1.Spicy food consumption and risk of vascular disease: Evidence from a large-scale Chinese prospective cohort of 0.5 million people.
Dongfang YOU ; Dianjianyi SUN ; Ziyu ZHAO ; Mingyu SONG ; Lulu PAN ; Yaqian WU ; Yingdan TANG ; Mengyi LU ; Fang SHAO ; Sipeng SHEN ; Jianling BAI ; Honggang YI ; Ruyang ZHANG ; Yongyue WEI ; Hongxia MA ; Hongyang XU ; Canqing YU ; Jun LV ; Pei PEI ; Ling YANG ; Yiping CHEN ; Zhengming CHEN ; Hongbing SHEN ; Feng CHEN ; Yang ZHAO ; Liming LI
Chinese Medical Journal 2025;138(14):1696-1704
BACKGROUND:
Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association.
METHODS:
This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results.
RESULTS:
During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037).
CONCLUSIONS
Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
Humans
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Male
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Female
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Prospective Studies
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Middle Aged
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Aged
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Vascular Diseases/etiology*
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Risk Factors
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China/epidemiology*
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Adult
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Proportional Hazards Models
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Cerebrovascular Disorders/epidemiology*
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East Asian People
2.An investigation of hepatitis D virus infection among patients with chronic hepatitis B virus infection in some regions of China
Yumei LIU ; Xiaoping GUO ; Huimin ZHANG ; Hongxia BAI ; Chunmei WANG ; Shan REN ; Yongfang JIANG ; Sheng YANG ; Feng PENG ; Xiaozhong WANG ; Lei YU ; Boming LIAO ; Ling NING ; Yingli HE ; Xia YANG ; Liang HUANG ; Xueen LIU ; Hui ZHUANG
Journal of Clinical Hepatology 2023;39(4):795-803
Objective To investigate the prevalence of hepatitis D virus (HDV) infection among patients with chronic hepatitis B virus (HBV) infection in some regions of China. Methods Serum samples were collected from 3 131 patients with chronic HBV infection in 10 provinces, cities, and autonomous regions of China from March 2021 to June 2022, and anti-HDV IgG ELISA was used for the detection of all serum samples. Nested reverse transcription-polymerase chain reaction (nRT-PCR) was used to detect HDV RNA in anti-HDV IgG-positive samples, and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype. The clinical features of anti-HDV IgG-positive patients were analyzed. The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results The positive rate of anti-HDV IgG in the 3 131 patients with chronic HBV infection was 0.70% (22/3 131), and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, Beijing, and Hunan Province was 1.81% (16/886), 0.88% (2/226), 0.28% (2/708), and 1.00% (2/200), respectively; the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing ( P =0.004), and there was no significant difference between the other regions ( P > 0.05). Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group, the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality ( P =0.001), abnormal alanine aminotransferase ( P =0.007), or antiviral treatment ( P =0.029), as well as a significantly lower median HBV DNA level ( P =0.030). A total of 19 HDV RNA-positive samples were identified, all of which had HDV genotype 1. Conclusion The prevalence rate of HDV varies greatly across different regions of China, with a higher prevalence rate of HDV in patients with chronic HBV infection from Inner Mongolia Autonomous Region. HDV genotype 1 is the predominant genotype in some provinces and cities of northern China.
3.Potentilla anserina polysaccharide alleviates cadmium-induced oxidative stress and apoptosis of H9c2 cells by regulating the MG53-mediated RISK pathway.
Lixia ZHAO ; Ju CHENG ; Di LIU ; Hongxia GONG ; Decheng BAI ; Wei SUN
Chinese Journal of Natural Medicines (English Ed.) 2023;21(4):279-291
Oxidative stress plays a crucial role in cadmium (Cd)-induced myocardial injury. Mitsugumin 53 (MG53) and its mediated reperfusion injury salvage kinase (RISK) pathway have been demonstrated to be closely related to myocardial oxidative damage. Potentilla anserina L. polysaccharide (PAP) is a polysaccharide with antioxidant capacity, which exerts protective effect on Cd-induced damage. However, it remains unknown whether PAP can prevent and treat Cd-induced cardiomyocyte damages. The present study was desgined to explore the effect of PAP on Cd-induced damage in H9c2 cells based on MG53 and the mediated RISK pathway. For in vitro evaluation, cell viability and apoptosis rate were analyzed by CCK-8 assay and flow cytometry, respectively. Furthermore, oxidative stress was assessed by 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) staining and using superoxide dismutase (SOD), catalase (CAT), and glutathione/oxidized glutathione (GSH/GSSG) kits. The mitochondrial function was measured by JC-10 staining and ATP detection assay. Western blot was performed to detect the expression of proteins related to MG53, the RISK pathway, and apoptosis. The results indicated that Cd increased the levels of reactive oxygen species (ROS) in H9c2 cells. Cd decreased the activities of SOD and CAT and the ratio of GSH/GSSG, resulting in decreases in cell viability and increases in apoptosis. Interestingly, PAP reversed Cd-induced oxidative stress and cell apoptosis. Meanwhile, Cd reduced the expression of MG53 in H9c2 cells and inhibited the RISK pathway, which was mediated by decreasing the ratio of p-AktSer473/Akt, p-GSK3βSer9/GSK3β and p-ERK1/2/ERK1/2. In addition, Cd impaired mitochondrial function, which involved a reduction in ATP content and mitochondrial membrane potential (MMP), and an increase in the ratio of Bax/Bcl-2, cytoplasmic cytochrome c/mitochondrial cytochrome c, and Cleaved-Caspase 3/Pro-Caspase 3. Importantly, PAP alleviated Cd-induced MG53 reduction, activated the RISK pathway, and reduced mitochondrial damage. Interestingly, knockdown of MG53 or inhibition of the RISK pathway attenuated the protective effect of PAP in Cd-induced H9c2 cells. In sum, PAP reduces Cd-induced damage in H9c2 cells, which is mediated by increasing MG53 expression and activating the RISK pathway.
Cadmium/metabolism*
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Caspase 3/metabolism*
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Potentilla/metabolism*
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Glycogen Synthase Kinase 3 beta/pharmacology*
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Proto-Oncogene Proteins c-akt/metabolism*
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Cytochromes c/metabolism*
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Glutathione Disulfide/pharmacology*
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Oxidative Stress
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Myocytes, Cardiac
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Reactive Oxygen Species/metabolism*
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Reperfusion Injury/metabolism*
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Apoptosis
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Polysaccharides/pharmacology*
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Adenosine Triphosphate/metabolism*
4.The hippo kinases MST1/2 in cardiovascular and metabolic diseases: A promising therapeutic target option for pharmacotherapy.
Yunfei YIN ; Mingyue TAN ; Lianhua HAN ; Lei ZHANG ; Yue ZHANG ; Jun ZHANG ; Wanqian PAN ; Jiaxiang BAI ; Tingbo JIANG ; Hongxia LI
Acta Pharmaceutica Sinica B 2023;13(5):1956-1975
Cardiovascular diseases (CVDs) and metabolic disorders are major components of noncommunicable diseases, causing an enormous health and economic burden worldwide. There are common risk factors and developmental mechanisms among them, indicating the far-reaching significance in exploring the corresponding therapeutic targets. MST1/2 kinases are well-established proapoptotic effectors that also bidirectionally regulate autophagic activity. Recent studies have demonstrated that MST1/2 influence the outcome of cardiovascular and metabolic diseases by regulating immune inflammation. In addition, drug development against them is in full swing. In this review, we mainly describe the roles and mechanisms of MST1/2 in apoptosis and autophagy in cardiovascular and metabolic events as well as emphasis on the existing evidence for their involvement in immune inflammation. Moreover, we summarize the latest progress of pharmacotherapy targeting MST1/2 and propose a new mode of drug combination therapy, which may be beneficial to seek more effective strategies to prevent and treat CVDs and metabolic disorders.
5.Influencing factors of pulmonary ventilation function and its relationship with indoor air pollution in rural areas of Gansu Province
Xiaoyu TIAN ; Hongxia SHI ; Sheng LI ; Yanjun BAI ; Keqin HU ; Jun YAN ; Baode XUE ; Yanlin LI ; Jingping NIU ; Bin LUO
Journal of Environmental and Occupational Medicine 2022;39(5):485-492
Background Indoor air pollution is an important risk factor affecting health of the respiratory system. Studies on indoor air pollution in China are mostly limited to the central and eastern regions, and there are few studies in the rural areas of northwest China. Objective To explore the influencing factors of lung ventilation function and its relationship with indoor air pollution in rural areas of Gansu Province based on a cross-sectional investigation. Methods A total of 399 subjects were selected from four villages in Baiyin and Yuzhong of Gansu Province. Questionnaires were used to collect demographic information, lifestyle, disease history, fuel use, and other information, and physical and functional tests were ordered such as height, weight, and lung function. The Indoor Air Pollution (IAP) exposure index was calculated based on smoking, fuel type, and weekly ventilation. IAP > 5 was defined as a high level of indoor air pollution. Lung function indexes included forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, forced vital capacity as a percentage of predicted value (FVC%), and forced expiratory volume in the first second as a percentage of predicted value (FEV1%), which were used to determine pulmonary ventilation dysfunction. Logistic regression model was used to evaluate the relationship between indoor air pollution and pulmonary ventilation function, and subgroup analysis was further conducted according to home address and BMI , in order to identify the high-risk population of pulmonary ventilation dysfunction. Results The mean age of the subjects was (56.75±7.31) years old; 155 subjects (38.85%) had normal pulmonary ventilation function, and the other 244 subjects (61.14%) had impaired pulmonary ventilation function; about 89.97% of the subjects were exposed to high level of indoor air pollution (IAP > 5). We found that IAP > 5 (OR=2.327, 95%CI: 1.089-4.974) and use of bituminous coal as the main heating fuel in winter (OR=3.467, 95%CI: 1.197-10.037) increased the risk of pulmonary ventilation dysfunction after adjusting for age, BMI, residence, gender, smoking, drinking, and cardiovascular disease. The subgroup analysis results showed that no ventilation in the living room/bedroom (OR=3.460, 95%CI: 1.116-10.268) increased the risk of pulmonary ventilation dysfunction in Baiyin. Heating with coal stoves and Chinese Kang in the bedroom (OR=2.092, 95%CI: 1.030-4.247) and cooking in the bedroom in winter ( OR =2.954, 95% CI : 1.046-8.344) also increased the risk of pulmonary ventilation dysfunction in the residents with BMI≤24 kg·m−2. IAP > 5 (OR=3.739, 95%CI: 1.147-12.182) was associated with a significantly increased risk of pulmonary ventilation dysfunction in the BMI > 24 kg·m−2 subgroup. Conclusion The pulmonary ventilation function of rural residents in Gansu is poor, which is negatively correlated with indoor air pollution. Coal use, overweight, cooking in bedroom, and use of coal stoves and Chinese Kang for heating may increase the risk of pulmonary ventilation dysfunction, while room ventilation is a beneficial factor.
6.The current situation and its influential factors of social isolation in community elderly patients with knee osteoarthritis
Pingping WEI ; Jianping SUN ; Aihong GAO ; Hongxia WU ; Likun HUANG ; Huiqiong BAI
Chinese Journal of Practical Nursing 2022;38(23):1775-1781
Objective:To investigate the incidence of social isolationin community elderly patients with knee osteoarthritis and analyze its influencing factors.Methods:From January to April 2021, 240 community elderly with knee osteoarthritis in three community health service centers in Taiyuan (Yingbin community, Dawang community and Pingyang second community) were selected as research objects by convenient sampling method. They were investigated by general data questionnaire, Lubben Social Network Scale-6(Lubben-6), Geriatric Depression Scale-15, Perceived Social Support Scale, Numerical Rating Scale. Single factor analysis and binary Logistic regression analysis were used to explore the influencing factors of social isolation in elderly patients with knee osteoarthritis.Results:The prevalence of social isolation among community elderly patients with knee osteoarthritis was 43.33% (104/240) . The results of binary logistic regression analysis showed that age ( OR = 2.228, 95% CI 1.436-3.457), complicated diseases ( OR = 1.733, 95% CI 1.028-2.919), exercise ( OR = 0.560, 95% CI 0.360-0.869), depression ( OR = 3.603, 95% CI 1.768-7.339), comprehension of social support ( OR = 0.424, 95% CI 0.253-0.710) and pain ( OR = 1.792, 95% CI 1.147-2.799) were the influencing factors of social isolation in elderly patients with knee osteoarthritis ( P<0.05). Conclusions:The degree of social isolation in community elderly patients with knee osteoarthritis is relatively high, and is affected by many factors. Community medical staff should formulate targeted nursing intervention plans based on their influencing factors to reduce the occurrence of social isolation.
7.Status and influencing factors of motoric cognitive risk syndrome among the elderly in Taiyuan
Pingping WEI ; Jianping SUN ; Hongxia WU ; Guifang NIU ; Likun HUANG ; Huimin WANG ; Huiqiong BAI ; Xuanxuan LI
Chinese Journal of Modern Nursing 2022;28(15):2036-2042
Objective:To explore the current situation of motoric cognitive risk syndrome (MCR) in the community elderly in Taiyuan and analyze its influencing factors.Methods:From January to April 2021, convenience sampling was used to select 500 elderly people from 5 communities in Taiyuan as the research object. The elderly were investigated with the General Information Questionnaire, Mini-Mental State Examination (MMSE) , simplified Geriatric Depression Scale-15 (GDS-15) , Short-Form Mini Nutritional Assessment (MNA-SF) and Lubben Social Network Scale-6 (Lubben-6) , and 4-meter walk test.Results:A total of 500 questionnaires were distributed, and 492 valid questionnaires were recovered, with a valid recovery rate of 98.40%. The prevalence of MCR among 492 community elderly people in Taiyuan was 11.38% (56/492) . Univariate analysis showed that there were statistically significant differences in the incidence of MCR among the community elderly in Taiyuan with different age, education level, obesity, living alone, number of diseases, diabetes, coronary heart disease, stroke, number of medications, chronic pain, nutritional status, depression and social isolation ( P<0.05) . Logistic regression analysis showed that educational level, obesity, diabetes, chronic pain, nutritional status, depression, and social isolation were the influencing factors of MCR in the elderly in Taiyuan ( P<0.05) . Conclusions:The incidence of MCR among the elderly in Taiyuan is high. Individualized interventions should be formulated according to the influencing factors to prevent or delay the occurrence of MCR in the community elderly.
8.BRICS report of 2020: The bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China
Yunbo CHEN ; Jinru JI ; Chaoqun YING ; Zhiying LIU ; Qing YANG ; Haishen KONG ; Yuanyuan DAI ; Jiliang WANG ; Haifeng MAO ; Hui DING ; Yongyun LIU ; Yizheng ZHOU ; Hong LU ; Youdong YIN ; Yan JIN ; Hongyun XU ; Lixia ZHANG ; Lu WANG ; Haixin DONG ; Zhenghai YANG ; Fenghong CHEN ; Donghong HUANG ; Guolin LIAO ; Pengpeng TIAN ; Dan LIU ; Yan GENG ; Sijin MAN ; Baohua ZHANG ; Ying HUANG ; Liang GUO ; Junmin CAO ; Beiqing GU ; Yanhong LI ; Hongxia HU ; Liang LUAN ; Shuyan HU ; Lin ZHENG ; Aiyun LI ; Rong XU ; Kunpeng LIANG ; Zhuo LI ; Donghua LIU ; Bo QUAN ; Qiang LIU ; Jilu SHEN ; Yiqun LIAO ; Hai CHEN ; Qingqing BAI ; Xiusan XIA ; Shifu WANG ; Jinhua LIANG ; Liping ZHANG ; Yinqiao DONG ; Xiaoyan QI ; Jianzhong WANG ; Xuefei HU ; Xiaoping YAN ; Dengyan QIAO ; Ling MENG ; Yonghong XIAO
Chinese Journal of Clinical Infectious Diseases 2021;14(6):413-426
Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.
9.Construction of early warning evaluation index system for high-risk pregnancy during childbirth
Hui FANG ; Jingxuan YANG ; Hua BAI ; Xiaoyu YANG ; Lixia QU ; Ming ZHAO ; Hongxia CUI
Chinese Journal of Modern Nursing 2021;27(29):3976-3980
Objective:To construct a scientific and reasonable early warning evaluation index system for high-risk pregnancy during childbirth, so as to provide a content framework for the establishment of an information management platform.Methods:Convenience sampling was used to select 15 experts from 2 colleges and universities, 5 ClassⅢ Grade A general hospitals and 2 ClassⅢ Grade A maternal and child health hospitals in Henan Province as the subject of consultation. The early warning evaluation indicators of high-risk pregnancy during childbirth were determined through literature research, group discussion, and Delphi expert consultation method. Convenience sampling method was adopted to select 288 pregnant women admitted to the hospital for delivery from February to April 2020 in a ClassⅢ Grade A hospital in Henan Province as the research object. The early warning evaluation index system for high-risk pregnancy during childbirth was used to evaluate pregnant women.Results:The final early warning evaluation index system for high-risk pregnancy during childbirth included 7 first-level indicators and 27 second-level indicators. The expert authority coefficients of the two rounds of consultation were 0.91 and 0.93, respectively, and the Kendall harmony coefficients were 0.241 and 0.385, respectively ( P<0.001) . The area under the ROC curve predicted by the early warning evaluation index system for high-risk pregnancy during childbirth was> 0.85, and the best cut-off point was 9.98. Conclusions:The constructed early warning evaluation index system for high-risk pregnancy during childbirth has comprehensive content and high reliability, which will help midwives to identify high-risk pregnancy during childbirth.
10.Effect of imatinib on the height of children with chronic myeloid leukemia in the chronic phase
Fangyuan ZHENG ; Yanli ZHANG ; Liqiang ZHANG ; Bingcheng LIU ; Li MENG ; Jie JIN ; Huilan LIU ; Zimin SUN ; Li’e LIN ; Pingchong LEI ; Xiaofan ZHU ; Hongxia MA ; Zesheng LU ; Hua JIANG ; Yanhong ZHAO ; Hai LIN ; Xiong ZHANG ; Ganping YANG ; Huanling ZHU ; Suning CHEN ; Yong YOU ; Weiming LI ; Qingxian BAI ; Xielan ZHAO ; Zhenyu LI ; Xiaomei SHEN ; Leping ZHANG ; Qian JIANG
Chinese Journal of Hematology 2020;41(7):545-551
Objective:To evaluate the effect of imatinib on growth impairment in children with chronic myeloid leukemia (CML-CP) in the chronic phase.Methods:From July 2018 to July 2019, questionnaires were distributed to CML children aged <18 years at the time of diagnosis who were receiving imatinib for at least 3 months or to their parents in China. The height-for-age standard deviation score (HtSDS) and the difference of standard deviation integral (△HtSDS) were used to explore the change in height with imatinib therapy.Results:The data of 238 respondents were included; 138 (58.0% ) respondents were men. The median age at the first diagnosis of CML was 11.0 years (range, 1.4-17.9 years) , and 93 (39.0% ) respondents were at the prepuberty stage. At the time of completing the questionnaires, the median age was 15.0 years (range, 2.0-34.0 years) . The median duration of imatinib therapy was 28 months (range, 3-213 months) . Among all the respondents, the mean HtSDS when completing the questionnaires (-0.063±1.361) was significantly lower than that at the time of starting imatinib treatment (0.391±1.244) ( P<0.001) . Total 71.0% respondents showed growth impairment that was more common in those starting imatinib therapy at prepubertal age than in those starting at pubertal age. Multivariate analysis showed that younger at the start of imatinib therapy ( P<0.001) and longer duration of imatinib therapy ( P<0.001) were significantly associated with severe growth impairment on imatinib therapy. Conclusions:Imatinib induced growth impairment in children with CML-CP. Younger the age of initiation and longer the duration of imatinib therapy, more obvious the effect of imatinib on growth impairment.

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