scholarly journals Association between adiposity measures and COPD risk in Chinese adults

2020 ◽  
Vol 55 (4) ◽  
pp. 1901899 ◽  
Author(s):  
Jiachen Li ◽  
Lu Zhu ◽  
Yuxia Wei ◽  
Jun Lv ◽  
Yu Guo ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Fat Distribution ◽  
Baseline Survey ◽  
Abdominal Adiposity ◽  
Chinese Adults ◽  
Cox Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Anthropometric Indexes ◽  
Objectively Measured

Bodyweight and fat distribution may be related to COPD risk. Limited prospective evidence linked COPD to abdominal adiposity. We investigated the association of body mass index (BMI) and measures of abdominal adiposity with COPD risk in a prospective cohort study.The China Kadoorie Biobank recruited participants aged 30–79 years from 10 areas across China. Anthropometric indexes were objectively measured at the baseline survey during 2004–2008. After exclusion of participants with prevalent COPD and major chronic diseases, 452 259 participants were included and followed-up until the end of 2016. We used Cox models to estimate adjusted hazard ratios relating adiposity to risk of COPD hospitalisation or death.Over an average of 10.1 years of follow-up, 10 739 COPD hospitalisation events and deaths were reported. Compared with subjects with normal BMI (18.5–<24.0 kg·m−2), underweight (BMI <18.5 kg·m−2) individuals had increased risk of COPD, with adjusted hazard ratio 1.78 (95% CI 1.66–1.89). Overweight (BMI 24.0–<28.0 kg·m−2) and obesity (BMI ≥28.0 kg·m−2) were not associated with an increased risk after adjustment for waist circumference. A higher waist circumference (≥85 cm for males and ≥80 cm for females) was positively associated with COPD risk after adjustment for BMI. Additionally, waist-to-hip ratio and waist-to-height ratio were positively related to COPD risk.Abdominal adiposity and underweight were risk factors for COPD in Chinese adults. Both BMI and measures of abdominal adiposity should be considered in the prevention of COPD.

scholarly journals Combined Influence of Waist and Hip Circumference on Risk of Death in a Large Cohort of European and Australian Adults

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Adrian J. Cameron ◽  
Helena Romaniuk ◽  
Liliana Orellana ◽  
Jean Dallongeville ◽  
Annette J. Dobson ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Antihypertensive Drugs ◽  
Density Lipoprotein ◽  
Hip Circumference ◽  
Cox Models ◽  
Risk Of Death ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Scale Models ◽  
History Of

Background Waist circumference and hip circumference are both strongly associated with risk of death; however, their joint association has rarely been investigated. Methods and Results The MONICA Risk, Genetics, Archiving, and Monograph (MORGAM) Project was conducted in 30 cohorts from 11 countries; 90 487 men and women, aged 30 to 74 years, predominantly white, with no history of cardiovascular disease, were recruited in 1986 to 2010 and followed up for up to 24 years. Hazard ratios were estimated using sex‐specific Cox models, stratified by cohort, with age as the time scale. Models included baseline categorical obesity measures, age, total and high‐density lipoprotein cholesterol, systolic blood pressure , antihypertensive drugs, smoking, and diabetes mellitus. A total of 9105 all‐cause deaths were recorded during a median follow‐up of 10 years. Hazard ratios for all‐cause death presented J‐ or U‐shaped associations with most obesity measures. With waist and hip circumference included in the same model, for all hip sizes, having a smaller waist was strongly associated with lower risk of death, except for men with the smallest hips. In addition, among those with smaller waists, hip size was strongly negatively associated with risk of death, with ≈20% more people identified as being at increased risk compared with waist circumference alone. Conclusions A more complex relationship between hip circumference, waist circumference, and risk of death is revealed when both measures are considered simultaneously. This is particularly true for individuals with smaller waists, where having larger hips was protective. Considering both waist and hip circumference in the clinical setting could help to best identify those at increased risk of death.

scholarly journals Mortality Risk and The Progression of The Electronic Frailty Index and Hospital Frailty Risk Score Over Time

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Joe Hollinghurst ◽  
Alan Watkins
Keyword(s):  
Risk Score ◽  
Frailty Index ◽  
Time Frame ◽  
Time Dependent ◽  
Cox Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Matrix ◽  
Time Dependent Covariates ◽  
Over Time

IntroductionThe electronic Frailty Index (eFI) and the Hospital Frailty Risk Score (HFRS) have been developed in primary and secondary care respectively. Objectives and ApproachOur objective was to investigate how frailty progresses over time, and to include the progression of frailty in a survival analysis.To do this, we performed a retrospective cohort study using linked data from the Secure Anonymised Information Linkage Databank, comprising 445,771 people aged 65-95 living in Wales (United Kingdom) on 1st January 2010. We calculated frailty, using both the eFI and HFRS, for individuals at quarterly intervals for 8 years with a total of 11,702,242 observations. ResultsWe created a transition matrix for frailty states determined by the eFI (states: fit, mild, moderate, severe) and HFRS (states: no score, low, intermediate, high), with death as an absorbing state. The matrix revealed that frailty progressed over time, but that on a quarterly basis it was most likely that an individual remained in the same state. We calculated Hazard Ratios (HRs) using time dependent Cox models for mortality, with adjustments for age, gender and deprivation. Independent eFI and HFRS models showed increased risk of mortality as frailty severity increased. A combined eFI and HFRS revealed the highest risk was primarily determined by the HFRS and revealed further subgroups of individuals at increased risk of an adverse outcome. For example, the HRs (95% Confidence Interval) for individuals with an eFI as fit, mild, moderate and severe with a high HFRS were 18.11 [17.25,19.02], 20.58 [19.93,21.24], 21.45 [20.85,22.07] and 23.04 [22.34,23.76] respectively with eFI fit and no HFRS score as the reference category. ConclusionFrailty was found to vary over time, with progression likely in the 8-year time-frame analysed. We refined HR estimates of the eFI and HFRS for mortality by including time dependent covariates.

scholarly journals Midday Nap Duration and Hypertension among Middle-Aged and Older Chinese Adults: A Nationwide Retrospective Cohort Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3680
Author(s):  
Jialin Fu ◽  
Xinge Zhang ◽  
Justin B. Moore ◽  
Bowen Wang ◽  
Rui Li
Keyword(s):  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Middle Aged ◽  
Chinese Adults ◽  
Hazard Ratios ◽  
Older Chinese ◽  
Objectively Measured ◽  
Older Chinese Adults

The goal of this study was to investigate the associations of midday nap duration and change in midday nap duration with hypertension in a retrospective cohort using a nationwide representative sample of middle-aged and older Chinese adults. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) database during 2011–2015. Information on midday nap duration was collected via a self-reported questionnaire and blood pressure was objectively measured. Hazard ratios (HR) with 95% confidence interval (CI) were estimated using Cox proportional hazards regression models to quantify the associations. A sample of 5729 Chinese adults (≥45 years old) were included in the longitudinal analysis. Relative to non-nappers, participants who napping for ≥90 min/day was associated with significantly larger HR for hypertension at four-year follow-up (HR = 1.18, 95% CI = 1.01–1.40, p = 0.048). Compared with people who napped ≥90 min/day both at baseline (2011) and follow-up (2013), hypertension risk at four-year follow-up declined in individuals whose midday nap durations decreased in the 2-year study period from ≥ 90 min/day to 1–59 min/day (HR = 0.59, 95% CI = 0.36–0.97, p = 0.037) and 60–89 min/day (HR = 0.68, 95% CI = 0.47–0.99, p = 0.044). Among middle-aged and older Chinese adults, relative to non-nappers, people who had longer midday nap duration (≥90 min/day) were associated with significantly larger HR for hypertension and decreased napping duration may confer benefit for hypertension prevention.

Depression as a Mediator of the Association Between Wealth Status and Risk of Cognitive Impairment and Dementia: A Longitudinal Population-Based Cohort Study

2021 ◽  
pp. 1-11
Author(s):  
Rui Zhou ◽  
Hua-Min Liu ◽  
Fu-Rong Li ◽  
Hai-Lian Yang ◽  
Jia-Zhen Zheng ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Population Based ◽  
Cognitive Status ◽  
Wealth Status ◽  
Cox Models ◽  
Mediating Role ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Time Dependent Covariates

Background: Wealth and income are potential modifiable risk factors for dementia, but whether wealth status, which is composed of a combination of debt and poverty, and assessed by wealth and income, is associated with cognitive impairment among elderly adults remains unknown. Objective: To examine the associations of different combinations of debt and poverty with the incidence of dementia and cognitive impairment without dementia (CIND) and to evaluate the mediating role of depression in these relationships. Methods: We included 15,565 participants aged 51 years or older from the Health and Retirement Study (1992–2012) who were free of CIND and dementia at baseline. Dementia and CIND were assessed using either the modified Telephone Interview for Cognitive Status (mTICS) or a proxy assessment. Cox models with time-dependent covariates and mediation analysis were used. Results: During a median of 14.4 years of follow-up, 4,484 participants experienced CIND and 1,774 were diagnosed with dementia. Both debt and poverty were independently associated with increased dementia and CIND risks, and the risks were augmented when both debt and poverty were present together (the hazard ratios [95% confidence intervals] were 1.35 [1.08–1.70] and 1.96 [1.48–2.60] for CIND and dementia, respectively). The associations between different wealth statuses and cognition were partially (mediation ratio range: 11.8–29.7%) mediated by depression. Conclusion: Debt and poverty were associated with an increased risk of dementia and CIND, and these associations were partially mediated by depression. Alleviating poverty and debt may be effective for improving mental health and therefore curbing the risk of cognitive impairment and dementia.

scholarly journals Trends of Waist Circumference Distribution and Abdominal Adiposity among Chinese Adults, 1993‐2004

2008 ◽  
Vol 22 (S1) ◽  
Author(s):  
Bing Zhang ◽  
Huijun Wang ◽  
Shufa Du ◽  
Fengying Zhai ◽  
Barry M Popkin
Keyword(s):  
Waist Circumference ◽  
Abdominal Adiposity ◽  
Chinese Adults

Abstract 14854: Optimal Cut-off Points of Waist Circumference for Detecting Central Obesity and Severe Central Obesity in Chinese Adults

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Xiaoxiao Wen ◽  
Jinzhuang Mai ◽  
Xiangmin Gao ◽  
Min Guo ◽  
Yong Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Waist Circumference ◽  
Roc Curve ◽  
Central Obesity ◽  
Adult Population ◽  
Overweight And Obesity ◽  
Chinese Adults ◽  
Chinese Adult ◽  
Increased Risk ◽  
Left Corner

Introduction: Given that no consensus has yet been reached over the optimal cut-off points of waist circumference (WC) for Chinese, this study aimed to determine the appropriate cut-off points of WC for detecting central obesity and severe central obesity in a Chinese adult population. Methods: Data from the cross-sectional survey of the PRC-USA Collaborative study of Cardiovascular and Cardiopulmonary Epidemiology in 1993-1994 was used, including 10265 subjects (4921 men and 5344 women) aged 35-69 years. Each integer of WC in centimeters was used as the cut-off point to detect clustering of cardiovascular risk factors, which was defined as the presence of two or more risk factors among hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol. Based on the Receiver operating characteristic (ROC) curve analysis, the WC value corresponding to the point on the ROC curve nearest to the upper left corner of the ROC graph was considered the optimal cut-off for central obesity and the value corresponding to the point with specificity of 90% or more was considered the optimal cut-off for severe central obesity. Results: The optimal cut-off value of WC to detect clustering of risk factors was ≥84 cm for men and was ≥80 cm for women with the shortest distance to the upper left corner being 0.4304 and 0.4504, respectively. The cut-off values of WC with specificity above 90% were ≥93 cm and ≥91 cm for men and women respectively. Conclusions: These results were equal or similar to the WC cut-off points proposed by the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults, i.e., ≥85/80 cm (men/women) for increased risk for obesity related diseases and ≥95/90 cm (men/women) for much higher risk. For practical reasons, WC≥85/80 cm and ≥95/90 cm (men/women) could be the optimal cut-off values for detecting central obesity and severe central obesity, respectively, in Chinese adult population.

scholarly journals Hb level, iron intake and mortality in Chinese adults: a 10-year follow-up study

2017 ◽  
Vol 117 (4) ◽  
pp. 572-581 ◽  
Author(s):  
Zumin Shi ◽  
Shiqi Zhen ◽  
Yonglin Zhou ◽  
Anne W. Taylor
Keyword(s):  
Iron Intake ◽  
Food Record ◽  
Chinese Adults ◽  
Hazard Ratios ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Weighed Food Record ◽  
Fourth Quartile ◽  
Cvd Mortality

AbstractAnaemia is prevalent in developing countries and is commonly Fe deficiency related. We aimed to assess the association between Fe status, Fe intake and mortality among Chinese adults. We prospectively studied 8291 adults aged 20–98 years with a mean follow-up of 9·9 years. All participants were measured for Hb at baseline in 2002. Food intake, measured by 3-d weighed food record (n 2832), and fasting serum ferritin were measured. We documented 491 deaths (including 192 CVD and 165 cancer deaths) during 81 527 person-years of follow-up. There was a U-shaped association between Hb levels and all-cause mortality. Compared with the second quartile of Hb (121 g/l), the first (105) and fourth quartile (144) had hazard ratios (HR) of 2·29 (95 % CI 1·51, 3·48) and 2·31 (95 % CI 1·46, 3·64) for all-cause mortality in women. In men, compared with third quartile of Hb (143 g/l), first (122) and fourth quartiles (154) had 61 and 65 % increased risk of all-cause mortality. Anaemia was associated with an increased risk of all-cause and CVD mortality in men but not in women after adjusting for potential confounders. Low and high Fe intake as percentage of Chinese recommended nutrient intake (RNI) were positively associated with all-cause mortality in women but not in men. In women, across quartiles of relative Fe intake, HR for all-cause mortality were 2·55 (95 % CI 0·99, 6·57), 1·00, 3·12 (95 % CI 1·35, 7·18) and 2·78 (95 % CI 1·02, 7·58). Both low and high Hb levels are related to increased risk of all-cause mortality. Both low and high intake of Fe as percentage of RNI was positively associated with mortality in women.

scholarly journals Associations Between Physical Activity and Incident Hypertension Across Strata of Body Mass Index: A Prospective Investigation in a Large Cohort of French Women

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Conor‐James MacDonald ◽  
Anne‐Laure Madika ◽  
Martin Lajous ◽  
Nasser Laouali ◽  
Fanny Artaud ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
High Body Mass Index ◽  
Healthy Weight ◽  
Cox Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Diet History Questionnaire ◽  
Diet History

Background High body mass index (BMI) and low physical activity are associated with increased risk of hypertension. Few studies have assessed their joint impact or the relation of physical activity and hypertension among individuals within a healthy BMI range. The objective of this study was to investigate the associations between physical activity and hypertension across strata of BMI. Methods and Results We used data from the E3N (Etude Epidémiologique de femmes de la Mutuelle Générale de l´Education) cohort, a French prospective study of women aged 40 to 65 years. We included participants who completed a diet history questionnaire and who did not have prevalent hypertension at baseline, resulting in a total of 41 607 women. Questionnaires assessed time spent undertaking various types of physical activity. Hypertension cases were self‐reported. Cox models were used to calculate hazard ratios (HRs) for physical activity. Associations were assessed over strata of BMI. Among the 41 607 included women, 10 182 cases of hypertension were identified in an average follow‐up time of 14.5 years. Total physical activity was associated with a lower hypertension risk in women within the high‐normal BMI range (BMI, 22.5–24.9) (HR Quartile 1–Quartile 4 , 0.89; 95% CI, 0.79–0.99). An inverse relationship was observed between sports (HR sports >2 hours , 0.87; 95% CI, 0.83–0.93), walking (HR walk >6.5 hours , 0.94; 95% CI, 0.90–1.00), and gardening (HR gardening >2.5 hours , 0.94; 95% CI, 0.89–0.99). Sports were associated with a reduced risk of hypertension in women with a healthy weight, but evidence was weaker in overweight/obese or underweight women. Conclusions Women with a healthy weight were those who could benefit most from practicing sports, and sports provided the largest risk reduction compared with other types of activity.

Abstract MP60: Coronary Artery Calcium and Dementia Risk in the Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Akira Fujiyoshi ◽  
David R Jacobs ◽  
Annette L Fitzpatrick ◽  
Alvaro Alonso ◽  
Daniel A Duprez ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Agatston Score ◽  
Dementia Diagnosis ◽  
Cox Models ◽  
Ethnic Study ◽  
Risk Of Death ◽  
Hazard Ratios ◽  
Incident Dementia ◽  
Increased Risk

Introduction: Vascular risk factors (VRFs) predict incident dementia. Coronary artery calcium (CAC), capturing cumulative VRFs exposure, may predict dementia beyond VRFs. Hypothesis: In a community-based sample, baseline CAC is associated with incident dementia independent of VRFs assessed at baseline and APOE -ε 4 genotype. Methods: Among 6,814 participants of the Multi-Ethnic Study of Atherosclerosis (MESA), aged 45-84 years at baseline (2000-2002), we first identified candidate cases for incident all-cause dementia using hospital and death certificate ICD codes. For the analyses, we limited to cases whose diagnosis was validated using following criteria: 1) verifiable medical records available, 2) unlikely alternative diagnosis (e.g. delirium), and 3) written dementia diagnosis. Baseline CAC was categorized according to Agatston score (0, > 0 to <50, 50 to <100, 100 to <400, and ≥400). Cox models were used to obtain hazard ratios (HRs) adjusted for demographics, VRFs, APOE -ε 4, and incident stroke prior to dementia diagnosis. Results: We had complete data on 6,295 individuals for analysis with a mean follow-up of 11.1 years (208 validated cases). Crude rates of dementia were greater with higher baseline CAC categories. Adjusted HR of dementia per one higher CAC category was 1.14 (95%CI 1.03, 1.26) (see Table). The associations were similar when excluding interim incident coronary heart disease, or cardiovascular diseases, or using a model that accounted for competing risk of death with no dementia diagnosis. Conclusion: Higher CAC score measured at baseline was independently and significantly associated with increased risk of dementia. This finding is consistent with an important role for vascular injury in development of dementia.

Abstract P132: Potato Consumption And Risk Of Diabetes And Cardiovascular Mortality In The Alpha Omega Cohort

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Esther Cruijsen ◽  
Anne W Simon ◽  
Indira M Indyk ◽  
Maria C Busstra ◽  
Johanna M Geleijnse
Keyword(s):  
Population Based ◽  
French Fries ◽  
Cox Models ◽  
Preparation Methods ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Alpha Omega ◽  
All Cause Mortality ◽  
Potato Consumption

Introduction: Higher potatoes intake, especially French fries, was unfavorably associated with cardiometabolic endpoints in population-based studies. Little is known about this in coronary heart disease (CHD) patients. Hypothesis: Boiled potatoes and French fries intake might increase the risk of type 2 diabetes (T2D), cardiovascular disease (CVD) mortality and all-cause mortality after myocardial infarction (MI). Methods: We analyzed 3401 Dutch patients (60-80 y, 78% male) from the Alpha Omega Cohort, free from T2D, with an MI ≤ 10 y before enrolment. Diet was assessed at baseline (2002-2006) using a 203-item validated food frequency questionnaire, including potato preparation methods. T2D incidence (self-reported physician diagnosis and/or prescribed anti-diabetes medication) was monitored during the first 40 months of follow-up and cause-specific mortality through December 2018. Multivariable Cox models were used to obtain Hazard Ratios (HRs) for incident T2D and fatal endpoints in potato categories. Results: Patients had a median potato intake (mainly boiled) of 111 g/d (3.8 weekly servings of 200 g), with 6% consuming <1 serving per week. French fries were consumed by 48% of the patients (median: 6 g/d). Total potato intake was non-linearly associated with T2D risk during early follow-up (186 cases). Compared to 0-2 servings, HRs were 1.52 (0.97, 2.39) for 3-4 servings and 1.78 (1.10, 2.89) for ≥5 servings per week. During >12 y of follow-up (38,987 person-years) 1618 deaths occurred, of which 697 from CVD, 431 from CHD and 128 from stroke. HRs for fatal endpoints were non-significant in categories of total and boiled potatoes (Table). For French fries (consumers vs. non-consumers), HRs were 1.23 (0.89, 1.69) for T2D, 1.03 (0.87, 1.22) for fatal CVD and 0.93 (0.83, 1.04) for all-cause mortality. Conclusion: In Dutch post-MI patients, potatoes (mainly boiled) were neutrally associated with CVD and all-cause mortality. An increased risk of T2D was found for French fries, which warrants further study in CHD patient cohorts.

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