Objective To investigate the association of single nucleotide polymorphisms (SNPs) in the SCGB3A2(secretoglobin family 3A member 2) gene promoter with susceptibility of Graves' disease.Methods One-hundred and seventy-nine SNPs within a 3.0 Mb region surrounding marker D5s2090 were scanned in a case-control study.The size of the region(s) associated with GD was then narrowed.Results Total 179 SNPs within a 3.0 Mb region surrounding marker D5s2090 were analyzed.The most significant association signal was found at SNP rs1368408 (P =3.69 × 10-5).Subsequent association analysis was then performed and the results suggested that the SNP76 (P =4.11 × 10-8) and SNP75 (P =1.37 × 10-8) in the promoter of SCGB3A2 gene may be the causal variants of GD.Logistic regression analysis suggested these 2 SNPs in this region may contribute to GD susceptibility.Conclusion A significant association seems to exist between GD with the SCGB3A2 gene.

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.

Objective:To examine the association between height loss and calcaneus bone mineral density (BMD) through data gathered from the China Kadoorie Biobank (CKB).Methods:The present study included 24 231 participants who attended the CKB resurvey during 2013-2014, in which calcaneus BMD was measured by quantitative ultrasound method for the first time. Height loss was calculated according to the differences appeared in height measurement between baseline and resurvey. We used linear regression models to estimate the association between height loss and BMD measures.Results:The mean interval between baseline and resurvey was (8.0±0.8 ) years. 33.0 % of the participants showed a height loss of ≥1.0 cm, and another 3.7 % were with height loss of ≥3.0 cm. After adjustment for potential confounders, there was a linear correlation seen between height loss and BMD ( P for all linear trend were <0.001). The βs (95 %CIs) for each 1.0 cm of height loss were -0.79 (-0.95--0.63) for broadband ultrasound attenuation (BUA), -2.74 (-3.35--2.13) for speed of sound (SOS), and -1.29 (-1.54--1.04) for stiffness index (SI). Compared with participants with stable height, the multivariate-adjusted βs (95 %CIs) for those with height loss of ≥3.0 cm were -3.29 (-4.08--2.50) for BUA, -10.70 (-13.66--7.73) for SOS, and -5.16 (-6.36--3.96) for SI, respectively. According to the subgroup analyses, the association of height loss with BMD measures seemed to be more apparent among females, in those aged ≥55 years, and those being less physically active. Conclusions:BMD became lower with the increase of height loss. Regular height measurement may contribute to the early diagnosis and prevention of osteoporosis.

Objective:To describe the regional and demographic differences on passive non-smokers from 10 regions involved in the China Kadoorie Biobank (CKB) study.Methods:Detailed information regarding passive smoking behaviors related to 317 486 non-smokers who were 30-79 years old from the 10 study regions were gathered and analyzed.Results:Following the standardization of the 2010 China national population, the prevalence rate of passive smoking was 56.7 %, and the prevalence rate of living with smokers was 66.5 % among the Chinese adults. Both of the aforementioned rates were higher in rural than in urban areas. Meanwhile, the regional distribution of weekly passive smoking frequency and cumulative duration of passive smoking per week and cumulative duration of passive smoking per day were significantly different. The cumulative passive smoking duration per week increased along with the weekly frequency in people living in urban areas. Among women, the weekly passive smoking frequency was the highest, and the cumulative durations per week and per day appeared the lowest in Hunan, opposite to the situation in Henan. The prevalence of passive smoking among participants living with smokers was 2.27 times (95 %CI: 2.24 -2.29) of those who were not and the association appeared stronger in women ( OR=2.61, 95 %CI: 2.58-2.64) but not in men ( OR=1.01, 95 %CI: 0.95-1.06). Almost all the indicators seemed higher in women than those in men, except for the cumulative duration per day. Furthermore, these indicators appeared higher among those who were at younger age or with less education. The prevalence rates of passive smoking and living with smokers were lower but the cumulative duration per day was higher among those with lower household income. And the two rates were higher in married women and lower in married men, as compared to their counterparts. Conclusion:Regional and demographic differences in passive smoking were noticed among study population of CKB in the 10 regions.

Background:It remains unclear about the association of muscle mass, strength, and quality with death in the general Chinese population of diverse economical and geographical backgrounds. The present study aimed to comprehensively examine such associations across different regions in China.Methods:Based on the China Kadoorie Biobank study, the present study included 23,290 participants who were aged 38 to 88 years and had no prevalent cardiovascular diseases or cancer. Muscle mass and grip strength were measured using calibrated instruments. Arm muscle quality was defined as the ratio of grip strength to arm muscle mass. Low muscle mass, grip strength, and arm muscle quality were defined as the sex-specific lowest quintiles of muscle mass index, grip strength, and arm muscle quality, respectively. Cox proportional hazards models yielded hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of all-cause mortality in relation to muscle mass, strength, and quality.Results:During a median follow-up of 3.98 years, 739 participants died. The HR (95% CI) of all-cause mortality risk was 1.28 (1.08-1.51) for low appendicular muscle mass index, 1.38 (1.16-1.62) for low total muscle mass index, 1.68 (1.41-2.00) for low grip strength, and 1.41 (1.20-1.66) for low arm muscle quality in models adjusted for sociodemographic characteristics, lifestyle factors, and medical histories.Conclusion:Low muscle mass, grip strength, and arm muscle quality are all associated with short-term increased risks of mortality, indicating the importance of maintaining normal muscle mass, strength, and quality for general Chinese adults.

Objective:To explore the correlation between chronic diseases and muscle mass, strength and quality in adults in China.Methods:Based on the second resurvey of China Kadoorie Biobank (CKB) in 2013-2014, logistic regression models were used to analyze the correlation of different types, number and duration of chronic diseases with low muscle mass, handgrip strength and muscle quality.Results:The prevalence rate of diabetes, coronary heart disease (CHD), stroke and chronic obstructive pulmonary disease (COPD) were 9.6%, 5.8%, 3.2% and 26.8%, respectively, and 38.8% of the participants had at least one disease, and they were more likely to have low handgrip strength and low arm muscle quality (AMQ), and the longer the chronic diseases duration, the higher the risk. The ORs (95% CIs) for low handgrip strength and low AMQ in patients with 1 chronic disease for more than 10 years was 1.64 (1.42-1.90) and 1.83 (1.60-2.10), respectively. The ORs (95% CIs) for low handgrip strength were 1.26 (1.17-1.37), 1.42 (1.23-1.64) and 2.27 (1.55-3.32) and the ORs (95% CIs) for low AMQ were 1.28 (1.18-1.38), 1.67 (1.46-1.92) and 2.41(1.69-3.45), respectively, in patients with 1, 2, ≥3 chronic diseases, the correlation showed a linear trend ( P for trend <0.001). Diabetes, CHD and stroke were positively correlated with low handgrip strength and low AMQ. Compared with participants without COPD, COPD patients were more likely to have low appendicular skeletal muscle mass index (ASMI), low total skeletal muscle mass index (TSMI) and low handgrip strength, and the risk was positively correlated with disease duration. Conclusions:Patients with chronic diseases were more likely to have lower muscle strength and muscle quality, especially the patients with multi diseases and longer disease duration. The proportion of low handgrip strength and low AMQ was higher in patients who reported multi-prevalence and longer duration of chronic diseases.

Objective:To describe the prevalence of daytime nap habit in participants of the China Kadoorie Biobank (CKB) study, across 10 study regions and explore its correlation with prevalence of major chronic diseases.Methods:Participants with a self-reported pre-diagnosis of any cancer at baseline survey were excluded. Logistic regression models were used to analyze the differences in study regions and age distribution of the prevalence daytime nap habit, and its correlation with the prevalence of diabetes, hypertension, coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD), and chronic liver diseases.Results:Among 510 145 participants, 39.9% had daytime nap habit in summer and 20.8% had daytime nap habit all the year round. Urban-rural differences were observed in the prevalence of summer nap habit and perennial nap habit. Daytime nap in summer was common in rural areas and Suzhou, with prevalence ranged from 32.9% to 73.3%. Haikou and Liuzhou had higher prevalence of perennial nap (60.4% and 63.3%). The proportion of people with daytime nap habit all the year round increased with age ( P for trend <0.001), the proportion was highest in those aged 70- years (31.9%). Daytime nap habit in summer was positively correlated with the prevalence of diabetes, hypertension, CHD and chronic liver disease with OR of 1.10 (95% CI: 1.07-1.14), 1.03 (95% CI:1.02-1.05), 1.07 (95% CI: 1.02-1.12) and 1.07 (95% CI:1.00-1.14), respectively. Daytime nap habit all the year round was positively correlated with the prevalence of diabetes, hypertension, CHD, stroke, COPD and chronic liver disease with OR of 1.33 (95% CI: 1.29-1.37), 1.11 (95% CI: 1.09-1.13), 1.39 (95% CI: 1.33-1.45), 1.33 (95% CI: 1.26-1.41), 1.12 (95% CI: 1.08-1.16) and 1.27 (95% CI:1.18-1.37) respectively. Conclusion:There were regional and age differences in prevalence of daytime nap habit among CKB participants. Daytime nap habit, especially daytime nap habit all the year round, was positively correlated with the prevalence of major chronic diseases.

Objective:To investigate the relationship between chronic obstructive pulmonary disease (COPD) and bone mineral density (BMD) in Chinese male and female adults.Methods:Linear regression models were used to analyze the correlations between COPD and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade concerning bone mineral density indices, including broadband ultrasound attenuation, speed of sound, and stiffness index, based on data from the second resurvey of China Kadoorie Biobank.Results:Among 23 876 participants, the prevalence of COPD was 34.3% (3 130/9 125) in males and 23.2% (3 416/14 751) in females. Compared with healthy males and healthy females, broadband ultrasound attenuation, speed of sound, and stiffness index decreased in males and females with COPD, with β values (95% CI) of -0.87 (-1.37- -0.36), -3.42 (-5.42- -1.43) and -1.53 (-2.34- -0.71) in males and -0.66 (-1.09- -0.23), -2.24 (-3.92- -0.55), -1.06 (-1.71- -0.40) in females, respectively. The decrease was greater in males than females (all P for interaction <0.05). The GOLD grade of COPD was inversely correlated with all the three indices in a dose-response manner (all P for trend <0.001). Subgroup analysis showed that patients with COPD had a greater decrease in BMD in males whose ages were ≥ 60 years, males who were less physically active, and participants who were not overweight or obese. Conclusions:COPD was negatively correlated with bone mineral density. More attention should be paid to the bone mineral density of patients with COPD, especially those with older age, less physical activity, or lower BMI.

Objective:To evaluate the associations of meeting intensive systolic blood pressure (SBP) control goals with risk for incident cardiovascular and cerebrovascular diseases among the adult hypertensive patients in China.Methods:We used data from adult hypertensive patients from the China Kadoorie Biobank. logistic regression models evaluated the influencing factors of meeting intensive and standard SBP control goals. Cox proportional hazard models evaluated the associations between meeting intensive vs. standard SBP control goals and risk for incident cardiovascular and cerebrovascular diseases.Results:A total of 3 628 hypertensive patients who reported continuous medication use were included in this study, of which 5.0% of the participants met the goals of intensive SBP control (≤130 mmHg). Participants with higher educational attainment ( OR=2.36,95% CI: 1.32-4.04), healthier diet ( OR=2.09,95% CI: 1.45-2.96), daily intake of fresh fruit ( OR=1.67,95% CI: 1.17-2.36) and combination treatment ( OR=1.82,95% CI: 1.03-3.09) were more likely to meet intensive SBP control goal after adjustment of age, sex and urban/rural areas. During an average follow-up of (10.0±3.7) years, 1 278 cases of composite cardiovascular outcome were recorded. This study did not find a statistical correlation between achieving the goal of enhanced SBP control and the occurrence of composite cardiovascular and cerebrovascular outcomes ( HR=0.89, 95% CI: 0.63-1.25). For major adverse cardiovascular events (MACE), cerebrovascular diseases, stroke, and ischemic stroke, we observed a trend of decrease in risk of outcomes with more intensive SBP control (trend test P<0.05). Conclusions:We observed decreased risk for MACE and cerebrovascular diseases with more intensive SBP control. However, there was no significant risk reduction for cardiovascular and cerebrovascular diseases when meeting the intensive SBP control goal, compared to the standard SBP control goal.