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The optimal P2Y 12 inhibitor in high bleeding risk (HBR) patients with acute coronary syndrome (ACS) remains unclear. We compared the in-hospital efficacy and safety of ticagrelor versus clopidogrel in ACS patients at HBR. We identified 22,120 hospitalized ACS patients with HBR treated with aspirin combined with either clopidogrel (n = 17,420) or ticagrelor (n = 4700) in the Improving Care for Cardiovascular Disease in China-ACS (CCC-ACS) project between November 2014 and December 2019. The median length of hospital stay was 10 days (interquartile range, 7–14 days). Compared with clopidogrel, ticagrelor was associated with a higher risk of in-hospital TIMI major or minor bleeding (4.8% vs 3.8%; adjusted OR 1.20; 95% CI 1.03–1.41; P = 0.022). The incidence of TIMI major bleeding (1.7% vs 1.1%, P = 0.005) and intracranial bleeding (0.8% vs 0.5%, P = 0.005) were also higher in the ticagrelor group than in the clopidogrel group. There was no significant difference in the rate of in-hospital major adverse cardiovascular and cerebrovascular event (MACCE) (a composite of all-cause death, myocardial infarction, stent thrombosis, or ischemic stroke) with ticagrelor compared with clopidogrel therapy (4.2% vs 4.3%; adjusted OR 1.08; 95% CI 0.90–1.28; P = 0.411). Outcomes in the propensity-matched cohorts and in sensitivity analyses were consistent with the those of the main analysis. Among ACS patients with HBR, ticagrelor as compared with clopidogrel was associated with an increased risk of in-hospital major bleeding without a significant reduction in in-hospital MACCE. https://www.clinicaltrials.gov. Unique identifier: NCT02306616. [ABSTRACT FROM AUTHOR]

There is a worldwide consensus that renewable energy sources, such as wind power, will play an essential role in the global low-carbon energy transition. However, most quantifications of the CO 2 emissions of wind power systems ignored the indirect footprints induced by supply chains. Thus, this study developed input–output (IO)-based hybrid life-cycle assessment (LCA) models based on China's 2007, 2012, and 2017 economic benchmark data to quantify the economy-wide greenhouse gas (GHG) footprint of China's wind power sector. Moreover, the key sectors driving the footprint variation were identified, and the footprint structure was analyzed via the production layer decomposition method. The study results confirm the decarbonization of the wind power sector in China, with a decrease in the GHG footprint from 52.27 g CO 2 e/kWh in 2007 to 21.23 g CO 2 e/kWh in 2017. This 59.38% GHG footprint reduction was mainly driven by the electricity and heat sector. Most of wind power's GHG footprint (more than 84%) was derived from upstream industries, highlighting the necessity of supply chain analysis in the governance of the wind power industry. • We developed IO-based hybrid LCA model for comprehensive and specific CO 2 footprint accounting. • The decarbonization of China's wind power sector during 2007 to 2017 was quantified. • The evolving trend and driving factors of the CO 2 footprint were identified. • Supply chain governance is indispensable for the decarbonization of China's wind power sector. [ABSTRACT FROM AUTHOR]

In this study, we first evaluated a satellite-based precipitation product (3B42V7) using gauge observations and then investigated its utility in supporting reservoir operation and water resources management in Hanjiang basin from January 1998 to December 2013. Direct comparison of 3B42V7 with gauge observations shows that it can well capture the spatial and temporal characteristics of precipitation over the study basin. However, the 3B42V7 estimates generally show slight underestimation of precipitation, especially for extreme precipitation events, which need be considered in the future algorithm development. Next, we conducted the long-term (2008–2013) hydrologic evaluation of the 3B42V7 product using a calibrated monthly hydrologic model. The results show that the performance of the monthly hydrologic model driven by 3B42V7 is compatible to the results driven by gauge-based simulations according to high values of Nash-Sutcliffe coefficients (0.83 and 0.66 for observation-driven and 3B47V7 driven simulations, respectively) and small values of biases (−8.16% and −3.98%). We further evaluated the applicability of 3B42V7 in reservoir operation through a set of operation experiments, in which modeled inflow series were used to make decisions. The results indicate that reservoir operations based on modeled streamflow using the 3B42V7 estimates perform well in water allocation decision-making and strongly agree with actual inflow based operations. Despite that 3B42V7 tends to slightly underestimate precipitation, the resultant operations do not impact the functions and benefits of reservoir operation much. This suggests that the 3B42V7 precipitation estimates are valuable and useful for monthly streamflow simulation and long-term reservoir operation in Hanjiang basin. This study provides a new insight on the evaluation and utility of the remote sensing based precipitation estimates. [ABSTRACT FROM AUTHOR]

The quantity of leachate is crucial when assessing pollution emanating from municipal landfills. In most cases, existing leachate quantification measures only take into account one source – precipitation, which resulted in serious underestimation in China due to its waste properties: high moisture contents. To overcome this problem, a new estimation method was established considering two sources: (1) precipitation infiltrated throughout waste layers, which was simulated with the HELP model, (2) water squeezed out of the waste itself, which was theoretically calculated using actual data of Chinese waste. The two sources depended on climate conditions and waste characteristics, respectively, which both varied in different regions. In this study, 31 Chinese cities were investigated and classified into three geographic regions according to landfill leachate generation performance: northwestern China (China-NW) with semi-arid and temperate climate and waste moisture content of about 46.0%, northern China (China-N) with semi-humid and temperate climate and waste moisture content of about 58.2%, and southern China (China-S) with humid and sub-tropical/tropical climate and waste moisture content of about 58.2%. In China-NW, accumulated leachate amounts were very low and mainly the result of waste degradation, implying on-site spraying/irrigation or recirculation may be an economic approach to treatment. In China-N, water squeezed out of waste by compaction totaled 22–45% of overall leachate amounts in the first 40 years, so decreasing the initial moisture content of waste arriving at landfills could reduce leachate generation. In China-S, the leachate generated by infiltrated precipitation after HDPE geomembranes in top cover started failing, contributed more than 60% of the overall amounts over 100 years of landfilling. Therefore, the quality and placing of HDPE geomembranes in the top cover should be controlled strictly for the purpose of mitigation leachate generation. [ABSTRACT FROM AUTHOR]

Municipal solid waste (MSW) properties and parameters for MSW treatment technologies are decisive for GHG emission of MSW treatment systems. But they are changing in China due to MSW source segregation and technological advancements, which requires new studies on GHG emissions of MSW treatment systems based on up-to-date data. In this study, GHG emission values and their uncertainties of waste treatment systems before and after MSW source segregation in Shanghai were analyzed utilizing Life Cycle Assessment (LCA) methods and Monte Carlo analysis. The results showed that before waste segregation, 21.0∼319 kg CO 2 -eq GHG per tonne was emitted and that -139∼203 kg CO 2 -eq GHG per tonne was emitted after waste source segregation. The source segregation helps to reduce GHG emissions from MSW treatment systems. In the long run, waste to energy incineration was not recommended from GHG perspective and anaerobic digestion has a great potential for GHG emission reductions. [Display omitted] [ABSTRACT FROM AUTHOR]

Highlights: [•] We established a comprehensive LCI method for landfill construction and operation. [•] We reported the consumption of materials and energy in a generic Chinese landfill. [•] The contribution of C&O to the impacts of total landfilling is not negligible. [•] Non-toxic and toxic impacts are attributed to diesel and mineral usage, respectively. [•] Replacing minerals with synthetic materials is effective in mitigating impacts. [Copyright &y& Elsevier]

Abstract: Determination of the amount of greenhouse gas (GHG) emitted during municipal solid waste incineration (MSWI) is complex because both contributions and savings of GHGs exist in the process. To identify the critical factors influencing GHG emissions from MSWI in China, a GHG accounting model was established and applied to six Chinese cities located in different regions. The results showed that MSWI in most of the cities was the source of GHGs, with emissions of 25–207kgCO2-eqt−1 rw. Within all process stages, the emission of fossil CO2 from the combustion of MSW was the main contributor (111–254kgCO2-eqt−1 rw), while the substitution of electricity reduced the GHG emissions by 150–247kgCO2-eqt−1 rw. By affecting the fossil carbon content and the lower heating value of the waste, the contents of plastic and food waste in the MSW were the critical factors influencing GHG emissions of MSWI. Decreasing food waste content in MSW by half will significantly reduce the GHG emissions from MSWI, and such a reduction will convert MSWI in Urumqi and Tianjin from GHG sources to GHG sinks. Comparison of the GHG emissions in the six Chinese cities with those in European countries revealed that higher energy recovery efficiency in Europe induced much greater reductions in GHG emissions. Recovering the excess heat after generation of electricity would be a good measure to convert MSWI in all the six cities evaluated herein into sinks of GHGs. [Copyright &y& Elsevier]

Although edge effects often significantly alter abiotic habitat variables, and the performance and behaviour of plant and animal species, they are rarely taken into account when designing nature reserves or managing the movement of visitors within reserves. In this study, we examined the effects of proximity to a habitat edge, created by a visitor pathway, on reproductive success of the orchids Phaius delavayi and Ponerorchis chusua within the Huanglong National Park, China. Parallel transects were established at different distances from the pathway to test the effects of proximity to the pathway on male and female reproductive success in two consecutive years. For Phaius delavayi, percentage pollinarium removal and percentage fruit set showed significant variation between transects in both years, with plants in transects closer to the pathway having lower reproductive success. P. chusua showed the same trends except for pollinarium removal in one year. These results are consistent with the hypothesis that proximity to the pathway, which is used by a large number of visitors every day throughout the orchids’ flowering seasons, interfered with pollinator activity, depressing male and female reproductive success in both species. The impacts on reproductive success were significant for plants within approximately 10 meters of the pathway. Such edge effects may be common, and may need to be considered when designing nature reserves in which visitor activity is encouraged. [Copyright &y& Elsevier]

• Four IFA reuse technologies are compared with the landfill option using LCA and LCC. • IFA heavy metals transfer coefficient model is establish using MFA. • Externality costs as environmental and social costs are estimated to reveal 'true' costs of technologies. • IFA-to-ceramsite is preferred option overall. • Waste disposal subsidies are crucial for IFA reuse technologies to be economic feasible. Harmless disposal and reutilization of municipal solid waste incinerator fly ash (IFA) attract growing interests due to the gap between increasing IFA generation and limited landfill space. Therefore, an economical-affordable and environmentally friendly approach to deal with IFA is required. Herein, major IFA reutilization technologies in China (IFA-to-cement, glassy slags, rock wool, and ceramsite) were evaluated and compared with the landfill using life cycle assessment (LCA) and environmental life-cycle costing (eLCC). Prior to assessments, material flow analysis (MFA) was used to establish a heavy metal transfer coefficient model. LCA results indicate IFA-to-cement and IFA-to-ceramsite outperform others while eLCC results show that IFA-to-ceramsite and IFA-to-rock wool are preferred, breaking even at years 3 and 5 compared to IFA-to-cement (new plant) at year 11. To reveal true costs of reutilization technologies, whole life costing (WLC) was applied to include externality costs via monetizing emissions. Major pollutants contributed to externality costs of these technologies were identified. IFA-to-ceramsite and IFA-to-rock wool technologies remain preferred with payback time as 4 and 6 years respectively. A scenario analysis suggests that replacing sintering aids with polluted soil and Sec-FA recovery could further improve the overall performance of IFA-to-ceramsite option. Policy scenario analysis reveals that corporate income tax and environmental protection tax have negligible impacts but waste disposal subsidy is vital for IFA reutilization technologies being economic feasible even without externalities. [Display omitted] [ABSTRACT FROM AUTHOR]

• 1,050 restaurant owners from six cities in Gansu province were surveyed to study their awareness level of food waste recycling. • The factors affecting the restaurant owner's awareness on food-waste recycling were investigated from four aspects and the related policy suggestions were put forward. Food waste has become an issue of great public concern because of its environmental impacts and strategic significance of food security worldwide. In the context of ecological civilization construction and circular economy development in China food waste recycling faces critical theoretical and practice obstacles in reality. As China's urban population grows and the restaurant industry expands, the food waste generated by restaurants increases. Therefore restaurant owners' attitude and behavior towards food waste recycling plays a pivotal role. As a stakeholder, the awareness of restaurant owners affects their attitudes and behavior towards the environment. In this paper, 1,050 restaurant owners from six cities of Gansu province in northwestern China were surveyed to study their awareness of food waste recycling. Using the awareness assessment model, the awareness level of 1,050 restaurant owners were calculated. The results show that 37.33% of respondents has a high awareness and 62.67% of them has a low awareness of food waste recycling. This indicates that the restaurant owners have a low level of overall awareness. Logistic regression model was used to examine factors that affect the awareness level of restaurant owners. Compared with the male restaurant owner, the female one has a lower awareness. The younger restaurant owner has a higher awareness than the older one. In addition, factors, including the educational level of restaurant owner, restaurant scale, amount of daily restaurant food waste, the way of food waste treatment, and the macroeconomic development of city where restaurants located, have positive effects on the awareness. [ABSTRACT FROM AUTHOR]

Methotrexate (MTX) and iguratimod (IGU) are conventional synthetic disease modifying antirheumatic drugs widely used in the treatment of Rheumatoid arthritis (RA) in China. Although MTX combined with IGU can significantly inhibit the progression of RA, some patients do not respond to the treatment. The purpose of this study is to explore the difference of serum protein expression between RA patients with good and poor response to the combined therapy by label-free quantitative proteomic approach. From the proteomics data, a total of 782 proteins in the serum of RA patients were detected, and of which 9 were upregulated and 18 were downregulated in the good response group compared to poor response group. Among them, four significantly differentially expressed proteins (RELN, LDHA, MRC1 and TKT) were further validated by multiple reaction monitoring (MRM)-based quantification approach, and three of them (RELN, LDHA and MRC1) were confirmed to be correlated with the response to MTX/IGU therapy. Logistic regression and ROC analysis indicated that the combination of RELN, LDHA and MRC1 had good performance in evaluating the response. This result proved the different serum proteins signature fingerprint between response group and non-response group; and highlighted the potential of the label-free and mass spectrometry-based quantitative proteomic approach in screening biomarkers for evaluating clinical response to MTX/IGU therapy in RA. • The expression of serum proteins is different between R and NR group after treating by MTX combined with IGU. • 9 upregulated and 18 downregulated proteins were detected in two groups, respectively. • Combination of RELN, LDHA and MRC1 was validated to be the candidate biomarker to evaluate the efficacy. • Several dysregulated serum proteins are involved in the anti-inflammatory progress of MTX and IGU. • The study provides a new option for further research on the mechanism of MTX and IGU. [ABSTRACT FROM AUTHOR]

Arbuscular mycorrhizal (AM) fungi are an important determinant of plant performance. The temporal distribution patterns of AM fungal communities, important groups in forest soil, are affected by various environmental factors. However, the effect of seasonal variation on AM fungal communities in forest soil is still not fully understood. To improve knowledge regarding the seasonal dynamics of AM fungal communities in forest soil, the Juglans mandshurica rhizosphere soil in a 30-year-old natural J. mandshurica and Larix gmelinii mixed forest in northeastern China was sampled and studied during different seasons. AM fungal community composition and structure in the rhizosphere soil were determined by using the Illumina MiSeq sequencing platform. The results showed that forest type significantly affected soil pH and the microbial biomass carbon (C mic), microbial biomass nitrogen (N mic), C, N, P, NH 4 +-N and NO 3 −-N contents. Similarly, soil moisture significantly decreased with seasonal progression in all forest types. Glomus and Diversispora were the dominant genera. The Shannon, Sobs and Chao1 indices of the mixed forest were higher in July than in May and September. The NO 3 −-N and water-soluble phenol (WSPh) contents were the most important factors driving the shift in the soil AM fungal community across the seasonal gradient. Network analysis revealed that AM fungal network structure was significantly different between seasons, and the number of links between species significantly increased with time. We observed a clear tendency for mixed forest management to significantly affect AM fungal community structure and composition but not diversity. Furthermore, the co-occurrence network and keystone taxa among AM fungi can change in response to environmental filtering due to mixed management in different seasons. • Mixed management had a significant effect on AM fungal community structure. • There was obvious seasonal variation in the AM fungal community in the mixed plantation. • Changes in NO 3 −-N and water-soluble phenol altered the AM fungal community. • AM fungal network structure was dynamic throughout the growing season. • Most of the hub OTUs belonged to Glomeromycetes in all seasons. [ABSTRACT FROM AUTHOR]

Based on the continuous online measurements of volatile organic compounds (VOCs) at a suburban site in Jinan, Shandong province in the wintertime of 2021, characteristics, chemical transformations and sources of VOCs were analyzed. The total mixing ratio of VOCs was 30.35 ± 19.9 ppbv, with alkanes being the most abundant species. Alkenes and aromatics were the major contributors to the hydroxyl radical loss rate (L OH) and the ozone formation potential (OFP), accounting for 44.9% and 32.7% to L OH , and 43.2% and 33.4% to OFP, respectively. Aromatics had the primary contribution (98.1%) to the secondary organic aerosol potential (SOAP), and the high correlation between SOAP and PM 2.5 concentrations (R = 0.70) suggested that VOCs were critical precursors of PM 2.5. Coal/biomass burning and motor vehicle emissions were the main sources of VOCs (24.6% and 23.8%, respectively), followed by petrochemical and fuel evaporation (19.9%), industrial sources (16.9%), and liquefied petroleum gas/natural gas use (14.8%). Backward trajectories and the potential source contribution function (PSCF) analysis results suggested that short-range transport from the southeast was the primary potential source of VOC concentrations in suburban Jinan. The results can provide theoretical support for local governments to develop VOC emission control strategies in suburban areas. • Daytime VOCs were significantly influenced by strong localized emissions. • SOAP of VOCs and PM 2.5 were highly correlated. • Coal/biomass burning and vehicle emissions were the most significant sources of VOCs. • Short-distance transport from the southeast was important for VOCs control. [ABSTRACT FROM AUTHOR]

Objective: The aim is to assess the relationship between the hemoglobin glycation index(HGI) and dietary patterns, and investigates whether inflammation and oxidative stress mediate the relationship.Methods: Cross-sectional data were collected from 453 dwellers in a Chinese rural community. Diet was assessed using 24 h food recalls. Based on the energy intake ratio from three macronutrients, dietary patterns were identified by cluster analysis. The HGI was defined as the observed HbA1c minus predicted HbA1c. Indicators of inflammation and oxidative stress were assessed.Result: 3 dietary patterns were clustered, namely "fat(n = 100)", "balance(n = 186)" and "carbohydrate(n = 167)". The fat dietary patterns had lower HGI than the other two dietary patterns. TNFα was higher in the carbohydrate dietary pattern. Linear regression analysis suggested that the carbohydrate dietary pattern was correlated with higher HGI levels(β = 0.204,95 %CI(0.071,0.338)), compared with the fat dietary pattern. The relationship disappeared after accounting for biomarkers of inflammation and oxidative stress. Mediation analyses indicated that TNFα might explain for 19.15 % effects of the carbohydrate dietary pattern on HGI, compared with the fat dietary pattern.Conclusion: The carbohydrate dietary pattern had positive associations with HGI and TNFα. TNFα partly mediated the relationship between dietary patterns and HGI. [ABSTRACT FROM AUTHOR]

Abstract: Cats are essential in the epidemiology of Toxoplasma gondii because they are the only hosts that can excrete the environmentally resistant oocysts in nature. This study was aimed to determine the seropositivity, distribution of genotypes and mouse virulence of T. gondii from stray cats in Beijing, China. A total of 64 serum samples, 23 feces and tissue samples were collected from stray cats in Beijing. Antibodies to T. gondii were assayed by the modified agglutination test (MAT). 57.8% (37/64) of these stray cats had titers of 1:20 or higher and were considered positive with infection. T. gondii oocysts were not found in feces of the 23 cats. Tissues of 23 cats were bioassayed in mice and 11 T. gondii isolates were obtained. The genotype of these isolates were identified by 11 PCR-RFLP markers, including SAG1, (3′+5′)SAG2, alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and an apicoplast marker, Apico. Only one genotype was identified. This genotype, designated as ToxoDB genotype #9, was previously reported in cats, pigs and human from Guangdong and Gansu provinces in China and animals from a few other countries. To determine mouse virulence of this lineage of parasites, one isolate was randomly selected and inoculated into BABL/c mice, the result showed that it is intermediately virulent to mice. These results indicated that an atypical, intermediately virulent T. gondii lineage is widespread in China. The high seropositivity of T. gondii in stray cats posts potential risk of transmission of the parasite to human population in the region. [Copyright &y& Elsevier]

Abstract: Backgroud: ChREBP regulates lipogenesis and glucose utilization in the liver. Current reports suggest a contradictive association between rs3812316 of this gene and triglyceride level. We hypothesized the polymorphisms in ChREBP gene were associated with CAD in Chinese population. Methods: The ChREBP gene polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods in 200 controls and 310 CAD patients. Serum lipids and glucose concentrations were measured in all subjects. Haplotypes were constructed based on rs3812316, rs7798357 and rs1051921. All the data were analyzed using SPSS14.0, PLINK1.07 and SHEsis software. Results: The rare allele G of rs3812316 was significantly lower in the CAD group after adjusting for age, sex, BMI, SBP and DBP (ORa =0.589, 95%CI=0.361–0.961, P =0.034). No significant differences between cases and controls were found in genotype or allele distributions of rs7798357, rs17145750 and rs1051921. Haplotype CGC was significant higher in CAD group (P <0.01, OR=2.364, 95%CI=1.608–3.474), while haplotypes GGC, CGT, CCC were significant lower in CAD group (P <0.05). Conclusions: The rs3812316 and the haplotypes in ChREBP gene appeared to be related to high susceptibility to CAD. [Copyright &y& Elsevier]

• Single-dose dupilumab pharmacokinetics (PK) were studied in 30 Chinese subjects. • Repeated-dose PK were studied in 82 Chinese adults with atopic dermatitis. • PK were comparable to non-Asians after accounting for body weight. Dupilumab, a fully human monoclonal antibody targeting IL-4Rα, has demonstrated rapid and sustained improvements in clinical outcomes in patients with atopic dermatitis (AD), asthma, and chronic rhinosinusitis with nasal polyps. In a phase 1, double-blind, ascending-dose study, 30 healthy Chinese adults were randomized to single subcutaneous doses of dupilumab 200, 300, 600 mg, or placebo. In a phase 3, double-blind study, 165 Chinese adults with AD were randomized to dupilumab 300 mg or placebo every 2 weeks. Following single doses of dupilumab 200, 300, and 600 mg in the phase 1 study, mean serum maximum concentrations (C max) were 25.4 ± 4.0, 37.2 ± 14.5, and 77.3 ± 19.0 mg/L, respectively. For a 1.5-fold increase in dupilumab dose, 1.31-, 1.73-, and 1.66-fold increases in C max , area under the curve to real time (AUC last), and extrapolated to infinity (AUC) were observed, respectively, while a 2-fold dose increase resulted in 2.17-, 2.81-, and 2.80-fold increases, respectively. In the phase 3 study, mean dupilumab trough concentrations were 78.8 ± 32.0 and 86.4 ± 33.6 mg/L at weeks 12 and 16, respectively. C max increased approximately proportionally to dose, while AUC and AUC last increased greater than proportionally. Dupilumab pharmacokinetics were generally comparable between Chinese and non-Asian healthy subjects (single dose) and between Chinese and non-Asian AD patients (repeated doses), with differences accounted for by body weight. As differences in exposure by weight are unlikely to be clinically relevant based on late-stage study results, no dose adjustment by ethnic origin or weight is required. [ABSTRACT FROM AUTHOR]

Abstract: Osteoporosis is a major public health problem, mainly characterized by low bone mineral density (BMD). BMD is a complex trait that is determined by multiple genes. Insulin-like growth factor I (IGF-I) is an important growth factor of bone and thus IGF-I gene has been considered as an attractive candidate gene for osteoporosis. A few studies on the relationship between variants of the IGF-I gene and BMD variation, via traditional association and/or linkage methods, have yielded conflicting results. In this study, we simultaneously tested association and/or linkage of a cytosine-adenine (CA) repeat polymorphism at 1 kb upstream of the transcription initiation site of the IGF-I gene with BMD variation in a large cohort of premenopausal Chinese women. A total of 1263 subjects from 402 Chinese nuclear families were examined. Each family consists of both parents and at least one daughter aged between 20 and 45 years. BMDs (g/cm2) at the lumbar spine and hip were measured using dual-energy X-ray absorptiometry (DXA). Applying the QTDT (quantitative transmission disequilibrium tests) progam, we did not find significant evidence of association or linkage between the CA repeat polymorphism of the IGF-I gene and BMD variation at any skeletal site. Our data do not support the IGF-I gene having major effect on BMD variation in premenopausal Chinese women. [Copyright &y& Elsevier]