1.Mechanism of different sources of mesenchymal stem cells in treatment of premature ovarian failure
Yanyan LIU ; Yuanyuan MA ; Xianghua HUANG ; Jingkun ZHANG
Chinese Journal of Tissue Engineering Research 2025;29(13):2764-2773
BACKGROUND:A large number of cell and animal tests have confirmed the effect of mesenchymal stem cells on improving ovarian function,and some clinical trials have been completed and their effectiveness has been preliminarily confirmed,bringing hope to women with premature ovarian failure.OBJECTIVE:To summarize and analyze the mechanism,research progress,and related clinical trials of mesenchymal stem cells from different sources in the treatment of premature ovarian failure in recent years,so as to provide a theoretical basis for further research and clinical application of mesenchymal stem cell therapy for premature ovarian failure.METHODS:Using "mesenchymal stem cells,premature ovarian failure" as keywords in Chinese and English,the relevant literature was searched in CNKI,WanFang Data,Chinese Medical Database,and PubMed database,and finally 72 articles that met the requirements were included for review.RESULTS AND CONCLUSION:Currently,there are seven types of commonly used mesenchymal stem cells for premature ovarian failure,which are umbilical cord mesenchymal stem cells,bone marrow mesenchymal stem cells,placental mesenchymal stem cells,menstrual blood mesenchymal stem cells,amniotic mesenchymal stem cells,amniotic fluid mesenchymal stem cells,and adipose mesenchymal stem cells.The mechanisms include inhibiting apoptosis and promoting proliferation,anti-inflammatory and inhibiting oxidative stress,homing,promoting angiogenesis,anti-fibrosis,parasecretory,immune regulation,autophagy,and improving microenvironment.Cell and animal experiments have proven that different sources of mesenchymal stem cells can have better intervention effect on premature ovarian failure through various mechanisms,and delay the progress of premature ovarian failure to a certain extent.If it can be successfully applied to the clinic in the future,it can alleviate the psychological and physical pain of patients to a great extent.However,due to the lack of comprehensive and accurate evidence in clinical studies such as stem cell source,administration mode and dose,adverse reactions,etc.,further studies are still needed to confirm it in the future,and its long-term safety needs to be further observed.
2.Association between hypertension subtypes and risk for all-cause mortality and cardio-cerebrovascular mortality in the elderly in communities of Beijing
Rongrong LI ; Shengshu WANG ; Haowei LI ; Shimin CHEN ; Junhan YANG ; Huaihao LI ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shanshan YANG ; Miao LIU ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):366-375
Objective:To study the association between subtypes of hypertension and risk for all-cause mortality and cardio-cerebrovascular mortalities in the elderly in communities of Beijing.Methods:The data were collected from the Beijing Healthy Aging Cohort Study. The elderly in 5 urban areas (former Xicheng, former Xuanwu, Fangshan, Haidian and Tongzhou) and 4 rural areas (Yanqing, Miyun, Huairou and Daxing) in Beijing were selected as the study subjects by multi-stage stratified cluster random sampling. The baseline survey was conducted from July 2009 to September 2015. The follow-up was conducted until March 31, 2021, and a total of 6 326 participants were enrolled. Cox proportional hazard regression model was used to analyze the association of SBP, DBP, normal blood pressure, high normal blood pressure, simple systolic hypertension, simple diastolic hypertension and systolic diastolic hypertension with all-cause mortality and cardio-cerebrovascular mortality.Results:By March 31, 2021, the median follow-up time was 6.30 years, the all-cause mortality density was 201.67/10 000 person-years, and the cardio-cerebrovascular mortality density was 90.20/10 000 person-years. Multivariate Cox proportional hazard regression model analysis showed that the risk for all-cause mortality increased by 5.6% ( HR=1.056, 95% CI: 1.020-1.092), and the risk for cardio-cerebrovasculvar mortality increased by 12.5% ( HR=1.125, 95% CI: 1.071-1.182) for every 10 mmHg increase in SBP. The risk for all-cause mortality increased by 8.6% ( HR=1.086, 95% CI: 1.023-1.152), and the risk for cardio-cerebrovascular mortality increased by 19.9% ( HR=1.199, 95% CI: 1.101-1.306) for every 10 mmHg increase in DBP. Compared with the normal blood pressure group, the risk for all-cause mortality increased by 64.8% ( HR=1.648, 95% CI: 1.049-2.591) and the risk for cardio- cerebrovascular mortality increased by 112.8% ( HR=2.128, 95% CI: 1.069-4.233) in the simple diastolic hypertension group. The risk for all-cause mortality increased by 34.4% ( HR=1.344, 95% CI: 1.023-1.467) and the risk for cardio-cerebrovascular mortality increased by 111.3% ( HR=2.113, 95% CI: 1.384-3.225) in the systolic-diastolic hypertension group. Conclusions:In the elderly in communities of Beijing, beside systolic-diastolic hypertension. It is necessary to pay close attention to the simple diastolic hypertension, which has lower prevalence, and give targeted prevention and treatment.
3.Association of urinary albumin-to-creatinine ratio and cardiovascular health score with cardio-cerebrovascular mortality and all-cause mortality in urban elderly residents in Beijing
Junhan YANG ; Haowei LI ; Shimin CHEN ; Rongrong LI ; Huaihao LI ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Shanshan YANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shengshu WANG ; Miao LIU ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):385-392
Objective:To investigate the association of urinary albumin-to-creatinine ratio (UACR) in normal range and cardiovascular health (CVH) score with cardio-cerebroascular and all-cause mortality in urban elderly residents in Beijing.Methods:Based on Beijing Healthy Aging Cohort Study, data from 1 817 elderly participants with normal UACR were analyzed, and UACR was used as both continuous and categorical variable. "Life's Essential 8" was used to develop a CVH score. Statistical analysis was performed by using software SPSS 26.0 and R 4.2.1, including two independent samples t-test, χ2 test and non-parametric test. Multivariable Cox proportional hazard regression models stratified by CVH score and the restricted cubic spline were used to analyse the association of UACR with the risk for cardio-cerebrovascular and all-cause mortality. Results:By March 31, 2021, the median follow-up time M ( Q1, Q3) was 11.28 (10.84, 11.36) years, a total of 308 deaths were recorded during follow-up, and the mortality density was 163.87/10 000 person-years. The age of the participants was (71.4±6.6) years, and 1 070 participants were women. The results showed that the risk for both cardio-cerebrovascular disease and all-cause mortality decreased with the decrease of UACR in the low CVH score group ( HR=0.500, 95% CI: 0.341-0.734; HR=0.793, 95% CI: 0.647-0.971), and in the high CVH score group, there was a decreasing trend in the risk for cardio-cerebrovascular mortality with the decrease of UACR ( HR=0.665, 95% CI: 0.447-0.990). Compared with the participants with low CVH score and higher UACR, the risk for cardio-cerebrovascular and all-cause mortality decreased by 68.9% and 45.6%, respectively, in the participants with high CVH score and lower UACR ( HR=0.311, 95% CI: 0.131-0.739; HR=0.544, 95% CI: 0.360-0.822), and the risk for all-cause mortality decreased by 26.7% in the participants with high CVH score and higher UACR ( HR=0.733, 95% CI: 0.542-0.993). Conclusions:In urban elderly residents in Beijing, higher UACR were associated with a significantly increased risk for cardio-cerebrovascular and all-cause mortality, and in the low-CVH score group, decreased UACR was protective factor against cardio-cerebrovascular and all-cause mortality. The combined effect of cardiovascular health status and normal UACR had a greater protection against the risk for cardio-cerebrovascular and all-cause mortality.
4.Association between a body shape index and all-cause mortality in the elderly in communities of Beijing
Huaihao LI ; Shengshu WANG ; Haowei LI ; Rongrong LI ; Shimin CHEN ; Junhan YANG ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Miao LIU ; Shanshan YANG ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):393-401
Objective:To describe and analyze the distribution characteristics of a body shape index (ABSI) and its association with all-cause mortality in the elderly in communities of Beijing.Methods:The baseline and follow-up data of 10 423 subjects in Beijing Healthy Aging Cohort Study were used. The endpoint outcome was all-cause mortality in follow-up. The associations of ABSI, BMI and waist circumference with all-cause mortality were analyzed with a Cox proportional hazard regression model.Results:The mean follow-up time in this cohort was 6.36 years and the all-cause mortality was 15.27%. The restricted cubic spline results showed that ABSI showed a "U" association with all-cause mortality in the total population. After adjustment for confounding factors, compared with the normal ABSI group, the risk for all-cause mortality was higher in the low ABSI group ( HR=1.69, 95% CI: 1.32-2.17) and high ABSI group ( HR=1.75, 95% CI: 1.40-2.18). Compared with the normal BMI group, low BMI was associated with an increased risk for all-cause mortality ( HR=1.70, 95% CI: 1.40-2.08). Compared with the normal waist circumference group, central obesity was associated with a decreased risk for all-cause mortality ( HR=0.89, 95% CI: 0.80-0.99). The results of gender specific analysis on ABSI association with all-cause mortality were similar to that in total population, but the strength of association varied among different age groups. Cross-grouping results showed that older people with normal BMI and waist circumference and abnormal ABSI had an increased risk of all-cause mortality ( HR=1.91, 95% CI: 1.22-2.99). Conclusions:In Beijing, ABSI is correlated with the risk for all-cause mortality in the elderly population, which is more sensitive and specific than the traditional indicators (BMI and waist circumference). They can be used as one of the physical measurement indicators for all-cause mortality risk prediction in the health risk assessment and management in the elderly.
5.Association between physical activity and all-cause mortality in the elderly with different obesity status in Beijing: a prospective cohort study
Yueting SHI ; Junhan YANG ; Huaihao LI ; Shengshu WANG ; Haowei LI ; Shimin CHEN ; Rongrong LI ; Yinghui BAO ; Wenchang WANG ; Shengyan DU ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shanshan YANG ; Miao LIU ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):402-409
Objective:To explore the association between physical activity (PA) level and all-cause mortality in the elderly with different obesity status in Beijing.Methods:The study subjects were from the Cardiovascular and Cognitive Healthy Study in Middle-Aged and Elderly Residents of Beijing, a total of 3 746 individuals aged ≥60 years in the baseline survey between 2013 and 2015 were included in the study. Questionnaire survey and physical examination were conducted to collect the basic information of the individuals. The metabolic equivalent of the elderly was used to calculate the PA level, and an international PA questionnaire was used to determine the PA intensity. BMI, waist-to-height ratio (WHtR) and a body shape index (ABSI) were used to evaluate individuals' obesity status. The distribution of different PA levels under different obesity states was described by using bar chart and cumulative percentage bar chart. Cox proportional hazard regression model was used to analyze the correlation between the level of PA and all-cause mortality risk in different types of obesity status.Results:By December 31, 2019, the median follow-up time was 5.46 years, and the mortality density was 244.55/10 000 person-years. Compared with the individuals in high-PA intensity group, the all-cause mortality risk increased by 41% ( HR=1.41, 95% CI: 1.14-1.76) and 122% ( HR=2.22, 95% CI: 1.76-2.81), respectively, in moderate and low PA intensity groups. Compared with the individuals in high-PA intensity-high-obesity group, based on the BMI, the all-cause mortality risk increased by 85% ( HR=1.85, 95% CI: 1.08-3.16) and 250% ( HR=3.50, 95% CI: 2.01-6.10) in those in moderate-PA intensity-high-obesity group and in low-intensity-high-obesity group. Based on the WHtR, the all-cause mortality risk increased by 53% ( HR=1.53, 95% CI: 1.02-2.29) and 218% ( HR=3.18, 95% CI: 2.09-4.86), respectively, in those with moderate-PA intensity-high-obesity and those with low-PA intensity-high-obesity. According to the ABSI, the all-cause mortality risk increased by 120% in those in low-PA intensity-high-obesity group ( HR=2.20, 95% CI: 1.53-3.18). Based on any one of the indicators BMI, WHtR, or ABSI, there was no significant difference in all-cause mortality risk between high-intensity-moderate-obesity group and high-intensity-low-obesity group (all P>0.05). Conclusions:PA level is closely associated with the all-cause mortality risk in the elderly in communities of Beijing. Increasing PA level can not only reduce the all-cause mortality risk but also reduce even eliminate the excess all-cause mortality risk associated with obesity.
6.Association between remnant cholesterol and cardio-cerebrovascular mortality in the elderly in communities of Beijing
Shengyan DU ; Miao LIU ; Shanshan YANG ; Haowei LI ; Rongrong LI ; Shimin CHEN ; Junhan YANG ; Huaihao LI ; Yueting SHI ; Yinghui BAO ; Wenchang WANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shengshu WANG ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):376-384
Objective:To analyze the association between different lipid indicators and cardio-cerebrovascular mortality in the elderly, identify a better lipid indicator for the risk for cardio-cerebrovascular mortality in the elderly in communities of Beijing.Methods:The elderly aged 60 years and above were selected from the Beijing Healthy Aging Cohort Study from July 2009 to September 2015. Remnant cholesterol (RC) was derived by calculation. The Cox proportional hazard regression models determined the HR and 95% CI incidating the associations of baseline different lipid indicators with cardio-cerebrovascular and all-cause mortality. Results:By March 31, 2021, with a mean follow-up duration of 6.88 years in the study population, a total of 492 cardio-cerebrovascular deaths and 1 056 all-cause deaths wre recorded. The HR values indicating the association between LDL-C, HDL-C, and RC were 0.87 (95% CI: 0.78-0.97), 0.46 (95% CI: 0.35-0.62), and 1.29 (95% CI: 1.14-1.45) for cardio-cerebrovascular mortality, respectively, and 0.93 (95% CI: 0.86-1.00), 0.66 (95% CI: 0.55-0.80) and 1.22 (95% CI: 1.12-1.33) for all-cause mortality. The associations of RC and HDL-C with cardio-cerebrovascular mortality were consistent regardless of hyperlipidemia in the elderly. Subgroup analyses showed that elevated RC was associated with increased risk for cardio-cerebrovascular mortality, and elevated HDL-C was associated with decreased risk for cardio-cerebrovascular mortality in the elderly in different gender, age, smoking status, drinking status, and diabetes status groups in communities of Beijing. Conclusion:RC might be a better potential lipid indicator for the risk for cardio-cerebrovascular mortality in the elderly in communities compared with traditional cholesterol indicator.
7.Survey on nutritional risk of hospitalized patients from 23 hospitals in 12 cities of Jiangsu Province from 2020 to 2021
Tingting YANG ; Wei CHEN ; Xianghua MA ; Yan ZHAO
Chinese Journal of Preventive Medicine 2025;59(10):1648-1654
Objective:To understand the current status and related factors of nutritional risk among hospitalized patients in Jiangsu Province.Methods:A multi-center cluster sampling method was used to select 4 590 hospitalized patients from 23 hospitals in 12 cities of Jiangsu Province from October 2020 to June 2021. Nutritional risk screening was conducted using the Nutritional Risk Screening 2002 scale, and the social demographic characteristics and disease information of the subjects were collected. The multivariate logistic regression model was used to analyze the related factors of nutritional risk among hospitalized patients.Results:The age of patients was (60±14) years, ranging from 18 to 99 years, with 2 640 males (57.5%). The detection rate of nutritional risk was 14.0% (642/4 590). The detection rate of nutritional risk decreased first and then increased with age groups, with the highest rate in the 90-99 age group (45.5%) and the lowest in the 30-39 age group (5.2%). Among different regions, the detection rate was the highest in southern Jiangsu (16.1%) and the lowest in Nanjing (10.8%). Among different cities, the detection rate was the highest in Wuxi (27.8%) and the lowest in Changzhou (9.7%). Among different diseases, the detection rate was the highest in malnutrition-related diseases (22.2%), and no nutritional risk was detected in patients with pregnancy, childbirth and postpartum complications. Multivariate logistic regression model showed that compared with the reference groups of 30-39 years old, Nanjing area, college degree or above, no corresponding diseases and having <2 diseases, 70-79 years old [ OR (95% CI): 4.71 (2.56-8.67)], 80-89 years old [ OR (95% CI): 6.48 (3.36-12.50)], 90-99 years old [ OR (95% CI): 11.12 (3.85-32.06)], 18-29 years old [ OR (95% CI): 3.24(1.52-6.94)], southern Jiangsu [ OR (95% CI): 1.72 (1.32-2.26)], central Jiangsu [ OR (95% CI): 1.67 (1.27-2.21)], northern Jiangsu [ OR (95% CI): 1.37 (1.02-1.83)], never attended school [ OR (95% CI): 1.64 (1.05-2.56)], having tumors [ OR (95% CI): 2.16 (1.66-2.81)], neurological diseases [ OR (95% CI): 1.96 (1.48-2.58)], and having ≥2 diseases [ OR (95% CI): 1.49 (1.13-1.96)] were positively correlated with nutritional risk, while having endocrine, nutritional and metabolic diseases [ OR (95% CI): 0.74 (0.57-0.97)] was negatively correlated with nutritional risk. Conclusion:The detection rate of nutritional risk among hospitalized patients in Jiangsu Province is at a relatively low level in China. Special attention should be paid to the nutritional risk of patients over 70 years old, 18-29 years old, with low educational attainment, tumors, neurological diseases, and having ≥2 diseases.
8.Ghrelin-mediated HO-1/PGC-1α signaling pathway regulates mitochondrial oxidative stress to improve traumatic brain injury in rats
Zhihui ZHAO ; Xiuli ZHAI ; Jing WANG ; Min MA ; Xianghua BAI ; Nan SU
Journal of China Medical University 2025;54(4):351-358
Objective To investigate the protective effect of Ghrelin on traumatic brain injury(TBI)in rats based on the HO-1/PGC-1αsignaling pathway.Methods Thirty SPF male rats were randomly divided into sham,TBI,and Ghrelin groups,with 10 rats in each group.A TBI rat model was established using the Feeney free-fall impingement method.The Ghrelin group was injected by caudal vein at a dose of 20 μg/kg 30 min after modeling,while the sham group was not impinged.After 72 h of modeling,the brain tissues of the rats were col-lected,and the brain water content was measured in order to analyze the severity of brain edema.HE staining was used to observe patho-logical changes in brain tissue.The levels of the oxidative stress factors MDA,SOD,and GSH-Px were determined using ELISA.TUNEL staining was used to detect the apoptosis of the brain cells,and the expression levels of Bcl-2,Bax,caspase-3 and caspase-9 in the brain tissues were detected by Western blotting.Mitochondrial reactive oxygen species(mtROS)in the brain tissues were detected by immuno-fluorescence.Mitochondrial function indicators,including mitochondrial mitogen Mfn 1/2,nuclear respiration factor 1(NRF1),and mito-chondrial transcription factor A(TFAM)were detected by Western blotting.The expression levels of HO-1 and PGC-1α in the brain tis-sues of rats in each group were detected by Western blotting.Twenty TBI model rats treated with Ghrelin were divided into Ghrelin+sh-NC and Ghrelin+sh-HMOX1 group with 10 rats in each group.Rats were treated with Ghrelin and injected with knock-down control(adenovirus 2.5 × 109 pfu)or knock-down HMOX1 adenovirus(2.5 × 109 pfu)via tail vein.Western blotting was used to detect the expressions of HO-1,PGC-1 α,Bcl-2,Bax,caspase-3 and caspase-9 in the brain tissues of the two groups.The levels of MDA,SOD and GSH-Px in brain tissue of two groups were detected by ELISA.Results Compared with the sham group,the pathological injury and brain edema in TBI group were aggravated,the number of brain cell apoptosis increased,the levels of oxidative stress factors SOD and GSH-Px decreased,the level of MDA increased,the level of mtROS in brain tissue decreased,the expressions of Bax,caspase-3 and caspase-9 increased,and the expressions of Mfn1/2,NRF1,TFAM,HO-1 and PGC-1α decreased(P<0.05).Compared with TBI group,the pathological damage of brain tissue in Ghrelin group was improved,the brain edema was alleviated,the number of brain cell apoptosis was reduced,the levels of oxidative stress factors SOD and GSH-Px were increased,the level of MDA was decreased,the mtROS in brain tissue was decreased,the expression of Bcl-2 protein was increased,the expressions of Bax,caspase-3 and caspase-9 protein were decreased,and the expressions of Mfn1/2,NRF1,TFAM,HO-1 and PGC-1α were decreased(P<0.05).Compared with Ghrelin+sh-NC group,the expressions of Bax,caspase-3 and caspase-9,MDA in brain tissue of Ghrelin+sh-HMOX1 group increased,while the levels of SOD and GSH-Px decreased(P<0.05).Conclusion Chrelin has protective effect on TBI in rats,and can inhibit brain tissue injury and apoptosis in rats.Its mechanism may be achieved by regulating mitochondrial oxidative stress through HO-1/PGC-1α signaling pathway.
9.Association between hypertension subtypes and risk for all-cause mortality and cardio-cerebrovascular mortality in the elderly in communities of Beijing
Rongrong LI ; Shengshu WANG ; Haowei LI ; Shimin CHEN ; Junhan YANG ; Huaihao LI ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shanshan YANG ; Miao LIU ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):366-375
Objective:To study the association between subtypes of hypertension and risk for all-cause mortality and cardio-cerebrovascular mortalities in the elderly in communities of Beijing.Methods:The data were collected from the Beijing Healthy Aging Cohort Study. The elderly in 5 urban areas (former Xicheng, former Xuanwu, Fangshan, Haidian and Tongzhou) and 4 rural areas (Yanqing, Miyun, Huairou and Daxing) in Beijing were selected as the study subjects by multi-stage stratified cluster random sampling. The baseline survey was conducted from July 2009 to September 2015. The follow-up was conducted until March 31, 2021, and a total of 6 326 participants were enrolled. Cox proportional hazard regression model was used to analyze the association of SBP, DBP, normal blood pressure, high normal blood pressure, simple systolic hypertension, simple diastolic hypertension and systolic diastolic hypertension with all-cause mortality and cardio-cerebrovascular mortality.Results:By March 31, 2021, the median follow-up time was 6.30 years, the all-cause mortality density was 201.67/10 000 person-years, and the cardio-cerebrovascular mortality density was 90.20/10 000 person-years. Multivariate Cox proportional hazard regression model analysis showed that the risk for all-cause mortality increased by 5.6% ( HR=1.056, 95% CI: 1.020-1.092), and the risk for cardio-cerebrovasculvar mortality increased by 12.5% ( HR=1.125, 95% CI: 1.071-1.182) for every 10 mmHg increase in SBP. The risk for all-cause mortality increased by 8.6% ( HR=1.086, 95% CI: 1.023-1.152), and the risk for cardio-cerebrovascular mortality increased by 19.9% ( HR=1.199, 95% CI: 1.101-1.306) for every 10 mmHg increase in DBP. Compared with the normal blood pressure group, the risk for all-cause mortality increased by 64.8% ( HR=1.648, 95% CI: 1.049-2.591) and the risk for cardio- cerebrovascular mortality increased by 112.8% ( HR=2.128, 95% CI: 1.069-4.233) in the simple diastolic hypertension group. The risk for all-cause mortality increased by 34.4% ( HR=1.344, 95% CI: 1.023-1.467) and the risk for cardio-cerebrovascular mortality increased by 111.3% ( HR=2.113, 95% CI: 1.384-3.225) in the systolic-diastolic hypertension group. Conclusions:In the elderly in communities of Beijing, beside systolic-diastolic hypertension. It is necessary to pay close attention to the simple diastolic hypertension, which has lower prevalence, and give targeted prevention and treatment.
10.Association of urinary albumin-to-creatinine ratio and cardiovascular health score with cardio-cerebrovascular mortality and all-cause mortality in urban elderly residents in Beijing
Junhan YANG ; Haowei LI ; Shimin CHEN ; Rongrong LI ; Huaihao LI ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Shanshan YANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shengshu WANG ; Miao LIU ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):385-392
Objective:To investigate the association of urinary albumin-to-creatinine ratio (UACR) in normal range and cardiovascular health (CVH) score with cardio-cerebroascular and all-cause mortality in urban elderly residents in Beijing.Methods:Based on Beijing Healthy Aging Cohort Study, data from 1 817 elderly participants with normal UACR were analyzed, and UACR was used as both continuous and categorical variable. "Life's Essential 8" was used to develop a CVH score. Statistical analysis was performed by using software SPSS 26.0 and R 4.2.1, including two independent samples t-test, χ2 test and non-parametric test. Multivariable Cox proportional hazard regression models stratified by CVH score and the restricted cubic spline were used to analyse the association of UACR with the risk for cardio-cerebrovascular and all-cause mortality. Results:By March 31, 2021, the median follow-up time M ( Q1, Q3) was 11.28 (10.84, 11.36) years, a total of 308 deaths were recorded during follow-up, and the mortality density was 163.87/10 000 person-years. The age of the participants was (71.4±6.6) years, and 1 070 participants were women. The results showed that the risk for both cardio-cerebrovascular disease and all-cause mortality decreased with the decrease of UACR in the low CVH score group ( HR=0.500, 95% CI: 0.341-0.734; HR=0.793, 95% CI: 0.647-0.971), and in the high CVH score group, there was a decreasing trend in the risk for cardio-cerebrovascular mortality with the decrease of UACR ( HR=0.665, 95% CI: 0.447-0.990). Compared with the participants with low CVH score and higher UACR, the risk for cardio-cerebrovascular and all-cause mortality decreased by 68.9% and 45.6%, respectively, in the participants with high CVH score and lower UACR ( HR=0.311, 95% CI: 0.131-0.739; HR=0.544, 95% CI: 0.360-0.822), and the risk for all-cause mortality decreased by 26.7% in the participants with high CVH score and higher UACR ( HR=0.733, 95% CI: 0.542-0.993). Conclusions:In urban elderly residents in Beijing, higher UACR were associated with a significantly increased risk for cardio-cerebrovascular and all-cause mortality, and in the low-CVH score group, decreased UACR was protective factor against cardio-cerebrovascular and all-cause mortality. The combined effect of cardiovascular health status and normal UACR had a greater protection against the risk for cardio-cerebrovascular and all-cause mortality.

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