Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Objective:To investigate the correlation between iodine nutrition level and thyroid function in women in early pregnancy and to analyze the risk factors associated with adverse pregnancy outcomes.Meth-ods:A retrospective analysis of 566 early pregnant women who underwent routine prenatal examinations from Oc-tober 2020 to May 2022 in Peking Union Medical College Hospital.Their general clinical information,urinary iodine concentration and thyroid function were collected to determine the iodine nutritional status of pregnant women in early pregnancy.According to different iodine nutrient levels,they were divided into the iodine deficiency group(UIC＜150 μg/g),iodine beyond appropriate group(250 μg/g ≤ UIC＜500 μg/g),iodine excess group(UIC ≥500 μg/g),iodine appropriate group(150 μg/g≤UIC＜250 μg/g)and iodine nutrition abnormality group(inclu-ding iodine deficiency,iodine beyond appropriate,and iodine excess).The incidence of thyroid disease was com-pared and analyzed.Logistic regression analysis was used to analyze the risk factors of the adverse pregnancy outcomes(including hypertensive disorders in pregnancy,gestational diabetes mellitus,preterm delivery,miscar-riage,and low birth weight infants).Results:①The median urinary iodine/creatinine ratio of the 566 pregnant women in early pregnancy was 99 μg/g,indicating an overall iodine deficiency level.The abnormal rate of iodine nutrition was 82.9％(including 73.0％in iodine deficiency group,7.4％in iodine beyond appropriate group and 2.5％in iodine excess group),but only 17.1％in appropriate group.②There was no significant difference in the incidence of thyroid dysfunction(including hypothyroidism,subclinical hypothyroidism,and simple positive TPO-Ab)among groups with different levels of iodine nutrition(P＞0.05).However,the incidence of thyroid dys-function in pregnant women with iodine nutrition abnormalitieswas higher than that in pregnant women with moder-ate iodine and the difference was statistically significant(20.3％vs.11.3％,x2=4.198,P=0.04).③Multivariate Logistic regression analysis showed that age(≥35 years),body mass index(≥24 kg/m2)and abnormal iodine nutrition were independent risk factors of the adverse pregnancy outcomes(OR＞1,P＜0.05).Conclusions:The rate of abnormal iodine nutrition in early pregnancy is more than 80％,indicating an overall iodine deficiency state Abnormal iodine nutrition is a risk factor of adverse pregnancy outcomes.It is recommended to monitor the iodine nutrition level of pregnant women in early pregnancy,provide iodine supplementation or low iodine diet according to different iodine nutrition levels,correct abnormal iodine nutrition during pregnancy,and strengthen health educa-tion intervention to improve pregnancy outcomes.

Purpose: Tamoxifen showed individual differences in efficacy under different CYP2D6*10 genotypes. Our study evaluated the prognosis of tamoxifen or toremifene in hormone receptor (HR)–positive breast cancer patients under different genotypes. Materials and Methods: CYP2D6*10 genotypes of HR-positive breast cancer patients were determined by Sanger sequencing, and all the patients were divided into tamoxifen group or toremifene group. Results: A total of 268 patients with HR-positive breast cancer were studied. The median follow-up time was 72.0 months (range, 5.0 to 88.0 months). Of these, 88 (32.9%), 114 (42.5%), and 66 (24.6%) patients had C/C, C/T, and T/T genotypes, respectively. Among patients who received tamoxifen (n=176), the 5-year disease-free survival (DFS) rate in patients with C/C and C/T genotype was better than that in patients with T/T genotype, and the difference was statistically significant (p < 0.001 and p=0.030, respectively). In patients receiving toremifene, CYP2D6*10 genotype was not significantly associated with DFS (p=0.325). Regardless of genotypes, the 5-year DFS rate was higher in patients treated with toremifene than in patients with tamoxifen (91.3% vs. 80.0%, p=0.011). Compared with tamoxifen, toremifene remained an independent prognostic marker of DFS in multivariate analysis (hazard ratio, 0.422; p=0.021). For all the 180 patients with CYP2D6*10 C/T and T/T genotypes, the 5-year DFS rate was significantly higher in the toremifene group than in the tamoxifen group (90.8% vs. 70.1%, p=0.003). Conclusion Toremifene may be an alternative adjuvant endocrine therapy for patients with CYP2D6*10 mutant genotypes.