Objective To investigate the relationship between the C-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) prevalence.Methods In this study,63,486 workers who had participated in the Kailuan health examination from July 2012 to October 2013 and without history of drinking,myocardial infarction,stroke and cancer and without data incomplete were recruited.The observation population was divided into three groups according to the levels of CRP at baseline:group 1 (＜ 1 mg/L),group 2 (1-3 mg/ L) and group 3 (＞3 mg/L).The prevalence of NAFLD among three groups was observed.Multiple logistic regression was used to calculated relationship between the CRP and NAFLD prevalence.Results The prevalence of NAFLD in group 1,group 2 and group 3 were 26.9％,42.1％ and 49.3％,respectively,and the differences were significant (x2=2 192.31,P ＜ 0.01).Logistic model showed that after adjustment for age,gender,waist circumference and other confounders,the association between CRP and NAFLD was strong and the OR value (95％ CI) among the group 1,group 2 and group 3 were 1.00,1.49 (1.42-1.56),1.54 (1.45 -1.64),respectively.Conclusion CRP is independently associated with the nonalcoholic fatty liver disease.

Objective:To investigate the correlation between serum high sensitivity C-reactive protein and carotid intima-media thickness.Methods:A total of 5 136 health examination subjects, aged ≥40 years old, who met the inclusion criteria and had complete data, were selected as the research objects.A unified questionnaire survey, blood biochemistry and carotid artery color doppler ultrasound examination were performed.According to the diagnostic criteria of hs-CRP published by American Heart Association (AHA), the subjects were divided into three groups: 0.05 mg/L0.84 mm group.The results showed that when the concentration of hs-CRP was high, CIMT increased with the increase of hs-CRP( OR(95% CI) 1.24 (1.01~1.52), P<0.05). Conclusion:There was a positive correlation between hs-CRP and CIMT.Patients with higher levels of hs-CRP are more likely to develop CIMT thickening and increase the risk of arteriosclerotic disease.

Objective: To explore the relationship between longitudinal trajectory of systolic blood pressure (SPB) and atrial fibrillation (AF) in Kailuan group population. Methods: Our study cohort consisted of 40727 participants with the specific criteria in Kailuan group, Tangshan. SAS Proc Traj procedure was used to identify longitudinal trajectories of SPB throughout 2006-2007, 2008-2009 and 2010-2011. There were 5 longitudinal trajectories generated: Low-stable group,n=10950, Moderate-stable group, n=19158, Moderate-high stable group,n=3713, High-moderate stable group,n=4702 and High stable group,n=2181. Log-rank test was performed to compare AF incidence throughout 2012-2013 and 2014-2015 by physical examination among different groups; Multi Cox regression analysis was conducted to study the relationship among different SBP longitudinal trajectories and AF occurrence. Results:①The mean age of participants was (51.81±11.54) years including 30693 (75.4%) male.②AF occurrence rates in Low-stable, Moderate-stable, Moderate-high stable, High-moderate stable and High stable groups were 0.1%, 0.2%, 0.5%, 0.5% and 0.6% respectively, allP<0.05.③Multi Cox regression analysis presented that with adjusted confounding factors, compared with the patients in Low-stable group, Moderate-high stable, High-moderate stable and High stable SBP longitudinal trajectories were the risk factors for new AF occurrence (HR=7.58, 95% CI 2.08-27.73), (HR=5.30, 95% CI 1.88-14.95) and (HR=8.52, 95% CI 1.96-37.09) respectively, allP<0.05. With excluded history of myocardial infarction/stroke, the sensitivity study showed the similar result with the major research trend. Conclusion: Elevated long trajectory of SPB was the risk factor for new AF occurrence in Kailuan group population.

Objective: To explore the predictive value of inlfammatory factors on all cause mortality in normal population.
Methods: In our prospective cohort study, a total of 83,228 subjects from physical examination of Kailuan group from 2006-07 to 2007-10 were enrolled, nobody had acute inlfammation. The death information was collected once per year and the last follow-up was conducted in 2013-12-31. According to baseline levels, white blood cells (WBC), ratio of neutrophil/lymphocyte ratio (N/L) and C-reactive protein (CRP) were respectively divided into 4 Quartile groups; all cause mortality was compared among different groups and their risks were studied by multi-Cox regression analysis.
Results: The average follow-up time was 6.9 years. All cause mortality in Quartile 1, Quartile 2, Quartile 3 and Quartile 4 groups for WBC were 4.2%, 4.5%, 4.5% and 5.0% respectively; for N/L were 3.3%, 3.6%, 4.5% and 6.7% respectively; for CRP were 3.0%, 3.6%, 4.8% and 6.8% respectively. Multi-Cox regression analysis indicated that with adjusted age, gender, waist and other confounders, by elevation of WBC, N/R and CRP, the risks of all cause mortality were increased accordingly, and the risks in Quartile 4 groups were higher than those in Quartile 1 groups as for WBC, it was 1.17-time (95% CI 1.06-1.29);for N/L, it was 1.44-time (95% CI 1.31-1.59); for CRP, it was 1.33-time (95% CI 1.20-1.47) respectively.
Conclusion: Elevated WBC, N/R and CRP are independent risk factors for all cause mortality in normal population.

Objective: To investigate the changes of cardiovascular health indicator and arteriosclerosis in middle and elder population.
Methods: A total of 4190 subjects with the average age of (49.78 ± 9.74) years by 3 physical examinations in Kailuan group from 2006 to 2011 were randomly stratiifed for arm ankle arterial pulse wave velocity (baPWV) examination. According to 7 AHA cardiovascular health indicators of non-smoking, normal BMI, active excise, healthy diet, normal cholesterol, blood pressure and fasting blood glucose, each indicator had 3 conditions as ideal, general and poor by scores of 2, 1 and 0 respectively. Based on the 1st and 3rd physical examinations, the changes of cardiovascular health scores (△CHS), the subjects were divided into 8 groups as△CHS≤-4,-3,-2,-1, 0, 1, 2 and△CHS≥3, n=241, 368, 611, 855, 911, 647, 354 and 203 respectively. The impacts of△CHS on baPWV values were studied by liner and Logistic regression analyses.
Results: As△CHS increased by △CHS ≤ -4, -3,-2,-1,0,1, 2 and△CHS ≥ 3, the baPWV values were decreased accordingly by cm/s as (1590.78 ± 17.93), (1566.4 ± 14.5), (1552.83 ± 11.25), (1536.59 ± 9.51), (1508.85 ± 9.21), (1499.81 ± 10.93), (1485.92 ± 14.82) and (1475.85 ± 19.57) respectively. Multiple linear regression analysis showed that with adjusted confounding factors, as△CHS increasing 1 score, baPWV increasing 15.58 cm/s (B=15.58, P<0.001). Logistic regression analysis indicated that with adjusted confounding factors, as△CHS increasing 1 score, the risk for arteriosclerosis occurrence was decreased by 14%(OR=0.86, 95%CI 0.83-0.90).
Conclusion: △CHS was negatively related to baPWV in middle and elder subjects, improving cardiovascular health indicator may decrease arteriosclerosis occurrence.

Objective To observe the association between the cardiovascular health score and newonset atrial fibrillation.Methods A total of 95 026 participants who participated the health examination between July 2006 and October 2007 at Kailuan group and without history of atrial fibrillation were selected as the observation cohort.The second,the third and the fourth health examination were performed between July 2008 to October 2009,July 2010 to October 2011,July 2012 to October 2013,respectively.A total of 85 028 participants were included in the final analysis after excluding participants who had new-onset valvular atrial fibrillation and participants lost to follow-up.The participants were divided into 4 subgroups by cardiovascular health score at baseline according to the definition of AHA and cardiovascular health scoring system,namely group of 0-6 points (n =11 103),7-8 points (n=24 487),9-10 points (n =32 556),and 11 14 points (n =16 882).The incidence of atrial fibrillation in each subgroup was observed,and the association between cardiovascular health score and risk of new-onset atrial fibrillation was analyzed using multiple Cox regression analysis.Results A total of 254 participants developed atrial fibrillation during the median of (5.6 ± 1.4) years follow-up.The total incidence of new-onset atrial fibrillation was 0.53/1 000 person-year.The incidence of atrial fibrillation was 0.69/1 000 person-year,0.60/1 000 person-year,0.56/1 000 person-year,and 0.30/1 000 person-year,respectively in 0-6 points,7-8 points,9-10 points,and 11-14 points subgroups,respectively (P ＜ 0.01).After adjustment of age,gender,education level,income,drink,history of myocardial infarction,history of stroke,serum uric acid and C reactive protein level,multiple Cox regression analysis showed that one health score point increase was related to 8％ reduction of new onset atrial fibrillation(HR =0.92,95％ CI 0.86-0.99,P ＜ 0.05).Compared with the group of 0-6 points group,the risk of atrial fibrillation in the group of 11-14 points group was reduced by 49％ (HR =0.51,95 ％ CI 0.31-0.83,P ＜ 0.01).Conclusion The risk of new-onset atrial fibrillation is reduced in proportion to increase of cardiovascular health score.

Objective To investigate the predictive value of C-reactive protein (CRP) in emerging nonalcoholic fatty liver disease (NAFLD).Methods A prospective cohort study was performed.A total of 101510 employees of Kailuan Group Company who underwent physical examination from July 2006 to October 2007 were enrolled as study subjects.The employees with a history of drinking,fatty liver disease,myocardial infarction,stroke,and malignant tumors and incomplete data were excluded.Finally 25843 employees were enrolled in the cohort study.According to the baseline CRP level,these employees were divided into CRP ＜ 1 mg/L group,CRP 1-3 mg/L group,and CRP ＞ 3 mg/L group.The detection rate of emerging NAFLD was compared between groups,and the multivariate logistic regression model was used to analyze the risk of NAFLD in each group.Results With the increasing CRP level,age,systolic pressure,diastolic pressure,waist circumference,body mass index,fasting blood glucose,total cholesterol,serum uric acid,and the proportion of male patients tended to increase (P ＜ 0.01).The detection rate of emerging NAFLD was 24.6％ in the CRP ＜ 1 mg/L group,29.6％ in the CRP 1-3 mg/L group,and 30.6％ in the CRP ＞ 3 mg/L group (x2 =92.10,P ＜ 0.01).The results of the logistic regression analysis showed that after the confounding factors such as age,sex,and waist circumference were corrected,the risk of NAFLD in the CRP 1-3 mg/L group and CRP ＞ 3 mg/L group was 1.09 (95％ CI 1.01-1.17) and 1.24 (95％ CI 1.13-1.35) times that in the CRP ＜ 1 mg/L group.Conclusion CRP is the independent risk factor for the development of NAFLD.

Objectives:To evaluate the association between estimated pulse wave velocity(ePWV)and risk of new-onset diabetes. Methods:A total of 82 440 employees without prior diabetes who participated in the health examination from July 2006 to October 2007 were selected as the observation cohort,participants were followed-up for a mean of(13.19±3.73)years.The study population was divided into four groups according to the ePWV quartiles:group Q1(ePWV<12.35 m/s,n=20 610),group Q2(12.35 m/s≤ePWV<13.74 m/s,n=20 610),group Q3(13.74 m/s≤ePWV<15.16 m/s,n=20 611),and group Q4(ePWV≥15.16 m/s,n=20 609).ROC curve was used to analyze the predictive value of ePWV for new-onset diabetes.The incidence density of diabetes in each group was calculated.After adjustment for the traditional cardiovascular risk factors(including sex,smoking,drinking,exercise,education level,family history of cardiovascular disease,history of myocardial infarction,history of stroke,body mass index,total cholesterol,fasting blood glucose,uric acid and high-sensitivity C-reactive protein),multivariate Cox regression models were used to evaluate the association between ePWV and risk of new-onset diabetes. Results:The area under the ROC curve of ePWV was 0.60 in the prediction of new-onset diabetes,and the optimal cut-offvalue was 12.78 m/s.With the increase of ePWV quartile,the incidence density of diabetes showed an increasing trend,which was 5.84/1 000 person years,12.04/1 000 person years,15.70/1 000 person years and 16.87/1 000 person years,respectively.After adjusting for the traditional cardiovascular risk factors,the risk of new onset diabetes increased by 9%(HR=1.09,95%CI:1.08-1.11,P<0.01)for each 1 m/s increase in ePWV.Subgroup analysis showed that higher ePWV was significantly associated with increased risk of new-onset diabetes regardless of presence or absence of cardiovascular risk factors,male or female,and age<51 years or age≥51 years,with the HR(95%CI)values of 1.07(1.05-1.08)and 1.21(1.08-1.36),1.07(1.06-1.09)and 1.17(1.15-1.20),1.22(1.19-1.24)and 1.06(1.04-1.07). Conclusions:ePWV has a certain predictive value for new-onset diabetes and is an independent risk factor for new-onset diabetes.

OBJECTIVETo investigate the impact of premature birth on long term cardio-cerebral vascular events of puerpera.

METHODSAmbispective cohort study method was used and 3 659 pregnant women giving birth during October 1976 to December 2008 at Kailuan medical group were included and divided into premature birth (PTB) group (n = 226) and non-PTB (NPTB) group (n = 3 433) by the history of PTB. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.

RESULTS(1) The childbearing age, proportion of pregnancy-induced hypertension, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while weight and height of newborn were significantly less in PTB group than in NPTB group (P < 0.05 or 0.01). (2) There were 71 cardio-cerebral vascular events during the follow-up of (15.19 ± 7.75) years. In PTB group, the incidence of cardio-cerebral vascular events and myocardial infarction was 3.23/1 000 person-years and 2.05/1 000 person-years, respectively, while the corresponding incidence was 1.15/1 000 person-years and 0.42/1 000 person-years, respectively in NPTB group (all P < 0.05). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction in PTB group was 2.03 fold (95% CI: 1.02-4.04, P = 0.002) and 3.11 fold (95% CI: 1.18-8.18, P < 0.001) higher than in NPTB group.

CONCLUSIONPTB is an independent risk factor for total cardio-cerebral vascular events, especially myocardial infarction of puerpera.

Blood Pressure ; Cardiovascular Diseases ; epidemiology ; Cohort Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Myocardial Infarction ; epidemiology ; Pregnancy ; Premature Birth ; Proportional Hazards Models ; Risk Factors ; Stroke

OBJECTIVETo investigate the association between exposure to the famine during early life and elevated resting heart rate (RHR) in adulthood.

METHODFrom June 2006 to October 2007, the employees of kailuan group who took part in the health examination were selected. Of those, 18 619 cases who was born during October 1, 1956 to September 30, 1964 in Hebei province were finally included in the analysis based on the inclusion and exclusion criteria. All the subjects were received questionnaire survey, smoking and drinking, physical examination, Lab examination and the measurement of RHR. The subjects of famine exposure group (3 190 cases) were born from October 1, 1959 to September 30, 1961, semi-exposure group (3 851 cases) were born from October 1, 1958 to September 30, 1959 and from October 1, 1961 to September 30, 1962, control group (11 578 cases) were born from October 1, 1956 to September 30, 1958 and from October 1, 1962 to September 30, 1964. The RHR and the detection rate of elevated RHR were compared among the three groups. The Multivariate logistic regression model was used to analyze the association between of exposure to famine during early life and elevated RHR in adulthood.

RESULTSThe RHR level was higher in famine exposure group and semi-exposed group than control group, which were (74.34 ± 9.71), (74.41 ± 9.48) and (73.90 ± 9.45) beat per minute (bpm) (P values were 0.003 and 0.020, respectively). In all of the subjects. The results of multivariate logistic regression showed that exposure of famine during early life increased the risk of elevated RHR in adulthood after adjustment for age, gender and other confounders (OR = 1.10, 95% CI: 1.01-1.21). In men, exposure of famine during early life also increased the risk of elevated RHR in adulthood (OR = 1.15, 95% CI: 1.04-1.28); In women, there was no association between the famine exposure and elevated RHR (OR = 0.92, 95% CI: 0.74-1.14).

CONCLUSIONExposure of famine during early life increases the risk of elevated RHR in adulthood. This negative effect existed mainly in the male.

Adult ; Alcohol Drinking ; China ; Female ; Heart Rate ; Human Development ; Humans ; Logistic Models ; Male ; Risk Factors ; Smoking ; Starvation