Objective To construct profiles of health status based upon physical,mental and social support items in adult twins of Qingdao.Methods Grade of Membership(GoM) model was applied to a set of 31 indicators to construct ideal profiles.Results Four health profiles were identified: pure type Ⅰ(healthy),pure type Ⅱ(personality disorders),pure type Ⅲ(psychological symptoms) and pure type Ⅳ(physiological symptoms).The most frequently occurring combination in this population was profile Ⅰ,Ⅱ,Ⅳ(14.74%),followed by profile Ⅰ,Ⅱ,Ⅲ,Ⅳ(13.44%),and then type Ⅰ(11.08%).Only 13.56% of subjects fell completely into one single pure type.Conclusions One healthy type and three non-healthy types are determined.Most individuals exhibit some of the characteristics of two or more types,holding partial membership in multiple categories.

Objective To investigate the varying variances of the genetic components in birth cohorts.Methods Twin samples used in the current study were collected from the Chinese National Twin Registry and a two-wave study was conducted,in Qingdao and Lishui regions.Samples were broken down by birth cohort to create four subgroups:-1958,1959-1961,1962-1970 and 1970-.Structural equation models were fitted in each subgroup to estimate the genetic and environmental variances.Results From each birth cohort,weight and body mass index in 2012 appeared higher than those in 2001.Twins of 1971-cohort subgroup showed lower weight than in the other cohort subgroups.Except for the 1959-1961 cohort subgroup,the later birth cohorts were inversely related to the body mass indexes.Genetic factors might explain 54％-76％ of the total variations on the body mass index.Heritability of body mass index of twins born during 1959-1961 was increasing along with age.Conclusion Genetic factors might explain the main portion which related to the phenotypic variance of body mass index.Effects of genetic factors on body mass index of twins born during 1959-1961 might have increased along with age.

Objective: To explore the association between DNA methylation and body mass index (BMI) using Mendelian randomization analysis. Methods: A total of 469 participants were selected from the Chinese National Twin Registry in 2013, who were living in Shandong, Jiangsu, Zhejiang, and Sichuan provinces, and at least 18 years of age. A questionnaire survey and physical examination were conducted to collect demographic, clinical, and behavioral information. Peripheral blood cells were collected to detect genotype and methylation status. Association analyses between DNA methylation and BMI and between CpGs and cis-SNP were conducted. With rs748212 as the instrumental variable, the association between cg15053022 and BMI was explored using the Mendelian randomization method. Results: A total of 469 participants were selected. The mean age of participants was (44.8±13.2) years and the BMI was (25.0±3.8) kg/m². Nine BMI-related DNA methylation sites were found and DNA methylation site cg15053022 in the ATP4A gene was negatively associated with cis-SNP rs748212 (β=-0.020); the mean methylation level of AA, AC, and CC were 0.212±0.025, 0.242±0.024, and 0.264±0.028, respectively. rs748212 was associated with BMI (β=0.04, P=0.007) and closely related to cg15053022 (F=237.66, P=0.143). Mendelian randomization analysis showed lower methylation levels at cg15053022 were associated with higher BMI (β=-1.97, P<0.001). Conclusion This study supported the impact of cg15053022 methylation in the ATP4A gene on BMI using Mendelian randomization analysis and provided the basis for using Mendelian randomization analysis in methylation studies.

BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959–1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35–74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962–1978), fetal exposed (individuals born in 1959–1961), child exposed (individuals born in 1949–1958), and adolescent/adult exposed (born in 1931–1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29–3.60), 1.53 (0.93– 2.51), and 1.65 (0.75–3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82–42.54) and 2.33 (1.17–4.65), respectively. CONCLUSIONS These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

Objective:To analyze the association between waist circumference (WC) and ischemic stroke (IS).Methods:The data for the present study were from the prospective cohort study of China Kadoorie Biobank in Qingdao. Using baseline information and IS events of the participants, the Cox proportional hazard regression model and restricted cubic spline (RCS) were used to analyze the association between WC and IS.Results:A total of 33 355 participants were included in the study, with 302 008.88 person-years of follow-up. A total of 1 093 new cases of IS were observed. Multivariate Cox proportional hazard regression model analysis showed that compared to the respondents with normal WC (male <85.0 cm, female <80.0 cm), respondents with excessive WC (male ≥85.0 cm, female ≥80.0 cm) had a 78% higher risk of IS incidence [hazard ratio( HR)=1.78, 95% CI: 1.51-2.10], and the risk increased by 72% ( HR=1.72, 95% CI: 1.40-2.12) and 83% ( HR=1.83, 95% CI: 1.40-2.39) in men and women. According to the RCS, the increase in WC and the risk of IS showed an "S" trend of nonlinear dose-response relationship. Conclusions:The risk of IS would increase with the WC. Keeping a normal WC is important for preventing IS.

Objective:To investigate the association between solid fuel use for heating, smoking, and respiratory diseases.Methods:This study is based on the Qingdao project of the China Kadoorie Biobank. After screening, 26 165 individuals were included in the study. We employed Cox proportional hazards regression models, stratified by risk age (in 5-year intervals) and sex while adjusting for confounding variables such as occupation and physical activity level to analyze the association between solid fuel use for heating, smoking, and increased risk of respiratory diseases.Results:Among the 26 165 participants, the average age of those using solid fuel for heating was (52.57±10.31) years, with females constituting 58.04% and former/current smokers accounting for 65.38%. The results indicated that both the solid fuel group and the former/current smoking group had a higher risk of respiratory diseases, with hazard ratios ( HR) (95% CI) of 1.21 (1.04-1.41) and 1.41 (1.16-1.71), respectively. For the duration of solid fuel use, the HR (95% CI) for 20 years or more, it was 1.27 (1.07-1.51). The multiplicative interaction term between solid fuel use and smoking was statistically significant. Conclusions:The use of solid fuel for heating and smoking significantly increases the risk of respiratory diseases, and there may be a multiplicative interaction between solid fuel use and smoking.

Objective To investigate both genetic and environmental influences on the exercise participation and sedentary behavior in Qingdao,Shandong province and 326 in Lishui, Zhejiang province. Methods 568 twin pairs,including 242 in Qingdao and 326 in Lishui,were studied. Exercise participation was measured by two questions on the frequency and intensity and then divided into two groups. Sedentary behavior was measured by one question as‘how long do you spend on sitting every day’. Variance component models based on twins was used to estimate the genetic and environmental factors on these traits. Results The average age in monozygotic twins was(41.14 ± 10.11)while in dizygotic twins it was(41.23 ± 9.89). Genetic factors accounted 78%(35%-96%)and 59%(0-94%)for exercise participation variance in Qingdao and Lishui in people aged between 20 and 40. However,there were no heritability noticed on physical activity in people older than 40 years of age. Rates of heritability on sedentary behavior in Qingdao and Lishui were 68%(59%-75%)and 32%(7%-62%),respectively. Conclusion Results from the study suggested that sedentary behavior in Chinese people was influenced by genetic factors,which could also explain much of the exercise participation variance in people aged between 20 and 40.

Objective:To quantitate the association between birth weight and phenotypes of physical indicators in adulthood, i.e. BMI and waist circumference (WC) and to what degree genetic or environmental factors affect birth weight-obesity association.Methods:A total of 6 623 gender matched twin pairs aged 25 to 79 years were recruited through the Chinese National Twin Registry. The twins reported their own birth weight, current height and weight, and WC using a self-administered questionnaire. BMI was calculated according to the self-reports of body height and weight. Within twin-pair design was used to quantitate the association between birth weight and phenotypes related to obesity while bivariate structural equation models were used to decompose the phenotype correlation.Results:After adjusted for multiple factors, twin-pair analyses within monozygotic (MZ) showed that, on average, a 1.0 kg increase in birth weight corresponded to an increase of 0.33 kg/m 2 in BMI and 0.95 cm in WC in adulthood ( P<0.001). Bivariate structural equation models showed significant positive unique environmental correlation between birth weight and the two obesity-related phenotypes. Conclusion:The study supported the role of twin-specific supply line factors on relationship between birth weight and physical indicators in adulthood.

Objective:To analyze the heritability of coronary heart disease (CHD) among the Chinese twin adults.Methods:A total of 20 477 same-sex twin pairs aged 25 years and older from the Chinese National Twin Registry were interviewed. Structure equation model was used to estimate the heritability of CHD.Results:After adjusting for age and gender, the overall heritability of CHD was 0.75(0.68-0.81). Stratified analyses showed that genetic factors play a more important role in CHD incidence in ≥40 years or female twins. While the development of CHD was mainly influenced by environmental factors in 25-39 years or male twins.Conclusion:CHD is influenced by both genetic and environmental factors and the heritability is high.

Objective:To explore the genetic and environmental effects on alcohol intake.Methods:Data on 9 231 pairs of adult twins of the same sex was collected from the Chinese National Twin Registry (CNTR), between 2015 and 2018 and used in this study. Structural equation model was used to estimate the effects of genetic and environmental factors on alcohol intake.Results:A total of 9 231 pairs of twins were included in the analysis, of which 6 085 pairs were monozygotic (MZ). The average age of MZ was (36.91±13.07) years old, and males accounted for 56.80 %. The average age of dizygotic twins (DZ) was (35.22±12.48) years old, and males accounted for 55.91 %. There were 350 pairs of alcohol-drinking twins were with high-risk, accounting for 1.90 % and another 367 pairs (1.99 %) were with medium-risk. Alcohol-drinkers with medium-risk were affected by additive genetics, common and unique environmental factors, seen among the twins. The overall heritability appeared as 24.3 % (95 %CI: 0 to 56.8 %). Furthermore, 50.7 % of the variation (95 %CI: 20.4 %-79.0 %) could be explained by the common environmental factors and 24.9 % (95 %CI: 18.3 %-36.5 %) by unique environmental factors. High-risk related drinking behavior was affected by both common and unique environmental factors. The common environmental component appeared as 75.6 % (95 %CI: 69.6 %-80.8 %) and unique environmental component as 24.4 % (95 %CI: 19.2 %-30.4 %), respectively. Gender difference was seen in the heritability of those with medium or high-risk drinking behaviors. The heritability of men was 30.8 % (95 %CI: 9.8 %-53.5 %), while in women it was mainly affected by the environment. Conclusion:Both alcohol drinkers with medium and high-risk drinking behaviors were mainly affected by the environment factors and gender. With the increase of drinking volume, the effect of environment on drinking behaviors became more obvious.