid Technologies (Wolters Kluwer Health), Vol. 15, No. 9 ( 2022-09)
    Kurzfassung: 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.
    Materialart: Online-Ressource
    ISSN: 1941-7713 , 1941-7705
    URL: Article
    DOI: 10.1161/CIRCOUTCOMES.121.008774
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2022
    ZDB Id: 2453882-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 16
    Online-Ressource
    Online-Ressource
    Blood Pressure Levels, Cardiovascular Events, and Renal Outcomes in Chronic Kidney Disease Without Antihypertensive Therapy: A Nationwide Population-Based Cohort Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hypertension Vol. 80, No. 3 ( 2023-03), p. 640-649
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 80, No. 3 ( 2023-03), p. 640-649
    Kurzfassung: 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.
    Materialart: Online-Ressource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.122.19902
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2023
    ZDB Id: 2094210-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 17
    Online-Ressource
    Online-Ressource
    Isotemporal substitution of different behaviour patterns with the presence of MAFLD in Chinese adults
    Wiley ; 2022
    In:  Liver International Vol. 42, No. 12 ( 2022-12), p. 2683-2695
    Details
    In: Liver International, Wiley, Vol. 42, No. 12 ( 2022-12), p. 2683-2695
    Kurzfassung: 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.
    Materialart: Online-Ressource
    ISSN: 1478-3223 , 1478-3231
    URL: Issue
    URL: Article
    DOI: 10.1111/liv.v42.12
    DOI: 10.1111/liv.15439
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2022
    ZDB Id: 2124684-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 18
    Online-Ressource
    Online-Ressource
    High concentrations of triglycerides are associated with diabetic kidney disease in new‐onset type 2 diabetes in C hina: Findings from the C hina C ardiometabolic D isease and C ancer C ohort ( 4C ) S tudy
    Wiley ; 2021
    In:  Diabetes, Obesity and Metabolism Vol. 23, No. 11 ( 2021-11), p. 2551-2560
    Details
    In: Diabetes, Obesity and Metabolism, Wiley, Vol. 23, No. 11 ( 2021-11), p. 2551-2560
    Kurzfassung: The aims of this study were to evaluate the associations of metabolic abnormalities with incident diabetic kidney disease (DKD) and to explore whether dyslipidaemia, particularly high fasting triglyceride (TG), was associated with the development of DKD. Methods In total, 11 142 patients with new‐onset type 2 diabetes with baseline estimated glomerular filtration rates (eGFR) ≥60 mL/min/1.73 m 2 were followed up during 2011‐2016. Incident DKD was defined as eGFR 〈 60 mL/min/1.73 m 2 at follow‐up. Multiple logistic regression analysis was conducted to explore the relationship of metabolic abnormalities at baseline and at follow‐up with risks of DKD. High TG was defined by TG ≥1.70 mmol/L. Low high‐density lipoprotein cholesterol (HDL‐c) was defined by HDL‐c 〈 1.0 mmol/L for men or 〈 1.3 mmol/L for women. Results Participants who developed DKD had higher levels of waist circumference and systolic blood pressure, and lower levels of HDL‐c at both baseline and follow‐up visits. The DKD group also had higher levels of post‐load plasma glucose and TG at follow‐up. Multivariate logistic regression analysis revealed that both high TG at baseline [odds ratio (OR) = 1.37, p  = .012) and high TG at follow‐up (OR = 1.71, p   〈  .001) were significantly associated with increased risks of DKD. Patients with high TG levels at both baseline and follow‐up had higher risk of DKD compared with constantly normal TG (OR = 1.65, p   〈  .001) after adjustment for covariates. Conclusions In a large population of patients with new‐onset type 2 diabetes, a high TG level was an independent risk factor for the development of DKD. Tight TG control might delay the occurrence of DKD.
    Materialart: Online-Ressource
    ISSN: 1462-8902 , 1463-1326
    URL: Issue
    URL: Article
    DOI: 10.1111/dom.v23.11
    DOI: 10.1111/dom.14502
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2004918-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 19
    Online-Ressource
    Online-Ressource
    Non-alcoholic fatty liver disease, metabolic goal achievement with incident cardiovascular disease and eGFR-based chronic kidney disease in patients with prediabetes and diabetes
    Elsevier BV ; 2021
    In:  Metabolism Vol. 124 ( 2021-11), p. 154874-
    Details
    In: Metabolism, Elsevier BV, Vol. 124 ( 2021-11), p. 154874-
    Materialart: Online-Ressource
    ISSN: 0026-0495
    URL: Article
    DOI: 10.1016/j.metabol.2021.154874
    Sprache: Englisch
    Verlag: Elsevier BV
    Publikationsdatum: 2021
    ZDB Id: 2049062-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 20
    Online-Ressource
    Online-Ressource
    Association Between Insulin Resistance and Cardiovascular Disease Risk Varies According to Glucose Tolerance Status: A Nationwide Prospective Cohort Study
    American Diabetes Association ; 2022
    In:  Diabetes Care Vol. 45, No. 8 ( 2022-08-01), p. 1863-1872
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 45, No. 8 ( 2022-08-01), p. 1863-1872
    Kurzfassung: To investigate whether the association between insulin resistance and cardiovascular disease (CVD) differs by glucose tolerance status. RESEARCH DESIGN AND METHODS We analyzed a nationwide sample of 111,576 adults without CVD at baseline, using data from the China Cardiometabolic Disease and Cancer Cohort Study. Insulin resistance was estimated by sex-specific HOMA of insulin resistance (HOMA-IR) quartiles for participants with normal glucose tolerance, prediabetes, or diabetes, separately, and by 1 SD of HOMA-IR for the overall study participants. We used Cox proportional hazards models to examine the association between insulin resistance and incident CVD according to glucose tolerance status and evaluate the CVD risk associated with the combined categories of insulin resistance and obesity in prediabetes and diabetes, as compared with normal glucose tolerance. Models were adjusted for age, sex, education attainment, alcohol drinking, smoking, physical activity, and diet quality. RESULTS In participants with normal glucose tolerance, prediabetes, and diabetes defined by three glucose parameters, multivariable-adjusted hazard ratios (95% CIs) for incident CVD associated with the highest versus the lowest quartile of HOMA-IR were 1.03 (0.82–1.30), 1.23 (1.07–1.42), and 1.61 (1.30–2.00), respectively; the corresponding values for CVD per 1-SD increase in HOMA-IR were 1.04 (0.92–1.18), 1.12 (1.06–1.18), and 1.15 (1.09–1.21), respectively (P for interaction = 0.011). Compared with participants with normal glucose tolerance, in participants with prediabetes, the combination of the highest HOMA-IR quartile and obesity showed 17% (95% CI 2–34%) higher risk of CVD, while the combination of the lowest two HOMA-IR quartiles and nonobesity showed 15–17% lower risk of CVD. In participants with diabetes, the upper two HOMA-IR quartiles exhibited 44–77% higher risk of CVD, regardless of obesity status. Consistent findings were observed for glucose tolerance status defined by different combinations of glycemic parameters. CONCLUSIONS Glucose intolerance status exacerbated the association between insulin resistance and CVD risk. Compared with adults with normal glucose tolerance, adults with prediabetes who were both insulin resistant and obese exhibited higher risks of CVD, while in adults with diabetes, the CVD risk related to insulin resistance remained, regardless of obesity.
    Materialart: Online-Ressource
    ISSN: 0149-5992
    URL: Article
    DOI: 10.2337/dc22-0202
    Sprache: Englisch
    Verlag: American Diabetes Association
    Publikationsdatum: 2022
    ZDB Id: 1490520-6
    Standort Signatur Einschränkungen Verfügbarkeit
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