Qi-qiang He

Dietary flavonoids intake and risk of type 2 diabetes: a meta-analysis of prospective cohort studies.

BACKGROUND & AIMS Flavonoids may have cardioprotective effects, but epidemiological evidence on the relationship of dietary flavonoids with diabetes has not been systematically assessed. To examine the association between dietary flavonoids and type 2 diabetes, we performed a meta-analysis on this topic. METHODS We searched PubMed through March 2013 for relevant cohort studies that assessed total flavonoids and type 2 diabetes risks. A fixed-effect model was used to calculate the summary risk estimates. RESULTS Four articles consisting of 6 prospective cohorts that involved 18,146 cases and 284,806 participants were identified. The summary relative risk (RR) of type 2 diabetes for the highest intake of total flavonoids compared with the lowest was 0.91 (95% confidence interval (CI): 0.87-0.96). Furthermore, an increase in the total flavonoids intake of 500mg/d was associated with a significant risk reduction of 5% (RR=0.95, 95% CI: 0.91-0.98). In subgroup analyses, the observed beneficial effects were observed in US population, in those mean age>40 years old people and in studies ≥20 years in duration. CONCLUSIONS The present meta-analysis indicates that consumption of dietary total flavonoids is associated with a reduced risk of type 2 diabetes.

Passive Smoking and Risk of Type 2 Diabetes: A Meta-Analysis of Prospective Cohort Studies

Backgrounds/Objective The prevalence of diabetes is increasing rapidly all over the world. However, studies on passive smoking and type 2 diabetes have not been systematically assessed. Therefore, we conducted a meta-analysis to explore whether an association exists between passive smoking and risk of type 2 diabetes. Methods We searched PubMed, EMBASE, Cochrane library and Web of Science up to April 9th, 2013, to identify prospective cohort studies that assessed passive smoking and risk of type 2 diabetes. The fixed-effect model was used to calculate the overall relative risk (RR). Result 4 prospective cohort studies were included for analysis, with a total of 112,351 participants involved. The pooled RR was 1.28 (95% confidence interval (CI) 1.14 to 1.44) comparing those who were exposed to passive smoking with those who were not. Subgroup, sensitivity analysis and publication bias test suggested the overall result of this analysis was robust. Conclusions Passive smoking is associated with a significantly increased risk of type 2 diabetes. Further well-designed studies are warranted to confirm this association.

Respiratory health in overweight and obese Chinese children.

Childhood obesity has been suggested to be associated with asthma and impairment of pulmonary functions, but the findings are conflicting. The aim of this study was to examine the relationship of body mass index (BMI) with asthma, asthma‐like symptoms, and lung functions in Chinese schoolchildren.

Associations of physical activity, screen time with depression, anxiety and sleep quality among Chinese college freshmen.

Objectives To investigate the independent and interactive associations of physical activity (PA) and screen time (ST) with depression, anxiety and sleep quality among Chinese college students. Methods A cross-sectional study was conducted in Wuhan University, China from November to December 2011. The students reported their PA, ST and socio-economic characteristics using self-administered questionnaires. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Depression and anxiety were assessed using the Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS), respectively. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the independent and interactive relationships of PA and ST with depression, anxiety and sleep quality. Results A total of 1106 freshmen (471 females and 635 males) aged 18.9±0.9 years were included in the study. After adjustment for potential confounders, high PA and low ST were independently associated with significantly lower risks for poor sleep quality (OR: 0.48, 95% CI: 0.30–0.78) and depression (OR: 0.67, 95%CI: 0.44–0.89), respectively. An interactive inverse association was observed for combined effects of PA and low ST on depression (OR: 0.62, 95%CI: 0.40–0.92) and sleep quality (OR: 0.51, 95%CI: 0.27–0.91). No statistically significant associations were found between PA, ST and anxiety among the participants. Conclusions These findings suggest an independent and interactive relationship of high PA and low ST with significantly reduced prevalence of depressive problems and favorable sleep quality among Chinese college freshmen.

Effects of ambient air pollution on lung function growth in Chinese schoolchildren

OBJECTIVE To evaluate the adverse effect of exposure to air pollution on lung function growth in school-aged children. METHODS A cohort of 1983 children from three districts in Guangzhou, China was followed-up for 6 months. The children performed pulmonary function tests twice, and their parents reported the childs respiratory symptoms by self-administered questionnaires in both surveys. RESULTS The annual mean concentrations of air pollutants for the past 5 years for particulate matter less than 10 microns in diameter (PM(10)), nitrogen (NO(2)), and sulfur dioxide (SO(2)) were respectively: 96.1 microg/m(3), 76.0 microg/m(3), and 65.7 microg/m(3) in the highly-polluted district (HPD), 80.3 microg/m(3), 67.6 mug/m(3), and 54.5 microg/m(3) in the moderately-polluted district (MPD), and 80.0 microg/m(3), 48.1 microg/m(3), and 52.2 microg/m(3) in the least-polluted district (LPD). After adjustment for potential confounders, significant deficits were found in the annual growth rates of forced expiratory flows at 25% (FEF(25)), and between 25% and 75% (FEF(25-75)) in boys and FEF(25) in girls (In boys, for FEF(25), -0.136 l/s, p = 0.008 in MPD and -0.153 l/s, p = 0.004 in HPD, respectively; for FEF(25-75), -0.176 l/s, p = 0.013 in MPD and -0.167 l/s, p = 0.021 in HPD, respectively. In girls, for FEF(25), -0.123 l/s, p = 0.043 in HPD), using LPD as the reference. Deficits in the annual growth rate of forced expiratory volume in 1 s (FEV(1)) were also negatively associated with air pollution in boys (-0.063 L, p = 0.032 in HPD). CONCLUSIONS The study adds more evidence that exposure to air pollution has adverse effects on lung function growth in schoolchildren.

Fruit and vegetable consumption and risk of cardiovascular disease: A meta-analysis of prospective cohort studies

ABSTRACT A meta-analysis of prospective cohort studies was conducted to examine the relation between fruit and vegetables (FV) consumption and the risk of cardiovascular disease (CVD). We searched PubMed and EMBASE up to June 2014 for relevant studies. Pooled relative risks (RRs) were calculated and dose–response relationship was assessed. Thirty-eight studies, consisting of 47 independent cohorts, were eligible in this meta-analysis. There were 1,498,909 participants (44,013 CVD events) with a median follow-up of 10.5 years. The pooled RR (95% confidence interval) of CVD for the highest versus lowest category was 0.83 (0.79–0.86) for FV consumption, 0.84 (0.79–0.88) for fruit consumption, and 0.87 (0.83–0.91) for vegetable consumption, respectively. Dose–response analysis showed that those eating 800 g per day of FV consumption had the lowest risk of CVD. Our results indicate that increased FV intake is inversely associated with the risk of CVD. This meta-analysis provides strong support for the current recommendations to consume a high amount of FV to reduce CVD risk.

Relationship of body fat and cardiorespiratory fitness with cardiovascular risk in Chinese children.

Backgrounds/Objectives Cardiorespiratory fitness (CRF) and body fat play an important role in elevated risk for cardiovascular disease (CVD). However, the combined effects of CRF and obesity on metabolic health in Chinese children are unclear. The purpose of this study was to investigate the independent and combined associations between body fat, CRF, and CVD risk in Chinese schoolchildren. Methods The study subjects comprised 676 schoolchildren (392 boys and 284 girls, aged 9.6±0.7 yrs old) in Wuhan, China. Their body mass index (BMI), waist circumference (WC), CRF, blood pressure (BP), lipids, glucose, and pubertal status were assessed. Children were categorized into different groups based on their BMI, WC, and CRF using Chinese obesity cut-off points and CRF sex-specific median points. Metabolic Risk Score (MRS) was computed based on the standardized scores of BP, lipids, and glucose. Results Multiple linear regression models showed that, in the separate models, body fat was positively associated with MRS while CRF was inversely associated with MRS (p<0.001). However, when assessed simultaneously, only body fat had a significant association with MRS (p<0.001). In general, low-fit children had a lower MRS compared to their counterparts, and a significant difference between the two extreme groups was observed (low CRF and high fat vs. high CRF and low fat, p<0.001). Conclusions These findings suggest that both body fat and CRF should be considered when interpreting CVD risk in Chinese children, while body fat may be correlated with CVD risk more than CRF.

Association Between Alcohol Consumption and Risk of Cardiovascular Disease and All-Cause Mortality in Patients With Hypertension: A Meta-Analysis of Prospective Cohort Studies

OBJECTIVE To conduct a meta-analysis summarizing the risk of cardiovascular disease (CVD) and all-cause mortality (ACM) in relation to alcohol consumption in patients with hypertension, focusing on clarifying dose-response associations. PATIENTS AND METHODS PubMed and EMBASE were searched for eligible prospective cohort studies from December 3, 1949, through January 18, 2014. The semi-parameter method and dose-response analysis were used. RESULTS Nine studies (11 cohorts) were included in the meta-analysis. Compared with the lowest alcohol level (abstainers/occasional drinkers), the pooled relative risk (RR) was 0.72 (95% CI, 0.68-0.77) for the third highest category (median, 10 g/d), 0.81 (95% CI, 0.71-0.93) for the second highest category (median, 20 g/d), and 0.60 (95% CI, 0.54-0.67) for the highest category (median, 30 g/d). A J-shaped relationship between alcohol use and ACM was observed, and the nadir (RR, 0.82; 95% CI, 0.76-0.88) was found to be at a dose of 8 to 10 g of alcohol consumption per day. CONCLUSION Findings of this meta-analysis suggest that low-to-moderate alcohol consumption was inversely significantly associated with the risk of CVD and ACM in patients with hypertension.

Environmental tobacco smoke exposure and Chinese schoolchildren's respiratory health: a prospective cohort study.

BACKGROUND Although China is the most coveted cigarette market worldwide, few studies have examined the longitudinal effects of environmental tobacco smoke (ETS) on health. PURPOSE To examine the relationship between exposure to ETS and respiratory health in Chinese schoolchildren. METHODS The study subjects included 1718 children, who were never-smokers, aged 10.05±0.86 years and asthma-free at baseline. The children performed spirometric tests in 2006 and 18 months later. Parents reported the childrens respiratory symptoms and illnesses, ETS exposure, and other related information by self-administered survey at both assessment points. The data were analyzed in 2010. RESULTS Significant exposure-response relationships were found between ETS exposure and coughing at night (p for trend<0.001); sneezing (p for trend=0.031); and sneezing with itchy, watery eyes (p for trend=0.006) in the first survey, and coughing at night (p for trend=0.019); phlegm without a cold (p for trend<0.001); and sneezing (p for trend=0.036) in the second survey. Compared with those who reported no ETS exposure in either survey, children who had a high ETS exposure level (>5 cigarettes/day) in either survey had lower growth rates in forced expiratory flow between 25% and 75% of forced vital capacity (FEF(25-75); β= -0.104, p=0.020) and forced expiratory flow at 25% of forced vital capacity (FEF(25); β= -0.077, p=0.027). A monotonic exposure-response effect was observed between ETS exposure and the deficits in the growth rate of FEF(25) and FEF(25-75.) CONCLUSIONS Exposure to ETS increased the risks of respiratory symptoms in Chinese school-aged children and was associated with impaired lung function growth. A dose-response relationship was observed for the latter effect.

C‐reactive protein plays a marginal role in cognitive decline: a systematic review and meta‐analysis

The objective of the study was to investigate the association between peripheral levels of C‐reactive protein (CRP) and cognitive decline that is defined by 2–5 years of cognitive change in general cognitive function or specific cognitive domain.