No abstract

BackgroundCancer becomes the leading cause of premature death in China. Primary objective of this study was to determine the major risk factors especially glucose intolerance for cancer prophylaxis.MethodsA cluster sampling method was applied to enroll 10,657 community-based adults aged 15-92 years in Shanghai, China in 2013. A structured questionnaire and physical examination were applied in baseline survey. Prediabetes was diagnosed using 75-g oral glucose tolerance test. After excluding 1433 subjects including 224 diagnosed with cancer before and 1 year after baseline survey, the remaining 9,224 subjects were followed-up to December 31, 2020.ResultsA total of 502 new cancer cases were diagnosed. The cancer incidence was 10.29, 9.20, and 5.95/1,000 person-years in diabetes patients, those with prediabetes, and healthy participants, respectively (p<0.001). The multivariate Cox regression analysis indicated that age, prediabetes and diabetes, were associated with an increased risk of cancer in those <65 years, the hazard ratios (95% confidence interval) for prediabetes and diabetes were, 1.49(1.09-2.02) and 1.51(1.12-2.02), respectively. Glucose intolerance (prediabetes and diabetes) were associated with increased risks of stomach cancer, colorectal cancer, and kidney cancer in those <65 years. Anti-diabetic medications reduced the risk of cancer caused by diabetes. The multivariate Cox analysis showed that age, male, <9 years of education, and current smoking were associated with increased risks of cancer in those ≥65 years independently.ConclusionsGlucose intolerance is the prominent cancer risk factor in adults <65 years. Lifestyle intervention and medications to treat glucose intolerance help prevent cancer in this population.

No abstract

Interarm blood pressure difference (IAD) is a risk factor for peripheral artery disease and cardio‐cerebral vascular disease (CCVD). The current study examines the association of IAD with stroke and coronary heart disease in a Chinese community. A cross‐sectional study was conducted in Pudong New Area in Shanghai, China. A total of 10 657 residents aged 15 years and older were randomly selected through three‐stage sampling. Volunteers had systolic and diastolic blood pressure (BP) measured in both arms at recruitment, and IAD was defined in both arms as the absolute difference in BP. Medical records of study participants were reviewed by investigators to confirm measurements. Logistic regression models were used to assess the association between systolic interarm blood pressure difference (sIAD) and diastolic interarm blood pressure difference (dIAD) with stroke and coronary heart disease. Compared with dIAD <5 mm Hg, the multivariate adjusted odds ratio (OR) of stroke prevalence was 1.357 (95% CI 0.725‐2.542, P = 0.034) for dIAD ≥20 mm Hg and 1.702 (95% CI1.025‐2.828, P = 0.040) for dIAD between 15 and 19 mm Hg, and the multivariate adjusted OR of coronary heart disease prevalence was 1.726 (95% CI 1.093‐2.726, P = 0.019) for dIAD ≥20 mm Hg and 1.498 (95% CI 0.993‐2.261, P = 0.044) for dIAD between 15 and 19 mm Hg. The relationship between cardio‐cerebral vascular disease and dIAD was significant in a Chinese community population. Further cohort studies are needed to investigate the association of different levels of IAD with the incidence of cardiovascular and cerebrovascular diseases and subsequent mortality.

Importance Sleep duration plays an important role in predicting CCVD incidence, and have implications for reducing the burden of CCVD. However, the association between sleep duration and predicted cardio-cerebral vascular diseases (CCVD) risk remains to be fully understood. Objective To investigate the effects of sleep duration on the development of CCVD among Chinese community residents. Design A prospective cohort study. The baseline survey was conducted from January 2013 to July 2013. The cohort has been followed until December 31, 2016 using a combination of in-person interviews and record linkages with the vital registry of Pudong New Area, Shanghai, China. Subjects A total of 8245 Chinese community residents were initially enrolled in the cohort. Of those, 6298 underwent the follow-up examination. Exposure Self-reported sleep duration and sleep quality were obtained via the questionnaire. Sleep duration was divided into five categories: ≤5, 6, 7, 8, or ≥ 9 h per day. Main Outcome(s) and Measure(s) CCVD, Coronary heart disease (CHD) and Stroke occurrence, Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Fine-Gray proportional subdistribution hazards models. Results During a median follow-up of 3.00 years (IQR 2.92–3.08), we observed 370 participants have had incident CCVD events, of whom 230 had CHDs, 169 had strokes, and 29 had both. After adjustment for relevant confounders, short sleepers (≤ 5 h) had 83% higher risk of total CCVD incidence (HR: 1.83; 95% CI: 1.32–2.54), 82% higher risk of CHD incidence (HR: 1.82; 95% CI: 1.21–2.75), and 82% higher risk of stroke incidence (HR: 1.82; 95% CI: 1.12–2.98) in contrast to the reference group (7 h). Some of these U-shaped relationships varied by age, and were more pronounced in individuals aged < 65 years. Individuals who slept ≤ 5 h per day with baseline hypertension had the highest risk of CCVD incidence (HR: 3.38, 95% CI 2.08–5.48), CHD incidence (HR: 3.11, 95% CI 1.75–5.53), and stroke incidence (HR: 4.33, 95% CI 1.90–9.86), compared with those sleep 7 h and without baseline hypertension. Conclusions Short sleep duration is independently associated with greater incidence of CCVD, CHD and stroke.

Importance: Sleep duration plays an important role in predicting CCVD incidence, and have implications for reducing the burden of CCVD. However, the association between sleep duration and predicted cardio-cerebral vascular diseases (CCVD)risk remains to be fully understood. Objective: To investigate the effects of sleep duration on the development of CCVD among Chinese community residents. Design: A prospective cohort study. The baseline survey was conducted from January 2013 to July 2013. The cohort has been followed until December 31, 2016 using a combination of in-person interviews and record linkages with the vital registry of Pudong New Area, Shanghai, China. Subjects: A total of 9247 Chinese community residents were initially enrolled in the cohort. Of those, 6476 underwent the follow-up examination. Exposure: Self-reported sleep duration and sleep quality were obtained via the questionnaire. Sleep duration was divided into five categories: ≤5, 6, 7, 8, or≥9 hours per day. Main Outcome(s) and Measure(s): CCVD, Coronary heart disease (CHD) and Stroke occurrence, Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using Cox proportional hazards models. Results: During a median follow-up of 3.00 years (IQR 2.83-3.08), we observed 393 participants have had incident CCVD events, of whom 216 had CHDs, 148 had strokes, and 29 had both. After adjustment for relevant confounders, short sleepers (≤5h) had 70% higher risk of total CCVD incidence (HR: 1.70; 95%CI: 1.24-2.34), 66% higher risk of CHD incidence (HR: 1.66; 95%CI: 1.11-2.47), and 65% higher risk of stroke incidence (HR: 1.65; 95%CI: 1.03-2.65) in contrast to the reference group (7h). Some of these U-shaped relationships varied by age, and were more pronounced in individuals aged <65 years. Individuals who slept ≤5h per day with baseline hypertension had the highest risk of CCVD incidence (HR: 4.41, 95%CI 2.76-7.04), CHD incidence (HR: 2.52, 95%CI 1.43-4.44), and stroke incidence (HR: 3.72, 95%CI 1.66-8.34), compared with those sleep 7h and without baseline hypertension. Conclusions: Short sleep duration is independently associated with greater incidence of CCVD, CHD and stroke.