Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy, carries adverse health outcomes for both mothers and offspring. However, national data on the prevalence and secular trends of GDM during the past 10 years in the U.S. is lacking. This study included 26,340 ever-pregnant women aged ≥ 18 years from the National Health Interview Survey in 20and 2016. We examined GDM prevalence in 20and 2016. The prevalence of GDM increased from 4.6% in 20to 8.2% in 2016 (P<0.001). non-Hispanic white women showed less increase in the prevalence (2.8%) than non-Hispanic black women (3.8%), Hispanic women (4.1%), and women with other race/ethnicity (8.4%). The prevalence of GDM in non-Hispanic white women was higher than in non-Hispanic black (P=0.01) and women with other race/ethnicity (P=0.01) in 2006; but similar with in non-Hispanic black and lower than in women with other race/ethnicity (p=0.02) in 2016. The prevalence of GDM in non-Hispanic white and Hispanic women was similar in 20and 2016. In addition, the increase of GDM was more evident among women who were overweight, had low income, aged between 45-64 years, and had insufficient physical activity. In conclusion, the prevalence of GDM increased by 3.6% from 20to 2016; and the rise was more marked among non-white, overweight, low income, age 45-64 years, and insufficient activity groups. Disclosure T. Zhou: None. D. Sun: None. X. Li: None. Y. Heianza: None. H. Nisa: None. G. Hu: None. X. Pei: None. X. Shang: None. L. Qi: None.

BACKGROUND Associations between dairy intake and body mass index (BMI) have been inconsistently observed in epidemiological studies, and the causal relationship remains ill defined. METHODS We performed Mendelian randomization (MR) analysis using an established dairy intake-associated genetic polymorphism located upstream of the lactase gene (LCT-13910 C/T, rs4988235) as an instrumental variable (IV). Linear regression models were fitted to analyze associations between (a) dairy intake and BMI, (b) rs4988235 and dairy intake, and (c) rs4988235 and BMI in each study. The causal effect of dairy intake on BMI was quantified by IV estimators among 184802 participants from 25 studies. RESULTS Higher dairy intake was associated with higher BMI (β = 0.03 kg/m2 per serving/day; 95% CI, 0.00–0.06; P = 0.04), whereas the LCT genotype with 1 or 2 T allele was significantly associated with 0.20 (95% CI, 0.14–0.25) serving/day higher dairy intake (P = 3.15×10−12) and 0.12 (95% CI, 0.06–0.17) kg/m2 higher BMI (P = 2.11×10−5). MR analysis showed that the genetically determined higher dairy intake was significantly associated with higher BMI (β = 0.60 kg/m2 per serving/day; 95% CI, 0.27–0.92; P = 3.0×10−4). CONCLUSIONS The present study provides strong evidence to support a causal effect of higher dairy intake on increased BMI among adults.

Background There is an evidence gap about whether a low-risk lifestyle is as important as achieving blood pressure (BP) and random blood glucose (RBG) control. Objectives To explore the long-term impacts and relative importance of low-risk lifestyle and health factors on the risk of all-cause and cancer mortality and macrovascular and microvascular complications among diabetic patients. Methods This study included 26,004 diabetes patients in the China Kadoorie Biobank. We defined five lifestyle factors (smoking, alcohol drinking, physical activity, fruits and vegetables intake, and waist-to-hip ratio) and two health factors (BP and RBG). Cox regression was used to yield adjusted hazard ratios (HRs) and confidence intervals (CIs) for individual and combined lifestyle and health factors with the risks of diabetes-related outcomes. Results There were 5,063 deaths, 6,848 macrovascular complications, and 2,055 microvascular complications that occurred during a median follow-up of 10.2 years. Combined low-risk lifestyle factors were associated with lower risk of all main outcomes, with HRs (95%CIs) for participants having 4-5 low-risk factors versus 0-1 of 0.50 (0.44 to 0.57) for all-cause mortality, 0.55 (0.43 to 0.71) for cancer mortality, 0.60 (0.54 to 0.67) for macrovascular complications, and 0.75 (0.62 to 0.91) for microvascular complications. The combined 4-5 low-risk lifestyle factors showed relative importance in predicting all-cause and cancer mortality and macrovascular complications. Conclusions Assuming causality exists, our findings suggest that adopting a low-risk lifestyle should be regarded as important as achieving ideal BP and glycemic goals in the prevention and management of diabetes-related adverse outcomes.

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It is unclear how the dietary patterns reflecting C-reactive protein (CRP) affect metabolic syndrome (MetS) in the Chinese population. To examine the effect of the dietary pattern reflecting CRP with MetS, a cross-sectional study was based on the health checkup data from the Beijing MJ Health Screening Centers between 2008 and 2018. The CRP-related dietary pattern was derived from 17 food groups using reduced-rank regression. Participants were divided into five groups according to the quintiles of dietary pattern score. Multivariate logistic regression was then applied to estimate the odds ratios (OR) and 95% confidence intervals (CIs) for the quintiles of diet pattern score related to MetS and its four components. Of the 90,130 participants included in this study, 11,209 had MetS. A CRP-related dietary pattern was derived, characterized by a higher consumption of staple food, fresh meat, processed products, and sugar-sweetened beverages but a lower intake of honey and jam, fruits, and dairy products. Compared with participants in the lowest quintile (Q1), participants in the higher quintiles were associated with increased risks of MetS in a dose–response manner after adjustment for potential confounders (P for linear trend < 0.001), the ORs for Q2 to Q5 were 1.10 (95%CI: 1.02–1.19), 1.14 (95% CI: 1.05–1.22), 1.23 (95%CI: 1.15–1.33), and 1.49 (95%CI:1.38–1.61), respectively. Moreover, the effects were stronger among individuals aged 50 years or older. A CRP-related dietary pattern was associated with the risk of MetS. It provides new insights that dietary intervention to achieve a lower inflammatory level could potentially prevent MetS.

Diabetes affected over 30 million U.S. adults in 2015, and its comorbidities remained among the leading causes of premature death and reduced quality of life. However, little is known about the secular trend of diabetes comorbidities in the last 20 years. Sample-weighted prevalence of twelve common comorbidities of diabetes was estimated using data from 52,842 adults aged ≥18 years who had diabetes in the National Health Interview Survey from 1997 through 2016, with age-standardized to the 2000 U.S. population. We ranked the prevalence [% (SE)] of twelve diabetes comorbidities, and the top five were hypertension [53.7(3.1)], arthritis [33.2(3.1)], asthma [17.2(2.9)], coronary heart disease [CHD: 14.4(2.3)]), and chronic obstructive pulmonary disease [COPD: 9.1(2.3)]. From 1997 to 2016, the estimated prevalence (%) of diabetes comorbidities including hypertension (47.8 to 59.7), asthma (13.2 to 21.0), cancer (7.6 to 10.4), and liver cirrhosis (3.0 to 4.1) continuingly increased (P&lt;0.05), while CHD (15.4 to 13.4), COPD (10.1 to 8.0), and hepatitis (5.5 to 2.9) declined (P&lt;0.05). Such trends were similar among subgroups stratified by gender or by race. In the past two decades, along with continuing increase of diabetes, the rates of its comorbidities including hypertension, asthma, cancer, and liver cirrhosis showed increasing trends, whereas the rates of CHD, COPD, and hepatitis exhibited decreasing trends in the U.S. adults. Disclosure D. Sun: None. T. Zhou: None. X. Li: None. Y. Heianza: None. X. Shang: None. V. Fonseca: Consultant; Self; Abbott. Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Eli Lilly and Company. Stock/Shareholder; Self; Amgen Inc.. Consultant; Self; Asahi Kasei Corporation, AstraZeneca, Novo Nordisk Inc., ADOCIA, Intarcia Therapeutics, Inc., Sanofi-Aventis. L. Qi: None.

Background DNA methylation clocks emerged as a tool to determine biological aging and have been related to mortality and age-related diseases. Little is known about the association of DNA methylation age (DNAm age) with coronary heart disease (CHD), especially in the Asian population. Results Methylation level of baseline blood leukocyte DNA was measured by Infinium Methylation EPIC BeadChip for 491 incident CHD cases and 489 controls in the prospective China Kadoorie Biobank. We calculated the methylation age using a prediction model developed among Chinese. The correlation between chronological age and DNAm age was 0.90. DNA methylation age acceleration (Δage) was defined as the residual of regressing DNA methylation age on the chronological age. After adjustment for multiple risk factors of CHD and cell type proportion, compared with participants in the bottom quartile of Δage, the OR (95% CI) for CHD was 1.84 (1.17, 2.89) for participants in the top quartile. One SD increment in Δage was associated with 30% increased risk of CHD (OR = 1.30; 95% CI 1.09, 1.56; Ptrend = 0.003). The average number of cigarette equivalents consumed per day and waist-to-hip ratio were positively associated with Δage; red meat consumption was negatively associated with Δage, characterized by accelerated aging in those who never or rarely consumed red meat (all P < 0.05). Further mediation analysis revealed that 10%, 5% and 18% of the CHD risk related to smoking, waist-to-hip ratio and never or rarely red meat consumption was mediated through methylation aging, respectively (all P for mediation effect < 0.05). Conclusions We first identified the association between DNAm age acceleration and incident CHD in the Asian population, and provided evidence that unfavorable lifestyle-induced epigenetic aging may play an important part in the underlying pathway to CHD.