建立广州生物库进行慢性重大疾病研究概述

Establishment of the Guangzhou Biobank for the study of major chronic diseases:the past and coming decades

目的报告《建立广州生物库进行慢性重大疾病研究》过去十年的研究进展和今后十年的研究展望。方法选择≥50岁的30 518名有广州市户籍的居民,收集其个人背景资料、职业接触、居住和生活环境与习惯、营养摄入及个人与家族史等详细资料,并作体格检查,血生化检验、尿柯铁宁及心电图、X线胸片与肺功能检测等,同时储存其白细胞与血浆在-196℃液态氮库内使其永生化;定期重复体检随访及电话随访并建立亚队列进行基因、生活方式与职业环境等因素对慢性重大疾病影响的研究。计数资料采用χ2检验,计量资料符合正态分布的采用t检验,不符合正态分布的采用秩和检验,以双侧P<0.05为差异有统计学意义。结果 (1)建立液态氮生物库、条码识别技术与Fico11-Pague分离细胞室及分子流行病学研究室的管理系统;(2)分三个阶段收集30 518名研究对象建立生物库中老年队列;(3)基线资料分析表明,"三高"凸显,男女血压高值分别为24.0%和17.8%,高血压患病率分别为45.3%和41.3%,χ2值为39.89,P<0.001;血糖高值和糖尿病患者男性分别为11.1%和12.0%,略高于女性的9.9%和12.6%,χ2值分别为9.00和2.04,P=0.191和0.293,差异无统计学意义;而高脂血症更为明显,检出率则女性明显高于男性;(4)中央型肥胖、超重和全身性肥胖以及代谢综合征也呈现女性高于男性;短期记忆受损则男性为13.9%,稍高于女性的12.7%,χ2值为8.05,P=0.005;(5)发现不良的生活方式如吸烟、二手烟、饮酒、缺乏体力活动、不良睡眠状态及打鼾对健康的影响,经历不同社会经济环境(生命历程)成长发育对健康的影响,研究已发表论文80多篇;(6)第一次重复体检和电话随访已于2012年12月结束,除606名研究对象因户口迁出或身份证有误无法确定外,成功随访率达98.0%,已知1 801例死亡,随访资料仍在处理和分析中。结论既往十年《广州生物库中老年队列研究》项目已建立标准化的研究平台及完成第一次重复体检与电话随访,未来十年将继续重复体检为主的纵向随访及建立亚队列进行基因、职业与环境因素及生活方式对慢性重大疾病影响的研究,不断向深度和广度发展。

Objective To summarize and report the development and progression of Guangzhou Biobank Cohort Study （GBCS） over the past decade, and to oversee the future prospect in the coming decade. Methods A total of 30 518 Guangzhou permanent residents aged 50 years and older were recruited and their personal background information were collected, which included 12 aspects of information based on a standardized question naire with direct entry to computer. They also received physical examination, blood and urine routine test, urinary cotinine test, ECG, plain chest X ray and lung function test. Live white cells and plasma were collected and stored in two liquid nitrogen tanks. They were followed up regularly by face-to-face or telephone interview to establish sub cohorts for the study of genetic, lifestyle, occupational and environmental effects on major chronic diseases. Chi-square test and t test were applied for data analysis, and non-parametric test was used for variables not normally distributed. Results A liquid nitrogen biobank, a bar-code auto recognition technology and Ficoll Pague white cells isolation technology as well as a variety of operation procedures were set up and optimized. Meanwhile, 30 518 subjects were recruited and cohorted in biobank. In addition, baseline data analysis showed that the problem of ＂three high＂ （high blood pressure, glucose and lipid） was very obvious. 24.0% of men and 17.8% of women had pre hypertension and the prevalence of high blood pressure was 45.3% in men and 41.3% in women （χ^2 =39.89, P〈0. 001）. There were 11.1% and 12.0% of men with hyperglycemia and diabetics, which were slightly higher than the 9.9% and 12.6% in women. The differences were not significant （χ^2 =9.00, P=0. 191; χ^2 2.04, P=0. 293）, while, the prevalence of hyperlipidemia was much higher in women than in men. Also, the prevalences of central obesity, overweight, general obesity and metabolic syndrome were all higher in women compared to men. However, more men （13.9%） suffered from mild cognitive impairment than women （12.7%） （χ^2=8.05, P=0. 005）. The effects of unhealthy lifestyles, such as smoking and passive smoking, alcohol drinking, physical inactivity, insufficient sleeping and snoring as well as social experience on health were determined and 80 articles were published in PubMed. Moreover, the first follow up physical examination and telephone interview had been completed in December 2012, with the successful follow-up rate as high as 98.00%, since 606 subjects could not be tracked down because of emigration or incorrect identity number, and 1 801 deaths had been confirmed, the follow-up data were being processed. Conclusions Over the past decade, a standardized research platform has been established based on the GBCS, with the completion of the first follow-up physical examination and telephone interview. In the coming decade, we are aiming at an in-depth longitudinal follow-up based on repeating examination as well as establishing various sub-cohorts to explore effects of genetic, occupational, en vironmental factors and lifestyles on major chronic diseases.