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Cancer has contributed to an increasing proportion of diabetes-related deaths, while lifestyle management is the cornerstone of both diabetes care and cancer prevention. We aimed to evaluate the associations of combined healthy lifestyles with total and site-specific cancer risks among individuals with diabetes.We included 92,239 individuals with diabetes but without cancer at baseline from five population-based cohorts in the USA (National Health and Nutrition Examination Survey and National Institutes of Health [NIH]-AARP Diet and Health Study), the UK (UK Biobank study) and China (Dongfeng-Tongji cohort and Kailuan study). Healthy lifestyle scores (range 0-5) were constructed based on current nonsmoking, low-to-moderate alcohol drinking, adequate physical activity, healthy diet and optimal bodyweight. Cox regressions were used to calculate HRs for cancer morbidity and mortality, adjusting for sociodemographic, medical and diabetes-related factors.During 376,354 person-years of follow-up from UK Biobank and the two Chinese cohorts, 3229 incident cancer cases were documented, and 6682 cancer deaths were documented during 1,089,987 person-years of follow-up in the five cohorts. The pooled multivariable-adjusted HRs (95% CIs) comparing participants with 4-5 vs 0-1 healthy lifestyle factors were 0.73 (0.61, 0.88) for incident cancer and 0.55 (0.46, 0.67) for cancer mortality, and ranged between 0.41 and 0.63 for oesophagus, lung, liver, colorectum, breast and kidney cancers. Findings remained consistent across different cohorts and subgroups.This international cohort study found that adherence to combined healthy lifestyles was associated with lower risks of total cancer morbidity and mortality as well as several subtypes (oesophagus, lung, liver, colorectum, breast and kidney cancers) among individuals with diabetes.

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

Background. Several recent genome-wide association studies suggested insomnia and anemia may share some common genetic components. We thus examined whether adults with anemia had higher odds of having insomnia relative to those without anemia in a cross-sectional study and a meta-analysis. Methods. Included in this cross-sectional study were 12,614 Chinese adults who participated in an ongoing cohort, the Kailuan Study. Anemia was defined as hemoglobin levels below 12.0 g/dL in women and 13.0 g/dL in men. Insomnia was assessed using the Chinese version of the Athens Insomnia Scale (AIS). A total AIS score ≥6 was considered insomnia. The association between anemia and insomnia was assessed using a logistic regression model, adjusting for potential confounders such as age, sex, chronic disease status, and plasma C-reactive protein concentrations. A meta-analysis was conducted using the fixed effects model to pool results from our study and three previously published cross-sectional studies on this topic in adult populations. Results. Individuals with anemia had greater odds of having insomnia (adjusted odds ratio [OR]: 1.32; 95% confidence interval [CI]: 1.03–1.70) compared with individuals without anemia. A significant association persisted after we excluded individuals with chronic inflammation, as suggested by C-reactive protein levels >1 mg/L (adjusted OR: 1.68; 95% CI: 1.22–2.32). The meta-analysis results, including 22,134 participants, also identified a positive association between anemia and insomnia (pooled OR: 1.39; 95% CI: 1.22–1.57). Conclusions. The presence of anemia was significantly associated with a higher likelihood of having insomnia in adults. Due to the nature of the cross-sectional study design, results should be interpreted with caution.

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 and aim This study aimed to clarify health-related quality of life (HRQoL) of patients with colorectal precancer and colorectal cancer (CRC) in China and to better understand related utility scores. Methods A hospital-based cross-sectional survey was conducted in precancer and CRC patients from 2012 to 2014, covering 12 provinces in China. HRQoL was assessed with EuroQol 5-Dimensions 3-Levels. Utility scores were derived using Chinese value set. A multivariate regression model was established to explore potential predictors of utility scores. Results A total of 376 precancer (mean age 58.7 years, 61.2% men) and 2470 CRC patients (mean age 58.6 years, 57.6% men) were included. In five dimensions, there was a certain percentage of problem reported among precancer (range: 12.0% to 36.7%) and CRC (range: 32.4% to 50.3%) patients, with pain/discomfort being the most serious dimension. Utility scores of precancer and CRC patients were 0.870 (95% confidence interval [CI], 0.855-0.886) and 0.751 (95% CI, 0.742-0.759), both of which were lower than those of general Chinese population (0.960 [95% CI, 0.960-0.960]). Utilities for patients at stage I to stage IV were 0.742 (95% CI, 0.715-0.769), 0.722 (95% CI, 0.705-0.740), 0.756 (95% CI, 0.741-0.772), and 0.745 (95% CI, 0.742-0.767), respectively. Multivariate analysis showed that therapeutic regimen, time point of the interview, education, occupation, annual household income, and geographic region were associated with utilities of CRC patients. Conclusion Health-related quality of life of both precancer and CRC patients in China declined considerably. Utility scores differed by sociodemographic and clinical characteristics, and findings of these utilities may facilitate implementation of further cost-utility evaluations.

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.

Aim To analyze the systemic factors including stroke history related to the retinal artery occlusion (RAO). Methods Patients with an exact diagnosis of RAO in the medical database of the Kailuan Corporation were identified as the case group. Five patients without RAO were added for each case from the Kailuan Study and matched for sex and age (age±2) as the control group. The Kailuan Study is a general population-based cohort study in northern China, in which a total of 101 510 individuals (81 110 men) aged 18-98y were recruited to participate in the study. And the participants were bi-annually re-examined. The database of both groups was from Kailuan study of 2010 cohort. All the information, including the demographic characteristics, lifestyle behaviors, medical comorbidities, medical history, family medical history, drug usage, anthropometric measurements, blood pressure measurement, blood sample laboratory assessment, urine tests, and other physical examinations were all collected. A retrospective nested case-control method was used for this study. Conditional multivariate logistic regression was used to analyze the risk factors with SPSS 13.0 software and SAS 9.3 software. Results A total of 45 patients were included as the case group, and the control group included 225 patients. In the case group, 28 patients (62.2%) had a central retinal artery occlusion (CRAO), and 17 patients (37.8%) had a branch retinal artery occlusion (BRAO). A total of 18 patients (40.0%) had a stroke before the RAO (mean 4.04±3.88y before the RAO), and 31 patients (81.6%) had infarctions or malacia identified by the cranial computed tomography (CT) scans. The basal ganglia and centrum semiovale were the most frequently involved regions. Plaques in the common carotid artery were present in 32 patients (88.9%). Conditional multivariate logistic regression analysis showed that the RAO was found to be associated with the history of stroke (P=0.0023, OR=28.794; 95%CI: 3.322-249.586). Conclusion A history of stroke can significantly increase the incidence of RAO. Exists of plaque in the carotid artery is mean more than its severe stenosis for RAO.

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 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.

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.

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.

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 ...

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: Previous studies have shown that hypertension is an important factor contributing to the occurrence and progression of diabetic kidney damage. However, the relationship between the patterns of blood pressure (BP) trajectory and kidney damage in the diabetic population remains unclear. This prospective study investigated the effect of long-term systolic BP (SBP) trajectory on kidney damage in the diabetic population based on an 8-year follow-up community-based cohort. Methods: This study included 4556 diabetic participants among 101,510 participants. BP, estimated glomerular filtration rate (eGFR), and urinary protein were measured every 2 years from 2006 to 2014. SBP trajectory was identified by the censored normal modeling. Five discrete SBP trajectories were identified according to SBP range and the changing pattern over time. Kidney damage was evaluated through eGFR and urinary protein value. A multivariate logistic regression model was used to analyze the influence of different SBP trajectory groups on kidney damage. Results: We identified five discrete SBP trajectories: low-stable group (n = 864), moderate-stable group (n = 1980), moderate increasing group (n = 609), elevated decreasing group, (n = 679), and elevated stable group (n = 424). The detection rate of kidney damage in the low-stable group (SBP: 118–124 mmHg) was the lowest among the five groups. The detection rate of each kidney damage index was higher in the elevated stable group (SBP: 159–172 mmHg) compared with the low-stable group. For details, the gap was 4.14 (11.6% vs. 2.8%) in eGFR

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.

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

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.

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