Objective:To explore whether hyperuricemia was an independent risk factor for all-cause mortality in patients with atrial fibrillation.Methods:Patients with atrial fibrillation who were confirmed by 12-lead electrocardiogram in 11 hospitals of Kailuan Group from 2006 to 2007 were selected as the research objects.All patients were followed up by prospective cohort study, and all-cause deaths were observed.The last follow-up time was December 31, 2013.Kaplan-Meier curve and Cox proportional hazards model were used to analyze and compare the risk of all-cause mortality in patients with atrial fibrillation in the hyperuricemia group compared with the normal uric acid group.Results:A total of 388 community-based patients with atrial fibrillation were included in the final statistical analysis, with 136 all-cause deaths occurred during an average follow-up period of 6.93 years.The incidence of all-cause mortality was 9.24% per year(36/390)in the hyperuricemia group, whereas 5.16% per year(100/1 937) in the normal uric acid group.In the univariate Cox proportional risk model analysis, the risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in the hyperuricemia group (95% CI) was 1.84(1.26-2.69) times that in the normal uric acid group ( P<0.01). After adjusting for potential confounding variables, the adjusted risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in hyperuricemia group was still 1.94(1.32-2.85) times of that in normal uric acid group ( P<0.01). After adjustment for potential confounding variables, for each 0.01 g/L increase in uric acid (1 g/L=5 950 μmol/L), the risk of all-cause death in patients with atrial fibrillation increased by 1.15 (1.05-1.26) times ( P<0.01). Conclusion:Hyperuricemia was an independent risk factor for all-cause death in patients with atrial fibrillation in community.

Objective To investigate the correlation of short-term systolic blood pressure variability (SBPV) with esti?mated glomeruar filtration rate (eGFR) in the elderly. Methods In physical examination for the third time of kailuan group, the method of cluster sampling was used to collect randomly retired employees, age≥60 in kailuan group. The 24-hour am?bulatory blood pressure monitoring was given to these objects. Finally, 1 405 participants with integral data were recruited in?to the survey. SBPV indices were standard deviation of systolic blood pressure (SD), variability independent of the mean (VIM), maximum-minimum difference (MMD), and average real variability (ARV). Multivariate stepwise linear regression models were used to analyze the influence of short-term SBPV on eGFR. Results (1) Among 1 405 participants (67.16 ± 5.82) years, 933 individuals (66.4%) were male and 472 (33.6%) were female. (2) Study population were divided into four groups based on the 24-hour mean SBP, daytime mean SBP, night time mean SBP (group 1:mean SBP<120 mmHg, group 2:120≤mean SBP<140 mmHg, group 3:140≤mean SBP<160 mmHg, group 4:mean SBP≥160 mmHg), respectively. Values of SD, MMD and ARV, but not VIM were increased with increased mean SBP. (3) The participants were grouped according to the median SBPV with between-group comparison of the eGFR. The average eGFR levels were lower in the high 24-hour SB?PV group (SD, VIM, MMD and ARV), day-time SBPV group (SD, VIM, MMD and ARV) and night-time SBPV group (SD, MMD and ARV) than those in the low SBPV groups (P<0.05). (4) Multivariate stepwise linear regression showed that eGFR increased with 3 indices of 24-hour SBPV (SD, MMD and ARV) and 2 indices of day-time SBPV (MMD and ARV) but not for night-time SBPV (β=-0.07,-0.11,-0.07,-0.12 and-0.07, respectively). Conclusion There is a certain degree of asso?ciation between short-term SBPV indices and eGFR.

Objective: To investigate the relationship between long-, short-term systolic blood pressure variability (SBPV) and renal damage in elder population. Methods: Our research was conducted in the 3rd physical examination of healthy population from Kailuan group by cohort study. Cluster sampling was used by 25% ratio in subjects≥60 years of age to monitor their 24-hour ambulatory blood pressure and finally, 2464/3064 participants with inclusion criteria were recruited. SBPV indexes as standard deviation of systolic blood pressure (SSD), variability independent of the mean (VIM), maximum-minimum difference (MMD) and average real variability (ARV) were examined; renal damage indexes as estimated glomerular filtration rate (eGFR) and microalbuminuria (ALBU) were detected. Relationships between different long-term, short-term SBPV indexes and eGFR, ALBU were studied by multi-liner regression analysis. Results:①The mean age of 2464 participants was (67.41 ± 6.05) years including 1667 (67.7%) male and 797 (32.3%) female.②Multi-liner regression analysis indicated that different long-term SBPV indexes were not related to eGFR and ALBU; 24h SBPV in all 4 indexes and day-time SSD, MMD, ARV were negatively related to eGFR; 24h ARV and day-time MMD, ARV were positively related to ALBU; night-time SBPV indexes were not related to eGFR and ALBU.Conclusion: Different short-term SBPV indexes were, at certain point related to eGFR and ALBU

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re?sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re?gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.

Objective To investigate the incidence of miocardial infarction and risk factors in patients with different levels TG.Methods From June 2006 to October 2007,Kailuan coal mine group conducted an on-the-job and retired workers were took physical examination in Kailuan area,and their results were used in our study(n=100 271).According to different levels of TG,all cases were divided into five groups(TG1-5):TG1 group(0.0125 kg/m2,FBG≥6.1 mmol/L,HDL-C<1.5 mmol/L were all the risk factors for myocardial infarction (P<0.05).Cox proportional hazards regression model showed that after adjustment for sex,age and other factors,with the increase in TG levels.Conclusion In study of Kailuan crowd,the increased fasting triglycerides increase the risk of myocardial infarction,and the risk factors for myocardial infarction are age,BMI,FBG and HDL-C.

Objective To investigate the relationship between high-sensitivity C-reactive protein (hsCRP) and retinal vascular diameter.Methods This study was a cross-sectional study,the population was from the Kailuan study (clinical trial research registration NO.:ChiCTR-TNC-1100 1489) in 2012-2013 (age ≥ 40 years).All the people was checked by cardiovascular and epidemiological examination,of which 3 447 people had an analytical results of fundus color photography.The retinal vascular diameter was analyzed by software.Take the value of hsCRP 1％ to 99％ points and 3 363 people were finally included in the statistical analysis.The mean age of 3 363 people (male 1 880,female 1 483) was 56.69± 10.10 years old.The correlation between hsCRP and central retinal artery equivalent (CRAE),central retinal vein equivalent (CRVE),arteriovenous ratio (AVR) were evaluated by Spearman correlation coefficient.Multivariate linear regression analysis was used to futher analyze the association between hsCRP and retinal fundus diameter parameters.Results The median value of hsCRP was 1.10 (0.50,2.21) mmo/L,CRAE was (174.16±24.36) μm,CRVE was (282.70±26.32) μm,AVR was 0.62-±0.09.Spearman correlation analysis showed that hsCRP was positively correlated with CRVE (r =0.052,P =0.003) and negatively correlated with AVR (r =-0.052,P =0.002).The non-normal variables hsCRP were transformed into continuous variables lghsCRP,and CRAE,CRVE and AVR were used for multivariate linear regression analysis.After a number of factors were gradually corrected,the results showed that association between lghsCRP and CRVE (β =3.428) or AVR (β =-0.006) was statistically significant (P＜0.05).LghsCRP was a risk factor for CRVE both in men and women after the calculation of gender stratification.Conclusions CRVE increased and AVR decreased with the increase of hsCRP.The changes of retinal vascular diameter may be associated with hsCRP as a marker to predict cardiovascular and cerebrovascular disease.

OBJECTIVETo observe the effect of resting heart rate (RHR) on the progression to hypertension in patients with prehypertension.

METHODSPeople who participated the physical examination between 2006 and 2007 at Kailuan medical group and diagnosed as prehypentension were selected as the observation cohort. The second and the third physical examination were conducted between 2008 and 2009 and between 2010 and 2011. The observation population was divided into five groups according to the different levels of RHR at baseline: the first group ( ≤69 beats/min), the second group (70-74 beats/min), the third group (75-79 beats/min), the fourth group (80-84 beats/min) and the fifth group ( ≥85 beats/min). The rate of the progression to hypertension was compared among five groups, and the relationship between RHR and the progression to hypertension was estimated using Cox proportional hazard analysis.

RESULTSA total of 34 512 patients with prehypentension were recruited and 25 392 patients were involved in the final statistics after excluding patients who died or were lost to follow-up. A total of 13 228 (52.1%) patients with prehypentension developed hypertension during follow-up. The rate of the progression to hypertension increased with the RHR (first group: 51.2%, second group: 50.1%, third group: 52.9%, fourth group: 53.5%, fifth group: 57.5%). Multiple Cox regression models showed that the risk of the progression to hypertension increased with the RHR levels. Patients in the fifth group carried 1.25 times higher risk for developing hypertension than patients in the second group after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, fasting blood glucose, serum uric acid, C-reactive protein, smoking, drinking, physical exercise and family history of hypertension at baseline.

CONCLUSIONElevated RHR is an independent risk factor for the progression to hypertension in patients with prehypertension.

Adult ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cohort Studies ; Disease Progression ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Middle Aged ; Prehypertension ; Proportional Hazards Models ; Risk Factors ; Triglycerides

Objective: To investigate the impact of blood pressure and age on arterial stiffness in general population. Methods: Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups. Results: (1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group. Conclusion SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.

Objective:To explore the effects of pre- and post-diagnosis of malignant neoplasms total cholesterol difference on all-cause death in the Kailuan study population.Methods:A prospective cohort study method was used to observe on the job and retired workers who were diagnosed with malignant neoplasms during the healthy physical examination and had the complete data of total cholesterol pre- and post-diagnosis of malignant neoplasms at Kailuan (Group) Limited Liability Corporation from June 2006 to December 2015. Medical insurance system and medical records case management system of Kailuan General Hospital were used to retrieve the confirmed diagnosis time of participants with malignant neoplasms. SAS 9.4 software was used to extract the physical examination data of participants diagnosed as malignant neoplasms before and after 2 years. The whole participants were divided into 4 groups according to the quartile of the total cholesterol difference pre- and post-diagnosis of cancer. The first quartile group: the total cholesterol difference <-0.93 mmol/L (823 cases), the second quartile group: the total cholesterol difference≥-0.93 mmol/L and <-0.21 mmol/L (811 cases), the third quartile group: the total cholesterol difference≥-0.21 mmol/L and <0.49 mmol/L (832 cases), the forth quartile group: the total cholesterol difference≥0.49 mmol/L (833 cases). The incidence density was used to calculate the mortality of different total cholesterol difference quartile groups, and the Cox proportional hazards model was used to analyze the influencing factors of all-cause death of all quartile groups.Results:Totally, 1 564 cases had all-cause death during median 2.46 years of follow-up time. There were 481, 440, 333, 310 death cases respectively of 4 quartile groups. The death rates of all quartile groups were 230.10/1 000 person-years, 163.90/1 000 person-years, 115.34/1 000 person-years, and 83.44/1 000 person-years respectively ( χ2 = 604.62, P < 0.001). After adjusting for confounding factors, the Cox proportional hazards model analysis showed that compared with the first quartile group, the hazard ratio with the 95% confidence interval of all-cause death in the second, third, and fourth quartile groups was 0.86 (0.76-0.98), 0.62(0.54-0.72) and 0.58 (0.50-0.67) respectively (all Ptrend < 0.001). After adjusting for confounding factors of patients with cancer in different location, the forth quartile group except for cancer in thyroid, breast, prostate, testis and urinary system, all Ptrend was less than 0.05 compared with that of the first quartile group. Conclusion:Among Kailuan study population, the smaller decline or even rise in total cholesterol level of post-diagnosis compared with that of pre-diagnosis is a protective factor of all-cause death.

Objective To investigate the correlations of triglyceride glucose index(TyG)levels at different baselines with the risk of new-onset acute pancreatitis(AP)among the workers at Kailuan Group.Methods A total of 124 516 subjects were enrolled from 2006 to 2009 and followed up by health examinations of the workers in the group.The subjects with a history of AP or incomplete information on TG and FPG data were excluded.The cumulative incidence rate was determined by Log-Rank method.Multivariate Cox proportional hazards regression model was used to calculate hazard ratios(HR)for AP related to baseline TyG level after adjusting for the effects of multiple confunding factors.Results The subjects were divided into four groups(TyG≤6.59,6.597.46)according to the TyG levels,and the incidence of new-onset AP was observed in all the groups.For a follow-up of(12.59±0.98)years,399 cases of AP were observed.The corresponding incidence of AP in each tertile was 1.67,2.32,2.53,and 3.65 events per 10,000 person-years,respectively.After Cox analysis and correction of multiple confounding factors,the risk of AP incidence was increased in the TyG>7.46 group,with an HR of 1.94[(95%CI(1.42,2.65),P<0.01].Conclusion TyG at its baseline of above 7.46 can increase the risk of AP.