Minimal improvement in coronary artery disease risk prediction in Chinese population using polygenic risk scores: evidence from the China Kadoorie Biobank / 中华医学杂志(英文版)

BACKGROUND@#Several studies have reported that polygenic risk scores (PRSs) can enhance risk prediction of coronary artery disease (CAD) in European populations. However, research on this topic is far from sufficient in non-European countries, including China. We aimed to evaluate the potential of PRS for predicting CAD for primary prevention in the Chinese population.@*METHODS@#Participants with genome-wide genotypic data from the China Kadoorie Biobank were divided into training ( n = 28,490) and testing sets ( n = 72,150). Ten previously developed PRSs were evaluated, and new ones were developed using clumping and thresholding or LDpred method. The PRS showing the strongest association with CAD in the training set was selected to further evaluate its effects on improving the traditional CAD risk-prediction model in the testing set. Genetic risk was computed by summing the product of the weights and allele dosages across genome-wide single-nucleotide polymorphisms. Prediction of the 10-year first CAD events was assessed using hazard ratios (HRs) and measures of model discrimination, calibration, and net reclassification improvement (NRI). Hard CAD (nonfatal I21-I23 and fatal I20-I25) and soft CAD (all fatal or nonfatal I20-I25) were analyzed separately.@*RESULTS@#In the testing set, 1214 hard and 7201 soft CAD cases were documented during a mean follow-up of 11.2 years. The HR per standard deviation of the optimal PRS was 1.26 (95% CI:1.19-1.33) for hard CAD. Based on a traditional CAD risk prediction model containing only non-laboratory-based information, the addition of PRS for hard CAD increased Harrell's C index by 0.001 (-0.001 to 0.003) in women and 0.003 (0.001 to 0.005) in men. Among the different high-risk thresholds ranging from 1% to 10%, the highest categorical NRI was 3.2% (95% CI: 0.4-6.0%) at a high-risk threshold of 10.0% in women. The association of the PRS with soft CAD was much weaker than with hard CAD, leading to minimal or no improvement in the soft CAD model.@*CONCLUSIONS@#In this Chinese population sample, the current PRSs minimally changed risk discrimination and offered little improvement in risk stratification for soft CAD. Therefore, this may not be suitable for promoting genetic screening in the general Chinese population to improve CAD risk prediction.

Association between fresh fruit consumption and the risk of chronic obstructive pulmonary disease-related hospitalization and death in Chinese adults: A prospective cohort study / 中华医学杂志(英文版)

BACKGROUND@#Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease (COPD), but this is unclear in the Chinese population. We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide, population-based prospective cohort from China.@*METHODS@#Between 2004 and 2008, the China Kadoorie Biobank recruited >0.5 million adults aged 30 to 79 years from ten diverse regions across China. After excluding individuals diagnosed with major chronic diseases and prevalent COPD, the prospective analysis included 421,428 participants. Cox regression was used to calculate the hazard ratios (HRs) for the association between fresh fruit consumption and risk of COPD-related hospitalization and death, with adjustment for established and potential confounders.@*RESULTS@#During a mean follow-up of 10.9 years, 11,292 COPD hospitalization events and deaths were documented, with an overall incidence rate of 2.47/1000 person-years. Participants who consumed fresh fruit daily had a 22% lower risk of COPD-related hospitalization and death compared with non-consumers (HR = 0.78, 95% confidence interval [CI]: 0.71-0.87). The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index (BMI) (18.5 kg/m 2 ≤ BMI < 24.0 kg/m 2 ); the corresponding HRs for daily fresh fruit consumption were 0.78 (95% CI: 0.68-0.89) and 0.69 (95% CI: 0.59-0.79) compared with their counterparts, respectively.@*CONCLUSIONS@#High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults. Increasing fruit consumption, together with cigarette cessation and weight control, should be considered in the prevention and management of COPD.

Multimorbidity patterns and association with mortality in 0.5 million Chinese adults / 中华医学杂志(英文版)

BACKGROUND@#Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.@*METHODS@#We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.@*RESULTS@#Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14 - 2.26) and respiratory multimorbidity (HR = 2.13, 95% CI:1.97 - 2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR = 1.33, 95% CI:1.22 - 1.46). The mortality risk increased by 36% (HR = 1.36, 95% CI: 1.35 - 1.37) with every additional disease.@*CONCLUSION@#Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.

The cut-off points of body mass index and waist circumference for predicting metabolic risk factors in Chinese adults / 中华流行病学杂志

Objective@#To assess the association of BMI and waist circumference (WC) with metabolic risk factors, and confirm the appropriate cut-off points of BMI and WC among Chinese adults.@*Methods@#After excluding participants with missing or extreme measurement values, as well as individuals with self-reported histories of cancer, a total of 501 201 adults in baseline and 19 201 adults in the second re-survey from the China Kadoorie Biobank were included. The associations of BMI and WC with metabolic risk factors were estimated. Receiver operating characteristic (ROC) analyses were conducted to assess the appropriate cut-off values of BMI and WC to predict the risk of hypertension, diabetes, dyslipidemia and clustering of risk factors.@*Results@#The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all presented ascending trends with the increasing levels of BMI or WC. Defined as the points on the ROC curve where Youden’s index reached the highest, the appropriate overweight cut-off points of BMI were around 24.0 kg/m2 both in men and women, and the points of WC were around 85 cm in men and 80 to 85 cm in women. With specificity 90% for identification of risk factors, the appropriate obese cut-off points of BMI were around 28.0 kg/m2 both in men and women, with the range of 27.0 to 28.9 kg/m2.@*Conclusions@#The cut-off points for overweight and obesity recommended by Coorperative Meta-analysis Group of China Obesity Task Force was verified in the large sample survey conducted more recently. The cut-off points of BMI were 24.0 and 28.0 kg/m2 for overweight and obesity, and the cut-off point of WC was 85 cm in men and 80 to 85 cm in women for central obesity.

Association of body mass index and waist circumference with major chronic diseases in Chinese adults / 中华流行病学杂志

Objective@#To examine the association of BMI with major chronic diseases morbidity and all-cause mortality in Chinese adults.@*Methods@#This study is based on China Kadoorie Biobank. Anthropometric indexes were objectively measured at the baseline survey during 2004-2008. After excluding participants with heart disease, stroke, cancer, COPD and diabetes, 428 113 participants aged 30 to 79 years were included in the analysis. Cox regression models were used to investigate the associations of BMI and waist circumference with incidence of major chronic diseases (including cardiovascular disease, cancer, COPD, and type 2 diabetes) and all-cause mortality.@*Results@#Over an average of 10 years, 131 454 participants developed any one of major chronic diseases. A total of 26 892 all-cause deaths were reported. The risk of major chronic diseases increased with BMI. Compared with normal BMI (18.5-24.0 kg/m2), the HR (95%CI) of overweight (BMI 24.0-28.0 kg/m2) and obesity (BMI≥28.0 kg/m2) were 1.26 (95%CI: 1.24-1.27) and 1.59 (95%CI: 1.57-1.62) respectively. Underweight and obesity were both associated with risk of all-cause mortality. Waist circumference was positively associated with risk of major chronic diseases and all-cause mortality. According to recommended cut-off points of BMI and waist circumference for Chinese adults, maintaining a healthy body weight would prevent 12% incident cases of major chronic diseases.@*Conclusion@#General and central obesity were risk factors for major chronic disease among Chinese adults.

Levels of skeletal muscle mass and handgrip strength in adults from 10 regions of China / 中华流行病学杂志

Objective@#To describe the regional and population-related differences in skeletal muscle mass and handgrip strength across the 10 regions of China.@*Methods@#24 533 participants aged 38-88 years from the second resurvey of China Kadoorie Biobank were included in our analyses. Appendicular and trunk skeletal muscle mass were assessed using the bioelectrical impedance analysis (TANITA). Handgrip strength was measured using Jamar hand-held dynamometer. Low muscle mass and low muscle strength were defined as the lowest quintile of height-adjusted appendicular muscle mass or handgrip strength according to the Consensus Report of the Asian Working Group for Sarcopenia. We analyzed the mean value of absolute muscle mass, height-adjusted muscle mass, weight-adjusted muscle mass and handgrip strength. We also reported the prevalence of low muscle mass and low muscle strength.@*Results@#The average appendicular and total skeletal muscle mass were (22.0±0.02) kg and (49.7±0.05) kg in men, which were higher than in women [(15.9±0.02) kg and (37.2±0.04) kg, respectively]. The handgrip strength was (32.6±0.06) kg in men, which was higher than (19.9±0.05) kg in women. The absolute muscle mass was higher in north area and urban region (P<0.001). The weight-adjusted muscle mass showed reverse patterns of regional difference compared with height-adjusted muscle mass. Both muscle mass and handgrip strength decreased by age (trend P<0.001), with a larger decline observed in handgrip strength. According to AWGS criteria, the proportions of low muscle mass and strength increased by age. Among participants over 80 years old, the prevalence of low muscle mass and strength were 56.2% and 74.5% in men, and 35.7% and 66.0% in women.@*Conclusions@#Levels of skeletal muscle mass and strength varied greatly among people from 10 regions and among participants with different demographic characteristics. The prevalence of low muscle mass and strength was extremely high in elderly.

Analysis on adulthood weight change in adults in China / 中华流行病学杂志

Objective@#To understand the characteristics of adulthood weight change through the analysis on data from China Kadoorie Biobank (CKB) Study of 0.5 million adults from ten areas in China.@*Methods@#An electronic questionnaire was used to collect the information about the body weight at age 25 years, social-demographic characteristics and lifestyle of the study subjects and their body weight were measured. After excluding the adults with self-reported histories of coronary heart disease, stroke, cancer or diabetes and those who had no data of body weight at age 25 years and those aged outside of 35-70 years, a total of 360 903 adults were included in the analysis. Adulthood weight change were defined as difference value between current body weight and body weight at age 25 years.@*Results@#The mean adulthood weight change of the participants was 4.9 kg. The adults living in urban area showed more body weight increase compared with those living in rural area, so did the adults in northern area compared with those in southern area. Among the ten areas in China, Qingdao reported the highest adulthood weight increase (9.3 kg), and Gansu reported the lowest adulthood weight increase (1.5 kg). Older adults had higher BMI at early adulthood (25 years old), but the adults aged 45-50 years had the highest adulthood body weight increase. Adults with higher educational level, higher household income level, but lower physical activity level had more body weight increase, while current smokers, farmers and workers had less body weight increase. BMI at age 25 years was negatively associated with adulthood body weight change, but current BMI was positively associated with adulthood body weight change (P<0.001).@*Conclusion@#Adulthood body weight change varied greatly among population with different demographic characteristics and lifestyle and in ten areas in China.

Epidemiological characteristics and correlated factors of habitual snoring among Chinese aged 30 to 79 year-old / 中华流行病学杂志

Objective@#To describe the characteristics of habitual snoring among adults from 10 regions engaged in the China Kadoorie Biobank (CKB) study.@*Methods@#The baseline survey of CKB was conducted from 2004 to 2008. Data was collected regarding the information on socio- demographic characteristics, lifestyle, sleeping habits, and results from the physical examination of the participants. Logistic regression models were used to compare the regional differences and to estimate the associations of other baseline characteristics on snoring habit.@*Results@#A total of 512 713 participants were included in this study. The overall prevalence of habitual snoring was 21.2%, higher among men, in south regions and urban areas, but no difference observed among people with different socioeconomic status after adjusting for age, regions, BMI, waist circumference or lifestyle factors. Results showed that the prevalence of habitual snoring under the multivariable adjusted model increased among current and ever smokers, also among current and ever alcohol consumers. The risk of habitual snoring was increased by 19% per 1 kg/m2 and 6% per 1 cm increment in BMI or waist circumference, respectively. Among participants with similar BMI, central obese individuals were more likely to be habitual snorers. For individuals with similar waist circumference, the prevalence of habitual snoring was higher among those with higher BMI.@*Conclusion@#The prevalence of habitual snoring varied across regions. Substantial differences in habitual snoring were also seen among people with different lifestyles and body sizes.

Relationship between educational level and long-term changes of body weight and waist circumference in adults in China / 中华流行病学杂志

Objective: To evaluate the association of educational level with anthropometric measurements at different adult stages and their long-term changes in adults who participated in the second re-survey of China Kadoorie Biobank (CKB). Methods: The present study excluded participants who were aged >65 years, with incomplete or extreme measurement values, or with major chronic diseases at baseline survey or re-survey. The weight at age 25 years was self-reported. Body height, body weight and waist circumference at baseline survey (2004-2008) and re-survey (2013-2014) were analyzed. Results: The present study included 3 427 men and 6 320 women. Both body weight and waist circumference (WC) increased with age. From age 25 years to baseline survey (mean age 45.2±6.5), the mean weight change per 5-year was (1.70±2.63) kg for men and (1.27±2.10) kg for women. From baseline survey to re-survey (53.2±6.5), the mean changes per 5-year for body weight were (1.12±2.61) kg for men and (0.90±2.54) kg for women; and that for WC was (3.20±3.79) cm for men and (3.83±3.85) cm for women. Among women, low educational level was consistently associated with higher body mass index (BMI) and WC at age 25 years, baseline survey and re-survey. Among men, low educational level was associated with higher BMI at age 25 years. At baseline survey and re-survey, the educational level in men was not statistically associated with BMI; but men who completed junior or senior high school showed slight higher WC and increase of WC from baseline survey to re-survey than other male participants. Conclusions: Body weight and WC increased with age for both men and women. The associations of educational level with BMI and WC were different between men and women.

Relationship between educational level and long-term changes of body weight and waist circumference in adults in China / 中华流行病学杂志

Objective To evaluate the association of educational level with anthropometric measurements at different adult stages and their long-term changes in adults who participated in the second re-survey of China Kadoorie Biobank (CKB).Methods The present study excluded participants who were aged ＞65 years,with incomplete or extreme measurement values,or with major chronic diseases at baseline survey or re-survey.The weight at age 25 years was self-reported.Body height,body weight and waist circumference at baseline survey (2004-2008) and re-survey (2013-2014) were analyzed.Results The present study included 3 427 men and 6 320 women.Both body weight and waist circumference (WC) increased with age.From age 25 years to baseline survey (mean age 45.2 ± 6.5),the mean weight change per 5-year was (1.70 ± 2.63) kg for men and (1.27 ± 2.10) kg for women.From baseline survey to re-survey (53.2± 6.5),the mean changes per 5-year for body weight were (1.12±2.61) kg for men and 0.90±2.54) kg for women;and that for WC was (3.20±3.79) cm for men and (3.83 ± 3.85) cm for women.Among women,low educational level was consistently associated with higher body mass index (BMI) and WC at age 25 years,baseline survey and re-survey.Among men,low educational level was associated with higher BMI at age 25 years.At baseline survey and re-survey,the educational level in men was not statistically associated with BMI;but men who completed junior or senior high school showed slight higher WC and increase of WC from baseline survey to re-survey than other male participants.Conclusions Body weight and WC increased with age for both men and women.The associations of educational level with BMI and WC were different between men and women.

Association between tea drinking and stroke in adults in Zhejiang province: a prospective study / 中华流行病学杂志

Objective: To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province. Methods: After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis. Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke. Results: The main type of drinking tea was black tea (79.78%), followed by green tea (20.08%). Of the 53 916 participants, the proportion of participants who drank tea at least once per week was 31.27%. The corresponding proportions for men and women were 60.24% and 10.30%, respectively. Among 391 512 person-years of the follow-up program (median 7.26 years), a total of 1 487 men and 1 769 women were diagnosed with stroke. After adjusting for socio-demographic status, lifestyle, BMI, waist circumference, and systolic blood pressure, HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6). Compared with participants who did not drink tea weekly, the HRs for incident stroke in those consuming tea 0.1-, 3.0- and ≥5.0 g/d were 0.93 (95%CI: 0.85-1.00), 0.88 (95%CI: 0.77-0.99) and 0.79 (95%CI: 0.69-0.89), respectively. The HRs for incident stroke in smokers and non-smokers who consumed tea ≥5.0 g/d were 0.71 (95%CI: 0.59-0.86) and 0.97 (95%CI: 0.77-1.21), respectively, compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0). The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95%CI: 0.76-1.22) and 0.70 (95%CI: 0.58-0.84), respectively (P=0.040 0). The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95%CI: 0.44-0.81) and 0.86 (95%CI: 0.73-1.01), respectively (P=0.040 0). Conclusion: Tea drinking had an effect on reducing the possibility of incident stroke, especially among those who were current smokers, non-alcohol drinkers and central obese.

Association between tea drinking and stroke in adults in Zhejiang province: a prospective study / 中华流行病学杂志

Objective To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis.Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke.Results The main type of drinking tea was black tea (79.78％),followed by green tea (20.08％).Of the 53 916 participants,the proportion of participants who drank tea at least once per week was 31.27％.The corresponding proportions for men and women were 60.24％ and 10.30％,respectively.Among 391 512 person-years of the follow-up program (median 7.26 years),a total of 1 487 men and 1 769 women were diagnosed with stroke.After adjusting for socio-demographic status,lifestyle,BMI,waist circumference,and systolic blood pressure,HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6).Compared with participants who did not drink tea weekly,the HRs for incident stroke in those consuming tea 0.1-,3.0-and ≥5.0 g/d were 0.93 (95％ CI:0.85-1.00),0.88 (95％ CI:0.77-0.99) and 0.79 (95％ CI:0.69-0.89),respectively.The HRs for incident stroke in smokers and non-smokers who consumed tea ≥5.0 g/d were 0.71 (95％CI:0.59-0.86) and 0.97 (95％CI:0.77-1.21),respectively,compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0).The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95％CI:0.76-1.22) and 0.70 (95％CI:0.58-0.84),respectively (P=0.040 0).The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95％ C1:0.44-0.81) and 0.86 (95％ CI:0.73-1.01),respectively (P=0.040 0).Conclusion Tea drinking had an effect on reducing the possibility of incident stroke,especially among those who were current smokers,non-alcohol drinkers and central obese.

Differences in diet intake frequency of adults: findings from half a million people in 10 areas in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the differences in diet intake frequency of adults in 10 areas surveyed by China Kadoorie Biobank (CKB) project.</p><p><b>METHODS</b>CKB project recruited voluntary residents aged 30-79 years from 5 urban areas and 5 rural areas in China. The baseline survey was conducted among 512 891 eligible subjects during 2004-2008. The intake frequencies of 12 food groups were assessed through in-person interviews and analyzed. The results were adjusted for age and sex structure of the study population.</p><p><b>RESULTS</b>Rice was the main cereal consumed every day in urban areas (99.0%) and rural areas (99.9%) in southern China, while wheat was the main cereal consumed every day in rural areas (99.0%) and Qingdao (88.4%) in northern China. Most subjects in Henan (98.8%) consumed other staple food every day. The lowest proportion of daily intake of fresh vegetables was observed in Gansu (74.0%) . In both southern and northern areas, urban subjects had higher proportions of daily intakes of fresh fruits, preserved vegetables, and meat than rural subjects. Similar results were found when comparing the proportions of intakes of poultry and fish/seafood at least 1 day every week. Contrast to southern China (urban: 6.5%, rural: 6.9%) , the proportions of daily intake of fresh eggs were higher in both urban areas (37.1%) and rural areas (14.6%) in northern China. The highest proportions of daily intake of soybean products and dairy products were observed in Harbin (10.0%) and Qingdao (34.3%).</p><p><b>CONCLUSION</b>The intake of cereal, fresh eggs and soybean products differed between the south and the north of China. The intake of meat, poultry, fish/seafood, fresh fruits, preserved vegetables and dairy products varied considerably between urban areas and rural areas.</p>

Regional differences on patterns of physical activity and leisure sedentary time: findings from the China Kadoorie Biobank study, including a million people from 10 regions / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the gender and regional differences in patterns of physical activity and sedentary behavior across 10 study areas through data from the China Kadoorie Biobank (CKB) that involving half a million adults.</p><p><b>METHODS</b>The baseline survey of CKB took place in 5 urban and 5 rural areas across China during 2004-2008. After excluding those who had a prior history of heart disease, stroke and/or cancer, 486 514 participants (age: 30-79 y) were included in the analyses. MET-h/d was calculated for each one of the participant, based on the type, duration and intensity of self-reported physical activity, along with time spent on sedentary activity. These data were compared, after standardization for age between sex and study areas.</p><p><b>RESULTS</b>The mean total physical activity was 22.9 MET-h/d among men, 20.6 MET-h/d among women, and the mean sedentary leisure time appeared 3.1 h/d in men and 2.9 h/d in women. In men, the total physical activity ranged from 13.3 MET-h/d in Haikou to 31.3 MET-h/d in Zhejiang, while in women it ranged from 14.7 MET-h/d to 30.2 MET-h/d across the 10 areas. For sedentary leisure time, it ranged from 2.0 h/d in Zhejiang to 3.8 h/d in Sichuan in men and 1.6 h/d to 3.7 h/d in women. In both men and women, occupational physical activities (77.6% and 59.8% respectively) accounted for most of the daily activities, while leisure time physical activities accounted for the least (3.1% in both men and women). Among men, the proportion of occupational physical activity ranged from 86.5% in Zhejiang to 69.4% in Haikou (69.4%), while in women it ranged from 74.8% in Zhejiang to 40.9% in Henan. Gansu (men 17.8%, women 18.1%) reported the highest proportion of transportation physical activities. Among women, areas reporting the highest proportion of physical activity at home would include Henan (54.0%) and Hunan (39.1%), whereas adults in Zhejiang (20.0%) reported the lowest proportion. Among men, Hunan (18.0%) reported the highest proportion of physical activity at home. Compared with rural areas, male and female participants from urban areas tended to have more leisure time for physical activity and less vigorous-intensity physical activity.</p><p><b>CONCLUSION</b>The patterns of physical activity and sedentary behavior including the levels of physical activity, domains and intensity of physical activities. Sedentary leisure time appeared all various greatly across different regions in China.</p>

Relationship between anthropometric measures and the prevalence of diabetes in adults of Suzhou city, Jiangsu province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the relationships between anthropometric measures as body mass index (BMI), percentage body fat, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the risks of diabetes.</p><p><b>METHODS</b>We analyzed the baseline data of 53 260 participants who were aged 30-79 years and had been enrolled into the China Kadoorie Biobank (CKB) study from Suzhou city,Jiangsu province. Unconditional logistic regression analyses were conducted with adjustment for potential confounders.</p><p><b>RESULTS</b>Overall, 5.3% of the participants had diabetes, with about a half of them being newly detected through on-site screening tests. The prevalence of diabetes increased with age, 61% higher (OR = 1.61, 95% confidence interval: 1.54-1.67) risk of diabetes, with 10 years increase of age. In both genders, all anthropometric measures were positively and significantly associated with diabetes, with the associations of measures in central adiposity stronger than those in general obesity, with WHR as the strongest. Each standard deviation (1- s) with greater WHR (<0.06 in men and 0.07 in women) was associated with 72% (61%-83%) higher risk of diabetes in men and 93% (83%-102%) in women. After adjusting for HC, each WC with 5 cm larger, showing 65% and 57% higher risks in men and women respectively. However, after adjusting for WC, every 5cm greater HC appeared and associated with respective 38% and 34% lower risks.</p><p><b>CONCLUSION</b>Measures on adiposity including BMI, percentage body, WC, WHR and WHtR fat were all positively associated with the prevalence of diabetes. Measures of central obesity, particularly WHR, were more strongly associated with diabetes than measures of general obesity. When WC was under control, HC appeared inversely associated with diabetes.</p>

Biocompatibility study of polylactic/glycolic acid and Schwann cell / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To examine the biocompatibility of polylactic/glycolic acid (PLGA) and Schwann cells.@*METHOD@#Schwann cells were harvested from rat brachial and sciatic nerves. Schwann cells were cultured with PLGA, observed by phase-contrast microscopy and electron microscopy.@*RESULT@#Schwann cells could attach and proliferate on the surface of the PLGA.@*CONCLUSION@#The PLGA has good cellular biocompatibility. It can be used as biomaterial for tissue engineering.