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Objective:To explore the association between dietary patterns and the incidence of type 2 diabetes mellitus(T2DM), so as to provide insights for the prevention and management of T2DM.Methods:Participants were recruited from the " The Tianjin Chronic Inflammation and Health Cohort Study(TCLSIH)" cohort study from 2013 to 2018, who had completed the modified semiquantitative food frequency questionnaire(FFQ) and blood glucose testing( n=26 425), free of cardiovascular disease, cancer, or diabetes at baseline. The relevant information collected includes food frequency, blood glucose concentration, and other confounding factors. In this study, the correlation between dietary patterns and T2DM was tested using Cox proportional risk regression model, and the gender stratification analysis and body mass index stratification analysis of different gender groups were carried out. All statistical analysis was performed using SAS 9.3 software. Results:The age of all participants was (41.0±11.5)years, and the cumulative incidence was 3.84% for T2DM. The cumulative incidence of T2DM in male population was 5.29%, while that in female population was 2.16%. There were significant differences in the incidence of T2DM among different genders( P <0.001). The multivariable-adjusted hazard ratios( HR) and corresponding 95% CI of T2DM across the plant-based dietary pattern score were 1.09(95% CI 0.91-1.31), 0.80(95% CI 0.66-0.97), and 0.76(95% CI 0.62-0.94; Ptrend =0.010). Moreover, no statistically significant differences were observed between animal and traditional northern Chinese diets with the incidence of T2DM. Conclusions:The plant-based dietary patterns were associated with substantially lower risk of developing T2DM, and there were no significant association between animal and traditional northern Chinese dietary patterns with T2DM. Plant-based dietary patterns characterized by a variety of fruit, leeks, onions, seaweed may be beneficial to the prevention and control of T2DM.
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Objective:Investigate the relationship between dietary patterns and sarcopenia in a Chinese elderly population.Methods:Participants in this cross-sectional study were recruited from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. The study population comprised 2 423 participants, with mean age of (67.6±5.2) years. Sarcopenia was defined based on the guidelines of the Asian Working Group for Sarcopenia. Three dietary patterns were derived by factor analysis: fruit and sweet pattern, traditional oriental pattern, and animal food pattern. The association between quartile categories of dietary pattern scores and the presence of sarcopenia was analyzed using multiple logistic regression models. Odds ratios ( OR) and 95% confidence interval ( CI) were calculated. Results:The prevalence of sarcopenia was 16.1%. After adjusting for confounding factors, compared with the lowest quartile, the adjusted OR ( 95%CI) of sarcopenia for the highest quintile of Fruit and sweet pattern score, Traditional oriental pattern score and Animal food pattern score were 1.06 (0.74, 1.50), 0.54 (0.34, 0.86), and 0.50 (0.33, 0.74), ( P for trend were 0.87,<0.01, and<0.001), respectively. Conclusions:The current study found that the traditional oriental pattern and animal food pattern has a protective relation for sarcopenia in elderly adults, which suggests its potential to attenuate or prevent the progression of sarcopenia.
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Objective:To access the independent associations between serum ferritin quintile levels and metabolic syndrome (MS) in adults of different genders.Methods:19 563 participants over the age of 18 years were recruited from "TCLSIH Cohort Study" from 2007 to 2015. Serum ferritin concentration was measured by Enzyme-linked immunoassay, while metabolic syndrome was diagnosed according to MS diagnostic criteria formulated by Chinese Diabetes Society in 2013. Multiple logistic regression analysis was used to assess the association between serum ferritin quintile levels and the prevalence of MS in males and females. Results:After adjusting the confounding factors, the overall prevalence of MS gradually increased with the increasing of serum ferritin levels, similar results were observed in males and females. Subjects were divided into 5 subgroups according to serum ferritin levels. Compared with level 1 group, logistic regression showed that the serum ferritin quintiles of males and females ranged from low to high, the OR (95% confidence interval) for metabolic syndrome were 1.142 (0.998, 1.307), 1.382 (1.210, 1.579), 1.680 (1.472, 1.917), 2.085 (1.827, 2.380), respectively ( Ptrend<0.01), and 1.147 (0.911, 1.444), 1.346 (1.075, 1.687), 1.567 (1.268, 1.941), 2.444 (1.981, 3.023), respectively ( Ptrend<0.01). Conclusion:The elevated ferritin levels were positively related to the prevalence of metabolic syndrome in adults of different genders.
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Objective To evaluate the prediction value of serum uric acid level in the occurrence of multiple metabolic disorders.Methods The subjects are from the Health Management Centre,Tianjin Medical University General Hospital.Four kinds of metabolic diseases,namely type 2 diabetes mellitus,hypertension,hyperlipidemia,and nonalcoholic fatty liver disease (NAFLD),were analyzed by four-cohort analysis.Sample sizes were 56 915,47 387,31 431,and 35 203.The average follow-up time for each cohort was (3.56±2.32),(3.31±2.24),(2.70±1.95),(2.90± 1.76) years,respectively.In each cohort,the population was divided into two groups,depending on the occurrence of type 2 diabetes,hypertension,hyperlipidemia,and NAFLD during follow-up.All relevant variables were tested for baseline and follow-up,including laboratory tests,lifestyle questionnaire,and physical examination.Statistical analysis by Cox proportional hazard regression model was performed for the relationships between the fifth percentile of the distribution of serum uric acid levels and incidence of type 2 diabetes,hypertension,hyperlipidemia,and NAFLD.Results During the follow-up period,the incidence of type 2 diabetes,hypertension,hyperlipidemia,and NAFLD were 3.5％,17.6％,33.4％,and 15.7％,respectively.After adjustment for confounding factors,with the increase in serum uric acid level,the hazard ratios (95％CI) of type 2 diabetes were 1.00,0.82 (0.70,0.95),0.80 (0.69,0.92),0.77 (0.67,0.88),and 0.83 (0.72,0.95) (P=0.02).Meanwhile,higher risk of hypertension,hyperlipidemia,and NAFLD were associated with elevated serum uric acid level.In the group with the highest serum uric acid level in each cohort,the hazard ratio (95％CI) of hypertension,hyperlipidemia,and NAFLD were 1.17 (1.09,1.25),1.20 (1.13,1.28),and 1.56 (1.43,1.70),respectively (P＜ 0.01),as compared to the group with the lowest level.Conclusion Serum uric acid levels have a positive predictive value for the occurrence of hypertension,hyperlipidemia,and NAFLD,but have a negative predictive value for type 2 diabetes.
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Objective To investigate the relationship between white blood cell count (WBC) and the prevalence of simple fatty liver disease (SFL) and nonalcoholic steatohepatitis (NASH). Methods We designed a large scale cross-sectional study in an adult population. Participants were selected from Tianjin Medical University's General Hospital-Health Management Centre. The diagnoses of simple fatty liver disease and nonalcoholic steatohepatitis were based on liver ultrasonography and serum alanine aminotransferase concentration. A total of 37507 subjects (8644 SFL and 2557 NASH) were included in this study. Multiple logistic regression analysis was used to assess whether the quartiles of WBC were associated with the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Results After adjusting for potential confounders, the odds ratios (95% confidence interval) of simple fatty liver disease and nonalcoholic steatohepatitis for increasing quartiles of WBC were: simple fatty liver disease, 1.00 (reference), 1.37 (1.24, 1.50), 1.70 (1.55, 1.86) and 2.09 (1.90, 2.29) (P for trend<0.0001);nonalcoholic steatohepatitis, 1.00 (reference), 1.39 (1.16, 1.66), 1.69 (1.43, 1.99) and 2.13 (1.81, 2.50) (P for trend<0.0001). Conclusions This study proves the correlation between WBC and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Further study is needed to clarify whether WBC has a predictive value for the occurrence of nonalcoholic fatty liver disease.
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Objective To investigate the relationships between different dietary patterns and serum uric acid in Tianjin residents. Method By cross-sectional study design, 11282 subjects were studied via lifestyle questionnaires (including a valid food frequency questionnaire), physical examination and laboratory tests. Using factor analysis method to establish the dietary patterns, and relationships between different dietary patterns and serum uric acid were analyzed. Results Factor analysis showed 3 kinds of dietary patterns, including eastern dietary pattern, vegetable diets and Tianjin dietary pattern. There were more males in hyperuricemic population, who have a higher BMI, waist circumference, blood lipids, blood pressure and blood sugar levels, and also higher proportion of metabolic syndrome, smokers and alcohol drinkers. In addition, hyperuricemia patients had a higher level of social status and income. After adjustments for age, sex, BMI, smoking habits, alcohol consumption, hypertension, hyperlipidemia, education level, occupational status, energy intake, physical activity and metabolic syndrome, logistic regression analysis showed the odds ratio (95%confidence interval) for hyperuricemia across the quartiles of 3 dietary patterns as follows: 1.00, 1.07 (0.91, 1.25), 0.96 (0.82, 1.14), 1.12 (0.94, 1.33);1.00, 1.03 (0.88, 1.21), 1.04 (0.88, 1.23), 1.00 (0.84, 1.19); 1.00, 1.28 (1.08, 1.52), 1.40 (1.22, 1.71), 1.37 (1.15, 1.63), respectively. Significantly positive correlation was shown between Tianjin dietary pattern and hyperuricemia. Conclusion Tianjin residents' Tianjin dietary pattern is closely related to serum uric acid levels. Tianjin dietary patterns have characteristics of high calorie, high fat, high protein. Healthy eating habits have significant importance to prevent occurrence of hyperuricemia.
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Objective To explore the association between the infection rate of Helicobacter pylori (Hp) and intake frequency of capsicum in dietary pattern. Methods A total of 914 health check-up participants were recruited from Tianjin Medical University General Hospital (male: 510,female:404). All participants were asked about the intake frequency of capsicum. Diagnostic criteria of the Hp infection included positive C13 breath test. Results The intake frequency of capsicum was ≥2 times/week, 1 time/week and <1 time/week. The infection rate of Hp was 56.08%, 49.04% and 48.29%. After adjusting for covariates, compared with the≥2 times/week, the odds ratios(95%confidence interval)of intake frequency of capsicum 1 time/week and <1 time/week: the frequency of capsicum intake ≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 0.57(0.33-0.97) and the frequency of capsicum intake<1 time/week was 0.69(0.42-1.14) in men;the frequency of capsicum intake≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 1.01(0.54-1.88), and the frequency of capsicum intake<1 time/week was 0.71(0.41-1.23) in women. Conclusions This study found that food intake frequency of capsicum≥2 times/week was associated with the infection rate of Hp in men. But similar relationship was not observed in women.
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Objective To evaluate whether serum complement C3 concentration was associated with the prevalence and incidence of prediabetes in an adult population. Methods A cross-sectional (n=10 539) and prospective cohort (n=3 064, followed up for-6 years, mean:2.8 y) study was performed on subjects recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin. Measurements of serum C3 concentration, blood fasting glucose and other potential confounding factors were assessed at baseline and per year during the follow-up period. Prediabetes was defined according to the criteria of American Diabetes Association. Adjusted Logistic and Cox proportional hazards regression models were used to assess the associations between C3 quintiles and prediabetes. Results The prevalence and incidence of prediabetes were 19.9% and 99.5 per 1 000 person-year, respectively. In cross-sectional analysis, after adjusted for potential confounders, the odds ratios (95% confidence interval) of prediabetes for increasing quintiles of C3 were 1.00 (reference), 1.18 (0.98-1.42), 1.11 (0.92-1.34), 1.38 (1.15-1.65) and 1.63 (1.36-1.95) (P for trend<0.000 1). In cohort analysis, in the final multivariate models, the hazard ratios (95% confidence interval) for prediabetes across C3 quintiles were 1.00 (reference), 1.20 (0.94-1.54), 1.48 (1.16-1.88), 1.38 (1.09-1.76) and 1.53 (1.21-1.95) (P for trend <0.001), respectively. Conclusion The study suggests that the elevated C3 level is significantly associated with the prevalence and incidence of prediabetes, which means that C3 can be used as a biomarker in early prevention of prediabetes and diabetes.
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Objective To explore the association between complement C3 and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Methods A total of 2 799 health check-up participants were recruited from Tianjin Medical University General Hospital-Health Management Centre. Serum C3 levels were measured using immunoturbidimetry method and simple fatty liver disease and nonalcoholic steatohepatitis were diagnosed by liver ultrasonography and serum alanine aminotransferase concentration. Multiple logistic regression analysis was used to examine the association between quartiles of serum C3 levels and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Results After adjusting for covariates, the odds ratios (95% confidence interval) of simple fatty liver disease and nonalcoholic steatohepatitis for increasing quartiles of C3 were: 1.00 (reference), 2.15 (1.55, 3.01), 3.28 (2.35, 4.6) and 4.31 (3.11, 6.02); and 1.00 (reference), 4.54 (1.68, 15.91), 7.81 (3.02, 26.67) and 14.91 (5.94, 50.14) (both P for trend<0.000 1), respectively. Conclusions The study found that the elevated C3 levels were significantly associated with the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Further study is needed to clarify whether C3 has a predictive value for the occurrence of nonalcoholic fatty liver disease.
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Objective The aim of this study was to investigate the relationship between serum C-reactive protein (CRP) and muscle strength, physical performance in the elderly. Methods A cross-sectional study was conducted in Hangu district of Tianjin from April to June in 2013. Totally 1 131 subjects aged 60 years or older completed the survey. Every subject filled out a standard questionnaire and underwent grip strength test, timed up and go test (TUGT). Serum CRP concentrations were determined using chemiluminescent immunoassay kits. Multivariate analysis was performed to determine the relationship between CRP and muscle strength, physical performance. Results After adjustment for potential confounding factors including age, BMI, smoking status, drinking status, hypertension, diabetes, cardiovascular disease, anemia, cancer and physical activity, the multiple linear regression analysis suggested that CRP levels were inversely related to handgrip strength (β'=-0.11, P<0.01), and the logistic regression analysis showed that compared with subjects in the lowest quintile, the odds ratios and 95%confidence interval of higher quintile of CRP were 1.09 (0.50, 2.39) and 2.70 (1.34, 5.66) (Ptrend<0.05) in males. However, the relationship between CRP and muscle strength, physical performance was not statistically significant in females. Conclusions In males, higher serum CRP levels were independently correlated with lower muscle strength and poor physical performance in older adults. These results suggested that inflammation-signaling pathways may play an important role in the progression of sarcopenia.
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Objective Neutrophil/lymphocyte ratio (NLR) is a simple and reliable inflammation biomarker but few studies have assessed the relationship between NLR and hypertension in Chinese population. In order to evaluate how NLR is related to the incidence of hypertension, we designed a large scale prospective cohort study in an adult population. Method Participants were recruited from Tianjin Medical University's General Hospital?Health Management Centre. Hypertension?free subjects (men, 13 638;women,15 212) were followed up for a median of 2.7 years. Adjusted Cox proportional hazards regression models were used to assess relationships between the quintiles of NLR and the incidence of hypertension. Result During the follow-up period, 1 348 subjects in men and 476 subjects in women developed hypertension. The hazard ratios of hypertension incidence were evaluated in increasing NLR quintiles both in men and women. In the final multivariate models, the hazard ratios (95% confidence interval) for hypertension across NLR quintiles were 1.00 (Reference), 1.05 (0.87, 1.26), 1.02 (0.85, 1.22), 1.07 (0.90, 1.29) and 1.22 (1.03, 1.45) (P for trend=0.01), in men;1.00 (Reference), 1.11 (0.82, 1.49), 0.79 (0.58, 1.08), 1.13 (0.85, 1.52) and 1.25 (0.94, 1.66) (P for trend=0.07), in women, respectively. Conclusion This study showed that the elevated NLR levels were significantly related to an increased risk of developing hypertension in men, but not in women.
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Objective Neutrophil/lymphocyte ratio (NLR) is an easy-to-analyze inflammation biomarker but few studies have assessed the relationship between NLR and type 2 diabetes. In order to evaluate how NLR is related to type 2 diabetes, we designed a large scale cross?sectional study in an adult population. Method A cross?sectional study (including 49 861 men and 40 376 women) was conducted on participants recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin, China. Measurements of neutrophil and lymphocyte counts, fasting blood glucose and other potential confounding factors were performed. Type 2 diabetes was defined according to the criteria of American Diabetes Association. Adjusted logistic regression models were used to assess relationships between NLR quintiles and type 2 diabetes. Result In the final multivariate models, the odds ratios (95% confidence interval) for T2D across NLR quintiles were 1.00 (Reference), 1.19 (1.05, 1.35), 1.33 (1.17, 1.50), 1.28 (1.13, 1.44) and 1.34 (1.19, 1.51) (P for trend<0.000 1), in men. Similar relationships were also observed in women. Conclusion This study demonstrated that NLR was related to the prevalence of type 2 diabetes in men and women, and suggesting that NLR may be an efficient and accurate prognostic biomarker for type 2 diabetes.
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Objective To evaluate whether the serum uric acid (SUA) levels are related to development of prediabetes. Methods This was a 6-year cohort study, subjects were recruited from Tianjin Medical University General Hospital Health Management Center. A prospective assessment (n=30 910) was performed. Subjects without a history of prediabetes were followed up for 6 years (with a median follow-up of 2.7 person-years). All relevant variables including SUA concentrations, and fasting plasma glucose were assessed at baseline and yearly during the follow-up. Prediabetes was defined in accordance with the American Diabetes Association criteria of 2014. Multivariate-adjusted Cox proportional hazards regression models were fitted to assess relationships between the quintiles of baseline SUA and the incidence of prediabetes. Results The incidence of prediabetes was 55 per 1 000 person-years. In comparison with subjects in the lowest quintile, the odds ratios and hazard ratio (95%confidence interval) of higher quintile of SUA were 1.04 (0.93, 1.15), 1.07 (0.95, 1.19), 1.13 (1.01, 1.28) and 1.15 (1.02, 1.30) (P for trend=0.01), respectively, after adjusting for potential confounders. Conclusion SUA levels predicted an increased risk of prediabetes in adults.
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Objective To understand the relationship between dietary patterns and breast cancer and to provide a possible scientific basis for breast cancer prevention,we performed a meta-analysis in order to evaluate the current relevant literature.Method Meta-analysis was used to pool the effect of vegetable,fruit,fish and soybean dietary patterns on the risk of breast cancer.The breast cancer risk of the highest categories compared to the lowest categories of such dietary patterns was combined using fixed effect model.Searching the database (Chinese databases included CQVIP,WANFANG medicine online,CNKI and SinoMED,and English databases included PubMed,Embase,Cochrane database,Medline and Google Scholar) for articles published between January 1997 and June 2014.All statistical analyses were performed using the Stata 11.0.Result Twelve cohort studies involving 623 536 participants and 19 707 patients with brcast cancer were found to be eligible.Our results indicate that a reasonably healthy dietary pattern (which is characterized by a high consumption of vegetables,fruit,fish and soybean) is beneficial for the prevention of breast cancer.Compared to the lowest categories of such dietary patterns,relative risk (RR) of the highest categories is 0.86 (95％ CI 0.80-0.92).Conclusion A reasonably healthy dietary pattern (which is characterized by a high consumption of vegetables,fruit,fish and soybean) is beneficial for the prevention of breast cancer.
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Coffee administration has been shown to increase maximum voluntary contraction and muscular endurance. However, no study has addressed the association between daily consumption of coffee with muscular function. This cross sectional study aimed to investigate the association between frequency of coffee consumption (CC) in daily life and muscle strength among a population of working adult men. This cross sectional study included men (n = 516, mean age: 47.1) who participated in an annual health examination conducted in Sendai. The monthly frequency of coffee consumed was reported by a brief-type self-administered dietary history questionnaire. Leg extension power (LEP) was measured as an index of muscle strength. Subjects were divided into tertile levels according to CC. Analysis of covariance was used to examine the relation between the tertile levels of CC and LEP. After adjustment for potential confounders (including all lifestyle factors), the adjusted means (95% confidence interval) of LEP across the tertiles of CC were 17.4 (16.6 - 18.1) for the lowest tertile, 17.9 (17.4 - 18.5) for the mid tertile, and 18.9 (18.3 - 19.5) for the highest tertile (p for trend = 0.007). Higher frequency of monthly coffee consumption was associated with higher muscle strength.
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[Purpose] To investigate the relation between isotonic leg extension strength (ILES) and the prevalence of metabolic syndrome (MS) in Japanese male adults.[Methods] This cross-sectional study included 395 Japanese men. Metabolic syndrome was determined according to the criteria of International Diabetes Federation (IDF), Japan Society for the Study of Obesity (JASSO), or National Cholesterol Education Program's Adults Treatment Panel III (NCEP-ATPIII). Muscular strength was measured on a horizontal dynamometer. Subjects were divided into tertile levels according to ILES (watts/kg). Multiple logistic regression analysis was used to examine the relation between ILES levels and the prevalence of MS.[Results] The prevalence of MS were 14.4% (IDF), 17.0%(JASSO), and 20.0% (NCEP-ATPIII). After adjustment for confounding factors, the odd's ratios (95% confidence interval) of MS (IDF) compared with the lowest ILES level were 0.90 (0.48-1.68) and 0.31 (0.13-0.64) in the middle and high levels of ILES (<i>p</i> for trend=0.03). The association between the level of ILES and the prevalence of MS by JASSO and NCEP-ATPIIIcriteria were similar.[Conclusion] The prevalence of MS was associated with the level of ILES.
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Objective To investigate the association between physical activity volume and medical care cost in elderly persons aged 70 years and over in Crane Valley, Sendal, Japan. Methods A total of 494 community-dwelling Japanese elderly persons living in residential area of Sendai City in northern Japan completed a self-administered questionnaire that included questions on physical activity. We ascertained total medical care costs through computerized linkage with claims lodged between November 2002 and December 2004 from the Miyagi National Health Insurance Association.Results After multivariate adjustment for potential confounders, the average monthly medical costs of hospitalization, hospital days, outpatient medical expenses, out-patient numbers and the total medical expenses in grade Ⅰ exercise volume group were (196.7±72.1) U.S. dollars, (0. 7±0.3) d, (308. 7±54.4) U.S. dollars, (6.2±1.1) times and (506. 95±94. 2) U.S. dollars; in grade Ⅱ exercise volume group were (139. 8±72.1) U.S. dollars, (0.5±0. 3) d, (295.3±54.6) U.S.dollars, (6.1±1.1) times and (437.8±94.5) U.S. dollars; in grade Ⅲ exercise volume group were (134.1±72.5) U.S. dollars, (0.4±0.3) d, (278.8±54.9) U.S. dollars, (5.8±1.1) times and (418. 1±95.0) U.S. dollars. With the increase in physical activity, there were significant differences between the medical costs of hospitalization and total medical expenses (F=5.85 and 8.11, both P=0.01). Conclusions This prospective study indicates that a higher volume of physical activity is associated with lower medical care costs among Japanese elderly persons.
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The purpose of this study was to determine whether improved physical fitness through a new exercise program intervention including elements of Tai Chi Chuan and Kung Fu gymnastics among elderly people who have lower physical. Eighty older adults with less physical strength aged 71-89 (mean age±SD=77.3±3.9), recruited from Tsurugaya area of Sendai, participated in a 3-month randomized controlled trial, with allocation to a new exercise program or well-accepted exercise program control. Physical performance measures included the timed up and go test (TUGT), the functional reach test, a 6 min continuous walking test, and the sit-and-reach test were conducted before and after the intervention. Data were analyzed through on-treatment-analysis of variance. After training, although no significant between-groups differences were observed for all the measures, TUGT, which is recommended as a simple screening tool to identify those at risk of falling was improved in both groups following the intervention (P<0.05). The findings revealed that the new exercise program including Tai Chi Chuan and Kung Fu gymnastics element could improve physical fitness to a similar level as the well-accepted exercise program.