Severity of non-alcoholic fatty liver disease is a risk factor for developing hypertension from prehypertension / 中华医学杂志(英文版)

BACKGROUND@#There is little published evidence about the role of non-alcoholic fatty liver disease (NAFLD) in the progression from prehypertension to hypertension. This study was conducted to investigate the association of NAFLD and its severity with the risk of hypertension developing from prehypertension.@*METHODS@#The study cohort comprised 25,433 participants from the Kailuan study with prehypertension at baseline; those with excessive alcohol consumption and other liver diseases were excluded. NAFLD was diagnosed by ultrasonography and stratified as mild, moderate, or severe. Univariable and multivariable Cox proportional hazard regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident hypertension according to the presence and 3 categories of severity of NAFLD.@*RESULTS@#During a median of 12.6 years of follow-up, 10,638 participants progressed to hypertension from prehypertension. After adjusting for multiple risk factors, patients with prehypertension and NAFLD had a 15% higher risk of incident hypertension than those without NAFLD (HR = 1.15, 95% CI 1.10-1.21). Moreover, the severity of NAFLD was associated with the incidence of hypertension, which was higher in patients with more severe NAFLD (HR = 1.15 [95% CI 1.10-1.21] in the mild NAFLD group; HR = 1.15 [95% CI 1.07-1.24] in the moderate NAFLD group; and HR = 1.20 [95% CI 1.03-1.41] in the severe NAFLD group). Subgroup analysis indicated that age and baseline systolic blood pressure may modify this association.@*CONCLUSIONS@#NAFLD is an independent risk factor for hypertension in patients with prehypertension. The risk of incident hypertension increases with the severity of NAFLD.

Case-control study on fragility fractures in coal miners: A comparison between surface and underground workers / 环境与职业医学

Background The prevalence of osteoporosis and osteopenia is higher among underground coal miners than surface workers. The special underground work environment and unhealthy habits such as smoking, drinking, and a high-salt diet may lead to changes in bone metabolism, increasing the risk of fragility fractures and placing a heavy economic burden on individuals and society. Objective To identify potential factors influencing fragility fractures among coal miners in different working environments and to provide a basis for targeted preventive measures to reduce the occurrence of fragility fractures. Methods Male participants who attended at least one of the physical examinations in Kailuan Group between June 2006 and December 2020 were included in the study. The participants were divided into two groups based on their working environment: surface or underground. A case-control study was conducted, where patients with new fragility fractures served as the case group and participants without fragility fractures served as the control group. The two groups were matched with a case:control ratio of 1:4 by age (±1 year) and the same year of physical examination. The matching process was repeated twice, once for the surface working population and once for the underground working population. The analysis of risk factors was conducted using conditional logistic regression models. Results Among a total of 113138 employees in Kailuan Group, 82631 surface workers and 30507 underground workers were included, respectively. The number of individuals who suffered fragility fractures was 1375, accounting for 1.22% of the total population. The incidence of fragility fractures in underground workers was significantly higher than that in surface workers (1.63%>1.07%, P<0.001). The results of conditional logistic regression model showed that current smoking (OR=1.26, 95%CI: 1.05, 1.51), manual labor (OR=1.37, 95%CI: 1.06, 1.78), diabetes (OR=1.26, 95%CI: 1.04, 1.54), sinus tachycardia (OR=1.81, 95%CI: 1.23, 2.66), history of stroke (OR=1.51, 95%CI: 1.09, 2.09), education at college and above (OR=0.65, 95%CI: 0.45, 0.95), high income level (OR=0.69, 95%CI: 0.54, 0.90), elevated hemoglobin (OR=0.91, 95%CI: 0.85, 0.98), and elevated total cholesterol (OR=0.90, 95%CI: 0.82, 0.99) were associated with fragility fractures in the surface working population of coal mines; current smoking (OR=1.48, 95%CI: 1.17, 1.87), current drinking (OR=1.26, 95%CI: 1.01, 1.56), manual labor (OR=2.64, 95%CI: 1.41, 4.94), history of dust exposure (OR=1.28, 95%CI: 1.03, 1.58), and obesity (OR=0.72, 95%CI: 0.52, 0.96) were associated with fragility fractures in the underground working population of coal mines. Conclusion In preventing fragility fractures, special attention should be paid to the bone health of underground workers engaged in manual labor or having a history of dust exposure. It is important to correct their unhealthy behaviors in a timely manner, such as smoking and drinking, and to appropriately increase body weight to prevent fragility fractures. For surface workers, particular attention should be given to the high-risk group for fragility fractures, such as low family income per capita, manual labor, and having a history of stroke or diabetes; in addition, close monitoring of their resting heart rate, hemoglobin levels, and total cholesterol levels may help prevent fragility fractures.

Ideal cardiovascular health and mortality: pooled results of three prospective cohorts in Chinese adults / 中华医学杂志(英文版)

BACKGROUND@#Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.@*METHODS@#A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis.@*RESULTS@#During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed.@*CONCLUSIONS@#ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.

Effects of pre- and post-diagnosis of malignant neoplasms total cholesterol difference on all-cause death in the Kailuan study population / 肿瘤研究与临床

Objective:To explore the effects of pre- and post-diagnosis of malignant neoplasms total cholesterol difference on all-cause death in the Kailuan study population.Methods:A prospective cohort study method was used to observe on the job and retired workers who were diagnosed with malignant neoplasms during the healthy physical examination and had the complete data of total cholesterol pre- and post-diagnosis of malignant neoplasms at Kailuan (Group) Limited Liability Corporation from June 2006 to December 2015. Medical insurance system and medical records case management system of Kailuan General Hospital were used to retrieve the confirmed diagnosis time of participants with malignant neoplasms. SAS 9.4 software was used to extract the physical examination data of participants diagnosed as malignant neoplasms before and after 2 years. The whole participants were divided into 4 groups according to the quartile of the total cholesterol difference pre- and post-diagnosis of cancer. The first quartile group: the total cholesterol difference <-0.93 mmol/L (823 cases), the second quartile group: the total cholesterol difference≥-0.93 mmol/L and <-0.21 mmol/L (811 cases), the third quartile group: the total cholesterol difference≥-0.21 mmol/L and <0.49 mmol/L (832 cases), the forth quartile group: the total cholesterol difference≥0.49 mmol/L (833 cases). The incidence density was used to calculate the mortality of different total cholesterol difference quartile groups, and the Cox proportional hazards model was used to analyze the influencing factors of all-cause death of all quartile groups.Results:Totally, 1 564 cases had all-cause death during median 2.46 years of follow-up time. There were 481, 440, 333, 310 death cases respectively of 4 quartile groups. The death rates of all quartile groups were 230.10/1 000 person-years, 163.90/1 000 person-years, 115.34/1 000 person-years, and 83.44/1 000 person-years respectively ( χ2 = 604.62, P < 0.001). After adjusting for confounding factors, the Cox proportional hazards model analysis showed that compared with the first quartile group, the hazard ratio with the 95% confidence interval of all-cause death in the second, third, and fourth quartile groups was 0.86 (0.76-0.98), 0.62(0.54-0.72) and 0.58 (0.50-0.67) respectively (all Ptrend < 0.001). After adjusting for confounding factors of patients with cancer in different location, the forth quartile group except for cancer in thyroid, breast, prostate, testis and urinary system, all Ptrend was less than 0.05 compared with that of the first quartile group. Conclusion:Among Kailuan study population, the smaller decline or even rise in total cholesterol level of post-diagnosis compared with that of pre-diagnosis is a protective factor of all-cause death.

Relationship of hyperuricemia with all-cause mortality in patients with atrial fibrillation / 中国综合临床

Objective:To explore whether hyperuricemia was an independent risk factor for all-cause mortality in patients with atrial fibrillation.Methods:Patients with atrial fibrillation who were confirmed by 12-lead electrocardiogram in 11 hospitals of Kailuan Group from 2006 to 2007 were selected as the research objects.All patients were followed up by prospective cohort study, and all-cause deaths were observed.The last follow-up time was December 31, 2013.Kaplan-Meier curve and Cox proportional hazards model were used to analyze and compare the risk of all-cause mortality in patients with atrial fibrillation in the hyperuricemia group compared with the normal uric acid group.Results:A total of 388 community-based patients with atrial fibrillation were included in the final statistical analysis, with 136 all-cause deaths occurred during an average follow-up period of 6.93 years.The incidence of all-cause mortality was 9.24% per year(36/390)in the hyperuricemia group, whereas 5.16% per year(100/1 937) in the normal uric acid group.In the univariate Cox proportional risk model analysis, the risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in the hyperuricemia group (95% CI) was 1.84(1.26-2.69) times that in the normal uric acid group ( P<0.01). After adjusting for potential confounding variables, the adjusted risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in hyperuricemia group was still 1.94(1.32-2.85) times of that in normal uric acid group ( P<0.01). After adjustment for potential confounding variables, for each 0.01 g/L increase in uric acid (1 g/L=5 950 μmol/L), the risk of all-cause death in patients with atrial fibrillation increased by 1.15 (1.05-1.26) times ( P<0.01). Conclusion:Hyperuricemia was an independent risk factor for all-cause death in patients with atrial fibrillation in community.

Association between resting heart rate trajectory pattern and risk of cardiovascular and cerebrovascular diseases / 中华心血管病杂志

Objective@#To examine whether the long-term resting heart rate (RHR) pattern can predict the risk of cardiovascular and cerebrovascular diseases (CVDs).@*Methods@#This prospective cohort study included 63 040 participants who took part in the health examination in 2006 and one of the health examinations on 2008 or 2010 and were free of myocardial infarction, stroke, arrhythmia, cancer and not treated with β-recepter blocker. The outcomes were the first occurrence of myocardial infarction and stroke during the follow up ended on December 31, 2015. RHRs were measured in 2006, 2008, and 2010. We used latent mixture modeling SAS Proc procedure to identify RHR trajectories. We identified 4 distinct RHR trajectory patterns based on the data derived from 2006 and on the pattern change during 2006 to 2010 (low-stable, moderate-stable, moderate-increasing, elevated-decreasing). Collected the general clinical data of the patients. Cox regression model was used to determine the association between RHR trajectory patterns and the risk of CVDs during follow up. Hazard ratio (HR) with 95% confidence intervals (CI) were calculated using Cox regression modeling.@*Results@#There were statistical significance among the 4 distinct RHR trajectory patterns on the following variables: age, gender, smoking status, drinking status, physical activity, education status, history of use antihypertensive drugs, history of hypertension,history of diabetes, body mass index, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, and the level of high-sensitivity C-reactive protein (all P<0.01). The moderate-increasing pattern experienced the highest risk of developing stroke and CVDs among all 4 patterns. The cumulative incidence of cerebral infarction, cerebral hemorrhage and CVDs in the order of low-stable trajectory, moderate-stable trajectory and moderate-increasing trajectory. The cumulative incidences of cerebral infarction, cerebral hemorrhage and CVDs in elevated-decreasing trajectory group were significantly lower than those in moderate-increasing trajectory group, but higher than those in moderate-stable trajectory group. Compared to the low-stable pattern, adjusted HR was 1.3 (95%CI 1.0-1.6) for the moderate-increasing pattern after adjustment for potential confounders.@*Conclusion@#Our study finds that individuals with moderate-increasing RHR trajectory pattern are associated with higher risk of cardiovascular and CVDs.

Association between sleep duration and brachial-ankle pulse wave velocity / 中华心血管病杂志

Objective@#To investigate the association between sleep duration and brachial-ankle pulse wave velocity (baPWV).@*Methods@#A cross-sectional study method was used to observe 38 604 employees of Kailuan Group who participated in the physical examination and the baPWV test from January 2010 to July 2018. The age was (51.6±11.1) years old. There were 72.4% (27 955/38 604) male participants. According to the sleep duration, subjects were divided into 5 groups including ≤ 5 hours group (3 762 cases),>5 hours and ≤6 hours group (9 585 cases),>6 hours and ≤7 hours group (12 604 cases), >7 hours and ≤8 hours group (11 921 cases) and >8 hours group (732 cases). Multivariate logistic regression model was used to analyze the association between sleep duration and the baPWV.@*Results@#The age was (51.6±11.1) years old. There were 72.4% (27 955/38 604) male participants. The prevalence of baPWV≥14 m/s in ≤ 5 hours group, >5 hours and ≤6 hours group, >6 hours and ≤7 hours group, >7 hours and ≤8 hours group, and >8 hours group was 63.5% (2 389/3 762), 58.9% (5 645/9 585), 55.0% (6 926/12 604), 53.3% (6 356/11 921) and 54.8% (401/732) respectively. After adjusting for confounding factors including age, gender, smoking, drinking, physical exercise, snoring, hypertension, diabetes mellitus, dyslipidemia, body mass index≥24 kg/m2, mean arterial pressure, heart rate, and C-reactive protein, the multivariate logistic regression analysis showed that the OR were 1.48 (95%CI 1.29-1.70, P<0.01) and 1.18 (95%CI 1.07-1.30, P<0.01) respectively for baPWV≥14 m/s in ≤ 5 hours and >5 hours and ≤6 hours group when compared with >7 hours and ≤ 8 hours group.@*Conclusion@#Short sleep duration is associated with elevated baPWV in mid-aged Chinese population.

Progress in epidemiologic research of association between anthropometric indicators and risk for gastric cancer / 中华流行病学杂志

Gastric cancer is one of the most common cancer. Studies have been conducted to evaluate the association between anthropometric indicators and gastric cancer, but the results were inconsistent. Therefore, a literature retrieval was conducted by using PubMed and Wanfang databases to summarize the latest research progress in the cohort study of the association between anthropometric indicators and the risk for gastric cancer. It was found that both general obesity and abdominal obesity might increase the risk for gastric cancer, while the association between underweight and gastric cancer needs further study. This paper summarizes the progress in the cohort study of association between anthropometric indicators for the risk for gastric cancer in order to provide evidence for the prevention and control of gastric cancer.

Body mass index and the risk of gastric cancer in males: a prospective cohort study / 中华流行病学杂志

Objective@#To investigate the association between BMI and gastric cancer risk in Chinese males.@*Methods@#Data on body weight, body height and incidence of gastric cancer were collected on a biennial basis in males in Kailuan Cohort during 2006-2015. In addition, electronic databases of hospitals affiliated to Kailuan Group, insurance system of Kailuan Group and medical insurance system of Tangshan were used for supplementary information. Males with normal body weight (18.5 kg/m2≤BMI<24.0 kg/m2) were used as controls. Cox proportional hazards regression model was used to evaluate the association between baseline BMI and the risk of gastric cancer in males through the calculations of hazard ratio and 95% confidence interval.@*Results@#A total of 109 600 males were included and 272 new gastric cancer cases were identified in Kailuan male cohort study, with a follow-up of 860 399.79 person-years during 2006-2015. The median follow-up period was 8.8 years. When compared with normal weight, the hazard ratios (HR) of underweight (BMI≤18.5 kg/m2) for gastric cancer risk were 2.11 (95%CI: 1.23-3.62) after adjusting for potential confounding factors (age, education level, smoking status, alcohol drinking status, dust exposure, salty food intake, tea drinking status). However, overweight or obesity showed no significant association with gastric cancer risk. The stratified analyses based on age, education level, status on smoking, alcohol drinking, tea drinking and dust exposure indicated that underweight showed significant association with gastric cancer risk in those with older age, those with high education level, non-smokers, non-alcohol drinkers, non-tea drinkers and those with dust exposure.@*Conclusion@#Underweight might increase the risk of gastric cancer in males in China, and this positive association might be associated with age, education level, status on smoking, alcohol-drinking, tea-drink, and dust exposure.

Alcohol consumption and the risk of lung cancer in males: a prospective cohort study / 中华流行病学杂志

Objective To investigate the association between alcohol consumption and lung cancer risk in Chinese males.Methods Information on alcohol consumption and outcomes were collected on a biennial basis among males in Kailuan Cohort (2006-2015).In addition,electronic databases of hospitals affiliated to Kailuan Community,Insurance Systems of Kailuan Community and Tangshan were also used for supplementary information retrieval.Cox proportional hazards regression models were used to evaluate the hazard ratio (HR) and 95％ CI of baseline frequency and type of alcohol consumption associated with lung cancer risk in males.Non-drinkers were used as control group.Results A total of 101 751 males were included and 913 new lung cancer cases were identified in the Kailuan male cohort study,with a total follow-up time of 808 146.56 person-years and a median follow-up time of 8.88 years by 31 December 2015.After adjusting for potential confounding factors,the HR of former drinkers,occasional drinkers (＜ 1/day) and drinkers (≥ 1/day) were 1.30 (95％CI:0.90-1.88),0.80 (95％CI:0.64-1.01) and 1.04 (95％CI:0.85-1.27),respectively,compared with non-drinkers.In addition,drinking beer/red wine (HR=0.91,95％CI:0.69-1.20) and white wine (HR=0.99,95％ CI:0.83-1.19) showed no significant association with lung cancer.The results were similar when stratified analysis were conducted.Conclusion Our study results don't support the hypothesis that alcohol consumption is significantly associated with the risk of lung cancer in males.

Association between total cholesterol and risk of lung cancer incidence in men: a prospective cohort study / 中华流行病学杂志

Objective To assess the association and intensity of baseline TC level with the incidence of lung cancer in men in China.Methods Since May 2006,all the male workers,including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study.Information about demographics,medical history,anthropometry and TC level were collected at the baseline interview,as well as the information of newly-diagnosed lung cancer cases during the follow-up period.According to guidelines for blood lipids in Chinese adults and the distribution in the population,TC level was classified into five groups as followed:＜ 160,160-,180-,200-and ≥240 mg/dl,with the second quintile group (160-mg/dl) serving as the referent category.Cox proportional hazards regression model and restricted cubic spline (RCS) model were used to evaluate the association and the nonlinear association between baseline TC level and the risk of lung cancer in the men.Results By December 31,2014,for the 109 884 men,a follow up of 763 819.25 person-years was made with a median follow-up period of 7.88 years.During the follow up,808 lung cancer cases were identified.After adjustment for age,education level,income level,smoking status,alcohol consumption level,history of dust exposure,FPG level and BMI,HR (95％CD of lung cancer for men with lower TC level (＜160 mg/dl) and higher TC level (≥240 mg/dl) were 1.34 (1.04-1.72) and 1.45 (1.09-1.92),respectively,compared with men with normal TC level (160-mg/dl).The results didn't change significantly after exclusion of newly diagnosed cancer cases within 2 years of follow up and subjects with the history of hyperlipidemia.Conclusion Our results showed that TC might be associated with higher risk of lung cancer.Men with lower TC level or higher TC level had higher risk for lung cancer.Keep moderate TC level might be one of the effective precaution for the prevention of lung cancer.

Alcohol consumption and the risk of lung cancer in males: a prospective cohort study / 中华流行病学杂志

Objective To investigate the association between alcohol consumption and lung cancer risk in Chinese males.Methods Information on alcohol consumption and outcomes were collected on a biennial basis among males in Kailuan Cohort (2006-2015).In addition,electronic databases of hospitals affiliated to Kailuan Community,Insurance Systems of Kailuan Community and Tangshan were also used for supplementary information retrieval.Cox proportional hazards regression models were used to evaluate the hazard ratio (HR) and 95％ CI of baseline frequency and type of alcohol consumption associated with lung cancer risk in males.Non-drinkers were used as control group.Results A total of 101 751 males were included and 913 new lung cancer cases were identified in the Kailuan male cohort study,with a total follow-up time of 808 146.56 person-years and a median follow-up time of 8.88 years by 31 December 2015.After adjusting for potential confounding factors,the HR of former drinkers,occasional drinkers (＜ 1/day) and drinkers (≥ 1/day) were 1.30 (95％CI:0.90-1.88),0.80 (95％CI:0.64-1.01) and 1.04 (95％CI:0.85-1.27),respectively,compared with non-drinkers.In addition,drinking beer/red wine (HR=0.91,95％CI:0.69-1.20) and white wine (HR=0.99,95％ CI:0.83-1.19) showed no significant association with lung cancer.The results were similar when stratified analysis were conducted.Conclusion Our study results don't support the hypothesis that alcohol consumption is significantly associated with the risk of lung cancer in males.

Association between total cholesterol and risk of lung cancer incidence in men: a prospective cohort study / 中华流行病学杂志

Objective To assess the association and intensity of baseline TC level with the incidence of lung cancer in men in China.Methods Since May 2006,all the male workers,including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study.Information about demographics,medical history,anthropometry and TC level were collected at the baseline interview,as well as the information of newly-diagnosed lung cancer cases during the follow-up period.According to guidelines for blood lipids in Chinese adults and the distribution in the population,TC level was classified into five groups as followed:＜ 160,160-,180-,200-and ≥240 mg/dl,with the second quintile group (160-mg/dl) serving as the referent category.Cox proportional hazards regression model and restricted cubic spline (RCS) model were used to evaluate the association and the nonlinear association between baseline TC level and the risk of lung cancer in the men.Results By December 31,2014,for the 109 884 men,a follow up of 763 819.25 person-years was made with a median follow-up period of 7.88 years.During the follow up,808 lung cancer cases were identified.After adjustment for age,education level,income level,smoking status,alcohol consumption level,history of dust exposure,FPG level and BMI,HR (95％CD of lung cancer for men with lower TC level (＜160 mg/dl) and higher TC level (≥240 mg/dl) were 1.34 (1.04-1.72) and 1.45 (1.09-1.92),respectively,compared with men with normal TC level (160-mg/dl).The results didn't change significantly after exclusion of newly diagnosed cancer cases within 2 years of follow up and subjects with the history of hyperlipidemia.Conclusion Our results showed that TC might be associated with higher risk of lung cancer.Men with lower TC level or higher TC level had higher risk for lung cancer.Keep moderate TC level might be one of the effective precaution for the prevention of lung cancer.

A prospective cohort study on triglycerides levels and risk of acute pancreatitis / 中华消化杂志

Objective To investigate the effects of fasting serum triglycerides (TG) levels at different baseline on the risk of new-onset acute pancreatitis (AP) in in-service and retired employees of Kailuan Group.Methods A total of 125 178 in-service and retired employees of Kailuan Group who received health check-ups from 2006 to 2009 and had no AP history but had complete TG data were prospectively enrolled.According to quantile level,the baseline serum fasting TG level of study subjects were divided into ＜1.01 mmol/L group (n=42 128),1.01 to 1.64 mmol/L group (n=41 711) and ＞ 1.64 mmol/L group (n=41 339).The incidence of new-onset AP of these three groups was analyzed.The survival curve was plotted by Kaplan-Meier method.The cumulative incidence rate was calculated and tested by log-rank method.And multivariate Cox proportional hazards regression model was performed to calculate hazard ratios (HR) of baseline fasting serum TG level for AP.Results After followed up for (7.36±1.23) years,a total of 193 cases of AP occurred.The incidences of AP in ＜1.01 mmol/L group,1.01 to 1.64 mmol/L group and ＞ 1.64 mmol/L group were 1.43 events/10 000 person-years,2.37 events/10 000 person-years and 2.49 events/10 000 person-years,respectively.The cumulative incidence rates of AP in ＜1.01 mmol/L group,1.01 to 1.64 mmol/L group and ＞1.64 mmol/L group were 0.10％ (44/42 128),0.18％ (73/41 711) and 0.18％ (76/41 339),respectively,and the difference was statistically significant (x2 =9.998,P=0.007).The results of multivariate Cox proportional hazards regression model analysis indicated that the risk of AP increased in 1.01 to 1.64 mmol/L group and ＞ 1.64 mmol/L group compared with that of ＜1.01 mmol/L group,HR and 95％ confidence interval (CI) were 1.56 (1.07 to 2.29) and 1.57 (1.06 to 2.32),respectively.After excluded onset AP within one year,with a control group of ＜1.01 mmol/L group,the results of multivariate Cox proportional hazards regression model analysis indicated that the HR and 95％CI for AP of 1.01 to 1.64 mmol/L group and ＞ 1.64 mmol/L group were 1.70 (1.11 to 2.58) and 1.69 (1.10 to 2.60),respectively.Conclusion Baseline fasting serum TG levels over 1.01 mmol/L may increase the risk of AP.

Effect of dietary pattern on the brachial ankle pulse wave velocity in the northern industrial urban population / 中国综合临床

Objective To investigate the effects of different dietary patterns on brachial ankle pulse wave velocity in northern industrial cities. Methods According to the selection criteria,from 2014 to 2015, 22436 health checkup persons were selected as the subjects of Kailuan Group,they were followed up with health examination and questionnaire investigation, at the same time, the brachial ankle pulse wave velocity was detected. According to the dietary advice given by the Chinese dietary guidelines,the proportion of animal and plant food in the food frequency questionnaire and the supply of nutrients are divided into 4 groups,which are the traditional Chinese diet group (3 585 cases),the Western diet group (13 639 cases),the balanced diet group (1 309 cases),the Mediterranean diet group (3 903 cases). Logistic multivariate regression analysis was used to analyze he risk factors of atherosclerosis. Results The mean value of brachial ankle pulse wave velocity in 22 436 cases was ( 1 462. 46 ± 320. 69) cm/s, and the incidence of peripheral arteriosclerosis was 50. 78%(11 392/22 436). The incidence of arteriosclerosis around the balanced diet group, the Mediterranean diet group,the traditional Chinese diet group and the Western diet group were 48. 82%( 639/1 309), 49. 12%(1 917/3 903),50. 49%(1 810/3 585),51. 51%(7 026/13 639),and the difference between the groups was statistically significant (P＝0. 024); after adjusting other related risk factors,compared with the balanced diet group,the risk of peripheral arteriosclerosis in the Mediterranean diet group,the traditional diet group and the Western diet group was 121(95%CI:0. 557～2. 258),1. 015(95%CI:0. 663～1. 554),1. 033(95%CI:0. 677～1. 575), respectively. Conclusion The incidence of peripheral arteriosclerosis increased gradually in the balanced diet group,the Mediterranean diet group,the Chinese traditional diet group and the Western diet group, but there was no statistical significance in the risk of peripheral arteriosclerosis after adjusting other related risk factors. This Conclusion requires more large samples,long-term follow-up study to further confirm.

Relationship between the changes of high-sensitivity C-reactive protein and retinal vessel diameter in the middle-aged and elderly:the Kailuan Study / 中华实验眼科杂志

Objective To investigate the relationship between high-sensitivity C-reactive protein (hsCRP) and retinal vascular diameter.Methods This study was a cross-sectional study,the population was from the Kailuan study (clinical trial research registration NO.:ChiCTR-TNC-1100 1489) in 2012-2013 (age ≥ 40 years).All the people was checked by cardiovascular and epidemiological examination,of which 3 447 people had an analytical results of fundus color photography.The retinal vascular diameter was analyzed by software.Take the value of hsCRP 1％ to 99％ points and 3 363 people were finally included in the statistical analysis.The mean age of 3 363 people (male 1 880,female 1 483) was 56.69± 10.10 years old.The correlation between hsCRP and central retinal artery equivalent (CRAE),central retinal vein equivalent (CRVE),arteriovenous ratio (AVR) were evaluated by Spearman correlation coefficient.Multivariate linear regression analysis was used to futher analyze the association between hsCRP and retinal fundus diameter parameters.Results The median value of hsCRP was 1.10 (0.50,2.21) mmo/L,CRAE was (174.16±24.36) μm,CRVE was (282.70±26.32) μm,AVR was 0.62-±0.09.Spearman correlation analysis showed that hsCRP was positively correlated with CRVE (r =0.052,P =0.003) and negatively correlated with AVR (r =-0.052,P =0.002).The non-normal variables hsCRP were transformed into continuous variables lghsCRP,and CRAE,CRVE and AVR were used for multivariate linear regression analysis.After a number of factors were gradually corrected,the results showed that association between lghsCRP and CRVE (β =3.428) or AVR (β =-0.006) was statistically significant (P＜0.05).LghsCRP was a risk factor for CRVE both in men and women after the calculation of gender stratification.Conclusions CRVE increased and AVR decreased with the increase of hsCRP.The changes of retinal vascular diameter may be associated with hsCRP as a marker to predict cardiovascular and cerebrovascular disease.

Analysis on the gender-specific risk factors of new-onset cerebral hemorrhage / 中华心血管病杂志

Objective@#To explore the gender-specific risk factors of new-onset cerebral hemorrhage.@*Methods@#In this prospective cohort study,a total of 98 961 participants((51.1±12.6)years old), who underwent the 2006 to 2007 physical examination and met the inclusion criteria, were enrolled from the Kailuanstudy cohort. There were 78 908 (79.7%) male,and 20 053 (20.3%) female.The incidence of cerebral hemorrhage was observed once per year until December 31, 2016.The difference on the incidence of cerebral hemorrhage between male and female was compared. Multivariate Cox regression analysis was applied to analyze therisk factors of cerebral hemorrhage events among different genders.@*Results@#The participants were followed up for(10.00±0.73) years,and 860 cerebral hemorrhage events were recorded during follow up. The incidence of cerebral hemorrhage in the population was 86.90/10 million person years (standardized incidence rate of 47.85/10 million person years). The incidence of cerebral hemorrhage was significantly higher in male (49.61/10 million person years) than in female (34.07/10 million person years, P<0.05). Multivariate Cox regression analysis showed that 45-59 years old, ≥ 60 years old, diabetes,and waist-hip ratio were more strongly related to new-onset of cerebral hemorrhage events in female than in male, and the hazard ratios(95%CI) were 2.33 (1.23-4.43) ,2.71 (1.30-5.66) ,2.16 (1.24-3.74) and 8.79 (1.42-54.32) in female versus 1.55 (1.21-1.97) ,2.16 (1.68-2.78) ,1.19 (0.93-1.53) and 3.21 (1.09-9.41) in male, respectively. The risk of male cerebral hemorrhage increased by 29% (HR=1.29, 95%CI 1.19-1.40) in male and 24% (HR=1.24, 95%CI 1.20-1.28) in female,when the systolic blood pressure increased 10 mmHg (1 mmHg=0.133 kPa).@*Conclusions@#The incidence of cerebral hemorrhage is higher in male than in female in this cohort.The association between systolic blood pressure and cerebral hemorrhage is stronger in male than that in female.The associations between age, waist-hip ratio, diabetes and cerebral hemorrhage are stronger in female than in male.@*Trial Registration@#Chinese Clinical Trail Registry, ChiCTR-TNC-11001489.

Comparison of arterial stiffness in non-hypertensive and hypertensive population of various age groups / 中华心血管病杂志

Objective@#To investigate the impact of blood pressure and age on arterial stiffness in general population.@*Methods@#Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups.@*Results@#(1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group.@*Conclusion@#SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.

Anthropometry and the risk of colorectal cancer in males: a prospective cohort study / 中华预防医学杂志

Objective@#To investigate the association between anthropometry and colorectal cancer risk in Chinese males.@*Methods@#Anthropometry and incident colorectal cancer cases were collected on a biennial basis starting in May 2006 among males in Kailuan Cohort (2006-2014). In addition, electronic database of hospitals affiliated to Kailuan Community, Insurance System of Kailuan Community and Tangshan were also searched for supplementary information. Cox proportional hazards regression models and linear models were used to evaluate the association between baseline anthropometry and the risk of colorectal cancer in males.@*Results@#A total of 106 786 males were included and 318 new colorectal cancer cases were identified in the Kailuan male cohort study, with 747 337.60 person-years follow-up by 31 December 2014. The median follow-up time was 7.90 years. Highest quartile waist circumference (≥94.0 cm) or WHtR (≥0.55) had 1.45 (95%CI: 1.05-2.02) and 1.66 (95%CI: 1.15-2.41) higher risk of colorectal cancer when compared with lowest waist circumference (<82.0 cm) or WHtR (<0.48) after adjusting for age, education, smoking, alcohol drinking, sitting time and dust exposure. Subgroup analyses by site indicated that males with BMI ≥26.27 kg/m2, waist circumference ≥94.0 cm or WHtR ≥0.55 had HRs (95%CI) of 2.18(1.27-3.73), 2.20 (1.27-3.78) and 2.42 (1.29-4.56) for colon cancer risk, respectively. Linear models showed the HR of colon cancer and 95%CI would be 1.59 (1.24-2.02) with every 0.1 growth in WHtR.@*Conclusion@#Obesity may be responsible for an increased risk of colorectal cancer in male. Reasonable weight control may be one of the effective measures to prevent colorectal cancer.

Tea consumption and the risk of lung cancer in Chinese males: a prospective cohort study / 中华预防医学杂志

Objective@#To investigate the association between tea consumption and lung cancer risk in Chinese males.@*Methods@#Tea consumption and incident lung cancer cases were collected on a biennial basis among males in Kailuan Cohort during 2006-2015. Up to 31st December 2015, a total of 103 010 male candidates from the Chinese Kailuan Male Cohort Study were enrolled in the present study. Cox proportional hazards regression model was used to evaluate the association between tea consumption and risk of lung cancer in males.@*Results@#The age of male candidates was (51.3±13.4)years old. There were 828 810.74 person-years of follow-up and 8.91 years of median follow-up period. During the follow-up, 964 lung cancer cases were identified. In male, the rate of never cosumers, tea drinkers (<4/week) and tea drinkers (≥4/week) were 58.17%(n=59 926), 24.04%(n=24 765) and 17.78%(n=18 319), respectively. After adjustment for potential confounding factors, HR (95%CI) of lung cancer for subjects with tea drinkers (<4/week) and tea drinkers (≥4/week) were 0.80 (0.63-1.02) and 1.02 (0.80-1.30), respectively, as compared with never cosumers. The results showed no significant association with lung cancer. Stratification analysis and sensitivity analysis showed no significant changes.@*Conclusion@#Our study has not found that tea consumption is significantly associated with the risk of male lung cancer.