Risk factors for cardiovascular disease in the Chinese population:recent progress and implications

Cardiovascular disease(CVD)is the leading cause of death in both urban and rural areas of China.The current evidence regarding CVD risk factors was primarily established in Western countries,with limited generalizability to the Chinese population.In China,a growing number of population-based prospective cohort studies have emerged that have yielded substantial research data on CVD risk factors in the past five years.The research studies have covered biological risk factors(e.g.,blood lipids,blood pressure,blood glucose,adiposity),lifestyle risk factors(e.g.,smoking,alcohol,diet,physical activity),environmental risk factors(e.g.,ambient and indoor air pollution),and risk prediction.This study aimed to systematically review the research progress on CVD risk factors in the Chinese population in the past five years.Prospective studies in China have identified biological,lifestyle,and environmental risk factors for CVD and its main subtypes,along with some protective factors unique to the Chinese(e.g.,spicy food and green tea).This review aimed to provide high-quality evidence for achieving the Outline of Healthy China 2030,developing disease prevention guidelines and measures,and deepening efforts for popularization of health knowledge.

Risk factors for early-onset colorectal cancer:A large-scale Chinese cohort study

Background:The incidence of early-onset colorectal cancer(EOCRC)has increased globally since the early 1990s.Comprehensively examining the risk factors would be helpful for risk stratification and the development of per-sonalized colorectal cancer screening strategies.Methods:We performed a prospective study of the Chinese population aged 30-50 years to identify potential risk factors during a median follow-up of 9.1 years.We compared the distribution of demographic characteris-tics,lifestyle factors,dietary habits,and medical history among 222 EOCRC cases and 87,833 normal controls.Multivariate adjusted Cox hazard models were used for estimating EOCRC risks of each risk factor.Results:Our final analyses indicated that participants with a higher body mass index(HR,1.04;95%CI:1.00,1.08),regular alcohol consumption(HR,1.69;95%CI:1.12,2.91),higher intake of fish(HR,1.64;95%CI:1.01,2.67),hypertension(HR,1.99;95%CI:1.04,3.81),diabetes(HR,2.20;95%CI:1.08,4.49),and first-degree relatives with cancer(HR,1.70;95%CI:1.23,2.36)were at higher risk of EOCRC.Conclusion:We identified several modifiable as well as nonmodifiable risk factors,such as higher BMI,alcohol and fish consumption,hypertension,and diabetes,were associated with EOCRC.

Development of a prediction model to identify undiagnosed chronic obstructive pulmonary disease patients in primary care settings in China

Background:At present,a large number of chronic obstructive pulmonary disease(COPD)patients are undiagnosed in China.Thus,this study aimed to develop a simple prediction model as a screening tool to identify patients at risk for COPD.Methods:The study was based on the data of 22,943 subjects aged 30 to 79 years and enrolled in the second resurvey of China Kadoorie Biobank during 2012 and 2013 in China.We stepwisely selected the predictors using logistic regression model.Then we tested the model validity through P-P graph,area under the receiver operating characteristic curve(AUROC),ten-fold cross validation and an external validation in a sample of 3492 individuals from the Enjoying Breathing Program in China.Results:The final prediction model involved 14 independent variables,including age,sex,location(urban/rural),region,educational background,smoking status,smoking amount(pack-years),years of exposure to air pollution by cooking fuel,family history of COPD,history of tuberculosis,body mass index,shortness of breath,sputum and wheeze.The model showed an area under curve(AUC)of 0.72(95%confidence interval[CI]:0.72-0.73)for detecting undiagnosed COPD patients,with the cutoff of predicted probability of COPD=0.22,presenting a sensitivity of 70.13%and a specificity of 62.25%.The AUROC value for screening undiagnosed patients with clinically significant COPD was 0.68(95%CI:0.66-0.69).Moreover,the ten-fold cross validation reported an AUC of 0.72(95%CI:0.71-0.73),and the external validation presented an AUC of 0.69(95%CI:0.68-0.71).Conclusion:This prediction model can serve as a first-stage screening tool for undiagnosed COPD patients in primary care settings.