Mary Schooling

Mortality associated with passive smoking in Hong Kong.

Passive smoking can cause death from lung cancer and coronary heart disease, but there is little evidence for associations with other causes of death in never smokers. A recent study showed increased all cause mortality with exposure to secondhand smoke at home but did not examine associations with specific causes of death and dose-response relations.1 We have published estimates of the mortality attributable to active smoking in Hong Kong2 and now present the related findings on passive smoking at home. Details of the sample selection and data collection have been reported.2 Each person who reported a death in 1998 at four death registries was given a questionnaire which asked about the lifestyle 10 years earlier of the decedent and of a living person about the same age who was well known to the informant. Passive smoking was identified in the interview with the question, “Ten years ago, in about 1988, excluding the decedent/control, how many persons who lived with the decedent/control smoked?” Decedents or …

Adult height and the risks of cardiovascular disease and major causes of death in the Asia-Pacific region: 21 000 deaths in 510 000 men and women

BACKGROUND In Caucasian populations, adult height is inversely associated with cardiovascular disease (CVD) risk and positively related to some cancers. However, there are few data from Asian populations and from women. We sought to determine the sex- and region-specific associations between height and cardiovascular outcomes, and deaths due to cancer, respiratory and injury in populations from the Asia-Pacific region. METHODS Thirty-nine studies from the Asia Pacific Cohort Studies Collaboration database were included. We used Cox proportional hazard regression models to estimate the associations between height and pre-specified outcomes. RESULTS A total of 510,800 participants with 21,623 deaths were included. Amongst men, inverse linear associations were observed between height and coronary heart disease (CHD), stroke, CVD, injury and total mortality. The hazard ratios [95% confidence intervals, (CI)] for a 1-SD (= 6 cm) increment in height ranged from 0.85 (0.80-0.91) for injury to 0.97 (0.95-0.98) for total mortality. Similar trends were found between height and CHD, haemorrhagic stroke and CVD in women. A positive linear association was observed between height and cancer mortality. For each standard deviation greater height, the risk of cancer was increased by 5% (2-8%) and 9% (5-14%) in men and women, respectively. No regional difference was observed between Asian and Australasian cohorts. Adjusting for markers of education did not alter the results. CONCLUSIONS The opposing relationships of height with CVD and cancer suggest that care is required in setting national policies on childhood nutrition lest they have unintended consequences on the incidence of major non-communicable diseases.

Parity and the metabolic syndrome in older Chinese women: the Guangzhou Biobank Cohort Study

Objective  To examine whether parity or gravidity contributes to the development of the metabolic syndrome (MS).

Foetal Exposure to Maternal Passive Smoking Is Associated with Childhood Asthma, Allergic Rhinitis, and Eczema

Objective. We examined the hypothesis that foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. Methods. The study was a population-based cross-sectional survey of Hong Kong Chinese children aged ≤14 years carried out in 2005 to 2006. Results. Foetal exposure to maternal passive smoking was significantly associated with wheeze ever (OR 2.05; 95% CI 1.58–2.67), current wheeze (OR 2.06; 95% CI 1.48–2.86), allergic rhinitis ever (OR 1.22; 95% CI 1.09–1.37), and eczema ever (OR 1.61; 95% CI 1.38–1.87). Foetal exposure to maternal active smoking was significantly associated with asthma ever (OR 2.10; 95% CI 1.14–3.84), wheeze ever (OR 2.46; 95% CI 1.27–4.78), and current wheeze (OR 2.74; 95% CI 1.24–6.01) but not with allergic rhinitis ever (OR 1.01; 95% CI 0.70–1.46) or eczema ever (OR 1.38; 95% CI 0.87–2.18). The dose response relationship between wheeze ever and current wheeze with increasing exposure, from no exposure to maternal passive smoking and then to maternal active smoking, further supports causality. Conclusion. There is significant association between foetal exposure to maternal passive smoking and maternal active smoking with childhood asthma and related atopic illnesses. Further studies are warranted to explore the potential causal relationship.

Dietary habits and the short-term effects of air pollution on mortality in the Chinese population in Hong Kong

Background Both diet and air pollution are associated with mortality risks. However, no epidemiological study has examined the potential interaction between diet and air pollution on mortality. We assessed their interaction on an additive scale. Methods We analysed the data on daily concentrations of ambient air pollutants (PM10, NO2, SO2 and O3) and a total of 23 484 deaths in 1998 in Hong Kong. A standardised questionnaire was used in all four death registries to collect food frequency data from proxy respondents while waiting for the registration to be completed. We fitted a linear odds ratio model and estimated excess relative risk due to the interaction (ERRI) between air pollution and regular consumption (at least once per week) of each food item to measure departure from additivity of effects on mortality. Results We observed consistently negative ERRI between all of the four pollutants and regular consumption of vegetables, fruits and soy. The effects of PM10, NO2 and O3 were significant smaller in the subjects who regularly consumed fruits than those who never or seldom consumed such food. The effect modification of soy consumption on PM10, NO2 and SO2 associated mortality was also found statistically significant. However, regular consumption of dairy products was associated with significant increased effects of PM10 and NO2. Conclusions This study provides insight into dietary habit as one of the modifiers of health effects of air pollution. Our findings merit further studies to characterise the influence of diet on air pollution-related health and elucidate the underlying mechanisms.

P2-132 Intergenerational influences on diabetes in a developing population: the Guangzhou Biobank Cohort Study

Introduction Intergenerational “mismatch” has been suggested as being relevant to the emergent epidemic of diabetes in developing populations. Conversely, constrained growth conditions over generations may also increase susceptibility to diabetes. In a rapidly developing southern Chinese population, we tested whether maternal environment, proxied by maternal literacy, or family socio-economic position (SEP), proxied by paternal literacy, were associated with fasting blood glucose and diabetes. To assess if intergenerational mismatch contributed, we tested whether the associations were modified by life course SEP. Methods In 19 818 older (≥50 years) adults from the Guangzhou Biobank Cohort Study (phases 2 and 3) examined in 2005–2008, we used multivariable censored and logistic regression to assess the associations of maternal and paternal literacy with fasting blood glucose and diabetes and whether these associations varied by sex, age or life course SEP. Results Adjusted associations of maternal, but not paternal, literacy was negatively associated with fasting blood glucose (−0.07, 95% CI −0.13 to −0.02) and diabetes (0.92, 95% CI 0.83 to 1.02). These associations did not vary by sex, age or life course SEP. Conclusions Better living conditions over generations may reduce the risk of diabetes, consistent with the high levels of diabetes in recently developed or developing populations.

P2-133 Muscle mass is associated with diabetes in a developing population: the Guangzhou Biobank Cohort Study

Introduction Asian populations tend to be more susceptible to type 2 diabetes. In Asians low muscle-mass may also be a contributory factor. In a rapidly developing southern Chinese population, we examined whether skeletal muscle-mass, proxied by serum creatinine, was associated with diabetes or adiposity. Methods In 9768 older (≥50 years) adults from the Guangzhou Biobank Cohort Study (phase 1) examined in 2003–2004, we used multivariable logistic, linear and censored regression to assess the adjusted associations of serum creatinine with diabetes, waist-hip ratio, body mass index and fasting blood glucose. We also examined whether these associations varied by sex and age. Results The association of serum creatinine with diabetes did not vary by sex. Serum creatinine was negatively associated with diabetes (OR 0.65, 95% CI 0.56 to 0.75) and fasting glucose (−0.43 mmol/l, 95% CI −0.53 to −0.34) for highest compared with lowest tertile, adjusted for age, education, occupation and lifestyle. Serum creatinine had sex-specific associations with waist-hip ratio, negatively associated (−0.10 SDs, 95% CI −0.15 to −0.04) in women only. Conclusions The observed pattern of associations is compatible with the hypothesis that nutritionally driven increases in muscle-mass, reduces diabetes risk while having sex-specific effects on central obesity, with corresponding implications for prevention.