The correlation of brachial ankle pulse wave velocity with arterosclerosis at different estimated levels of glomerular filtration rate / 中华内科杂志

To explore the relationship between brachial ankle artery pulse wave velocity of the (baPWV) in different estimation GFR (eGFR) groups and atherosclerosis.In 2010,2012 and 2014,eGFR and baPWV were detected in 1 427 healthy persons.As eGFR level decreased,baPWV increased accordingly with higher proportion of baPWV ≥1 400 cm/s.The percentage of eGFR lower than 60 ml · min-1 · 1.73 m-2 was similar in subgroups with different baPWV.However,the proportion of eGFR reduction ≥ 30％ decreased according to the elevation of baPWV.Multivariate logistic regression analysis indicated the lower the eGFR,the higher the risk of atherosclerosis.Low eGFR is an independent risk factor for atherosclerosis.

Association between carotid artery plaques and all-cause mortality and cardiovascular events / 中华心血管病杂志

Objective@#To observe the association of carotid artery plaque with all-cause mortality and cardiovascular events.@*Methods@#A total of 7 017 participants who completed the carotid sonography examination between 2010 and 2011 were selected from the stroke and the elderly prospective cohort Kailuan study. The participants of stroke cohort received health examination between 2006 and 2007, and participants of elderly cohort received health examination between 2010 and 2011. All participants were divided into plaque group (3 285 cases) and without plaque group (3 732 cases) according to with or without carotid artery plaque.The all-cause mortality and cardiovascular events were compared between the 2 groups. Multivariate Cox regression analysis was used to identify the association of carotid artery plaque with all-cause mortality and cardiovascular events.@*Results@#(1) There were 4 297 male (61.2%) and 2 720 female (38.8%) in this cohort and participants were (58.1±11.8) years old. Age, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, rates of male, smoking, drinking, history of hypertension and diabetes mellitus were higher in the plaque group than in the without plaque group, and high density lipoprotein cholesterol was lower in the plaque group than in the without plaque group (all P<0.01) at baseline. (2) During a follow-up period of (4.92±0.59) years, the incidence rates of all-cause mortality in the plaque group and without plaque group were 5.5% (180/3 285) and 1.5% (57/3 732) ,respectively (P<0.01) .The incidence rates of cardiovascular events in the plaque group and without plaque group were 3.8% (124/3 285) and 1.4% (52/3 732) , respectively (P<0.01) . (3) Multivariate Cox regression analysis showed that carotid plaque was an independent risk factor of all-cause mortality (HR=1.667, 95%CI 1.160-2.395, P<0.01) and cardiovascular events (HR=1.942, 95%CI 1.312-2.876, P<0.01) after adjusting for age, sex, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, body mass index, total cholesterol,low density lipoprotein cholesterol, high density lipoprotein cholesterol, smoking, drinking, history of hypertension and diabetes mellitus, and use of lipid-regulating drugs.@*Conclusion@#Carotid plaque is an independent risk factor of all-cause mortality and cardiovascular events. Clinical Trial Registration Chinese Clinical Trials Registry, ChiCTR-TNC-11001489.

Association between cumulative exposure to blood pressure and new-onset chronic kidney disease / 中华肾脏病杂志

Objective To investigate the association between cumulative exposure blood to pressure (cum BP) and new-onset chronic kidney disease (CKD).Methods In this prospective cohort study,101 510 employees of Kailuan Group receiving annual health examination during 2006 to 2007 were observed.The participants received the second,third,and fourth annual health examinations during 2008 to 2009,2010 to 2011,and 2012 to 2013 year respectively.Their urinary and serum creatinine were tested,and participants with incomplete SBP,DBP data and CKD were excluded.Further excluding those who somehow failed to take annual health examination,with incomplete data,or new-onset CKD 27 809 participants were selected in the analysis.According to cum BP exposure quintile grouping:Q1 ＜ 3.70 scores;Q2:3.70-6.16 scores;Q3:6.17-8.45 scores;Q4:8.46-10.95scores;Q5 ≥ 10.96 scores.Multivariate Logistic regression was used to analyze the association between cum BP level and new-onset CKD by cum BP exposure quintile grouping.Results The rise of cum BP exposure level caused the increased incidence of CKD.The incidences of CKD in the five quintile groups were 2.59％,3.11％,4.19％,5.81％,and 7.73％ respectively (P＜ 0.01).Compared with Q1 group,multivariate logistic regression analysis showed that after the adjustment of age,gender,education,income,smoking,drinking,BMI,FBG,TC,TG,LDL,HDL,UA and CRP,the incidences of CKD gradually increased in the Q2,Q3,Q4,and Q5 cum BP quintile groups,and OR(95％CI) values were 1.08(0.86-1.35),1.26(1.01-1.58),1.57(1.27-1.95),1.78(1.43-2.21) respectively (P for trend ＜0.01).Similar results were obtained in different genders.For each single point increase of cum BP exposure level,the incidence of CKD increased 6％ in the general population (P for trend ＜ 0.01),increased 8％ in male (P for trend ＜ 0.01),and 3％ in female (P for trend=0.12).Conclusion As the cumulative exposure to blood pressure increases,the risk of CKD incidence rises,especially in men.

The prediction of high-sensitivity C reactive protein for peripheral arterial sclerosis in middle-aged population / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the predictive value of high-sensitivity C reactive protein (hsCRP) in middle-aged population during the peripheral arteriosclerosis.</p><p><b>METHODS</b>Random sampling method was used in the study. In 2006-2007 Kailuan Group health examination of 101,510 employees, using stratified random sampling method to select 5,852 as observational cohort included, in the final with a standard queue 5,440 in December 2009. This study selected to participate in the 2012-2013 health examination cohort as the research object, in accordance with the inclusion criteria ultimately selected survey 3,978, select the epidemiological investigation, physical examination, laboratory testing data analysis. Of the 3 978 subjects, 2,282 were male and 1,696 were female, and the baseline age was (53.80±11.14) years. According to the baseline hsCRP quartile level was divided into four groups for comparison of baseline data, using multiple linear regression analysis between hsCRP and brachial-ankle pulse wave velocity (baPWV). Area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the prediction of hsCRP levels in peripheral arteriosclerosis.</p><p><b>RESULTS</b>With increase of hsCRP levels, the survey of baseline levels of baPWV showed increasing trend, (1,445.49±300.55), (1,494.46±307.94), (1,547.67±320.34), (1,621.32±342.53) cm/s, respectively. Multiple linear regression results showed that age, by logarithmic transformation of hsCRP (lghsCRP) level, systolic blood pressure and fasting blood glucose for each additional unit, baPWV levels were increased 266.47, 58.00, 5.02, 39.79 cm/s (P<0.001), and BMI for each additional unit, baPWV level decreased 9.52 cm/s (P=0.030). The prediction of hsCRP in peripheral artery showed that lghsCRP level of AUC to 0.59 (95% CI: 0.57-0.61), lower than the age and systolic blood pressure predicted value AUC (95% CI) of 0.69 (0.67-0.71), 0.75 (0.73-0.77), respectively.</p><p><b>CONCLUSION</b>The hsCRP level could not predict the peripheral arteriosclerosis alone, and the combined age and systolic blood pressure level could have better predictive value.</p>

Study on the prevalence of metabolic syndrome among diabetic population / 中华流行病学杂志

Objective To observe the prevalence of metabolic syndrome(MS) among people with diabetes.Methods 9 275 diabetic patients (FPG was ≥7.0 mmol/L or FPG＜7.0 mmol/L but diagnosed as diabetes or having history of diabetes,or were under hypoglycemic agents treatment) of 101 510 employees of Kailuan group who took physical check-up between 2006 and 2007,were recruited to take part in this study.Using the latest defined diagnostic criteria on MS from the 2010 hypertension guidelines,prevalence of MS among the population was analyzed,according to age and gender.Multiple logistic regression analysis was used to test the relevant factors of MS.Results There were 6 105 cases with MS among the population with the prevalence as 65.8％ (female:70.0％,male:64.9％).Stratified by age and gender,the prevalence rates of MS among young-age group,middle-age group and elderly group were 59.7％,66.0％ and 68.8％,respectively.The prevalence in males among the three groups was 61.4％,64.9％ and 67.0％,respectively.The prevalence rates in females among the three groups were 50.3％,70.7％ and 78.8％,respectively Stratified by age and gender,the prevalence of waist abnormal in female was the highest (100.0％) in the youth group that with MS.However,the prevalence of dyslipidemia appeared the highest (86.3％) in males.In the elderly group with MS,the prevalence of abnormal blood pressure was the highest in both males and females,up to 96.0％.Results from multi-factor logistic regression analysis showed that cigarette smoking would increase the risk of developing MS in the youth group (OR=1.89,95％CI:1.09-3.28) and the risk of developing MS of man was lower than women in the middle-aged group (OR=0.77,95％ CI:0.67-0.89; OR=0.48,95％ CI:0.35-0.66).Conclusion In the diabetic population,MS prevalence in female appeared to be higher than in males.The prevalence of MS tended to increase with age.Cigarette smoking could increase the risk of MS in the youth group.

Effect of central obesity on the events of new-onset cerebral infarction among type 2 diabetes mellitus patients / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the effect of central obesity on new-onset cerebral infarction events among type 2 diabetes mellitus patients in the Kailuan Group.</p><p><b>METHODS</b>This was a prospective cohort study. In a total of 101 510 employees who had been carried out a healthy examination in Kailuan Group from Jul. 2006 to Oct. 2007. 8 306 type 2 diabetes mellitus patients were selected. According to the baseline waist measurement, the observed population was divided into two groups-with central obesity or without. The total period of follow-up was 38-53 (48.05 ± 3.09) months.</p><p><b>RESULTS</b>1) Mean age, BMI, the levels of SBP, DBP, pulse pressure, FPG, TC, LDL-C, uric acid significant increased in the central obesity group were higher than in the non-obese group (P < 0.01). 2) The incidence of new onset cerebral infarction in obese group was higher than that in the non-obese group (3.1% vs. 1.6%, 6.8%, P < 0.01; 3.3% vs. 1.7%, P < 0.01 in male respectively. 3) Results from the multiple logistic regression analysis showed that, compared with the non-obese group, the obese group had an increase of relative risk (RR) on new onset cerebral infarction events after adjustment on age, gender and other risk factors, with RR value as 2.07 (95%CI:1.39-3.09, P < 0.01).</p><p><b>CONCLUSION</b>Type 2 diabetes mellitus patients with central obesity seemed to have increased the risk of new-onset cerebral infarction events.</p>

On the relationship between the change in waist circumference and new onset of diabetes: Study on a population of Northern China / 中华内分泌代谢杂志

Objective To explore the relationship between the change in waist circumference (WC) and new onset diabetes (NOD) in a population of north China.Methods A total of 101510 subjects took part in the health examination from 2006 to 2007 for the employees of Kailuan Group.89364 subjects with fasting plasma glucose (FPG) ＜7.0 mmol/L,no history of diabetes,with complete data of FPG and WC,and without taking hypoglycemic agents were sclected as the observation cohort.Subjects who did not participate in the health examination from 2010 to 2011 and had incomplete data were finally excluded and thus 58426 subjects were included for final analysis.According to the baseline WC measurement and its quartile in the health examination during 2006 to 2007,the observed population was divided into two groups (obese group and non-obese group) or four groups ( first,second,third,and forth quartile groups).Multiple logistic regression analysis was used to test the relation between the change in WC and NOD.Results ( 1 ) The incidence of NOD in obese group was higher than that in non-obese group (8.02％ vs 3.37％,P＜0.01 ).Along with increasing WC in the 4 quartile groups,the incidence of NOD was progressively increased,being 2.32％,3.62％,5.46％,and 8.89％ respectively in the total population ( 2.84％,3.65％,5.32％,and 8.95％ in male,and 1.50％,3.41％,6.22％,and 8.51％ in female).( 2 ) Multiple logistic regression analysis showed that compared with the first quartile group,the second,third,and forth quartile groups had increased risks of NOD after adjusting age,gender,and other risk factors,the OR value being 1.17,1.47,and 1.95,respectively.After adjusting above factors in different genders,the influence of the second group on NOD in males and females was not significant,however,they still increased the risks of NOD,with the OR value being 1.08,1.36,and 1.90 in male,and 1.35,1.70,and 1.88 in female,respectively.Conclusion The incidence of NOD is increased with increasing WC.