Liebin Zhao

Cohort profile: Risk evaluation of cancers in Chinese diabetic individuals: A longitudinal (REACTION) study

To demonstrate whether abnormal glucose metabolism (diabetes and prediabetes) is associated with increased risk for cancer in the Chinese population and to identify factors that modify the risk of cancer among individuals with abnormal glucose metabolism.

Sleep duration and snoring associate with hypertension and glycaemic control in patients with diabetes

Few studies have analysed the effect of sleep duration and snoring on hypertension and glycaemic control in patients with diabetes. This study aims to investigate the relationship of sleep duration and snoring on prevalent hypertension and glycaemic control in people with diabetes.

Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults.

To examine the association between depression and impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in middle‐aged and elderly Chinese people, and whether depression was associated with different treatment regimens or durations of diabetes.

Risk of all-cause mortality and cardiovascular disease associated with secondhand smoke exposure: A systematic review and meta-analysis

BACKGROUND Emerging studies have assessed the association between secondhand smoke (SHS) exposure and cardiovascular disease (CVD) as well as all-cause mortality. However, findings were not consistent due to the heterogeneity of study characteristics. METHODS PubMed and Embase were searched through May 2014 for prospective cohort and case-control studies investigating the associations of SHS exposure in never smokers with all-cause mortality and the risk of CVD. The main analysis was performed in studies using self-reported SHS exposure and secondary analysis was performed in studies using objectively measured SHS exposure. Summary estimates were calculated using random-effects models. RESULTS Twenty-three prospective and 17 case-control studies were included. The pooled relative risks (RR) for never smokers exposed to SHS in comparison with those unexposed were 1.18 [95% confidence interval (CI): 1.10-1.27] for all-cause mortality (12 studies), and 1.23 (1.16-1.31) for CVD (38 studies). The association of SHS exposure with CVD was markedly stronger among studies conducted in China (RR=1.65, 95% CI 1.27-2.13) than that in the US (RR=1.09, 95% CI 1.03-1.16). Studies using objectively measured SHS exposure demonstrated a slightly higher risk for CVD compared with those using self-reported SHS exposure. CONCLUSIONS Exposure to SHS significantly increased the risk for all-cause mortality and CVD. The risk associated with SHS exposure was large in China while the risk was only modest in the US. Studies using objectively measured SHS exposure may yield a higher risk of CVD than those using self-reported SHS exposure.

Reduced Kidney Function Is Associated With Cardiometabolic Risk Factors, Prevalent and Predicted Risk of Cardiovascular Disease in Chinese Adults: Results From the REACTION Study

Background Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk. However, the association of mildly reduced kidney function with CVD risk is unclear. Methods and Results This study investigated the association of estimated glomerular filtration rate (eGFR) with prevalent CVDs, 10‐year Framingham risk for coronary heart disease (CHD), and 10‐year risk of atherosclerotic cardiovascular diseases (ASCVD) in 239 832 participants from the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study. With an interviewer‐assisted questionnaire, we collected information on CVD, including reported CHD, stroke, or myocardial infarction. Chronic Kidney Disease–Epidemiology Collaboration (CKD‐EPI) equation was used to calculate eGFR. Compared with individuals with normal eGFR (≥90 mL/min per 1.73 m2), those with decreased eGFR (75–89, 60–74, and <60 mL/min per 1.73 m2) had higher risk of prevalent obesity, diabetes mellitus, hypertension, and dyslipidemia in both men and women (P for trend all <0.001). Moreover, a significantly higher 10‐year Framingham risk for CHD and 10‐year risk for ASCVD was observed in both men and women with mildly decreased eGFR (60–89 mL/min per 1.73 m2). Conclusions Even mildly reduced eGFR (under 90 mL/min per 1.73 m2) is associated with elevated 10‐year Framingham risk for CHD and 10‐year ASCVD risk among Chinese adults.

Free Triiodothyronine Concentrations are Inversely Associated with Elevated Carotid Intima-Media Thickness in Middle-Aged and Elderly Chinese Population

AIM Increased carotid artery intima media thickness (C-IMT) is an early feature of atherosclerosis. It has been reported to be altered in patients with thyroid dysfunction, and the evidence is still controversial. The present study aimed to explore the relationship between C-IMT and possible variations in thyroid function in Chinese adults aged 40 years and above. METHODS A community-based cross-sectional study was conducted among 2276 non-diabetic participants. Serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were determined by chemiluminescent microparticle immunoassay. RESULTS The prevalence of elevated C-IMT decreased according to FT3 quartiles (29.8%, 24.3%, 24.2%, and 22.2%, P for trend=0.005). In both univariate and multivariate linear regression analyses, FT3 levels were inversely associated with C-IMT (both P values ≤ 0.002). Multivariate-adjusted logistic regression analysis showed that high FT3 levels were associated with low prevalent elevated C-IMT. The adjusted odds ratio for elevated C-IMT was 0.71 (95% confidence interval, 0.52-0.99, P=0.04) when comparing the highest with the lowest quartile of FT3. CONCLUSIONS Serum FT3 levels were inversely associated with elevated C-IMT in middle-aged and elderly Chinese adults without diabetes, independent of traditional risk factors for atherosclerosis.

Association between the change in body mass index from early adulthood to midlife and subsequent type 2 diabetes mellitus.

To clarify the quantitative relationship of body mass index (BMI) change from early adulthood to midlife with presence of type 2 diabetes mellitus (T2DM) after midlife.

HLA-A*33-DR3 and A*33-DR9 haplotypes enhance the risk of type 1 diabetes in Han Chinese.

To investigate the typing for human leukocyte antigen (HLA) class I in Chinese patients with type 1 diabetes as a complement screening for HLA class II.

Prevalence of Diabetes and Cardiometabolic Disorders in Spouses of Diabetic Individuals

Pairs of spouses share common lifestyle factors. In a cross-sectional analysis, we investigated whether spouses of diabetic individuals had a higher prevalence of diabetes and cardiometabolic disorders in a community-based population of Chinese adults aged 40 years or older between 2011 and 2012. A total of 34,805 pairs of spouses were identified. All participants underwent a standard oral glucose tolerance test and provided detailed clinical, sociodemographic, and lifestyle information. Diabetes and multiple cardiometabolic disorders were defined according to standard criteria. Compared with participants whose spouses did not have diabetes, participants whose spouses had diabetes had higher odds of having diabetes (for men, odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.22, 1.45; for women, OR = 1.35, 95% CI: 1.24, 1.47), obesity (for men, OR = 1.34, 95% CI: 1.13, 1.59; for women, OR = 1.19, 95% CI: 1.05, 1.35), metabolic syndrome (for men, OR = 1.31, 95% CI: 1.21, 1.42; for women, OR = 1.12, 95% CI: 1.04, 1.20), and cardiovascular disease (for men, OR = 1.18, 95% CI: 1.03, 1.34; for women, OR = 1.18, 95% CI: 1.03, 1.35). The associations were independent of age, body mass index, education, family history of diabetes, cigarette smoking, alcohol drinking, physical activity, and diet. Spousal diabetes was simple and valuable information for identifying individuals at risk for diabetes and cardiometabolic disorders.

Association between smoking and glycemic control in diabetic patients: R esults from the R isk E valuation of c A ncers in C hinese diabe T ic I ndividuals: A l ON gitudinal ( REACTION ) study

A number of primary studies suggested that active smoking could be independently associated with incident diabetes. However less is known about the effect of active smoking and smoking cessation on glycemic control in patients with diabetes. The aim of this study was to evaluate the associations of active smoking and smoking cessation with glycemic control in diabetic patients.Background A number of primary studies suggested that active smoking could be independently associated with incident diabetes. However less is known about the impact of active smoking and smoking cessation on glycemic control in patients with diabetes. We aimed to evaluate the associations of active smoking and smoking cessation with glycemic control in diabetic patients. Methods This is a cross-sectional study of 10,551 man and 15,297 women with diabetes from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. Risk factors for glycemic control and the association of active smoking with glycemic control were evaluated using logistic regression models. Hemoglobin A1c (HbA1c) ≥7.0% was defined as poor glycemic control. Results Current smokers have increased risk for poor glycemic control, and the multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) of HbA1c≥7.0% with current smoking were 1.49 (1.35-1.66) in men and 1.56 (1.13-2.15) in women. Further analysis demonstrated a dose–response relationship between active smoking and the risk of poor glycemic control in men. Former smokers who quit smoking for <10 years remained at increased risk for poor glycemic control, and the risk leveled off after 10 years of smoking cessation compared with non-smokers, while the risk was significantly decreased compared with current smokers. Conclusions Active smoking is a modifiable risk factor for poor glycemic control in Chinese diabetic patients.