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Changes on Stroke Burden Attributable to Ambient Fine Particulate Matter in China

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Biomedical and Environmental Sciences 2024年第8期37卷 823-833页

作者： Jingyu Wang Yan Wang Xiaohua Liang Keyong Huang Fangchao Liu Shufeng Chen xiangfeng lu Jianxin Li Department of Epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Key Laboratory of Cardiovascular Epidemiology Chinese Academy of Medical SciencesBeijing 100037China Department of Clinical Epidemiology and Biostatistics Children’s Hospital of Chongqing Medical UniversityNational Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChongqing Key Laboratory of Pediatric Metabolism and Inflammatory DiseaseChongqing 400016China

Objective In recent decades,China has implemented a series of policies to address air *** aimed to assess the health effects of these policies on stroke burden attributable to ambient fine particulate matter(PM_(2.5)).Methods Joinpoint regression was applied to explore the temporal tendency of stroke burden based on data from the Global Burden of Disease 2019 *** The age-standardized rates of disability-adjusted life year(DALY)for stroke attributable to ambient PM2.5 in China,increased dramatically during 1990-2012,subsequently decreased at an annual percentage change(APC)of-1.98[95% confidence interval(CI):-2.26,-1.71]during *** ischemic stroke(IS),the age-standardized DALY rates doubled from 1990 to 2014,and decreased at an APC of-0.83(95%CI:-1.33,-0.33)during *** hemorrhage(ICH)showed a substantial increase in age-standardized DALY rates from 1990 to 2003,followed by declining trends,with APCs of-1.46(95%CI:-2.74,-0.16)during 2003-2007 and-3.33(95%CI:-3.61,-3.06)during 2011-2019,***,the age-standardized DALY rates for subarachnoid hemorrhage(SAH)generally declined during *** Our results clarified the dynamic changes of the ambient PM_(2.5)-attributable stroke burden in China during 1990-2019,highlighting the health effects of air quality improvement policies.

关键词： Ambient fine particulate matter Stroke Disease burden Temporal trend Policy

Metabolomics signature of blood pressure salt sensitivity and its link to cardiovascular disease:A dietary salt-intervention trial

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Science China(Life Sciences) 2024年第8期67卷 1666-1675页

作者： Zhennan Lin Jianxin Li Fangchao Liu Jie Cao Shufeng Chen Jichun Chen Keyong Huang Yaqin Wang Hongfan Li Yan Wang Jianfeng Huang Dongfeng Gu xiangfeng lu Key Laboratory of Cardiovascular Epidemiology Department of EpidemiologyFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical College/National Center for Cardiovascular DiseasesBeijing 100037China Medical School Southern University of Science and TechnologyShenzhen 518055China

Individuals with a high degree of salt sensitivity(SS)have a greater risk of cardiovascular disease(CVD),but whether SS fosters CVD by influencing metabolomics homeostasis remains *** study aimed to reveal the role of the SS-related metabolomics signature in the development of CVDs,based on the MetaSalt study,which was a dietary salt-intervention trial conducted at four centers in China in 2019.A total of 528 participants were recruited and underwent 3 days of baseline observations,a 10-day low-salt intervention,and a 10-day highsalt *** untargeted metabolomics,lipidomics,and BP measurements were scheduled at each *** were grouped into extreme SS,moderate SS,and salt-resistant(SR)individuals according to their BP responses to *** mixed models were used to identify SS-related metabolites and determine the relationship between the SS-related metabolomics signature and arterial *** randomization(MR)analyses were applied to establish the causal pathways among the SS-related metabolites,BP,and *** the 713 metabolites,467 were significantly changed after the high-salt *** them,the changes in 30 metabolites from the low-salt to the high-salt intervention differed among the SS *** the remaining nonsalt-related metabolites,the baseline levels of 11 metabolites were related to *** 41 metabolites explained 23%of the variance in ***,SS and its metabolomics signature were positively correlated with arterial *** analyses demonstrated that the SS-related metabolites may affect CVD risk by altering BP,indicating that the increase in BP was the consequence of the changes in SS-related metabolites rather than the *** study revealed that the metabolomics signature of SS individuals differs from that of SR individuals and that the changes in SS-related metabolites may increase arterial stiffness and foster *** study provides insight into understanding the biolog

关键词： salt sensitivity dietary salt intake metabolomics Mendelian randomization cardiovascular disease

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Physical activity, long-term fine particulate matter exposure and type 2 diabetes incidence: A prospective cohort study

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Chronic Diseases and Translational Medicine 2024年第3期10卷 205-215页

作者： Qian Li Fangchao Liu Keyong Huang Fengchao Liang Chong Shen Jian Liao Jianxin Li Chenxi Yuan Xueli Yang Jie Cao Shufeng Chen Dongsheng Hu Jianfeng Huang Yang Liu xiangfeng lu Dongfeng Gu Department of Epidemiology Center for Global HealthSchool of Public HealthNanjing Medical UniversityNanjingJiangsuChina Department of Epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Key Laboratory of Cardiovascular Epidemiology Chinese Academy of Medical SciencesBeijingChina School of Public Health and Emergency Management Southern University of Science and TechnologyShenzhenGuangdongChina Research Units of Cohort Study on Cardiovascular Diseases and Cancers Chinese Academy of Medical SciencesBeijingChina Tianjin Key Laboratory of Environment Nutrition and Public HealthDepartment of Occupational and Environmental HealthSchool of Public HealthTianjin Medical UniversityTianjinChina Department of Epidemiology and Health Statistics College of Public HealthZhengzhou UniversityZhengzhouHenanChina Department of Epidemiology and Health Statistics School of Public HealthShenzhen University Health Science CenterShenzhenGuangdongChina Gangarosa Department of Environmental Health Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA

Background: Despite the adverse effects of ambient fine particulate matter (PM_(2.5) ) on type 2 diabetes and the beneficial role of physical activity (PA), the influence of PM_(2.5) on the relationship between PA and type 2 diabetes remains ***: In this prospective study with 71,689 participants, PA was assessed by a questionnaire and was categorized into quartiles for volume and three groups for intensity. Long-term PM_(2.5) exposure was calculated using 1-km resolution satellite-based PM_(2.5) estimates. PM_(2.5) exposure and PA's effect on type 2 diabetes were assessed by cohort-stratified Cox proportional hazards models, individually and in ***: In 488,166 person-years of follow-up, 5487 incident type 2 diabetes cases were observed. The association between PA and type 2 diabetes was modified by PM_(2.5) . Compared with the lowest quartile of PA volume, the highest quartile was associated with reduced type 2 diabetes risk in low PM_(2.5) stratification (≤65.02 μg/m^(3)) other than in high PM_(2.5) stratification (>65.02 μg/m^(3)), with the hazard ratio (HR) of 0.75 (95% confidence interval [CI]: 0.66-0.85) and 1.10 (95% CI: 0.99-1.22), respectively. Similar results were observed for PA intensity. High PM_(2.5) exposure combined with the highest PA levels increased the risk of type 2 diabetes the most (HR= 1.79, 95% CI: 1.59-2.01 for PA volume;HR = 1.82, 95% CI: 1.64-2.02 for PA intensity).Conclusion: PA could reduce type 2 diabetes risk in low-pollution areas, but high PM_(2.5) exposure may weaken or even reverse the protective effects of PA. Safety and health benefits of PA should be thoroughly assessed for long-term polluted residents.

关键词： fine particulate matter physical activity type 2 diabetes

Cardiovascular risk assessment: The key path toward precision prevention

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Chronic Diseases and Translational Medicine 2023年第4期9卷 273-276页

作者： Jianxin Li xiangfeng lu Department of Epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Key Laboratory of Cardiovascular Epidemiology Chinese Academy of Medical SciencesBeijingChina

1 INTRODUCTION Cardiovascular disease(CVD)is the most common noncommunicable disease and the leading cause of death globally.l It has resulted in enormous economic and social burdens,while posing a ggreat challenge for the prevention and control of CvD worldwide,especially in *** and management of cardiovascular risk is the foundation of CvD prevention,and is strongly recommended by ***,it can help screen the target population who would benefit most from the lower-cost intervention,while informing them the cardiovascular risk,which will help in promoting *** can also guide doctors in making logical management decisions,and implement precision prevention and treatment strategies to reduce the CVD burden.2,4 Therefore,it is a key approach in achieving the goals of"Good Health and Well-being"in the United Nations and"Healthy China 2030"in China.

关键词： prevention cardiovascular globally

Temporal trend in mortality of cardiovascular diseases and its contribution to life expectancy increase in China, 2013 to 2018

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Chinese Medical Journal 2022年第17期135卷 2066-2075页

作者： Xue Xia Yue Cai Xiang Cui Ruixian Wu Fangchao Liu Keyong Huang Xueli Yang xiangfeng lu Shiyong Wu Dongfeng Gui Department of Epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Key Laboratory of Cardiovascular Epidemiology Chinese Academy of Medical SciencesBejing 100037China Center for Health Statistics and Information National Health CommissionBejing 100044China Department of Occupational and Environmental Health Tianjn Key Laboratory of EnvironmentNutrtion and Public HealthSchool of Public HealthTianjin Medical UniversityTianjin 300070China School of Medicine Southern University of Science and TechnologyShenzhenGuangdong 518055China

Backgrounds::Cardiovascular disease(CVD)remains the leading cause of deaths ***,little is understood about its temporal trend and corresponding influence on longevity *** aimed to describe the updated tendency in CVD mortality and to quantify its impact on life expectancy(LE)increase in ***::All-cause mortality rates were calculated with population sizes from the National Bureau of Statistics and death counts from the National Health *** estimated CVD mortality rates by allocating age-and sex-based mortality envelopes to each CVD subtype based on its proportion derived from the Disease Surveillance Points *** probability of CVD premature deaths and LE were calculated with life tables and we adopted Arriaga’s method to quantitate age-and cause-specific contributions to LE ***::During 2013 to 2018,the age-standardized mortality rate of CVD decreased from 289.69(95%confidence interval[CI]:289.03,290.35)/100,000 to 272.37(95%CI:271.81,272.94)/100,000,along with a decline in probability of CVD premature deaths from 9.05%(95%CI:9.02%,9.09%)to 8.13%(95%CI:8.10%,8.16%).The gap in CVD mortality across sexes expanded with more remarkable declines in females,especially for those aged 15 to 64 *** major subtypes,the probability of premature deaths from hemorrhage stroke declined fastest,while improvements of ischemic stroke and ischemic heart disease were limited,and there was an increase in stroke *** in China reached 77.04(95%CI:76.96,77.12)years in 2018 with an increase of 1.38 years from *** the total LE gains,21.15%(0.29 years)were attributed to reductions of CVD mortality in the overall population,mostly driven by those aged>65 ***::The general process in reducing CVD mortality has contributed to longevity improvements in *** attention should be paid to prevention and control of atherosclerotic CVD and stroke sequelae,especially for the ***-age males also d

关键词： Aged Cardiovascular diseases Causes of death Hemorrhagic stroke Ischemic stroke Longevity Mortality,premature Myocardial ischemia Life expectancy China

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累积空腹血糖水平与冠状动脉钙化的关联

中国循环杂志 2024年第5期39卷 444-450页

作者：李晨阳刘芳超陈恕凤李建新曹杰黄克勇赵连成李莹黄建凤吕滨鲁向锋顾东风中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管流行病学重点实验室流行病研究部北京102300 中国医学科学院北京协和医学院国家心血管病中心阜外医院放射影像科北京100037

目的:探讨累积空腹血糖水平与冠状动脉钙化(CAC)的关联。方法:选取来自北京社区动脉粥样硬化队列的1 113例研究对象,所有研究对象分别于1998年、2008~2009年、2013~2014年进行人体测量和血糖等生化指标检测,并于2013~2014年进行冠状动... 详细信息

目的:探讨累积空腹血糖水平与冠状动脉钙化(CAC)的关联。方法:选取来自北京社区动脉粥样硬化队列的1 113例研究对象,所有研究对象分别于1998年、2008~2009年、2013~2014年进行人体测量和血糖等生化指标检测,并于2013~2014年进行冠状动脉CT检查。根据累积空腹血糖水平(至少两次空腹血糖的10年加权累积水平)将研究对象分为四组:0分定义为存在CAC。应用Logistic回归模型分析累积空腹血糖水平对CAC的影响,并根据性别、年龄等进行亚组分析。结果:1 113例研究对象的平均年龄为(59.7±6.4)岁,其中男性523例(47.0%),478例(42.9%)存在CAC。随着累积空腹血糖水平升高,CAC比例逐渐增加。多因素Logistic回归分析显示,与累积空腹血糖水平<50.0 mmol/L组相比,50.0~55.9 mmol/L组、56.0~69.9 mmol/L组及≥70.0 mmol/L组研究对象存在CAC的OR (95%CI)分别为1.43 (1.04~1.98)、1.92(1.24~2.99)和2.79(1.35~5.77)(Ptrend<0.05)。累积空腹血糖水平每升高10 mmol/L,CAC风险增加34%(OR=1.34,95%CI:1.12~1.59,P<0.05)。在各亚组中,累积空腹血糖水平每升高10 mmol/L的CAC风险差异无统计学意义(P均≥0.05)。结论:累积空腹血糖水平升高是CAC的危险因素,提示长期维持健康血糖水平的重要性。

关键词：累积空腹血糖冠状动脉钙化冠状动脉钙化评分危险因素

Fruit and vegetable consumption,cardiovascular disease,and all-cause mortality in China

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Science China(Life Sciences) 2022年第1期65卷 119-128页

作者： Jun Wang Fangchao Liu Jianxin Li Keyong Huang Xueli Yang Jichun Chen Xiaoqing Liu Jie Cao Shufeng Chen Chong Shen Ling Yu Fanghong lu Xianping Wu Liancheng Zhao Ying Li Dongsheng Hu Jianfeng Huang Dongfeng Gu xiangfeng lu Department of Epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Key Laboratory of Cardiovascular Epidemiology Chinese Academy of Medical SciencesBeijing 100037China Tianjin Key Laboratory of Environment Nutrition and Public Health/Department of Occupational and Environmental HealthSchool of Public HealthTianjin Medical UniversityTianjin 300070China Division of Epidemiology Guangdong Provincial People’s Hospital and Cardiovascular InstituteGuangzhou 510080China Department of Epidemiology and Biostatistics School of Public HealthNanjing Medical UniversityNanjing 211166China Department of Cardiology Fujian Provincial HospitalFuzhou 350014China Cardio-Cerebrovascular Control and Research Center Institute of Basic MedicineShandong Academy of Medical SciencesJinan 250062China Sichuan Center for Disease Control and Prevention Chengdu 610041China Department of Epidemiology and Health Statistics College of Public HealthZhengzhou UniversityZhengzhou 450001China Department of Epidemiology and Health Statistics School of Public HealthShenzhen University Health Science CentreShenzhen 518060China School of Medicine Southern University of Science and TechnologyShenzhen 518055China

Evidence about the response patterns of fruit and vegetable consumption with the risk of cardiovascular disease(CVD)and allcause mortality was *** associations were examined using a large-scale,population-based Chinese cohort comprising 100,728 participants.A food-frequency questionnaire was used to assess fruit and vegetable *** were ascertained by interviewing individuals or their proxies and checking hospital records or death *** proportional hazards regression was used to calculate hazard ratios(HRs)with 95% confidence intervals(CIs).At the 736,668 person-years of follow-up,3,677 CVD cases and 5,466 deaths were *** multivariable-adjusted HRs for CVD across increasing quartiles of total fruit and vegetable consumption were 1(reference),0.94(95%CI=0.85-1.04),0.89(95%CI=0.80-0.98),and 0.85(95%CI=0.77-0.95).Moreover,participants in the highest quartile displayed a 13% lower risk of all-cause mortality(HR=0.87;95%CI=0.80-0.95).A nonlinear dose-response relation was found for CVD,without additional benefits beyond a consumption of600 g d-1,whereas the all-cause mortality risk decreased along with higher consumption,with a linear *** associations remained significant for fruit consumption but not for vegetable *** findings indicated that greater fruit and vegetable consumption was significantly associated with a lower risk of CVD and all-cause *** fruit and vegetable consumption,especially fruit,in the general population would prevent CVD and premature mortality.

关键词： fruit vegetable cardiovascular disease mortality

Integrating polygenic and clinical risks to improve stroke risk stratification in prospective Chinese cohorts

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Science China(Life Sciences) 2023年第7期66卷 1626-1635页

作者： Qingmei Cui Fangchao Liu Jianxin Li Xiaoge Niu Zhongying Liu Chong Shen Dongsheng Hu Keyong Huang Shufeng Chen Jie Cao Xiaoqing Liu Ling Yu Fanghong lu Xianping Wu Liancheng Zhao Jianfeng Huang Ying Li Zhibin Hu Hongbing Shen Dongfeng Gu xiangfeng lu Department of Epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing100037China Key Laboratory of Cardiovascular Epidemiology Chinese Academy of Medical SciencesBeijing100037China Department of Nephrology Henan Provincial Key Laboratory of Kidney Disease and ImmunologyHenan Provincial Clinical Research Center for Kidney DiseaseHenan Provincial People’s Hospital and People’s Hospital of Zhengzhou UniversityZhengzhou450053China Department of Epidemiology and Biostatistics Center for Global HealthSchool of Public HealthNanjing Medical UniversityNanjing211166China Department of Epidemiology and Health Statistics College of Public HealthZhengzhou UniversityZhengzhou450001China Department of Prevention Medicine Shenzhen University School of MedicineShenzhen518060China Division of Epidemiology Guangdong Provincial People’s Hospital and Cardiovascular InstituteGuangzhou510080China Department of Cardiology Fujian Provincial People’s HospitalFuzhou350014China Cardio-Cerebrovascular Control and Research Center Institute of Basic MedicineShandong Academy of Medical SciencesJinan250062China Sichuan Center for Disease Control and Prevention Chengdu610041China Research Units of Cohort Study on Cardiovascular Diseases and Cancers Chinese Academy of Medical SciencesBeijing100730China School of Medicine Southern University of Science and TechnologyShenzhen518055China

The utility of the polygenic risk score(PRS)to identify individuals at higher risk of stroke beyond clinical risk remains unclear,and we clarified this using Chinese population-based prospective *** proportional hazards models were used to estimate the 10-year risk,and Fine and Gray’s models were used for hazard ratios(HRs),their 95%confidence intervals(CIs),and the lifetime risk according to PRS and clinical risk categories.A total of 41,006 individuals aged 30–75 years with a mean follow-up of 9.0 years were *** the top versus bottom 5%of the PRS,the HR was 3.01(95%CI 2.03–4.45)in the total population,and similar findings were observed within clinical risk *** gradients in the 10-year and lifetime risk across PRS categories were also found within clinical risk ***,among individuals with intermediate clinical risk,the 10-year risk for those in the top 5%of the PRS(7.3%,95%CI 7.1%–7.5%)reached the threshold of high clinical risk(≥7.0%)for initiating preventive treatment,and this effect of the PRS on refining risk stratification was evident for ischemic *** among those in the top 10%and 20%of the PRS,the 10-year risk would also exceed this level when aged≥50 and≥60 years,***,the combination of the PRS with the clinical risk score improved the risk stratification within clinical risk strata and distinguished actual high-risk individuals with intermediate clinical risk.

关键词： stroke polygenic risk score clinical risk score utility stratification

新疆哈萨克族血脂异常、高血压和糖尿病共病现状及影响因素研究

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中国全科医学 2024年第12期27卷 1438-1444页

作者：金梦龙秦晓英马力亚·阿米提加孜呢·努尔拜李建新曹杰罗思富刘成张雨晨盖敏涛李艳鹏鲁向锋付真彦新疆医科大学第一附属医院心血管病中心新疆医科大学省部共建中亚高发病成因与防治国家重点实验室新疆维吾尔自治区乌鲁木齐市830000 富蕴县卫生健康委员会新疆维吾尔自治区阿勒泰地区836100 富蕴县吐尔洪乡中心卫生院新疆维吾尔自治区阿勒泰地区836100 富蕴县杜热镇中心卫生院新疆维吾尔自治区阿勒泰地区836100 北京协和医学院国家心血管病中心中国医学科学院阜外医院流行病研究部北京市100037

背景心血管疾病是我国居民的首要死亡原因,高血压、高血糖和血脂异常(“三高”)是心血管疾病的重要危险因素,因此国家提出实施“三高”共管,但目前缺乏关于新疆哈萨克族“三高”共病情况的相关研究。目的调查哈萨克族血脂异常、高血压... 详细信息

背景心血管疾病是我国居民的首要死亡原因,高血压、高血糖和血脂异常(“三高”)是心血管疾病的重要危险因素,因此国家提出实施“三高”共管,但目前缺乏关于新疆哈萨克族“三高”共病情况的相关研究。目的调查哈萨克族血脂异常、高血压和糖尿病患病率及共病情况,探索三者共病的影响因素。方法本研究为横断面研究。2022年3—6月,在新疆阿勒泰地区富蕴县,选取杜热镇和吐尔洪乡两个人口较多且以哈萨克族为主的乡镇,调查该地区18岁以上哈萨克族常住居民,通过问卷调查(一般信息、吸烟饮酒史、患病情况等)、体格检查(腰围、臀围、身高、体质量、血压、心率等)和实验室检查(总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、三酰甘油和空腹血糖等)收集患者信息,使用多因素Logistic回归分析探究哈萨克族“三高”共病的相关影响因素。结果共纳入4835名哈萨克族居民,男、女各占48.2%(2231/4835)和51.8%(2504/4835),平均年龄(45.8±12.7)岁。血脂异常、高血压和糖尿病标化患病率分别为37.9%、21.1%和4.0%。血脂异常患者中高胆固醇、高低密脂蛋白胆固醇、低高密度脂蛋白胆固醇和高三酰甘油血症人群的标化患病率分别为24.1%、24.8%、10.0%和7.3%。“三高”共病的标化患病率为11.8%。单因素Logistic回归分析显示,性别、年龄、BMI、腰围、臀围、心率、婚姻状况和文化程度是“三高”共病的影响因素(P<0.05);多因素Logistic回归分析显示,性别、年龄、婚姻状况、BMI和心率是“三高”共病的影响因素(P<0.05)。结论哈萨克族血脂异常患病率高于高血压和糖尿病,血脂异常以高胆固醇血症为主。血脂异常与高血压共病在“三高”共病中最为常见,应将老年人、男性和高BMI人群作为“三高”共管的重点人群。

关键词：血脂异常高血压糖尿病慢性病共病哈萨克族影响因素分析

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