Dietary patterns and type 2 diabetes: A cohort study / 中华内分泌代谢杂志

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.

The cancer risk and epidemiological analysis for medical X-ray workers in Shanghai / 中华放射医学与防护杂志

Objective:To study the risk of malignant tumor in medical X-ray workers in Shanghai and provide scientific data for the study on occupationally exposed population.Methods:A retrospective cohort study was conducted to investigate the risk of cancer. Totally, 715 physicians in radiology departments during 1950-1980 in Shanghai were selected as exposure group, while 738 with non-radiology departments in the same hospital in the same time period as control group. The basic information on the selected physicians and associated cancer incidence were collected. The comulative number of individuals with cancer from 1980 to 2021 was calculated. The relative risk ( RR) of cancer was analyzed using logistic regression model in terms of gender, birth year, and work starting year. As well, stratified analysis based on confounding factors was conducted. Results:A total of 1 369 individuals were followed up, including 668 in exposure group and 701 in control group. The cumulative person-year of observed individuals was 52 980. As of 31 December 2021, a total of 199 patients with various malignant tumors were identified. The results of the logistic regression analysis showed that the risk of malignant tumors in exposure group was significantly higher than that in control group. The adjusted RR of solid cancer and total cancer was 1.49 (95% CI: 1.08-2.05, P=0.015) and 1.40 (95% CI: 1.02-1.92, P=0.036), respectively. In addition, the risk of thyroid cancer in exposure group was significantly higher than that in control group ( RR=10.06, 95% CI: 2.05-49.62, P=0.005). Stratified analysis showed that the exposure group had a higher risk of total cancer both for femals and workers taking their jobs at age of 21-25. Conclusions:The risk of thyroid cancer, solid cancer and total cancer in the medical X-ray workers was significantly higher than that in control group. It is suggested that radiation protection in medical practice should be strengthened for the occupationally exposed workers, especially for femals and workers taking their jobs at low age.

Study on non-cancer incidence among medical radiation workers in Chongqing / 中华放射医学与防护杂志

Objective:To study the effect of occupational X-ray exposure on non-cancer diseases of radiation workers.Methods:The medical X-ray workers in Chongqing mumicipality were surved in 1980. In 2020, the previous 91 medical institutions distributed across 41 districts and counties of Chongqing continued to be selected as the survyed units, including 53 grade-A top-class hospitals. Using the method of prospective cohort study, the fifth follow-up survey was conducted for Chongqing′s medical X-ray workers and the control groups in 1980 with respect to their personal information, occupational radiation exposure, disease history and others. The incidence rate, relative risk ( RR) and 95% confidence interval of diseases in each system were analyzed. Results:There were 937 individuals in this cohort. So far, 359 cases of non-cancer diseases had been counted. Compared with the control group, the relative risk RR of cardiovascular system, ophthalmology and other unclassified diseases in the exposure group were 1.50, 2.03 and 2.64 ( χ2=5.97, 3.97, 4.25, P <0.05) , respectively. The adjusted confounding factors showed that the RR of the incidence rate of cardiovascular, ophthalmic and digestive diseases in the female exposure group was generally higher than that in the control group ( RR=2.33, 2.59, 7.55; χ2= 7.28, 4.17, 8.64, P < 0.05) , respectively. The RR of the incidence rate of cardiovascular and ophthalmic diseases in exposure group was generally higher than that in the control group among 25-29 year-old workers ( RR=2.26, 5.07; χ2 =8.22, 4.91, P < 0.05) , respectively. For compasion between the the accumulated dose groups, the incidence rate of cardiovascular system, ophthalmology and digestive system diseases in the exposure group was generally higher than that in the control group ( RR=1.86, 2.91, 3.59; χ2= 9.83, 8.21, 5.58, P < 0.05) , respectively. Conclusions:The non-cancer risk of X-ray workers exposed to long-term occupational exposure was increased, among which the risk of cardiovascular system, digestive system, ophthalmic diseases and others might be related to the occupational exposure.

Dietary patterns and sarcopenia in older adults: a cross-sectional study / 中华健康管理学杂志

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.

Relationship between serum ferritin levels and metabolic syndrome in adults / 中华内分泌代谢杂志

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.

Relationship between serum C-reactive protein concentration and muscle strength, physical performance among the aged in Tianjin / 中华健康管理学杂志

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.

The relationship between serum complement C3 concentration and prediabetes in an adult population / 天津医药

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.

Complement C3 and simple fatty liver disease and nonalcoholic steatohepatitis in an adult population / 中华健康管理学杂志

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.

Serum uric acid levels predict the risk of developing prediabetes in an adult population / 中华健康管理学杂志

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.