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Associations between metabolic dysfunction-associated fatty liver disease and extrahepatic cancers:a cohort in China

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Hepatobiliary Surgery and Nutrition 2023年第5期12卷 671-681,I0004-I0015页

作者： Xiaojie Yuan Xiaomo Wang Shouling Wu shuohua chen Yanhong Wang Jierui Wang Ying Lu Yuanyuan Sun Qingjiang Fu Li Wang Department of Epidemiology and Biostatistics Institute of Basic Medical Sciences Chinese Academy of Medical SciencesSchool of Basic Medicine Peking Union Medical CollegeBeijingChina Department of Cardiology Kailuan General HospitalTangshanChina Department of Rheumatology Kailuan General HospitalTangshanChina Department of Hepatobiliary Surgery Kailuan General HospitalTangshanChina

Background:To evaluate the associations between a new definition of metabolic dysfunction-associated fatty liver disease(MAFLD)and extrahepatic cancers and compare with nonalcoholic fatty liver disease(NAFLD).Methods:We enrolled 151,391 Chinese participants in the Kailuan *** steatosis was detected by abdominal *** and Gray competing risk regression models were used to estimate hazard ratios(HRs)and 95%confidence interval(CI)between MAFLD and extrahepatic ***:MAFLD was associated with increased risk of prostate(HR=1.49,95%CI:1.07-2.08)and obesity-related cancers,including thyroid(HR=1.47,95%CI:1.01-2.12),kidney(HR=1.54,95%CI:1.18-2.00),colorectal(HR=1.15,95%CI:0.98-1.34)and breast cancer(HR=1.31,95%CI:1.04-1.66).The results were consistent in NAFLD ***-NAFLD and MAFLD-NAFLD *** *** with the neither FLD group,the NAFLD-only group had a higher risk of extrahepatic cancers(HR=1.57,95%CI:1.18-2.09),esophageal(HR=5.11,95%CI:2.25-11.62),and bladder cancer(HR=3.36,95%CI:1.23-9.17).The additional risk of extrahepatic cancers(HR=1.42,95%CI:1.17-1.73),esophageal(HR=4.37,95%CI:2.55-7.49),and breast cancer(HR=1.99,95%CI:1.01-3.92)was observed in MAFLD with metabolic dysregulation,and kidney(HR=1.83,95%CI:1.38-2.43),prostate(HR=1.46,95%CI:1.00-2.14)and breast cancer(HR=1.33,95%CI:1.02-1.74)was observed in MAFLD with overweight and metabolic dysregulation,as well as colorectal(HR=1.45,95%CI:1.07-1.96)and prostate cancer(HR=2.44,95%CI:1.42-4.21)in MAFLD with three risk ***,MAFLD with excessive alcohol consumption would increase extrahepatic cancers(HR=1.14,95%CI:1.01-1.29)and breast cancer(HR=7.27,95%CI:2.33-22.69)***:MAFLD and NAFLD shared similar excessive risks of obesity-related cancers,suggesting a driving role of FLD in these *** dysregulation beyond obesity may play additional kidney,colorectal,and prostate cancer risks in MAFLD *** may be helpful in the clinic to relie

关键词： Metabolic dysfunction-associated fatty liver disease(MAFLD) nonalcoholic fatty liver disease(NAFLD) extrahepatic cancers metabolic risk dual etiology

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Associations between blood glucose and early- and late-onset colorectal cancer: evidence from two prospective cohorts and Mendelian randomization analyses

Journal of the National Cancer Center

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Journal of the National Cancer Center 2024年第3期4卷 241-248页

作者： chenyu Luo Jiahui Luo Yuhan Zhang Bin Lu Na Li Yueyang Zhou shuohua chen Shouling Wu Qingsong Zhang Min Dai Hongda chen Department of Cancer Epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Center for Prevention and Early Intervention National Infrastructures for Translational MedicineInstitute of Clinical MedicinePeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Cardiology Department Kailuan General HospitalTangshanChina Department of General Surgery Kailuan General HospitalTangshanChina

Background: The incidence of early-onset colorectal cancer (EOCRC), which exhibits differential clinical, patho- logical, and molecular features compared to late-onset CRC (LOCRC), is rising globally. The potential differential effects of blood glucose on EOCRC compared to LOCRC have not been investigated. Methods: This study analyzed 374,568 participants from the UK Biobank cohort and 172,809 participants from the Kailuan cohort. The linear associations between blood glucose and EOCRC/LOCRC were estimated using Cox regression models. Restricted cubic spline (RCS) analysis and non-linear Mendelian randomization (MR) analysis using a 70-SNPs genetic instrument for fasting glucose were used to explore the potential non-linear associations. Results: Participants in the highest quintile of blood glucose had higher overall CRC risk compared to the lowest quintile (HR = 1.10 in the UK Biobank cohort, 95% CI: 1.01-1.21, P -trend = 0.012;HR = 1.23 in the Kailuan cohort, 95% CI: 1.01-1.51, P -trend = 0.036). Elevated glucose ( > 7.0 mmol/L) was more strongly associated with increased risk of EOCRC (HR = 1.61, 95% CI: 1.07-2.44) than with LOCRC (HR = 1.14, 95% CI: 1.02-1.27) in the UK Biobank cohort ( P- heterogeneity = 0.014). Elevated glucose ( > 7.0 mmol/L) was associated with increased risk of LOCRC (HR = 1.25, 95% CI: 1.04-1.65) in the Kailuan cohort as well. There was no evidence for non-linear associations between blood glucose and risks of EOCRC/LOCRC. Conclusions: This study showed a positive association between blood glucose and CRC risk in a dose-response manner, particularly for EOCRC, suggesting that tighter glucose control should be a priority for younger age groups.

关键词： Colorectal cancer Early-onset colorectal cancer Glucose Mendelian randomization Cancer prevention

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Low Concordance Between Blood Pressures Measured in Periodic Health Examinations and in a Workplace-Based Hypertension Management Program

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Phenomics 2022年第6期2卷 419-429页

作者： Jun-Xiang chen Yan-Feng Zhou Tingting Geng Simiao chen shuohua chen Guodong Wang Yan-Bo Zhang Yi Wang Zhou-Zheng Tu Gang Liu Shouling Wu An Pan Department of Epidemiology and Biostatistics Ministry of Education Key Laboratory of Environment and HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology13 Hangkong RoadWuhan 430030HubeiChina Heidelberg Institute of Global Health Faculty of Medicine and University HospitalHeidelberg University44883 HeidelbergGermany Department of Cardiology Kailuan General HospitalNorth China University of Science and Technology57 Xinhua East RoadTangshan 063000HebeiChina Department of Nutrition and Food Hygiene Hubei Key Laboratory of Food Nutrition and SafetySchool of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430040HubeiChina

Poor adherence to standard protocols of blood pressure(BP)measurement in routine clinical practice leads to higher readings than“research-quality”*** this phenomenon exists in periodic health examinations was *** aimed to explore the concordance between BP measurements in periodic health examinations and those measured following a standard measurement *** used data from the Kailuan Study,an ongoing longitudinal cohort study in China,of which participants received biennial health examinations in health management *** addition,BPs were measured following standard protocols in a workplace-based hypertension management program nested in the Kailuan *** compared BP readings of the same person between the two settings using generalized linear mixed-effects models.A total of 3988 men(the mean age was 44.9 years)had at least two BP measurements both in health examinations and management program with a time interval between the two settings that less than 90 *** mean systolic blood pressures(SBP)and diastolic blood pressures(DBP)in health examinations were 4.2(95%CI 3.9–4.5)mm Hg and 3.3(95%CI 3.1–3.5)mm Hg higher than those in the management program,***–Altman analyses showed the wide agreement inter-vals ranging from-27.7-to 36.5-mm Hg for SBP and-18.3-to 24.7-mm Hg for *** conclusion,BP measurements in periodic health examinations were generally higher than BPs measured following a standard *** findings highlight the importance of standard BP measurement to avoid overestimation of hypertension prevalence and treatment initiation.

关键词： Hypertension Physical examination Blood pressure determination Guideline adherence

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Severity of non-alcoholic fatty liver disease is a risk factor for developing hypertension from prehypertension

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Chinese Medical Journal 2023年第13期136卷 1591-1597页

作者： Qirui Song Qianhui Ling Luyun Fan Yue Deng Qiannan Gao Ruixue Yang shuohua chen Shouling Wu Jun Cai Hypertension Center Fuwai HospitalState Key Laboratory of Cardiovascular Disease of ChinaNational Center for Cardiovascular Diseases of ChinaChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China State Key Laboratory of Cardiovascular Disease of China Fuwai HospitalNational Center for Cardiovascular Diseases of ChinaChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Cardiology Kailuan General HospitalTangshanHebei 063000China

Background:There is little published evidence about the role of non-alcoholic fatty liver disease(NAFLD)in the progression from prehypertension to *** study was conducted to investigate the association of NAFLD and its severity with the risk of hypertension developing from ***:The study cohort comprised 25,433 participants from the Kailuan study with prehypertension at baseline;those with excessive alcohol consumption and other liver diseases were *** was diagnosed by ultrasonography and stratified as mild,moderate,or *** and multivariable Cox proportional hazard regression was used to calculate the hazard ratios(HRs)and 95%confidence intervals(CIs)of incident hypertension according to the presence and 3 categories of severity of ***:During a median of 12.6 years of follow-up,10,638 participants progressed to hypertension from *** adjusting for multiple risk factors,patients with prehypertension and NAFLD had a 15%higher risk of incident hypertension than those without NAFLD(HR=1.15,95%CI 1.10-1.21).Moreover,the severity of NAFLD was associated with the incidence of hypertension,which was higher in patients with more severe NAFLD(HR=1.15[95%CI 1.10-1.21]in the mild NAFLD group;HR=1.15[95%CI 1.07-1.24]in the moderate NAFLD group;and HR=1.20[95%CI 1.03-1.41]in the severe NAFLD group).Subgroup analysis indicated that age and baseline systolic blood pressure may modify this ***:NAFLD is an independent risk factor for hypertension in patients with *** risk of incident hypertension increases with the severity of NAFLD.

关键词： Hypertension Non-alcoholic fatty liver disease Prehypertension

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Composition and Functional Capacity of Gut Microbes are Associated with Arterial Stiffness:A Prospective Study

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Cardiology Discovery 2023年第2期3卷 102-111页

作者： Jing Li Yixuan Zhong Jingjing Bai shuohua chen Jun Cai Shouling Wu Weili Zhang Heart Center&Beijing Key Laboratory of Hypertension Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular DiseaseFuWai HospitalNational Center for Cardiovascular DiseasesPeking Union Medical College&Chinese Academy of Medical SciencesBeijing 100037China Department of Cardiology Kailuan General HospitalTangshanHebei 063000China Central-China Branch of National Center for Cardiovascular Diseases Henan Cardiovascular Disease CenterFuwai Central-China HospitalZhengzhou 450046China.

Objective:Arterial stiffness is an important predictor of cardiovascular *** diversity in the gut has been shown to be associated inversely with arterial stiffness in Caucasian ***,due to the different profiles of the gut microbiota among ethnicities,the relationship between gut-microbiota dysbiosis and the progression of arterial stiffness merits further *** study aimed to investigate the association between the composition and functional capacity of the gut microbiota and the progression of arterial ***:“Shotgun”metagenomics sequencing were undertaken in 96 individuals from a hypertension-associated gut-microbiota study in the Kailuan cohort,who measured brachial-ankle pulse wave velocity(baPWV)and provided fecal samples between September 2014 and February 2015 at Kailuan General Hospital and 11 affiliated *** different composition and functional capacity of the gut microbiota were compared between individuals without arterial stiffness(normal arterial stiffness group,baPWV<1,400 cm/s,n=27)and participants with arterial stiffness(increased arterial stiffness group,baPWV≥1,400 cm/s,n=69)at *** participants were followed up prospectively for a mean duration of 2.6 years,and 50 underwent a repeat baPWV *** between the gut microbiota and severity and progression of arterial stiffness were assessed using MaAsLin2 software after adjustment for age,sex,and mean arterial blood pressure and correction for multiple ***“catalogs”were aligned to the Kyoto Encyclopedia of Genes and Genomes(KEGG)database to obtain information for potential functional capacities of the gut ***:In this study,14 genera and 50 species of bacteria were identified to be abundant in participants with normal arterial stiffness compared with those with increased arterial *** 14 genera,the prevalence of beneficial bacteria of the genera Leadbetterella and Cytophaga was cor

关键词： Arterial stiffness Brachial-ankle pulse wave velocity Gut microbiota Microbial functions

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Association of insomnia with diet quality and eating behavior

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Chinese Medical Journal 2024年第16期137卷 2002-2004页

作者： Guliyeerke Jigeer Zhe Huang Jiaojiao Zou Siwei Zhu Yaqi Li shuohua chen Qishan Yang Liang Sun Shouling Wu Xiang Gao Department of Nutrition and Food Hygiene School of Public HealthInstitute of NutritionFudan UniversityShanghai 200032China Department of Cardiology Kailuan General HospitalTangshanHebei 063000China Department of Epidemiology Harvard T.H.Chan School of Public HealthBostonMA 02115USA Key Laboratory of Public Health Safety of the Ministry of Education Fudan UniversityShanghai 063000China

To the Editor:Insomnia affects 30%-50%of adults globally,leading to diminished quality of life and increased risks of developing physically and mentally demanding disorders.[1]Previous research,primarily in Western populations,reported the association between insomnia and poor diet quality,characterized by higher energy intake,lower vegetable consumption,and a preference for fatty foods,risk factors contributing to major chronic conditions.[2]This association,however,remains under-explored in Asian populations.

关键词： intake ins globally

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全血中铁、钙、铜、镁、硒与代谢综合征关联的病例对照研究

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石河子大学学报（自然科学版） 2022年第2期40卷 244-250页

作者：黄仙吴寿岭陈朔华郭淑霞石河子大学医学院预防医学系新疆石河子832000 开滦总医院心内科河北唐山063000 开滦(集团)公司员工健康保障中心河北唐山063000

目的探讨多金属暴露与代谢综合征(MS)发病风险的关联,为预防高危人群MS发生发展提供理论支持。方法纳入2017年8月到2018年5月在唐山开滦队列中的男性人群为研究对象,在3所附属医院共选取361例MS患者和1 109例经年龄频数匹配的非代谢... 详细信息

目的探讨多金属暴露与代谢综合征(MS)发病风险的关联,为预防高危人群MS发生发展提供理论支持。方法纳入2017年8月到2018年5月在唐山开滦队列中的男性人群为研究对象,在3所附属医院共选取361例MS患者和1 109例经年龄频数匹配的非代谢综合征者(non-MS)进行的病例对照研究。采用logistic回归分析分别评估单一金属元素与MS之间的风险关联;基于自适应弹性网回归方法量化多金属暴露时与MS之间的综合效应。结果 MS组中血钙、铜和镁浓度显著低于对照组(P<0.05),但硒浓度高于对照组(P<0.01)。在对可能的混杂进行校正后,金属元素第三分位组与第一分位组的MS比值比分别为:钙[0.52 (95%CI:0.38, 0.71),P<0.001]、硒[1.80 (95%CI:1.32, 2.44),P<0.001]和铜[0.60 (95%CI:0.44, 0.83),P<0.01]。与MS为U型关系的金属元素以第二分位组为参照组,比值比分别为:铁[第一分位组1.40 (95%CI:1.03, 1.92),P<0.05;第三分位组1.51 (95%CI:1.10, 2.06),P<0.01]和镁[第一分位组1.83 (95%CI:1.34, 2.51),P<0.001;第三分位组1.50 (95%CI:1.09, 2.08),P<0.05]。同时,金属元素共同暴露时,MS的发生风险显著增加[4.12 (95%CI:2.63, 6.47),P<0.001]。结论铁紊乱、低钙、低铜、高镁和高硒是MS发生的独立危险因素,且多金属共同暴露时,MS的风险更高。

关键词：金属元素代谢综合征男性自适应弹性网病例对照研究

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开滦研究人群中恶性肿瘤确诊前后总胆固醇差值对患者全因死亡的影响

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肿瘤研究与临床 2022年第5期34卷 364-369页

作者：迟玉玉陈朔华吴寿岭沧州市中西医结合医院急诊科沧州061001 开滦总医院心内科唐山063000

目的探讨开滦研究人群恶性肿瘤确诊前后总胆固醇差值对患者全因死亡的影响。方法采用前瞻性队列研究方法,选择2006年6月至2015年12月健康体检期间发现恶性肿瘤,且确诊恶性肿瘤前后总胆固醇资料完整的开滦(集团)有限责任公司在职和退休... 详细信息

目的探讨开滦研究人群恶性肿瘤确诊前后总胆固醇差值对患者全因死亡的影响。方法采用前瞻性队列研究方法,选择2006年6月至2015年12月健康体检期间发现恶性肿瘤,且确诊恶性肿瘤前后总胆固醇资料完整的开滦(集团)有限责任公司在职和退休职工作为观察对象。通过医疗保险系统、开滦总医院病案管理信息系统检索受试者恶性肿瘤首次确诊时间,采用SAS 9.4软件提取受试者肿瘤确诊前后2年内体检资料。根据恶性肿瘤确诊前后总胆固醇差值四分位数分组:第1分位组为总胆固醇差值<-0.93 mmol/L(823例);第2分位组为总胆固醇差值≥-0.93 mmol/L且<-0.21 mmol/L(811例);第3分位组为总胆固醇差值≥-0.21 mmol/L且<0.49 mmol/L(832例);第4分位组为总胆固醇差值≥0.49 mmol/L(833例)。采用发病密度计算第1、2、3、4分位组的死亡率,采用Cox比例风险模型分析各组全因死亡的影响因素。结果中位随访时间2.46年,共发生1564例全因死亡事件。第1、2、3、4分位组死亡例数分别为481、440、333、310例,死亡率分别为230.10/千人年、163.90/千人年、115.34/千人年和83.44/千人年(χ^(2)=604.62,P<0.001)。校正混杂因素后,Cox比例风险模型分析显示,与第1分位组相比,第2、3、4分位组发生全因死亡的HR(95%CI)分别为0.86(0.76~0.98)、0.62(0.54~0.72)、0.58(0.50~0.67)(均P_(趋势)<0.001)。不同部位肿瘤患者中,校正混杂因素后,与第1分位组比较,第4分位组肿瘤部位除甲状腺、乳腺、前列腺和睾丸、泌尿系统外,均P_(趋势)<0.05。结论开滦研究人群中,恶性肿瘤确诊后总胆固醇水平较确诊前下降幅度小及升高是全因死亡的保护因素。

关键词：肿瘤总胆固醇全因死亡开滦研究

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Insomnia, diet quality and eating behavior

Insomnia, diet quality and eating behavior

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中国睡眠研究会第十五届全国学术年会

作者： Guliyeerke Jigeer Xiang Gao Zhe Huang Jiaojiao Zou Siwei Zhu Yaqi Li shuohua chen Qishan Yang Liang Sun Shouling Wu Fudan University Kailuan General Hospital Harvard T.H.Chan School of Public Health

Background: Several studies suggested the association between sleep disorders and poor diet ***, there is limited knowledge on whether sleep disorders could impact eating behaviors, such as night eating and skipping breakfast, and whether the underlying sleep-diet relationship could be modified by these unhealthy eating ***: Included were 50,218 Chinese adults(mean age: 49.9 ± 14.6 y) who were free of diabetes, cardiovascular diseases, and cancer in 2014, when information on insomnia symptoms, dietary intake and presence of night-eating behavior and skipping breakfast was collected via ***: In the current cross-sectional study, individuals with insomnia had lower total modified Alternative Healthy Eating Index(mAHEI) score(adjusted mean difference=-1.14;95% confidence interval(CI):-1.48,-0.80), and higher odds of having behaviors of nighteating(adjusted OR=1.90, 95% CI: 1.69, 2.14) and breakfast-skipping(adjusted OR= 1.41, 95% CI: 1.24, 1.62), relative to those without insomnia, after adjusting for potential confounders, such as age, sex, total energy, and health conditions(P-difference<0.001 for all).The presence of these unhealthy eating behaviors significantly mediated the association between insomnia disorder and mAHEI score, with a mean proportion of 6.6% for night-eating and 2.6% for ***: Insomnia was associated with poorer diet quality and higher odds of having unhealthy eating behaviors in Chinese adults.

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Ideal cardiovascular health and mortality:pooled results of three prospective cohorts in Chinese adults

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Chinese Medical Journal 2023年第2期136卷 141-149页

作者： Yanbo Zhang Canqing Yu shuohua chen Zhouzheng Tu Mengyi Zheng Jun Lv Guodong Wang Yan Liu Jiaxin Yu Yu Guo Ling Yang Yiping chen Kunquan Guo Kun Yang Handong Yang Yanfeng Zhou Yiwen Jiang Xiaomin Zhang Meian He Gang Liu Zhengming chen Tangchun Wu Shouling Wu Liming Li An Pan Ministry of Education Key Laboratory of Environment and Health State Key Laboratory of Environmental Health(Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China Department of Epidemiology and Biostatistics School of Public HealthPeking University Center for Public Health and Epidemic Preparedness&ResponsePeking University Health Science CenterBeijing 100191China Department of Cardiology Kailuan HospitalNorth China University of Science and TechnologyTangshanHebei 063000China Department of Cardiology Tangshan Worker’s HospitalTangshanHebei 063000China Chinese Academy of Medical Sciences Beijing 100191China Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population HealthUniversity of OxfordOxford OX37LFUnited Kingdom Affiliated Dongfeng Hospital Hubei University of MedicineShiyanHubei 442001China

Background: Evidence on the relations of the American Heart Association’s ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps. Methods: A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis. Results: During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed. Conclusions: ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.

关键词： China Health behavior Ideal cardiovascular health Metabolic health Mortality Noncommunicable diseases Body mass index Smoking Alcohol Exercise

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