Objective To explore the diagnostic value of epicardial adipose tissue(EAT)thickness combined with serum disintegrin metalloprotease 10(ADAM10)and stromal interaction molecule 1(STIM1)in coronary heart disease(CHD).Methods A total of 119 CHD patients were included as the study group,and 100 non-CHD patients in the same period were selected as the control group.The clinical data of the patients were collected.Serum ADAM10 and STIM1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Color Doppler ultrasonography was applied to detect EAT thickness.Multivariate Logistic regression was used to analyze influencing factors of CHD occurrence.The diagnostic value of EAT thickness combined with serum ADAM10 and STIM1 levels in the diagnosis of CHD was analyzed by subject work characteristics(ROC)curves.Results The levels of triglycerides,low-density lipoprotein cholesterol(LDL-C),EAT thickness,serum ADAM10 and STIM1 were higher in the study group than those in the control group(P＜0.05).Logistic regression analysis showed that elevated EAT thickness,serum ADAM10,STIM1,triglyceride and LDL-C levels were independent risk factors for the occurrence of CHD(P＜0.05).ROC curve analysis showed that the area under the curve of EAT thickness combined with serum ADAM10 and STIM1 for the diagnosis of CHD[0.864(95%CI:0.811-0.907)]was higher than that of their respective individual diagnoses[0.801(95%CI:0.741-0.851),0.750(95%CI:0.687-0.806),respectively,0.799(95%CI:0.740-0.850)],and the sensitivity and specificity of the combined diagnosis were 82.35%and 83.00%,respectively.Conclusion EAT thickness,serum ADAM10 and STIM1 levels are obviously elevated in CHD patients,and the combination of the three tests has a high diagnostic value for CHD.

Objective To explore the diagnostic value of epicardial adipose tissue(EAT)thickness combined with serum disintegrin metalloprotease 10(ADAM10)and stromal interaction molecule 1(STIM1)in coronary heart disease(CHD).Methods A total of 119 CHD patients were included as the study group,and 100 non-CHD patients in the same period were selected as the control group.The clinical data of the patients were collected.Serum ADAM10 and STIM1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Color Doppler ultrasonography was applied to detect EAT thickness.Multivariate Logistic regression was used to analyze influencing factors of CHD occurrence.The diagnostic value of EAT thickness combined with serum ADAM10 and STIM1 levels in the diagnosis of CHD was analyzed by subject work characteristics(ROC)curves.Results The levels of triglycerides,low-density lipoprotein cholesterol(LDL-C),EAT thickness,serum ADAM10 and STIM1 were higher in the study group than those in the control group(P＜0.05).Logistic regression analysis showed that elevated EAT thickness,serum ADAM10,STIM1,triglyceride and LDL-C levels were independent risk factors for the occurrence of CHD(P＜0.05).ROC curve analysis showed that the area under the curve of EAT thickness combined with serum ADAM10 and STIM1 for the diagnosis of CHD[0.864(95%CI:0.811-0.907)]was higher than that of their respective individual diagnoses[0.801(95%CI:0.741-0.851),0.750(95%CI:0.687-0.806),respectively,0.799(95%CI:0.740-0.850)],and the sensitivity and specificity of the combined diagnosis were 82.35%and 83.00%,respectively.Conclusion EAT thickness,serum ADAM10 and STIM1 levels are obviously elevated in CHD patients,and the combination of the three tests has a high diagnostic value for CHD.

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.

Aim To explore the effect of estimated pulse wave velocity(ePWV)changes on cardiovascular and cerebrovascular events.Methods A total of 61 714 employees who participated in the 2006-2007 physical examina-tion and 2010-2011 physical examination of Kailuan Group were selected as the research subjects.The subjects were di-vided into four groups according to the ePWV values at baseline and at the end of the observation period:sustained normal group,normal-high group,high-normal group and sustained high group,Cox regression model was used to analyze the effect of different changes of ePWV on cardiovascular and cerebrovascular events.Results A total of 3 715(6.02％)cases of cardiovascular and cerebrovascular events occurred after a mean follow-up of(8.52±1.59)years.The incidence density of cardiovascular events was 3.81,10.80,13.54 and 15.85 per 1 000 person-year respectively in the sustained nor-mal group,the normal-high group,the high-normal group and the sustained high group.After adjusting for confounders,the risk of cardiovascular and cerebrovascular events was significantly increased in the normal-high group,the high-normal group and the sustained high group compared with the sustained normal group,the HR(95％CI)were 2.68(2.44～2.95),3.14(2.67～3.69)and 4.03(3.71～4.38),respectively.Conclusion Maintaining normal ePWV can effectively reduce cardiovascular and cerebrovascular events.

Aim To explore the effect of estimated pulse wave velocity(ePWV)changes on cardiovascular and cerebrovascular events.Methods A total of 61 714 employees who participated in the 2006-2007 physical examina-tion and 2010-2011 physical examination of Kailuan Group were selected as the research subjects.The subjects were di-vided into four groups according to the ePWV values at baseline and at the end of the observation period:sustained normal group,normal-high group,high-normal group and sustained high group,Cox regression model was used to analyze the effect of different changes of ePWV on cardiovascular and cerebrovascular events.Results A total of 3 715(6.02％)cases of cardiovascular and cerebrovascular events occurred after a mean follow-up of(8.52±1.59)years.The incidence density of cardiovascular events was 3.81,10.80,13.54 and 15.85 per 1 000 person-year respectively in the sustained nor-mal group,the normal-high group,the high-normal group and the sustained high group.After adjusting for confounders,the risk of cardiovascular and cerebrovascular events was significantly increased in the normal-high group,the high-normal group and the sustained high group compared with the sustained normal group,the HR(95％CI)were 2.68(2.44～2.95),3.14(2.67～3.69)and 4.03(3.71～4.38),respectively.Conclusion Maintaining normal ePWV can effectively reduce cardiovascular and cerebrovascular events.

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.