Shengli Wu

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.

The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population: results of the REACTION study.

OBJECTIVE Obesity and insulin resistance are risk factors for cardiovascular diseases. Whether insulin-sensitive obese individuals are at higher risk for cardiovascular diseases is still debated. We aim to investigate whether insulin-sensitive obesity associates with prevalent cardiovascular diseases and 10-year coronary heart disease (CHD) risk. RESEARCH DESIGN AND METHODS At the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study, 211,641 participants aged 40 years or older were recruited from 25 communities across the China mainland, in 2011 to 2012. Participants were categorized by insulin-sensitive/resistant and general/abdominal obese status. Cardiovascular diseases included CHD, stroke, and myocardial infarction. Framingham risk score (FRS) was calculated according to National Cholesterol Education Program-Adult Treatment Panel III and FRS greater than 20% or cardiovascular diseases were identified as high risk for 10-year CHD. RESULTS Controlling for potential confounders, compared with insulin-sensitive normal weight individuals, insulin-sensitive general obese individuals had increased risks for prevalent cardiovascular diseases (men: OR, 2.55, 95% CI, 2.04-3.18; women: 1.73, 1.45-2.06) and 10-year Framingham risk for CHD (men: 2.26, 1.86-2.76; women: 1.73, 1.46-2.06). Compared with insulin-sensitive normal waist subgroup, insulin-sensitive abdominal obesity was associated with higher risks for prevalent cardiovascular diseases (men: 1.32, 1.20-1.46; women: 1.36, 1.27-1.47) and 10-year Framingham risk for CHD (men, 1.34, 1.23-1.45; women, 1.37, 1.27-1.47). CONCLUSION Both general and abdominal obesity were associated with elevated prevalent cardiovascular diseases and 10-year CHD risk, regardless of the presence or absence of insulin resistance.

HbA1c and the diagnosis of diabetes and prediabetes in a middle-aged and elderly Han population from northwest China (HbA1c).

To identify the optimal threshold of HbA1c and to evaluate the predictive performance of HbA1c levels in diagnosing diabetes and prediabetes in a middle‐aged and elderly Han Chinese population from northwest China.

HbA1c and the diagnosis of diabetes and prediabetes in a middle‐aged and elderly Han population from northwest China (HbA1c与中国西北部地区中老年汉族人群糖尿病和糖尿病前期的诊断)

To identify the optimal threshold of HbA1c and to evaluate the predictive performance of HbA1c levels in diagnosing diabetes and prediabetes in a middle‐aged and elderly Han Chinese population from northwest China.

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.

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.

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.

Association between smoking and glycemic control in diabetic patients: Results from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal (REACTION) study: 吸烟与糖尿病患者血糖控制的相关性研究:来自中国2型糖尿病患者恶性肿瘤发生风险的纵向研究(REACTION)的发现

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.

Glycemic status and chronic kidney disease in Chinese adults: Findings from the REACTION study†

Diagnosed diabetes has been associated with chronic kidney disease (CKD). However, the association between non‐diabetic hyperglycemia and CKD remained uncertain. The aim of the present study was to investigate the association between different glycemic status and CKD in Chinese adults and to assess the prevalence and control of diabetes among individuals with CKD.