Su-Fang Wang

Birth weight and risk of coronary heart disease in adults: a meta-analysis of prospective cohort studies

Some studies have found a significant relationship between birth weight (BW) and the risk of coronary heart disease (CHD) in adulthood, but results were inconsistent. The purpose of this study was to characterize the association between BW and the risk of CHD in adults. Among 144 papers detected by our search, 27 papers provided data on the relationship between BW and CHD, of which 23 papers considered BW as a continuous variable, and 14 articles considered BW as a categorical variable for this meta-analysis. Based on 23 papers, the mean weighted estimate for the association between BW and the combined outcome of non-fatal and fatal CHD was 0.83 [95% confidence interval (CI), 0.80-0.86] per kilogram of BW (P<0.0001). Low birth weight (LBW<2500 g) was associated with increased risk of CHD [odds ratio (OR), 1.19; 95% confidence interval (CI), 1.11-1.27] compared with subjects with BW⩾2500 g. LBW, as compared with normal BW (2500-4000 g), was associated with increased risk of CHD (OR, 1.16; 95% CI, 1.08-1.25). High birth weight (HBW⩾4000 g) was associated with decreased risk of CHD (OR, 0.89; 95% CI, 0.81-0.98) compared with subjects with BW<4000 g. In addition, there was an indication (not quite significant) that HBW was associated with a lower risk of CHD (OR, 0.89; 95% CI, 0.79-1.01), as compared with normal BW. No significant evidence of publication bias was present. These results suggest that LBW is significantly associated with increased risk of CHD and a 1 kg higher BW is associated with a 10-20% lower risk of CHD.

Dietary Patterns Modulate the Risk of Non-Alcoholic Fatty Liver Disease in Chinese Adults.

Although previous studies reported the associations between the intakes of individual foods or nutrients and the risk of non-alcoholic fatty liver disease (NAFLD), the relationship between dietary patterns and NAFLD in the Chinese population has been rarely studied to date. This study aimed to investigate the associations between dietary patterns and the risk of NAFLD in a middle-aged Chinese population. The Study subjects were 999 Chinese adults aged 45–60 years in the Anhui province who participated in the Hefei Nutrition and Health Study. Dietary intake was collected by a semi-quantitative food frequency questionnaire. NAFLD was defined as the presence of moderate-severe hepatic steatosis (by B-ultrasonic examination); the absence of excessive alcohol use (>20 g day−1 in men and 10 g day−1 in women); no use of steatogenic medications within the past six months; no exposure to hepatotoxins; and no history of bariatric surgery. Log-binomial regression analysis was used to examine the association between dietary patterns and NAFLD with adjustment of potential confounding variables. Out of 999 participants, 345 (34.5%) were classified as having NAFLD. Four major dietary patterns were identified: “Traditional Chinese”, “Animal food”, “Grains-vegetables” and “High-salt” dietary patterns. After adjusting for potential confounders, subjects in the highest quartile of the “Animal food” pattern scores had greater prevalence ratio for NAFLD (prevalence ratio (PR) = 1.354; 95% confidence interval (CI): 1.063–1.724; p < 0.05) than did those in the lowest quartile. After adjustment for body mass index (BMI), compared with the lowest quartile of the “Grains-vegetables” pattern, the highest quartile had a lower prevalence ratio for NAFLD (PR = 0.777; 95% CI: 0.618–0.977, p < 0.05). However, the “traditional Chinese” and “high-salt” dietary patterns showed no association with the risk of NAFLD. Our findings indicated that the “Animal food” dietary pattern was associated with an increased risk of NAFLD.

Dietary patterns are associated with body mass index and bone mineral density in Chinese freshmen.

Objective: Our objective was to examine associations between dietary patterns and body mass index (BMI) and bone mineral density (BMD) in Chinese freshmen. Methods: A cross-sectional study was done in 1319 college freshmen (aged 18.1 ± 1.2 years old). Diet was assessed by using a validated self-administrated food-frequency questionnaire. Blood pressure, weight, height, waist circumference, and hip circumference were measured and bone measurements were done using Quantitative Ultrasound System. Results: Four dietary patterns were identified by factor analysis: Western food, animal protein, calcium food, and Chinese traditional patterns. The prevalence of overweight/obesity and osteopenia/osteoporosis were 8.2% (108/1319) and 28.1% (371/1319). The highest tertile of Western food pattern scores had greater odds of overweight/obesity (highest vs. lowest tertile, odds ratio [OR] = 2.00, 95% confidence interval [CI], 1.24–3.22), and the highest tertile of Chinese traditional pattern scores had lower risk of overweight/obesity (highest vs. lowest tertile, OR = 0.65, 95% CI, 0.53–0.80) in an adjusted model. The calcium food pattern and Chinese traditional pattern were negatively associated with the risk of osteopenia/osteoporosis (highest vs. lowest tertile, OR = 0.59, 95% CI, 0.41–0.87; OR = 0.78, 95% CI, 0.55–0.89) after adjusting for confounders. Conclusion: These findings suggested that there was a positive correlation between Chinese traditional dietary pattern and healthy BMI and BMD and that this same association existed between calcium food pattern and BMD in Chinese freshmen. In contrast, the Western-style diet was negatively correlated with healthy BMI in Chinese freshmen.

Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study

Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma’anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma’anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA) births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04)). This relation was strong or monotonic after adjusting for maternal age, newborn’s gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To confirm these findings, additional investigations or trials with a large sample and the tracking of folate status throughout pregnancy are recommended.

Gender difference in the association of hyperuricemia with hypertension in a middle-aged Chinese population

Abstract In this study, we report the relationship between hyperuricemia and hypertension in a middle-aged Chinese population, emphasizing the difference of gender. The cross-sectional study was conducted among 1776 adults aged 45–60 years, who participated in the Hefei Nutrition and Health Study (2012). Hyperuricemia was defined as serum uric acid (SUA)> 420 μmol/l for men, and > 360 μmol/l for women. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg. Anthropometric measurements and biochemical data were collected using standardized procedures. Multivariate logistic regression analysis was performed to determine the relationship between hyperuricemia and hypertension with adjustment of potential confounding factors. Body mass index (BMI), waist circumference (WC), SBP, DBP, fasting glucose, SUA and the prevalence of hyperuricemia and hypertension were significantly higher in male than in female (p < 0.001). Females had significantly higher levels of triglycerides (TG) and high-density lipoprotein (HDL)-cholesterol (5.23 ± 0.87 vs 5.12 ± 1.01, p < 0.05, 1.50 ± 0.37 vs 1.28 ± 0.41, respectively.) than males. Simple correlation analysis showed that SUA was positively associated with WC and TG. In addition, after adjusting for potential confounders, hyperuricemia was associated with increased risk of hypertension in both males and females, with odds ratios (95% CI) of 1.680 (1.110–2.543) and 1.065 (1.012–1.118), respectively. Conclusions: The association of hyperuricemia with hypertension was stronger in males than in females, and middle-aged men with hyperuricemia had greater association with hypertension. Our findings remain to be confirmed in future prospective studies.

Prognostic value of the expression of cancer stem cell-related markers CD133 and CD44 in hepatocellular carcinoma: From patients to patient-derived tumor xenograft models.

High expression of cancer stem cell (CSC) markers is related to poor prognosis of patients with hepatocellular carcinoma (HCC). However, the expression of these markers in patient-derived xenograft (PDX) models and the relationship of the expression levels of these markers between HCC patients and their PDX models at subsequent low passages are unclear. To investigate the prognostic impact of putative CSC markers in patients with HCC and in related PDX models, the expression of CD133, CD90, CD44, ALDH1, CK7, CK19, OCT4, SOX2, vimentin, nestin, CD13 and EpCam were assessed by quantitative reverse transcription-PCR (qRT-PCR) and then were validated using immunohistochemistry in tumor or peritumoral tissues from patients and tumor tissues from PDX models. Cumulative survival analysis of the patients and animals was conducted using the Kaplan-Meier method and the log-rank test. Only the expression levels of CD133 and CD44 were higher in tumor tissues than in the peritumoral tissues of HCC patients by qRT-PCR. High consistency of the prognostic value of the expression of CD133/CD44 was observed in HCC patients and the PDX models. High expression levels of CD133 and CD44 were positively related to the poor prognosis of HCC patients and to that in the PDX models. PDX HCC models in the present study have been suggested to be predictive of disease outcome, which could shed light on personalized medicine and the mechanisms of CSC marker expression on prognosis.

Weight changes since age 20 and cardiovascular risk factors in a middle-aged Chinese population

Background Little is known about the association between weight changes and adverse health outcomes among Chinese adults. Methods A total of 1715 Chinese adults, 45-60 years of age, have been recruited to participate in the Hefei Nutrition and Health Study started in 2012. Multivariate logistic regression analysis was performed to determine the association of weight changes since age 20 (loss ≥5.0 kg; maintain [±4.9 kg]; gain 5.0-9.9 kg; gain ≥10.0 kg) with cardiovascular risk factors. Results Men who gained 10.0 kg or more had increased risks of hypertension (odds ratios (OR) = 3.07; 95% CI: 1.98-4.76), impaired fasting glucose (OR = 1.74; 95% CI: 1.02-2.97), reduced high-density lipoprotein (HDL) cholesterol levels (OR = 2.77; 95% CI: 1.42-5.40) and elevated triglyceride levels (OR = 5.72; 95% CI: 2.94-11.12). Women who gained 10.0 kg or more had increased risks of hypertension, elevated low-density lipoprotein (LDL) cholesterol levels and elevated triglycerides levels of 2.01(95% CI: 1.18-3.42), 3.40 (95% CI: 1.18-9.82) and 5.60 (95% CI: 1.59-19.61), respectively. Conclusion Weight gain during adulthood was associated with increased risks of high triglycerides, hypertension, impaired fasting glucose and risk of reduced HDL cholesterol in men. Furthermore, weight gain was a predictor of high-risk triglycerides, hypertension and elevated LDL cholesterol in women.

The relationship between famine exposure during early life and body mass index in adulthood: A systematic review and meta-analysis

Background Previous epidemiologic studies have reported famine exposure during early life association with overweight or obesity in adulthood, but a consistent perspective has not been established to date. Purpose To determine, by conducting a systematic review and meta-analysis, whether exposure to famine could increase body mass index (BMI) in adult or not, and assess the association between famine exposure and the risk of overweight or obesity. Methods Published articles were systematically searched (until August, 2017) from PubMed, ScienceDirect, Cochrane, and China National Knowledge Infrastructure. Initially, comparing differences in BMI between exposed and non-exposed groups that weight mean difference (WMD) were used. Subsequently, the effect of famine exposure on overweight or obesity risk, which pooled relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Result Twenty studies were included in this systematic review and meta-analysis. Compared with non-exposed group, famine exposure group significantly increased the risk of overweight (OR = 1.10, 95% CI: 1.04–1.16) and obesity (OR = 1.15, 95% CI: 1.05–1.24). Sensitivity analyses revealed no significant change in the famine exposure and BMI, the risk of overweight and obesity study when any one study was excluded. Subgroup analyses showed that age, gender, exposure type, study type, continent, famine cause and paper publication date were associated with BMI, the risk of overweight and obesity. Meta-regression analyses suggested that continent, famine cause could partially explain heterogeneity for famine exposure and BMI studies. Conclusion The systematic review and meta-analysis indicates that famine exposure during early life may increase BMI, the risk of overweight and obesity, especially for female, fetal famine exposure or subject age less than 50. Furthermore, famine exposure group the risk of overweight and obesity in cross-sectional studies, Asian studies, famine cause by natural disaster or paper published from 2015 to the present studies are higher than that of non-exposed group.

Dietary patterns are not associated with overweight and obesity in a sample of 8900 Chinese preschool children from four cities

Globally, the prevalence of childhood obesity has substantially increased at an alarming rate. This study investigated associations between dietary patterns and overweight/obesity in 3- to 6-year-old children. Recruited children were from four prefecture-level cities in Eastern China. Childhood overweight and obesity were defined according to WHO Child Growth Standards. Individual dietary patterns were assessed by a comprehensive self-administered FFQ using thirty-five food items. Using factor analysis two dietary patterns were derived: the traditional Chinese pattern was characterised by high consumption of cereals, vegetables and fresh juices while the modern pattern was characterised by high consumption of Western fast food, Chinese fast food, sweets/sugary foods and carbonated beverages. The associations of dietary patterns with overweight/obesity were evaluated by logistic regression models. Data of 8900 preschool children from thirty-five kindergartens recruited from March to June 2015 were used in the final analysis. Adherence to the modern dietary pattern was positively associated with childrens age while adherence to the traditional dietary pattern was positively associated with maternal education; these associations were statistically significant. After adjustment, we found that being in the highest tertile of any identified dietary patterns was not significantly associated with overweight and obesity. Dietary patterns are not associated with overweight/obesity in Chinese preschool children. Prospective studies are needed to establish a causal link between dietary patterns and childhood obesity.

Perinatal sulfamonomethoxine exposure influences physiological and behavioral responses and the brain mTOR pathway in mouse offspring

Sulfamonomethoxine (SMM) is widely used in the veterinary field in China. Although some clinical surveys have revealed that sulfonamide antibiotics cause adverse nervous system symptoms, the related mechanisms of maternal SMM exposure on the neurobehavioral development of offspring remain unclear. Here, we investigated the effects of perinatal SMM exposure on the physiological and behavioral responses of pubertal offspring mice and the underlying mechanisms. We randomly allocated pregnant mice into the groups treated with SMM at different doses and the saline-treated groups. Maternal mice were orally administered SMM daily from gestational day 1 to postpartum day 21. On postnatal day (PND) 22, the parameters of growth, endocrine hormones, and brain amino acid composition were assessed, as well as the brain transcript levels of key genes involved in the mammalian target of rapamycin (mTOR) signaling pathway. From PND 50 to 55, a battery of behavioral tests relevant to anxiety and memory were then administered. Analysis of the results indicated that the pups, particularly the pubertal female offspring, showed anxiety-like behavior. Moreover, the pubertal offspring showed cognitive impairments and fat accumulation. Furthermore, the relative mRNA expression of genes involved in the mTOR signaling pathway in females on PND 22 was elevated, whereas the expression of N-methyl-d-aspartate receptor 2B (NR2B) was reduced. Together, the results showed that perinatal SMM exposure perturbs neuroendocrine functions, and further alters gene expression in the mTOR pathway and NR2B gene expression early in life, which may contribute to brain dysfunction in pubertal life.