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To investigate the association between brachial-ankle pulse wave velocity (baPWV) and cardiovascular and cerebrovascular disease (CVD) in different age groups.A total of 39 417 people, receiving Kailuan physical examination, completing baPWV examination from 2010 to 2017, with no history of CVD and atrial fibrillation, were selected as the observation objects. The population was categorized into one age group per 10 years, namely the50, 50-59, 60-69, 70-79, and ≥80-year-old groups, and the total population, and each group was further assigned into three classes according to the triple quartiles of baPWV. Kaplan-Meier method helped to calculate the cumulative incidence of CVD in different age groups. The effect of baPWV on CVD in different age groups was evaluated using the Cox proportional hazards regression model.Kaplan-Meier survival curve indicated statistical significance (p .05) in the cumulative incidence of CVD among the whole population,50, 50-59, and 60-69-year-old groups, while the cumulative incidence of end-point events among the baPWV subgroups of 70-79 and ≥80-year-old groups exhibited no statistical significance (p .05). Compared with baPWV in the Q1 group, hazard ratio value (95% confidence interval [CI]) of CVD in the Q3 group was 4.14 (95% CI: 2.98-5.75) in the total population, 2.98 (95% CI: 1.08-8.21) in50-year-old population, 4.49 (95% CI: 2.89-7.00) in 50-59-year-old population, 2.78 (95% CI: 1.76-4.39) in 60-69-year-old population, 1.39 (95% CI: 0.86-2.24) in 70-79-year-old population, and 1.15 (95% CI: 0.55-2.41) in ≥80-year-old population.CVD risk attributed to increased arterial stiffness reduces with age.

Background Lung cancer is the most prevalent cancer, and the leading cause of cancer-related deaths in China. The aim of this study was to estimate the direct medical expenditure incurred for lung cancer care and analyze the trend therein for the period 2002–2011 using nationally representative data in China Methods This study was based on 10-year, multicenter retrospective expenditure data collected from hospital records, covering 15,437 lung cancer patients from 13 provinces diagnosed during the period 2002–2011. All expenditure data were adjusted to 2011 to eliminate the effects of inflation using China’s annual consumer price index. Results The direct medical expenditure for lung cancer care (in 2011) was 39,015 CNY (US$6,041) per case, with an annual growth rate of 7.55% from 2002 to 2011. Drug costs were the highest proportionally in the total medical expenditure (54.27%), followed by treatment expenditure (14.32%) and surgical expenditure (8.10%). Medical expenditures for the disease varied based on region, hospital level, type, and stage. Conclusion The medical expenditure for lung cancer care is substantial in China. Drug costs and laboratory test are the main factors increasing medical costs.

Objective To investigate the relationship of longitudinal trajectory of systolic blood pressure (SBP) to newonset chronic kidney disease (CKD). Methods A prospective cohort study was performed with a total of 13 985 on job and retired Kailuan Group employees who met the standard and participated in health examination. SAS Proc Traj program was used to identify the longitudinal trajectories of SBP of the first three times health examination, and 5 different SBP trajectory groups formed: lowstability trajectory group (106.42-109.43 mmHg, n=2927), medium-stability trajectory group (120.63-124.46 mmHg, n=6916), medium-high trajectory group (132.22-142.97 mmHg, n=2716), high-medium trajectory group (156.77-134.15 mmHg, n=668) and high-stability trajectory group (154.65-158.98 mmHg, n=758). Log-rank test was performed to compare the differences of new-onset CKD cumulative incidence among different SBP trajectory groups during follow-up; Multi-Cox regression model was used to analyze the effect of different SBP longitudinal trajectories on new-onset CKD. Results The mean age of 13 985 subjects was (49.5±11.0) years, including 10 712 males (76.6%) and 3273 females (23.4%), the mean follow-up time was (6.8±1.0) years. The cumulative incidence of CKD was 13.9% (1187/13 985). The cumulative incidences of CKD in low-stability trajectory group, mediumstability trajectory group, medium-high trajectory group, high-medium trajectory group and high-stability trajectory group were 7.7% (147/2927), 12.2% (514/6916), 17.8% (291/2716), 21.9% (93/668), and 35.4% (142/758), respectively, the incidence of CKD increased with elevated stability trajectory (log-rank χ2=177.561, P

ObjectiveTo investigate whether in utero exposure to the Great Chinese Famine in 1959 to 1961 was associated with risk of intracerebral hemorrhage (ICH) in adulthood.MethodsIn this cohort analysis, we included 97,399 participants of the Kailuan Study who were free of cardiovascular disease and cancer at baseline (2006). Cases of incident ICH were confirmed by medical record review. We used the Cox proportional hazards model to calculate the hazard ratio (HR) and 95% confidence interval (CI) for ICH according to in utero famine exposure status.ResultsAmong 97,399 participants in the current analyses, 6.3% (n = 6,160) had been prenatally exposed to the Great Chinese Famine. During a median 9.0 years of follow-up (2006–2015), we identified 724 cases of incident ICH. After adjustment for potential confounders, the HR of ICH was 1.99 (95% CI 1.39–2.85) for in utero famine-exposed individuals vs individuals who were not exposed to the famine. When exposure to famine and severity of famine were examined jointly, the adjusted HR was 2.99 (95% CI 1.21–7.39) for in utero exposure to severe famine and 1.94 (95% CI 1.32–2.84) for in utero exposure to less severe famine relative to those without exposure to famine.ConclusionsIndividuals with in utero exposure to famine, especially those exposed to severe famine, were more likely to have ICH in midlife, highlighting the role of nutritional factors in susceptibility to this severe cerebral condition.

To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD.A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD.The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD.There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.

To prospectively examine the associations of combined lifestyle factors with incident cardiovascular disease (CVD) and mortality in patients with diabetes.Patients with prevalent diabetes were included from 5 prospective, population-based cohorts in China (Dongfeng-Tongji cohort and Kailuan study), the United Kingdom (UK Biobank study), and the United States (National Health and Nutrition Examination Survey and National Institutes of Health-AARP Diet and Health Study). Healthy lifestyle scores were constructed according to non-current smoking, low to moderate alcohol drinking, regular physical activity, healthy diet, and optimal body weight; the healthy level of each lifestyle factor was assigned 1 point, or 0 for otherwise, and the range of the score was 0 to 5. Cox proportional hazards models were used to estimate hazard ratios for incident CVD, CVD mortality, and all-cause mortality adjusting for sociodemographic, medical, and diabetes-related factors, and outcomes were obtained by linkage to medical records and death registries. Data were collected from October 18, 1988, to September 30, 2020.A total of 6945 incident CVD cases were documented in 41,350 participants without CVD at baseline from the 2 Chinese cohorts and the UK Biobank during 389,330 person-years of follow-up, and 40,353 deaths were documented in 101,219 participants from all 5 cohorts during 1,238,391 person-years of follow-up. Adjusted hazard ratios (95% CIs) comparing patients with 4 or 5 vs 0 or 1 healthy lifestyle factors were 0.67 (0.60 to 0.74) for incident CVD, 0.58 (0.50 to 0.68) for CVD mortality, and 0.60 (0.53 to 0.68) for all-cause mortality. Findings remained consistent across different cohorts, subgroups, and sensitivity analyses.The international analyses document that adherence to multicomponent healthy lifestyles is associated with lower risk of CVD and premature death of patients with diabetes.

Background To investigate the effect of brachial–ankle pulse wave velocity (baPWV) on new-onset acute myocardial infarction (AMI). Methods A retrospective cohort study was performed for the subjects who underwent baPWV examination during the follow-up of Kailuan Study Cohort from 2010 to 2017. The observation subjects were divided into 3 groups based on the levels of baPWV: Results A total of 41,405 subjects were included in the study. During 2.66 (1.07–5.39) years’ follow-up, 150 new-onset AMI cases were observed. The incidence density of AMI in 3 groups was 3.69, 12.79, and 26.65 per 10,000 person-years, respectively. Log-rank test result showed the cumulative AMI incidence increased gradually from the subjects with the lowest baPWV to those with the highest baPWV (P < 0.05). Compared with subjects with baPWV Conclusions The increased baPWV is a risk factor for new-onset AMI.

China has the largest number of adults with diabetes. Although multiple metabolic risk factors (MRFs) are implicated in the development of diabetes, it remains unclear how they progress during the development of diabetes among Chinese. We examined trajectories of multiple MRFs among Chinese and identified the critical period when drastic changes occurred during the development of diabetes.This prospective cohort study included participants since 2006-2007 in the Kailuan study. People attended biennial examinations until 2017 with additions of new participants at each examination cycle. The time when a participant first completed the examination was served as the baseline. A total of 122,659 participants without prevalent diabetes at baseline and with complete follow-up data were included. MRFs were collected via biennial physical examinations and laboratory measures. Incident diabetes cases were identified via biennial fasting glucose tests and self-reported physician-diagnosis.During up to 12 years of follow-up, 14,922 incident diabetes cases were identified. Compared with participants who did not develop diabetes, those who developed diabetes had more adverse levels of most MRFs at baseline and during follow-up. Abrupt increases in multiple MRFs (including fasting glucose, surrogate insulin resistance indicators, lipids, systolic blood pressure, pulse pressure, heart rate, alanine aminotransferase, and C-reactive protein) were observed 3 years before the diagnosis of diabetes.We identified 3 years before diabetes diagnosis as a critical period when multiple MRFs experienced drastic changes. This would have implications for early monitoring and timely prevention for individuals who experience sudden adverse progression of multiple MRFs.

Background Pulse wave velocity (PWV) is a marker of arterial stiffness, which represents sub-clinical atherosclerosis. Pulsatile stress and high-sensitivity C-reactive protein (hs-CRP) are associated with arteriosclerosis. However, there is no prospective data confirming whether changes in pulsatile stress and inflammatory markers affect the progression of arterial stiffness. The aim of this study was to investigate the relationships over time between the effects of changes in pulsatile stress and hs-CRP, and arterial stiffness progression during a 2-year follow-up. Methods We performed a longitudinal study involving 3978 participants. All participants underwent a physical examination in 2010–2011 and 2012–2013, during which we measured participants' hs-CRP levels, brachial–ankle pulse wave velocity (baPWV), and pulsatile stress. Results Baseline hs-CRP was correlated with baPWV (r = 0.18, P = 0.000); however the correlation was weaker than that with systolic blood pressure (r = 0.65), pulsatile stress (r = 0.57), and rate-pressure product (r = 0.58). Multiple linear regression analysis demonstrated that changes in pulsatile stress, mean arterial pressure, and low-density lipoprotein-C (LDL-C) were positively correlated with changes in baPWV, with correlation coefficients of 0.27, 0.25, and 0.07, respectively, but not with changes in hs-CRP. Moreover, each 100-aU increase in pulsatile stress, 1 mmHg increase in mean blood pressure, and 1 mmol/L increase in LDL-C was associated with a 3 cm/s, 4.78 cm/s, and 17.37 cm/s increase in baPWV, respectively. Conclusions Pulsatile stress increases are associated with arterial stiffness progression, but that changes in hs-CRP had no effect on arterial stiffness progression. Hs-CRP may simply be a marker of inflammation in arterial stiffness and has no association with arterial stiffness progression.

AIM: To evaluate retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal mine workers. METHODS: The community-based observational cross-sectional study included 4004 participants of a sub-population of the Kailuan Study. All the study participants underwent structured interviews with a standardized questionnaire, fundus photography and spectral-domain optical coherence tomography (OCT) examinations performed by trained doctors. RESULTS: The retinal nerve fiber layer thickness was significantly higher (P=0.006) and the central macular thickness was lower in coal miners (n=659, 51.0±7.8y) as compared to the control (working above the ground; n=477, 51.8±7.5y; P=0.032). Additionally, the downhole workers showed a significantly thicker retinal artery (P=0.012) and vein diameters (P

Objective: To examined whether prehypertension prior to pregnancy increased the risk of hypertensive disorders of pregnancy (HDP) and postpartum metabolic syndrome.Methods:1060 singleton pregnancy ...

Background To examine the effect of mean arterial pressure on the progression of arterial stiffness in normotensive subjects. Methods The subjects who completed 2 measurements of brachial–ankle pulse wave velocity (baPWV) and were normotensive at the first baPWV measurement, were enrolled during the second, third, fourth, and fifth follow-up of the Kailuan study. Multiple linear regression was used to analyze the effect of baseline mean arterial pressure and mean arterial pressure on arterial stiffness at the end of follow-up and its progression in normotensive subjects. Results Among the 11,697 subjects who met the inclusion criteria, the average age was (43.7 ± 12.2) years old with 6,284 males (53.7%). The average follow-up time was 3.7 years, and baseline baPWV value was (1,346.2 ± 239.9) cm/s. The follow-up baPWV value was (1,403.4 ± 273.5) cm/s, and the average baPWV progression was 57.2 cm/s. In multivariate linear regression analysis, after adjustment for age, glucose, serum lipid, and other factors, an increase of 1 mm Hg in baseline mean arterial pressure resulted in an increase of 8. 6 cm/s in baPWV at the end of follow-up and 3.7 cm/s in baPWV progression, respectively. An increase of 1 mm Hg in mean arterial pressure during follow-up period resulted in an increase of 5.2 cm/s at the end of follow-up and 2.9 cm/s in baPWV progression, respectively. Conclusions Mean arterial pressures at baseline and during follow-up are associated with the progression of arterial stiffness in normotensive subjects.

Objective To investigate the effects of hypertension, diabetes and the joint action of the two on the new chronic kidney disease (CKD). Methods This is a prospective cohort study. A total of 101,510 on job and retired Kailuan employees who participated in 2006-2007 annual physical examinations were as the research objects. Those without baseline data, and patients with CKD, cancer and history of cardiovascular and cerebrovascular diseases were excluded, and those with no physical examination during follow-up or missing follow-up data were also excluded, then 51,156 cases were included in the final analysis and divided into 4 groups: normal blood pressure (BP) and fasting blood glucose (FBG) group, hypertension group, diabetes group and hypertension+diabetes group. Multivariate COX risk proportional regression was performed to analyze the effect of hypertension, diabetes and the joint action of the two on the new CKD. Results After an average of 7.3±2.3 years follow-up, 8,179 participants were found to have developed CKD, the incidence density of CKD was 22.19 per 1000 person-year. The incidence density of CKD in the 4 groups above was 17.39, 27.78, 31.39 and 42.58 per 1000 person-year, respectively; while in males of the 4 groups was 18.20, 28.29, 32.77 and 44.37 per 1000 person-year, and in females of the 4 groups was 15.28, 25.37, 26.99 and 36.42 per 1000 person-year. Multivariate COX risk proportional regression analysis showed that, further adjusted by age, gender, physical exercise level, income level, smoking status, drinking status, body mass index (BMI), total cholesterol (TC), low density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) and using of anti-hypertensive drugs and hypoglycemic drugs, and compared with the normal BP and FBG group, the HR and 95% CI in hypertension group, diabetes group and hypertension+diabetes group showed an increased risk of CKD as 1.57(1.49-1.66), 1.67(1.45-1.92) and 2.13(1.89-2.39), respectively. It generated similar results in different gender. Conclusion Hypertension and diabetes are the independent risk factors for new-onset CKD, and the combined effect of the two may significantly increase the risk of new-onset CKD. DOI: 10.11855/j.issn.0577-7402.2018.10.14

Background: This study aims to investigate the associations of different (low/medium/high) levels of fasting triglyceride (TG) levels with cardiovascular endpoints. Methods: This cohort study comprised of in-service and retired employees of the Kailuan Coal Mine Group, who participated in the health examination conducted in 11 hospitals in the Kailuan region from June 2006 to October 2007 (n=100,271). The study population was divided into five groups according to different TG levels. Logistic regression analysis was used to analyze the risk factors for myocardial infarction (MI) in patients with elevated TG, and Cox proportional hazards regression analysis was used to analyze the effects of different TG levels on endpoint events. Results: After a median follow-up of 7 years, 961 patients developed MI and 3,142 subjects died. The multivariate logistic regression analysis revealed that elevated TG, an age of ≥65 years old, body mass index (BMI) >25 kg/m 2 , fasting blood glucose (FBG) ≥6.1 mmol/L and high density lipoprotein cholesterol (HDL-C) Conclusions: In the study population of the Kailuan region, elevated fasting TG increases the risk of MI, particularly in populations with an age of ≥65 years old, BMI >25 kg/m 2 , FBG ≥6.1 mmol/L and HDL-C

Background To investigate the relationship between baseline fasting blood glucose levels and the progression of arterial stiffness in nondiabetic population. Methods In this research, the individuals participated in the Kailuan research cohort and completed 2 tests of brachial–ankle pulse wave velocity (baPWV) from 2010 to 2018 and were not diabetic at the first baPWV testing were included. A multiple linear regression was applied to analyze the impact of baseline fasting blood glucose levels on baPWV and its progress during the follow-up. Results A total of 16,875 with 10,453 male (61.94%) subjects met the inclusion criteria. The average age at baseline (the first baPWV measurement) was (45.9 ± 13.0) years old and the average baPWV was (1,439.0 ± 309.3) cm/s. During the follow-up (the second baPWV measurement), the average age was (49.6 ± 13.3) years old, and the average baPWV was (1,494.6 ± 334.3) cm/s. The baPWV progression in the observed subjects was (55.7 ± 233.4) cm/s. After adjusted for other confounding factors, multiple linear regression analysis found that there was a positive correlation between the baseline fasting blood glucose levels and the follow-up baPWV. With every 1 mmol/l baseline fasting blood glucose increase, the follow-up baPWV increased 16.89 cm/s. With every 1 mmol/l fasting blood glucose level increase, the progress of baPWV increased by 3.70 cm/s. Conclusions Fasting blood glucose levels in nondiabetics affect arterial stiffness during follow-up. Elevated fasting blood glucose levels during the follow-up period are a risk factor that may increase the progression of arterial stiffness.

This study aims to investigate the correlation between the trajectory of systolic blood pressure (SBP) and new renal damage in a nonhypertensive population.This prospective cohort study included a total of 14 382 nonhypertensive individuals, employees of Kailuan Group of Companies, who took part in five healthy examinations in 2006-2007, 2008-2009, 2010-2011, 2012-2013, and 2014-2015, and had complete data. These individuals were divided into four groups according to the different trajectories of SBP: low-low, low-stable, middle-high, and high-high groups. The correlation between the trajectory of SBP and new renal damage in a nonhypertensive population was analyzed using a multivariate Cox's proportional hazard regression model.(a) A total of 14 382 individuals had complete data and the average age of these individuals was 44.6±10.8 years. Among these, 10 888 (75.7%) individuals were men and 3494 (24.3%) individuals were women. (b) These individuals were divided into four groups according to different trajectories of blood pressure: low-low group, accounting for 13.15% (blood pressure was106 mmHg); low-stable group, accounting for 53.91% (blood pressure was between 115 and 116 mmHg); middle-high group, accounting for 28.77% (blood pressure was between 125 and 131 mmHg); and high-high group, accounting for 4.6% (blood pressure was between 126 and 151 mmHg). (c) With the increase in the trajectory of SBP, the detection rate of renal damage increased gradually. From the low-low group to the high-high group, the detection rates of estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m were 2.3, 2.4, 3.6, and 4.3%, respectively; the positive rates of urinary protein were 1.7, 2.9, 3.8, and 5.5%, respectively; and the detection rates of eGFR less than 60 ml/min/1.73 m or positive urinary protein were 4, 5.2, 7.3, and 9.3%, respectively (P0.05). (d) After adjustment for other confounding factors, multivariate Cox's proportional hazard regression analysis showed that compared with the low-low group, the risk of eGFR less than 60 ml/min/1.73 m increased by nearly 1.5 times in the high-high group and in the low-stable, middle-high, and high-high groups, the risks of positive urinary protein, eGFR less than 60 ml/min/1.73 m, or positive urinary protein increased by 1.48-2.34 and 1.20-1.70 times, respectively.In a nonhypertensive population, the high trajectory of SBP is a risk factor for kidney damage.

Background Although recent studies have indicated that both orthostatic hypotension and orthostatic hypertension independently predict cardiovascular events, the underlying mechanisms are still controversial. The aim of the study was to investigate the relationships between orthostatic changes and organ damage in subjects over 60 years old. Methods This is a prospective observational cohort study. One thousand nine hundred and ninety-seven subjects over 60 years old were enrolled. Participants were grouped according to whether they had a drop ≥ 20 mmHg in systolic or ≥ 10 mmHg in diastolic BP (orthostatic hypotension), an increase in mean orthostatic systolic blood pressure ≥ 20 mm Hg (orthostatic hypertension), or normal changes within 3 min of orthostatism. Multiple regression modeling was used to investigate the relationship between orthostatic hypotension, orthostatic hypertension and subclinical organ damage with adjustment for confounders. Results Orthostatic hypotension and orthostatic hypertension were found in 461 (23.1%) and 189 (9.5%) participants, respectively. Measurement of carotid intima-media thickness (IMT), brachial-ankle pulse wave velocity (baPWV), clearance of creatinine, and microalbuminuria were associated with orthostatic hypotension; measurement of IMT and baPWV were associated with orthostatic hypertension in a cruse model. After adjustment, IMT [odds ratio (OR), 95% confidence interval (CI) per one-SD increment: 1.385, 1.052–1.823; P = 0.02], baPWV (OR = 1.627, 95% CI: 1.041–2.544; P = 0.033) and microalbuminuria (OR = 1.401, 95% CI: 1.002–1.958; P = 0.049) were still associated with orthostatic hypotension, while orthostatic hypertension was only associated with IMT (OR = 1.730, 95% CI: 1.143–2.618; P = 0.009). Conclusions Orthostatic hypotension seems to be independently correlated with increased carotid atherosclerosis, arterial stiffness and renal damage in subjects over 60 years old. Orthostatic hypertension correlates with carotid atherosclerosis only.

OBJECTIVES: This study compared the risk of cancer morbidity and mortality in midlife between Chinese adults who were exposed or were not exposed to the Great Chinese Famine (1959–1961) in utero or during early childhood. METHODS: The Kailuan Study Participants (n = 101,125) were classified into 5 famine exposure groups by category of the year of birth: after 1961 (unexposed, reference), 1959–1961 (in utero exposed), 1956–1958 (childhood exposed, aged 0.1–2.9 y), 1953–1955 (childhood exposed, aged 3.0–5.9 y), and before 1953 (exposed, aged 6 + y). The exposed groups were further classified by the severity of famine into less-severe or severe groups. Cancer and cancer mortality cases were confirmed by reviewing medical records from hospitals. Cox proportional hazard models were computed to examine the association between famine exposure and composite cancer events of incident cancer and cancer mortality (2006–2016), adjusting for sex, socioeconomic status, cancer-related lifestyle factors, blood C-reactive protein, and lipid profiles. RESULTS: During a median of 10.0 years of follow-up, we identified 3,589 incident cancer cases and 1,940 cancer deaths. After adjustment for covariates (eg, sex, socioeconomic status, and cancer-related lifestyle factors), compared to the unexposed group, the hazard ratios (HRs) of the composite cancer events ranged 2.24–2.72 for the in utero exposed and early childhood exposed groups (P

Background To investigate the relationship between arterial stiffness and new-onset diabetes mellitus in hypertensive population. Methods A total of 8,061 hypertensive and nondiabetic employees who participated in the yearly physical examination (2010–2015) of the Kailuan study were enrolled into the present study. Arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). Baseline was set at the first baPWV measurement, while follow-up ended at the first incident of diabetes mellitus or until the last examination (2016–2017). According to baPWV quartile, the effect of baPWV on new-onset diabetes mellitus was analyzed by Cox proportional hazard model, and a sensitivity test was analyzed by body mass index stratification. Results The mean follow-up time was (4.2 ± 2.1) years. During the follow-up period, 874 (10.8%) participants developed diabetes, with an average incidence rate of 25.7 per 1,000 person-years. The incidence rate (per 1,000 person-years) of new-onset diabetes in the first to fourth quartile of baPWV was 14.6, 23.8, 27.2, and 37.7, respectively (P < 0.001). Compared with the first quartile of baPWV, after adjustment for age, gender, mean arterial pressure, baseline fasting glucose, hypersensitive C-reactive protein, and other confounding factors, the HR and 95% confidence interval for new-onset diabetes of the second, third, and fourth quartile were 1.57 (1.24–1.98), 1.74 (1.37–2.20), and 2.38 (1.87–3.03), respectively. For each standard deviation increase of baPWV, the HR and 95% confidence interval were 1.32 (1.24–1.42). Conclusions Arterial stiffness is associated with new-onset diabetes mellitus in the hypertensive population.

Objective To investigate the influence of non-alcoholic fatty liver disease (NAFLD) on the onset of diabetes. Methods 44,019 employees of Kailuan coorperation who had retired but underwent health examination during July 2006 to October 2007 were included in this prospective cohort study. They had no history of diabetes and drinking, and their clinical data were complete. The second and third sessions of physical examination were conducted between 2008 and 2009, and then between 2010 and 2011. The subjects who participated in the study were divided into two groups, namely, NAFLD group and non-NAFLD group. The signs of diabetes were observed among all workers. Multiple cox regression was used to calculate risk ratios (RR) and 95% confidence intervals (95%CI) for diabetes. Results The cumulative incidence rates of diabetes were 12.5% and 4.7%, respectively, in NAFLD group and non-NAFLD group (P

This prospective study included 68,759 Chinese male adults from Kailuan cohort of China who had a standardized medical examination between 2006 and 2007 and were followed up for approximately 8 years until occurrence of ASCVD, cancer or death or until December 31, 2014. Subjects were divided into four categories based on the quartiles of TC, LDL-C and non-HDL-C. Cox regression models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs). During follow-up, 2,916 males developed ASCVD and 1,884 developed cancer. Compared with the lowest quartile, the upper-most quartiles of TC, LDL-C and non-HDL-C were all associated with increased ASCVD risk (HR 1.53; HR 1.16; HR 1.55); however, the upper-most quartiles of TC, LDL-C and non-HDL-C were all negatively associated with cancer (HR0.84; HR 0.82; HR 0.80) and these associations were present after exclusion of incident cancers during the first 4 years of follow-up. In a word, we report that high TC, LDL-C and non-HDL-C concentrations increased ASCVD incidence in a male population and that these lipid profiles were inversely associated with total cancer and several individual cancers.

Although sleep is one of the most important health-related behavioral factors, the association between night sleep duration and cognitive impairment has not been fully understood. A cross-sectional study was conducted with a random sample of 2,514 participants (⋝ 40 years of age; 46.6% women) in China to examine the association between night sleep duration and cognitive impairment.Night sleep duration was categorized as ⋜ 5, 6, 7, 8, or ⋝ 9 h per night. Cognitive function was measured using the Mini-Mental State Examination. A multivariate regression analysis was used to analyze the association of night sleep duration with cognitive impairment. A total of 122 participants were diagnosed with cognitive impairment.A U-shaped association between night sleep duration and cognitive impairment was found. The odds ratios (95% confidence intervals) of cognitive impairment (with 7 h of daily sleep being considered as the reference) for individuals reporting ⋜ 5, 6, 8, and ⋝ 9 h were 2.14 (1.20-3.83), 1.13 (0.67-1.89), 1.51 (0.82-2.79), and 5.37 (1.62-17.80), respectively (P ⋜ 0.01).Short or long night sleep duration was an important sleep-related factor independently associated with cognitive impairment and may be a useful marker for increased risk of cognitive impairment..

Objective To explore the correlations of ideal cardiovascular health behaviors and factors with the level of high sensitivity C-reactive protein (hsCRP) in diabetic population. Methods A cross-sectional method was used in present study. Seven thousand eight hundred and sixty-nine workers with diabetes were recruited who participated in the 2006-2007 Kailuan health examination without history of cerebral and myocardial infarction and without data incompleted. All the information was obtained from the unified questionnaire and measurement of blood biochemistry. Multivariate logistic regression analysis was used to analyze the effects of ideal cardiovascular health behaviors and factors on the level of hsCRP. Results The hsCRP concentrations decreased with the increasing numbers of ideal cardiovascular health behaviors and factors, the medians of hsCRP concentrations were 1.16mg/L, 1.11mg/L, 0.90mg/L and 0.76mg/L in 0-1, 2, 3 and 4-6 ideal cardiovascular health groups, respectively (P

Objective We aimed to explore an optimal anthropometric indicator and optimal cut-off points for incident diabetes in Chinese adults. Methods 61,703 subjects were followed for a median duration of 2 years. Body mass index, waist circumference, waist-to-hip ratio and waist-to-height ratio were collected base on a standard protocol. Receiver Operating Characteristic curve analyses were used to compare the predictive power of baseline BMI, WC, WHpR and WHtR for development of type 2 diabetes. Results There were 2991 new cases of type 2 diabetes during follow-up. ROC curve analyses indicated that WHtR was the best predictor of type 2 diabetes for male (AUC=0.633). For female, WHtR and WC had similar predictive ability (AUC=0.701 and 0.695 respectively) and were superior to BMI. WHpR was the weakest predictor in both genders. The optimal WHtR cut-off values for incidence of type 2 diabetes were similar in both genders (0.53 vs. 0.52). BMI was higher in men (26kg/m 2 ) than women (24kg/m 2 ); and so did WC (91cm in men vs. 85cm in women). Conclusions WHtR, and to some degree WC, are the best predictors of type 2 diabetes, followed by BMI then WHpR which is the weakest predictor in the tested adults.

To valuate whether angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and aldosterone synthase (CYP11B2) gene -344T/C polymorphism are associated with individual response to hydrochlorothiazide (HCTZ) in the Han Chinese population with essential hypertension. We enrolled 829 mild/moderate hypertensive patients and 12.5 mg of HCTZ was given daily. After 6 weeks, the results showed that the ACE I/D polymorphism, not the CYP11B2 -344T/C polymorphism, was associated with systolic blood pressure (SBP) response to HCTZ (P = 0.009) in the Han Chinese population with essential hypertension, with no interaction.