Xizhu Wang

Association between Ideal Cardiovascular Health Metrics and Depression in Chinese Population: A Cross-sectional Study

The study aimed to examine the association between ideal cardiovascular health (CVH) metrics and depression. We conducted a population-based, cross-sectional study of 6,851 participants aged 20 years or older (3,525 men and 3,326 women) living in Tangshan City, China. Information on the seven CVH metrics (including smoking, body mass index, dietary intake, physical activity, blood pressure, total cholesterol and fasting blood glucose) was collected via questionnaires, physical examination and laboratory test. Depression status was assessed using the Epidemiologic Studies Depression Scale (CES-D) and a score of 16 or above was considered depression. The relationship between CVH metrics and depression was analyzed using logistic regression. Of the 6,851 participants, 525 (7.7%) were in depression status. After adjustment for potential confounders, men in the highest quartile of ideal CVH metric summary score had a reduced likelihood of having depression compared to those in the lowest quartile (adjusted odds ratio (AOR): 0.46, 95% confidence interval (CI): 0.28–0.75, p = 0.002). A similar trend was found among women, even though the association was not significant (AOR = 0.74, 95%CI: 0.46–1.18, p = 0.211). This study suggested that better CVH status is associated with a lower risk of depression especially in Chinese male and young population.

Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population: The Kailuan Study

Background It is unclear whether ideal cardiovascular health (CVH), and particularly cumulative exposure to ideal CVH (cumCVH), is associated with incident diabetes. We aimed to fill this research gap. Methods and Results The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006–2007 and who were subsequently followed up at 2‐ (Exam 2), 4‐ (Exam 3), and 6 (Exam 4)‐year intervals after baseline. The main analysis is restricted to those individuals with complete follow‐up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal CVH (cumCVH) was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cumCVH and incident diabetes. In fully adjusted models, compared with the lowest quintile of cumCVH, individuals in the highest quintile had ~68% (95% confidence interval [CI] 60‐75) lower risk for incident diabetes (compared with 61% [95% CI 52‐69] lower risk when using baseline CVH). Every additional year lived with a 1‐unit increase in ideal CVH was associated with a 24% (95% CI 21‐28) reduction in incident diabetes. Conclusions Ideal CVH is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of CVH exposure are used. Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes. Clinical Trial Registration URL: https://www.chictr.org. Unique identifier: ChiCTRTNC‐11001489.

Sleep duration and risk of myocardial infarction and all-cause death in a Chinese population: the Kailuan study.

OBJECTIVE Although sleep is one of the most important health-related factors, the association of sleep duration with incidence of myocardial infarction or all-cause death has not been fully understood, especially in the general Chinese population. The objective of this study was to explore the relationship between sleep duration and risk of myocardial infarction and all-cause death in China. METHODS Out of the 101,510 participants who were originally included into the Kailuan prospective cohort study and followed up for an average of 3.98 years, 95,903 participants were actually sampled to evaluate the impacts of sleep duration on myocardial infarction and all-cause death. Sleep duration was categorized as ≤5, 6, 7, and 8 hours/night, and ≥9 hours per night. Cox proportional hazards models were used to analyze the association of sleep duration with the incidence of myocardial infarction and all-cause death. RESULTS After a mean follow-up period of 3.98 years, 423 participants developed myocardial infarction and 1793 participants died. A U-shape association between sleep duration and all-cause death was found. The age- and gender-adjusted hazard ratios (95% confidence interval [CI]) of all-cause death (with seven hours of daily sleep being considered for the reference group) for individuals reporting ≤5, 6, and 8 hours, and ≥9 hours were 1.29 (1.08-1.55), 0.97 (0.82-1.14), 1.11 (0.97-1.27), and 1.77 (1.31-2.38), respectively, with a p ≤ 0.01. However, no significant association was seen between sleep duration and myocardial infarction. CONCLUSION Both short and long duration of sleep might be potential predictors/markers for all-cause death, but not for myocardial infarction.

Long Sleep Duration and Risk of Ischemic Stroke and Hemorrhagic Stroke: the Kailuan Prospective Study

The objective of this study was to examine the relationship between sleep duration and ischemic and hemorrhagic stroke in a community-based cohort. The current analysis included 95,023 Chinese participants who were free of stroke at the baseline survey (2006–2007). Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for stroke, according to sleep duration. After a mean follow-up period of 7.9 years, 3,135 participants developed stroke (2,504 ischemic stroke and 631 hemorrhagic stroke). The full adjusted hazard ratio (95% CI) of total stroke (with 6–8 hours of night sleep being considered for the reference group) for individuals reporting greater than 8 hours was 1.29 (1.01–1.64). More significant association between long sleep duration and total stroke was found in the elderly (HR, 1.47; 95% CI, 1.05–2.07). Compared with participants getting 6–8 hours of sleep, only women who reported sleeping more than 8 hours per night were associated with hemorrhagic stroke (HR, 3.58; 95% CI, 1.28–10.06). This study suggested that long sleep duration might be a potential predictor/ marker for total stroke, especially in the elderly. And long sleep duration increased the risk of hemorrhagic stroke only in women.

Changes in sleep duration and risk of metabolic syndrome: the Kailuan prospective study

Using a large longitudinal data set spanning 4 years, we examined whether a change in self-reported sleep duration is associated with metabolic syndrome (MetS). Current analysis included 15,753 participants who were free of MetS during both 2006–2007 and 2010–2011. Sleep duration was categorized into seven groups: ≤5.5 h, 6.0–6.5 h, 7.0 h, 7.5–8.0 h, ≥8.5 h, decrease ≥2 h, and increase ≥2 h. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CI) for MetS, according to sleep duration. Compared to the reference group of persistent 7-h sleepers, a decrease of ≥2 h sleep per night was associated with a higher risk of incident MetS (HR = 1.23, 95% CI = 1.05–1.44) in analyses adjusted for age, sex, sleep duration at baseline, marital status, monthly income per family member, education level, smoking status, drinking status, physical activity, body mass index, snoring status and resting heart rate. An increased risk of MetS incidence was also observed in persistent short sleepers (average ≤5.5 h/night; HR = 1.22, 95% CI = 1.01–1.50). This study suggests individuals whose sleep duration decreases ≥2 h per night are at an increased risk of MetS.

Association between Ideal Cardiovascular Health Metrics and Suboptimal Health Status in Chinese Population

Suboptimal health status (SHS) is a physical state between health and illness, and previous studies suggested that SHS is associated with majority components of cardiovascular health metrics defined by American Heart Association (AHA). We investigated the association between SHS and cardiovascular health metrics in a cross-sectional analysis of China suboptimal health cohort study (COACS) consisting of 4313 participants (60.30% women) aged from 18 to 65 years old. The respective prevalence of SHS is 7.10%, 9.18%, 10.04% and 10.62% in the first, second, third and fourth quartiles of ideal cardiovascular health (CVH) metrics (P for trend = 0.012). Participants in the largest quartile of ideal CVH metrics show a lower likelihood of having optimal SHS score compared to those in the smallest quartile (odds ratio (OR), 0.43; 95% confidence interval (CI), 0.32–0.59), after adjusting for age, gender, marital status, alcohol consumption, income level and education. Four metrics (smoking, physical inactivity, poor dietary intake and ideal control of blood pressure are significantly correlated with the risk of SHS. The present study suggests that ideal CVH metrics are associated with a lower prevalence of SHS, and the combined evaluation of SHS and CVH metrics allows the risk classification of cardiovascular disease, and thus consequently contributes to the prevention of cardiovascular diseases.

Long Sleep Duration Is an Independent Risk Factor for Incident Atrial Fibrillation in a Chinese Population: A Prospective Cohort Study

There is limited information on the relation between sleep duration and incident atrial fibrillation. We aimed to investigate this association in a Chinese population using cohort data from a study in Kailuan. The analysis included 87,693 participants (age range, 18–98 years) free of atrial fibrillation at the baseline survey. Participants were divided into three categories according to self-reported sleep duration: ≤6.0 hours, 7 hours (ref), ≥8.0 hours. Atrial fibrillation diagnosis was made on a standard 12-lead electrocardiogram and via self-reported history. Cox proportional hazards models were used to calculate hazard ratio (HR) and confidence interval (CI) for atrial fibrillation, according to sleep duration. During median follow-up of 7.89 (range, 6.36–8.57) years, 322 cases of atrial fibrillation had occurred. Using 7 hours of sleep as the reference group, multivariable adjusted HRs (95% CI) for atrial fibrillation were 1.07 (0.75–1.53), 1.0 (ref), and 1.50 (1.07–2.10), from lowest to highest category of sleep duration. Secondary analysis showed no evidence of interactions between sleep duration and sex and snoring on the risk of incident atrial fibrillation (p = 0.75/0.25). We conclude long sleep duration may be a potential predictor/marker for incident atrial fibrillation.

Changes in ideal cardiovascular health status and risk of new-onset type 2 diabetes: The Kailuan prospective study.

AbstractThe aim of the present study was to investigate the association between the altered ideal cardiovascular health status (&Dgr;CHS) and the risk of developing diabetes mellitus in the Kailuan population of China.We included 50,656 Chinese adults aged 18 years or older (11,704 men and 38,952 women) without baseline diabetes mellitus in this study. Information about 7 individual components of the cardiovascular health metrics during 2006 to 2008 was collected. A &Dgr;CHS score was defined as the changes of ideal cardiovascular health status (CHS) from the year 2006 to 2008. New-onset diabetes was identified based on the history of diabetes, currently treated with insulin or oral hypoglycemic agents, or having a fasting blood glucose concentration ≥7.0 mmol/L during the 2010 to 2011 and 2012 to 2013 surveys. After a mean follow-up period of 3.80 years, a total of 3071 (6.06%) participants developed diabetes mellitus. Cox proportional hazards regression was used to calculate the hazard ratios and 95% confidence intervals for the CHS change and new-onset diabetes.A strong inverse association between the positive CHS changes and lower risks of developing diabetes mellitus was observed. After adjusting for age, sex, alcohol consumption, and other potential confounders, the hazard ratios for new-onset diabetes were 0.73, 0.59, 0.49, and 0.42 (95% confidence interval: 0.37–0.82; P trend <0.001) for those who met &Dgr;CHS = −1, 0, 1, and ≥2, respectively, compared with the participants with &Dgr;CHS ⩽−2.The study concluded that the improved CHS was associated with the reduced risk of developing diabetes mellitus in this investigated Chinese population.

Short-term changes in sleep duration and risk of type 2 diabetes: Kailuan prospective study.

AbstractEvidence suggests short or long sleep duration is associated with a higher risk of diabetes. Using a large longitudinal data set spanning 2 years, we examined whether a change in sleep duration is associated with diabetes.Current analysis included 56,588 participants who were free of diabetes during both 2006–2007 (exam1) and 2008–2009 (exam2). Sleep duration was categorized into 7 groups: ⩽5.5 hours, 6.0 to 6.5 hours, 7.0 hours, 7.5 to 8.0 hours, ≥8.5 hours, decrease ≥2 hours, and increase ≥2 hours. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CI) for diabetes, according to sleep duration.Compared to the reference group of persistent 7-h sleepers, participants who slept 7.5 to 8 hours per night (HR, 1.20; 95% CI, 1.02–1.40), ≥8.5 hours per night (HR, 1.37; 95% CI, 1.03–1.81) and an increase of ≥2 hours sleep per night (HR, 1.24; 95% CI, 1.05–1.48) were all associated with an increased risk of developing diabetes in analyses adjusted for age, sex, education level, income level, smoking status, drinking status, physical activity, BMI, snoring status, hypertension, hyperlipidemia, and family history of diabetes. The abovementioned associations of sleep duration and incident diabetes were only prominent among individuals aged <64 years.This study suggests that individuals whose sleep duration increases ≥2 hours per night are at an increased risk of diabetes.

Night Sleep Duration and Risk of Incident Anemia in a Chinese Population: A Prospective Cohort Study

The purpose was to study the association between sleep duration and the prevalence of anemia in Chinese people. There were 84,791 participants (men: 79.1%; women: 20.9%) aged 18–98 years in the prospective study. We divided the participants into five categories based on the individual sleep duration: ≤5 h, 6 h, 7 h(reference), 8 h, and ≥9 h. Anemia was defined based on hemoglobin <12 g/dL for men and <11 g/dL for women. The Cox proportional hazards model was used to assess the association between sleep duration and anemia. During median follow-up of 7.9 years, 2698 cases of anemia had occurred. The HRand (95% CI) of anemia (7 h as the reference group) for individuals reporting ≤5 h, 6 h, 8 h, and ≥9 h were 1.23(1.04–1.45), 1.26(1.11–1.44), 1.04(0.92–1.16) and 1.42(1.08–1.86), respectively. It showed that there was a significant interaction on the risk of anemia between sleep duration and sex in the secondary analysis (p < 0.001).The significant association between long sleepduration and anemia was found in women (HR, 2.29; 95% CI, 1.56–3.37), not in men(HR, 0.90; 95% CI, 0.60–1.34). Both short and long night sleep duration were associated with increased risk of anemia.