Publications by authors named "Chengzhang Liu"

54 Publications

Egg consumption associated with all-cause mortality in rural China: a 14-year follow-up study.

Eur J Public Health 2021 May 5. Epub 2021 May 5.

Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.

Background: Dietary recommendations regarding egg intake remain controversial topic for public health. We hypothesized that there was a positive association between egg consumption and all-cause mortality.

Methods: To test this hypothesis, we enrolled 9885 adults from a community-based cohort in Anhui Province, China during 2003-05. Egg consumption was assessed by food questionnaire. Stratified analyses were performed for age, sex, body mass index (BMI), blood pressure, smoking, drinking and laboratory tests.

Results: After an average follow-up of 14.1 years, 9444 participants were included for analysis. A total of 814 deaths were recorded. Participants' BMI and lipid profile had no significantly difference between three egg consumption groups. BMI was 21.6±2.7 of the whole population, especially BMI>24 was only 17.3%. A bivariate association of egg consumption >6/week with increased all-cause mortality was observed compared with ≤6/week (RR: 1.35, 95% CI: 1.05, 1.73, P = 0.018). A significant interaction was observed for BMI ≥ 21.2 kg/m2 vs. BMI<21.2 kg/m2 (P for interaction: 0.001). No other significant interactions were found.

Conclusions: In this study, consuming >6 eggs/week increased risk of all-cause mortality, even among lean participants, especially who with BMI ≥ 21.2 kg/m2. Eggs are an easily accessible and constitute an affordable food source in underdeveloped regions. Consuming <6 eggs/week may be the most suitable intake mode.
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http://dx.doi.org/10.1093/eurpub/ckaa250DOI Listing
May 2021

Inverse association between dietary vitamin A intake and new-onset hypertension.

Clin Nutr 2021 Apr 18;40(5):2868-2875. Epub 2021 Apr 18.

Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China; National Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China; State Key Laboratory of Organ Failure Research, Guangzhou, 510515, China; Guangdong Provincial Institute of Nephrology, Guangzhou, 510515, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China. Electronic address:

Background & Aims: The prospective relation of dietary vitamin A intake with hypertension remains uncertain. We aimed to investigate the relationship of dietary vitamin A intake with new-onset hypertension and examine possible effect modifiers in general population.

Methods: This prospective cohort study included 12,245 participants who were free of hypertension at baseline from China Health and Nutrition Survey (CHNS). Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up.

Results: During a median follow-up duration of 6.1 years, a total of 4,304 (35.1%) participants developed new-onset hypertension. Overall, there was an L-shaped relation of total dietary vitamin A intake with new-onset hypertension (P for nonlinearity <0.001). Accordingly, compared with participants with lower vitamin A intake (quartile 1, <227.3 μg RE/day), those with higher vitamin A intake (quartile 2-4, ≥227.3 μg RE/day) had a significantly lower risk of new-onset hypertension (adjusted HR, 0.73; 95%CI: 0.63, 0.78). Similar results were found for plant-derived vitamin A intake (adjusted HR, 0.65; 95% CI, 0.61, 0.70) or animal-derived vitamin A intake (adjusted HR, 0.76; 95% CI, 0.70, 0.82).

Conclusions: There was a L-shaped relation of dietary vitamin A intake with new-onset hypertension in general Chinese adults. Our results emphasized the importance of maintaining relatively higher vitamin A intake levels for the prevention of hypertension.
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http://dx.doi.org/10.1016/j.clnu.2021.04.004DOI Listing
April 2021

Association of estimated glomerular filtration rate from serum creatinine and cystatin C with new-onset diabetes: a nationwide cohort study in China.

Acta Diabetol 2021 Apr 28. Epub 2021 Apr 28.

National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

Aims: The association between estimated glomerular filtration rate (eGFR) and the risk of diabetes remains uncertain. We aimed to examine the association between eGFR based on creatinine (eGFRcr), cystatin C (eGFRcys), or a combination of both (eGFRcr-cys) and new-onset diabetes, using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative cohort study.

Methods: A total of 4,775 participants with pertinent measurements and without diabetes at baseline from CHARLS were included in the final analysis. The eGFR was calculated by creatinine, cystatin C or a combination of both using the Chronic Kidney Disease Epidemiology Collaboration equations. The study outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 126 mg/dL, random glucose ≥ 200 mg/dL, or HbA1c ≥ 6.5% (48 mmol/mol) at the exit visit.

Results: The mean age of the study population was 59.6 years. The mean values for the eGFRcr, eGFRcys, and eGFRcr-cys were 92.4, 78.9 and 85.9 mL/min/1.73m, respectively. Over 4 years of follow-up, 612 (12.8%) participants experienced diabetes. Participants with lower eGFRcr-cys (< 60 mL/min/1.73m) had a significantly higher risk of new-onset diabetes (adjusted OR, 1.46; 95%CI: 1.02, 2.09), compared to those with eGFRcr-cys ≥ 60 mL/min/1.73m. However, there was no significant association between eGFRcr (< 60 vs. ≥ 60 mL/min/1.73m; adjusted OR, 1.27; 95%CI: 0.75, 2.17) or eGFRcys (adjusted OR, 1.04; 95%CI: 0.80, 1.36) and new-onset diabetes.

Conclusions: Lower eGFRcr-cys (< 60 mL/min/1.73m), but not eGFRcr or eGFRcys, was significantly associated with an increased risk of new-onset diabetes in Chinese adults.
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http://dx.doi.org/10.1007/s00592-021-01719-5DOI Listing
April 2021

Association of visceral adiposity index with new-onset type 2 diabetes and impaired fasting glucose in hypertensive Chinese adults.

Eat Weight Disord 2021 Apr 12. Epub 2021 Apr 12.

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, 510515, China.

Purpose: Visceral adiposity index (VAI) is a reliable indicator for the distribution and function of adipose tissue in the body. The relation of VAI with new-onset type 2 diabetes and new-onset impaired fasting glucose (IFG) remains uncertain. We aimed to investigate the prospective relation of VAI with new-onset type 2 diabetes and new-onset IFG in Chinese hypertensive adults.

Methods: A total of 14,838 hypertensive adults free of type 2 diabetes at baseline were included from the China Stroke Primary Prevention Trial. The primary outcome was new-onset type 2 diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary outcome was new-onset IFG, defined as fasting glucose < 6.1 mmol/L at baseline, while fasting glucose ≥ 6.1 mmol/L and < 7.0 mmol/L at the exit visit.

Results: Over a median of 4.5 years' follow-up, 1612 (10.9%) participants developed type 2 diabetes. When VAI was categorized into quartiles, compared with participants in quartile 1-3 (< 2.80), significantly higher risk of new-onset type 2 diabetes (OR 1.30; 95% CI 1.08-1.56) and new-onset IFG (OR 1.28; 95% CI 1.08-1.52) was found in those in quartile 4 (≥ 2.80). Moreover, the positive associations were consistent in participants with or without single abnormal VAI components, including general obesity, abdominal obesity, elevated triglycerides and low high-density lipoprotein cholesterol (HDL-C) levels; or with different numbers of abnormal VAI components (all P interactions > 0.05).

Conclusion: Our study suggested a positive relation of VAI with the risk of new-onset type 2 diabetes and new-onset IFG in Chinese hypertensive patients, independent of its components.

Level Of Evidence: Level III, a well-designed cohort.
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http://dx.doi.org/10.1007/s40519-021-01187-4DOI Listing
April 2021

Prospective association between baseline plasma zinc concentration and development of proteinuria in Chinese hypertensive patients.

J Trace Elem Med Biol 2021 Apr 2;66:126755. Epub 2021 Apr 2.

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China. Electronic address:

Objective: We aimed to evaluate the association between baseline plasma zinc and the development of proteinuria as well as possible effect modifiers in hypertensive patients.

Methods: This is a subset of the China Stroke Primary Prevention Trial (CSPPT) Renal Sub-Study. In the CSPPT, participants were randomized to receive a daily oral dose of 1 tablet containing 10 mg enalapril and 0.8 mg folic acid or 1 tablet containing 10 mg enalapril only. A total of 783 participants with plasma zinc measurements and without proteinuria at baseline were included in the current study. The study outcome was the development of proteinuria during the follow-up, defined as a urine dipstick reading of trace or ≥1+ at the exit visit.

Results: During a median follow-up duration of 4.4 years, the development of proteinuria occurred in 93 (11.9 %) participants. There was an inverse relation of baseline plasma zinc with the development of proteinuria (per SD increment; OR, 0.74, 95 % CI: 0.55-0.99), p for trend of quartiles = 0.005.

Conclusions: In Chinese hypertensive patients, there was a significant inverse association between baseline plasma zinc and the development of proteinuria, although plasma zinc remained in the reference range.
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http://dx.doi.org/10.1016/j.jtemb.2021.126755DOI Listing
April 2021

MiR-92 Family Members Form a Cluster Required for Notochord Tubulogenesis in Urochordate .

Genes (Basel) 2021 Mar 12;12(3). Epub 2021 Mar 12.

Sars-Fang Centre, MoE Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao 266003, China.

MicroRNAs are frequently clustered in the genome and polycistronically transcribed, regulating targeted genes in diverse signaling pathways. The miR-17-92 cluster is a typical miRNA cluster, playing crucial roles in the organogenesis and homeostasis of physiological processes in vertebrates. Here, we identified three miRNAs (csa-miR-92a, csa-miR-92b, and csa-miR-92c) that belonged to the miR-92 family and formed a miRNA cluster in the genome of a urochordate marine ascidian . Except for miR-92a and miR-92b, other homologs of the vertebrate miR-17-92 cluster members could not be identified in the genome. We further found that the mature sequences of urochordate miR-92 family members were highly conserved compared with the vertebrate species. The expression pattern revealed that three miR-92 family members had consistent expression levels in adult tissues and were predominantly expressed in heart and muscle tissue. We further showed that, at the embryonic and larval stages, csa-miR-92c was expressed in the notochord of embryos during 18-31 h post fertilization (hpf) by in situ hybridization. Knockout of csa-miR-92c resulted in the disorganization of notochord cells and the block of lumen coalescence in the notochord. Fibroblast growth factor (FGF), mitogen-activated protein kinase (MAPK), and wingless/integrated (Wnt)/planar cell polarity (PCP) signaling pathways might be involved in the regulatory processes, since a large number of core genes of these pathways were the predicted target genes of the miR-92 family. Taken together, we identified a miR-92 cluster in urochordate and revealed the expression patterns and the regulatory roles of its members in organogenesis. Our results provide expression and phylogenetic data on the understanding of the miR-92 miRNA cluster's function during evolution.
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http://dx.doi.org/10.3390/genes12030406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001136PMC
March 2021

Simple sequence repeats drive genome plasticity and promote adaptive evolution in penaeid shrimp.

Commun Biol 2021 Feb 11;4(1):186. Epub 2021 Feb 11.

CAS Key Laboratory of Experimental Marine Biology, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China.

Simple sequence repeats (SSRs) are rare (approximately 1%) in most genomes and are generally considered to have no function. However, penaeid shrimp genomes have a high proportion of SSRs (>23%), raising the question of whether these SSRs play important functional and evolutionary roles in these SSR-rich species. Here, we show that SSRs drive genome plasticity and adaptive evolution in two penaeid shrimp species, Fenneropenaeus chinensis and Litopenaeus vannamei. Assembly and comparison of genomes of these two shrimp species at the chromosome-level revealed that transposable elements serve as carriers for SSR expansion, which is still occurring. The remarkable genome plasticity identified herein might have been shaped by significant SSR expansions. SSRs were also found to regulate gene expression by multi-omics analyses, and be responsible for driving adaptive evolution, such as the variable osmoregulatory capacities of these shrimp under low-salinity stress. These data provide strong evidence that SSRs are an important driver of the adaptive evolution in penaeid shrimp.
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http://dx.doi.org/10.1038/s42003-021-01716-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878876PMC
February 2021

Neutrophil counts and the risk of first stroke in general hypertensive adults.

Hypertens Res 2021 Feb 9. Epub 2021 Feb 9.

National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

We aimed to investigate the association between neutrophil counts and first stroke and examine possible effect modifiers among treated hypertensive adults. This is a post hoc analysis of the China Stroke Primary Prevention Trial (CSPPT). A total of 11,878 hypertensive adults with data on neutrophil counts at baseline were included in the current study. The primary outcome was first stroke. During a median follow-up of 4.5 years, 414 (3.5%) participants experienced a first stroke, including 358 with ischemic stroke, 55 with hemorrhagic stroke and one with uncertain type of stroke. Compared with participants in quartile 1 (<2.9 × 10/L) of neutrophil counts, those in the upper quartiles (quartile 2-4 [≥2.9 × 10/L]) had a significantly higher risk of first stroke (HR, 1.35; 95% CI: 1.02, 1.78) or first ischemic stroke (HR, 1.38; 95% CI: 1.02, 1.86). Moreover, a strong positive association between neutrophil counts and first ischemic stroke was found in participants with total homocysteine (tHcy) levels <15 μmol/L (HR, 1.74; 95% CI: 1.17, 2.58; vs. ≥15 μmol/L; HR, 0.91; 95% CI: 0.57, 1.46, P interaction = 0.042) at baseline or time-averaged mean arterial pressure (MAP) ≥102 mmHg (median) (HR, 1.92; 95% CI: 1.27, 2.89; vs. <102 mmHg; HR, 0.89; 95% CI: 0.57, 1.41, P interaction = 0.015) during the treatment period. However, no such association between neutrophil counts and first hemorrhagic stroke was found. In summary, high baseline neutrophil counts were associated with an increased risk of first ischemic stroke among hypertensive patients, especially in those with low tHcy at baseline or high time-averaged MAP during the treatment period.
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http://dx.doi.org/10.1038/s41440-021-00625-1DOI Listing
February 2021

Relationship of several serum folate forms with the risk of mortality: A prospective cohort study.

Clin Nutr 2021 Jan 27. Epub 2021 Jan 27.

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China. Electronic address:

Objective: We aim to examine the relation of several folate forms (5-methyltetrahydrofolate [5-mTHF], unmetabolized folic acid [UMFA], non-methyl folate, and MeFox [pyrazino-s-triazine derivative of 4α-hydroxy-5-methyltetrahydrofolate]) with the risk of mortality.

Methods: Using data from National Health and Nutrition Examination Survey 2011-2014, a total of 10,661 people with folate forms data were recruited. Death information was obtained from the National Death Index until 2015. Cox proportional hazards regression models were developed to evaluate the relationship between folate forms and mortality.

Results: During 2.99 years of follow-up, 344 (2.6%) deaths occurred. Overall, significantly higher risks of all-cause mortality were found in participants with higher level of serum 5-mTHF (≥51.3 nmol/L [quartile 4] vs. 23.9-51.3 nmol/L [quartile 2-3]; HR, 1.61; 95% CI: 1.03-2.53), UMFA (≥1.1 nmol/L [quartile 4] vs. <1.1 nmol/L [quartile 1-3]; HR, 1.55; 95% CI: 1.15-2.09), non-methyl folate (≥1.7 nmol/L [quartile 4] vs. 1.2-1.7 nmol/L [quartile 3]; HR, 1.62; 95% CI: 1.06-2.48), or MeFox (≥2.5 nmol/L [quartile 4] vs. <2.5 nmol/L [quartile 1-3]; HR, 1.54; 95% CI: 1.11-2.12). In addition, there was an increased risk of all-cause mortality for those with low level of serum 5-mTHF (<23.9 nmol/L [quartile 1] vs. 23.9-51.3 nmol/L [quartile 2-3]; HR, 1.66; 95% CI: 1.12-2.47). Most importantly, none of any folate forms significantly modified the association between other folate forms and mortality (all P for interactions >0.05).

Conclusion: Higher levels of serum folate forms (5-mTHF, UMFA, non-methyl folate, and MeFox) were associated with higher risk of mortality while 5-mTHF insufficiency also showed a negative impact on mortality. Our findings emphasized the importance of monitoring the folate forms concentrations and may help counsel future related clinical trials.
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http://dx.doi.org/10.1016/j.clnu.2021.01.025DOI Listing
January 2021

Dietary Carbohydrate Intake and New-Onset Hypertension: A Nationwide Cohort Study in China.

Hypertension 2021 Feb 8:HYPERTENSIONAHA12016751. Epub 2021 Feb 8.

From the Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, China (Q.L., C.L., Y.Z., P.H., Z.Z., M.L., C.Z., Z.Y., Q.W., H.L., X.Q.).

The association between carbohydrate intake and the risk of hypertension remains uncertain. We aimed to evaluate the prospective relations of the amount and type of carbohydrate intake with new-onset hypertension. A total of 12 177 adults who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by physician or under antihypertensive treatment during the follow-up. A total of 4269 subjects developed hypertension during 95 157 person-years of follow-up. Overall, there was a U-shaped association between the percentage energy consumed from total carbohydrate (mean, 56.7%; SD, 10.7) and new-onset hypertension ( for nonlinearity <0.001), with the lowest risk observed at 50% to 55% carbohydrate intake. The increased risks were mainly found in those with lower intake of high-quality carbohydrate (mean, 6.4%; SD, 5.6) or higher intake of low-quality carbohydrate (mean, 47.0%; SD, 13.0). Moreover, there was an inverse association between the plant-based low-carbohydrate scores for low-quality carbohydrate and new-onset hypertension. However, there was a U-shaped association between the animal-based low-carbohydrate scores for low-quality carbohydrate and new-onset hypertension ( for nonlinearity <0.001). In summary, both high and low percentages of carbohydrate diets were associated with increased risk of new-onset hypertension, with minimal risk at 50% to 55% carbohydrate intake. Our findings support the intake of high-quality carbohydrate, and the substitution of plant-based products for low-quality carbohydrate for prevention of hypertension.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.16751DOI Listing
February 2021

Relation of BMI and waist circumference with the risk of new-onset hyperuricemia in hypertensive patients.

QJM 2021 Jan 24. Epub 2021 Jan 24.

Institute of Biomedicine, Anhui Medical University, Hefei, China.

Background: We aimed to evaluate the relationship of body mass index (BMI) and waist circumference (WC) with the risk of new-onset hyperuricemia, and examine possible effect modifies in general hypertensive patients.

Methods: A total of 10,611 hypertensive patients with normal uric acid (UA) concentrations (<357μmol/L) at baseline were included from the UA Sub-study of the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset hyperuricemia, defined as a UA concentration ≥417μmol/L in men or ≥ 357μmol/L in women at the exit visit.

Results: During a median follow-up duration of 4.4 years, 1663 (15.7%) participants developed new-onset hyperuricemia. When analyzed separately, increased BMI (≥25 kg/m2, quartile 3-4; OR, 1.46; 95% CI: 1.29-1.65), or increased WC (≥85cm for females, quartile 3-4; OR, 1.24; 95% CI: 1.08-1.42; and ≥84cm for males, quartile 3-4; OR, 1.30; 95% CI: 1.01-1.67) were each significantly associated with higher risk of new-onset hyperuricemia. When WC was forced into the model with BMI simultaneously, its significant association with new-onset hyperuricemia disappeared in females (<85 versus ≥85cm; OR, 0.96, 95% CI: 0.81-1.13) or males (≥84 versus <84cm; OR, 1.13; 95%CI: 0.84-1.52); however, BMI was still significantly related with new-onset hyperuricemia (≥25 versus <25kg/m2; OR, 1.48; 95%CI: 1.27-1.73). Moreover, the positive BMI & new-onset hyperuricemia association was more pronounced in participants with higher time-averaged on-treatment SBP (median: <138.3 versus ≥138.3 mmHg; P-interaction = 0.041).

Conclusions: Higher BMI, but not WC, is significantly and independently associated with an increased risk of new-onset hyperuricemia among hypertensive patients.
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http://dx.doi.org/10.1093/qjmed/hcaa346DOI Listing
January 2021

Evaluation of Dietary Niacin and New-Onset Hypertension Among Chinese Adults.

JAMA Netw Open 2021 01 4;4(1):e2031669. Epub 2021 Jan 4.

National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Importance: The relationship of dietary niacin intake with the risk of hypertension remains unknown.

Objective: To determine the prospective association between dietary niacin intake and new-onset hypertension, and examine factors that may modify the association among Chinese adults.

Design, Setting, And Participants: This nationwide cohort study of 12 243 Chinese adults used dietary intake data from 7 rounds of the China Health and Nutrition Survey. Dietary intake was measured by 3 consecutive 24-hour dietary recalls from participants in combination with a weighing inventory taken over the same 3 days at the household level. Statistical analysis was conducted from May 2020 to August 2020.

Exposures: Dietary intake.

Main Outcomes And Measures: The study outcome was new-onset hypertension, defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater, diagnosis by physician, or current antihypertensive treatment during the follow-up.

Results: The mean (SD) age of the study population was 41.2 (14.2) years, and 5728 (46.8%) of participants were men. The mean (SD) dietary niacin intake level was 14.8 (4.1) mg/d. A total of 4306 participants developed new-onset hypertension during a median (interquartile range) follow-up duration of 6.1 (3.6-11.3) years. When dietary niacin was assessed in quartiles, the lowest risk of new-onset hypertension was found in participants in quartile 3 (14.3 to <16.7 mg/d; adjusted hazard ratio, 0.83; 95% CI, 0.75-0.90) compared with those in quartile 1 (<12.4 mg/d). Consistently in the threshold analysis, for every 1 mg/d increase in dietary niacin, there was a 2% decrease in new-onset hypertension (adjusted HR, 0.98; 95% CI, 0.96-1.00) in those with dietary niacin intake less than 15.6 mg/d, and a 3% increase in new-onset hypertension (adjusted HR, 1.03; 95% CI, 1.02-1.04) in participants with dietary niacin 15.6 mg/d or greater. Based on these results, there was a J-shaped association between dietary niacin intake and new-onset hypertension in the general population of Chinese adults, with an inflection point at 15.6 mg/d and a minimal risk at 14.3 to 16.7 mg/d (quartile 3) of dietary niacin intake.

Conclusions And Relevance: The results of this study provide some evidence for maintaining the optimal dietary niacin intake levels for the primary prevention of hypertension.
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http://dx.doi.org/10.1001/jamanetworkopen.2020.31669DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788463PMC
January 2021

Plasma 25-Hydroxyvitamin D3 Concentrations and Risk of New-Onset Proteinuria in Patients With Hypertension.

J Ren Nutr 2020 Dec 9. Epub 2020 Dec 9.

Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China. Electronic address:

Objective: We aimed to evaluate the relationship of plasma 25-hydroxyvitamin D3 (25[OH]D3) with the risk of new-onset proteinuria and examine the possible effect modifiers in patients with hypertension and without chronic kidney disease at baseline.

Methods: This is a post hoc analysis of the renal substudy of the China Stroke Primary Prevention Trial. A total of 1655 patients with hypertension, who had plasma 25(OH)D3 measurements, as well as without proteinuria and with an estimated glomerular filtration rate of ≥60 mL/min/1.73 m at baseline, were included in the present study. The main outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit.

Results: The mean (standard deviation) 25(OH)D3 level at baseline was 18.6 (7.5) ng/mL. The median follow-up duration was 4.4 years. Overall, there was a significant inverse association between plasma 25(OH)D3 and the risk of new-onset proteinuria (per standard deviation increment; [odds ratio] OR: 0.70; 95% confidence interval [CI]: 0.50, 0.97). Accordingly, when 25(OH)D3 was assessed as quartiles, a significantly lower risk of new-onset proteinuria was found in participants in quartiles 3-4 (≥17.8 ng/mL; OR: 0.45; 95% CI: 0.23, 0.87), compared with those in quartile 1 (<13.1 ng/mL). Furthermore, a stronger inverse relationship of plasma 25(OH)D3 and new-onset proteinuria was observed in nondiabetic participants (per standard deviation increment; OR: 0.57; 95% CI: 0.39, 0.83; vs. diabetics: OR: 1.48; 95% CI: 0.67, 3.28; P for interaction = 0.028).

Conclusion: There was a significant inverse association between plasma 25(OH)D3 and the risk of proteinuria in patients with hypertension, especially in those without diabetes.
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http://dx.doi.org/10.1053/j.jrn.2020.09.005DOI Listing
December 2020

Plasma Magnesium Concentrations and Risk of Incident Cancer in Adults with Hypertension: A Nested Case-Control Study.

Ann Nutr Metab 2020 3;76(5):304-312. Epub 2020 Dec 3.

Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.

Objective: The association between plasma magnesium and risk of incident cancer remains inconclusive in previous studies. We aimed to investigate the prospective relationship of baseline plasma magnesium concentrations with the risk of incident cancer and to examine possible effect modifiers.

Methods: A nested case-control study with 228 incident cancer cases and 228 matched controls was conducted using data from the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, controlled trial, conducted from May 2008 to August 2013. Study outcomes included incident cancer and its subtypes.

Results: When plasma magnesium concentrations were assessed as quartiles, a significantly higher incident risk of total cancer was found in participants in quartile 1 (<0.76 mmol/L; odds ratio [OR] = 2.70; 95% CI: 1.33-5.49) and quartile 4 (≥0.89 mmol/L; OR = 2.05; 95% CI: 1.12-3.76), compared with those in quartile 3 (0.83 to <0.89 mmol/L). In cancer site-specific analyses, similar trends were found for gastrointestinal cancer, esophageal cancer, gastric cancer, breast cancer, lung cancer, and other cancers. Furthermore, none of the variables, including age, sex, current smoking status, current alcohol intake, BMI, systolic blood pressure, and total cholesterol levels at baseline significantly modified the association between plasma magnesium and cancer risk.

Conclusions: Both low and high plasma magnesium concentrations were significantly associated with an increased incident risk of cancer, compared with the reference concentrations of 0.83 to <0.89 mmol/L among hypertensive adults.
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http://dx.doi.org/10.1159/000510214DOI Listing
December 2020

Relationship of Weight Change Patterns From Young to Middle Adulthood With Incident Cardiovascular Diseases.

J Clin Endocrinol Metab 2021 Jan;106(2):e812-e823

Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China.

Context: The effect of weight change patterns on cardiovascular diseases (CVD) remains uncertain.

Objective: We aim to examine the relation of weight change patterns and absolute weight change from young adulthood to midlife with incident CVD.

Design: Retrospective cohort study.

Setting: National Health and Nutrition Examination Survey 1999-2016.

Participants: A total of 20 715 US adults aged 40 through 79 with recalled weight at young adulthood (25 years) and midlife (10 years before baseline).

Main Outcome Measure: CVD status was determined by self-report of a prior diagnosis, and age at diagnosis was used to establish time of CVD onset. CVD events was defined as the first occurrence of a congestive heart failure, coronary heart disease, angina pectoris, heart attack, or stroke.

Results: After 9.76 years of follow-up, compared with participants who remained at normal weight, those in maximum overweight, changing from nonobese to obese, changing from obese to nonobese, maintaining obesity between young and middle adulthood had a 39% (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.19-1.62), 93% (HR, 1.93; 95% CI, 1.64-2.28), 125% (HR, 2.25; 95% CI, 1.29-3.94), and 132% (HR, 2.32; 95% CI, 1.68-3.20) higher risk of CVD, respectively. In addition, compared with weight change within 2.5 kg, weight gain ≥ 10.0 kg was associated with higher risk of CVD.

Conclusions: Both nonobese to obese, obese to nonobese, and stable obese from young to middle adulthood were associated with increased risks of CVD. The findings emphasize the importance of maintaining normal weight throughout the adulthood for preventing CVD in later life.
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http://dx.doi.org/10.1210/clinem/dgaa823DOI Listing
January 2021

Inverse Association Between Riboflavin Intake and New-Onset Hypertension: A Nationwide Cohort Study in China.

Hypertension 2020 12 2;76(6):1709-1716. Epub 2020 Nov 2.

From the Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, China (M.L., C.Z., Z.Z., P.H., Y.Z., H.L., C.L., X.Q.).

The prospective relation of dietary riboflavin intake with hypertension remains uncertain. We aimed to investigate the relationship of dietary riboflavin intake with new-onset hypertension and examine possible effect modifiers in general population. A total of 12 245 participants who were free of hypertension at baseline from China Health and Nutrition Survey were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by physician or under antihypertensive treatment during the follow-up. A total of 4303 (35.1%) subjects developed hypertension during 95 573 person-years of follow-up. Overall, there was a nonlinear, inverse association between total, plant-based, or animal-based riboflavin intake and new-onset hypertension (all for nonlinearity, <0.001). The risk of new-onset hypertension was increased only in participants with relatively lower riboflavin intake. Accordingly, a significantly lower risk of new-onset hypertension was found in participants in quartiles 2 to 4 of total riboflavin intake (hazard ratio, 0.74 [95% CI, 0.68-0.80]), plant-derived riboflavin intake (hazard ratio, 0.77 [95% CI, 0.71-0.84]), or animal-derived riboflavin intake (hazard ratio, 0.70 [95% CI, 0.65-0.77]), compared with those in quartile 1. In addition, the association between total riboflavin intake and new-onset hypertension was particularly evident in those with lower dietary sodium/potassium intake ratio ( interaction, <0.001). In summary, there was an inverse association between riboflavin intake and new-onset hypertension in general Chinese adults. Our results emphasized the importance of maintaining relatively higher riboflavin intake levels for the prevention of hypertension.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.16211DOI Listing
December 2020

Vitamin B and risk of diabetes: new insight from cross-sectional and longitudinal analyses of the China Stroke Primary Prevention Trial (CSPPT).

BMJ Open Diabetes Res Care 2020 10;8(1)

Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China

Introduction: Previous studies in mostly Western populations have yielded conflicting findings on the association of vitamin B with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B-diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses.

Research Design And Methods: This report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit.

Results: At baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B deficiency (<148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B measurements, we found a positive association between an increase in vitamin B and an increase in FBG.

Conclusions: In this large Chinese population of patients with hypertension mostly sufficient with vitamin B, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B and its longitudinal trajectory in order to better elucidate the role of vitamin B in the development of diabetes. Such findings would have important clinical and public health implications.
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http://dx.doi.org/10.1136/bmjdrc-2020-001423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539576PMC
October 2020

Serum folate modified the association between low-density lipoprotein cholesterol and carotid intima-media thickness in Chinese hypertensive adults.

Nutr Metab Cardiovasc Dis 2020 11 24;30(12):2303-2311. Epub 2020 Jul 24.

Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China. Electronic address:

Background And Aims: While folate is known for its importance in cardiovascular health, it is unknown whether folate status can modify the association between low-density lipoprotein cholesterol (LDL-C) and carotid intima-media thickness (CIMT). We aimed to investigate this question in a Chinese hypertensive population, who are at high-risk of low folate and atherosclerosis.

Methods And Results: This report included 14,970 hypertensive adults (mean age 64.5 years; 40.3% male) from the China Stroke Primary Prevention Trial (CSPPT) and analyzed the fasting serum LDL-C and folate, and CIMT data obtained at the last follow-up visit. LDL-C was calculated using the Friedewald equation. Serum folate levels were measured by chemiluminescent immunoassay. CIMT was measured by ultrasound. Non-parametric smoothing plots, multivariate linear regression analysis, subgroup analyses and interaction testing were performed to examine the LDL-C-CIMI relationship and effect modification by folate. Consistent with graphic plots, multivariate linear regression showed that LDL-C levels were independently and positively associated with CIMT (β = 7.69, 95%CI: 5.76-9.62). More importantly, the relationship between LDL-C and CIMT was significantly attenuated with increasing serum folate levels (1st tertile: β = 10.06, 95%CI: 6.67-13.46; 2nd tertile: β = 6.81, 95%CI: 3.55-10.07; 3rd tertile: β = 5.96, 95%CI: 2.55-9.36; P-interaction = 0.045). Subgroup analyses showed the association between LDL-C and CIMT across serum folate tertiles was robust among various strata (all P-interaction >0.05).

Conclusions: Among Chinese hypertensive adults, the serum folate levels could modify the association between LDL-C and CIMT. Our findings, if further confirmed, have important clinical implications.
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http://dx.doi.org/10.1016/j.numecd.2020.07.021DOI Listing
November 2020

Adaptation and molecular evidence for convergence in decapod crustaceans from deep-sea hydrothermal vent environments.

Mol Ecol 2020 10 11;29(20):3954-3969. Epub 2020 Sep 11.

CAS Key Laboratory of Experimental Marine Biology, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China.

Hydrothermal vents are unique deep-sea environments exhibiting extreme temperature gradients and toxic concentrations of H S that limit the growth of biological communities. Notably, some decapod crustaceans are the dominant organisms inhabiting these environments, and share similar phenotypic and physiological traits, such as white body coloration and chemosynthetic capacity. However, a lack of genomic information has precluded an understanding of these convergent phenotypes. Here, comparative transcriptomic analyses were performed in 14 decapod species, including four deep-sea hydrothermal vent species and 10 shallow-water relatives. Phylogenetic analysis suggested that the four deep-sea species stemmed from different ancestors despite being geographically close, and therefore their similar traits were probably the product of convergent evolution rather than lineal inheritance. A total of 391 positively selected genes, 109 parallel substituted genes and 33 significantly expanded gene families were identified in the deep-sea decapods. Among these, only the SNARE interactions in vesicular transport pathway was significantly enriched, with both positively selected genes and parallel substituted genes, suggesting that specific macromolecule transport might be a strong convergent evolution trait in deep-sea decapods. Furthermore, many genes involved in protein synthesis, processing and energy metabolism were detected under convergent evolution, suggesting a role for adaptive evolution in association with a specific metabolic pathway in response to chemosynthetic nutrition patterns. Moreover, our study suggests that convergently evolved white body colour might have resulted from the contraction of the crustacyanin gene family and the low content of astaxanthin in the body of deep-sea decapods. Therefore, this study provides valuable genetic evidence for convergent evolution in deep-sea decapods.
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http://dx.doi.org/10.1111/mec.15610DOI Listing
October 2020

Degree of Blood Pressure Control and Incident Diabetes Mellitus in Chinese Adults With Hypertension.

J Am Heart Assoc 2020 08 5;9(16):e017015. Epub 2020 Aug 5.

National Clinical Research Center for Kidney Disease State Key Laboratory for Organ Failure Research Division of Nephrology Nanfang HospitalSouthern Medical University Guangzhou China.

Background The association between blood pressure (BP) control and incident diabetes mellitus remains unknown. We aim to investigate the association between degree of time-averaged on-treatment systolic blood pressure (SBP) control and incident diabetes mellitus in hypertensive adults. Methods and Results A total of 14 978 adults with hypertension without diabetes mellitus at baseline were included from the CSPPT (China Stroke Primary Prevention Trial). Participants were randomized double-masked to daily enalapril 10 mg and folic acid 0.8 mg or enalapril 10 mg alone. BP measurements were taken every 3 months after randomization. The primary outcome was incident diabetes mellitus, defined as physician-diagnosed diabetes mellitus, or use of glucose-lowering drugs during follow-up, or fasting glucose ≥126 mg/dL at the exit visit. Over a median of 4.5 years, a significantly higher risk of incident diabetes mellitus was found in participants with time-averaged on-treatment SBP 130 to <140 mm Hg (10.3% versus 7.4%; odds ratio [OR], 1.37; 95% CI, 1.15‒1.64), compared with those with SBP 120 to <130 mm Hg. Moreover, the risk of incident diabetes mellitus increased by 24% (OR, 1.24; 95% CI, 1.00‒1.53) and the incidence of regression to normal fasting glucose (<100 mg/dL) decreased by 29% (OR, 0.71; 95% CI, 0.57‒0.89) in participants with intermediate BP control (SBP/diastolic blood pressure, 130 to <140 and/or 80 to <90 mm Hg), compared with those with a tight BP control of <130/<80 mm Hg. Similar results were found when the time-averaged BP were calculated using the BP measurements during the first 6- or 24-month treatment period, or in the analysis using propensity scores. Conclusions In this non-diabetic, hypertensive population, SBP control in the range of 120 to <130 mm Hg, compared with the 130 to <140 mm Hg, was associated with a lower risk of incident diabetes mellitus.
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http://dx.doi.org/10.1161/JAHA.120.017015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660809PMC
August 2020

Association of self-reported sleep duration and quality with BaPWV levels in hypertensive patients.

Hypertens Res 2020 12 16;43(12):1392-1402. Epub 2020 Jul 16.

Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China.

The association between sleep conditions and arterial stiffness remains inconclusive. We aimed to investigate the relationship of sleep duration and quality with brachial-ankle pulse-wave velocity (baPWV) in hypertensive patients. A total of 14,485 hypertensive adults were included in this cross-sectional analysis. Information about sleep duration and quality was obtained via questionnaire. A baPWV level ≥1800 cm/s was defined as indicative of arterial stiffness. Compared with participants with a sleep duration <8 h per day, participants with a sleep duration ≥8 h per day had a significantly higher baPWV level (β = 13.7 cm/s; 95% CI: 3.9, 23.5) and a nonsignificantly higher prevalence of arterial stiffness (39.7% vs. 33.0%; OR, 1.08; 95% CI: 0.99-1.19). Similarly, compared with participants with good or medium sleep quality, participants with poor sleep quality had a significantly higher baPWV level (β = 16.3 cm/s; 95% CI: 0.1, 32.6) and a nonsignificantly greater prevalence of arterial stiffness (36.6% vs. 35.3%; OR, 1.13; 95% CI: 0.97-1.32). When sleep duration and quality were examined jointly, participants with a sleep duration ≥8 h and/or poor sleep quality had a significantly higher baPWV level (β = 14.4 cm/s; 95% CI: 5.3, 23.4) and a greater prevalence of arterial stiffness (38.8% vs. 32.7%; OR, 1.10; 95% CI: 1.01-1.20) than those with a sleep duration <8 h and good/medium sleep quality. In summary, among hypertensive patients, a longer sleep duration (≥8 h per day) and poor sleep quality were associated with higher baPWV levels and a higher prevalence of arterial stiffness.
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http://dx.doi.org/10.1038/s41440-020-0509-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671938PMC
December 2020

Relationship of visceral adiposity index with new-onset proteinuria in hypertensive patients.

Clin Nutr 2021 Feb 2;40(2):438-444. Epub 2020 Jun 2.

National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. Electronic address:

Background & Aims: Visceral adiposity index (VAI) is a sex-specific surrogate marker of adipose tissue distribution and function. Little is known about the longitudinal relationship between VAI and proteinuria. This study aimed to examine the prospective relationship of baseline VAI with new-onset of proteinuria in hypertensive patients without major cardiovascular diseases.

Methods: A total of 10 699 hypertensive patients without proteinuria (negative urine dipstick reading) at baseline from the renal sub-study of the China Stroke Primary Prevention Trial (CSPPT) were included. Participants were randomly assigned to a double-blind daily treatment with 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. Participants were followed every 3 months after randomization. The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. The secondary outcome was progression of proteinuria, defined as a urine dipstick reading of trace or ≥1+ at the exit visit.

Results: During a median follow-up duration of 4.4 years, a total of 396 (3.7%) participants developed new-onset proteinuria, while 1236 (11.6%) participants met progression of proteinuria. When VAI was categorized into quartiles, compared with participants in quartile 1-3 (<2.99), a significantly higher risk of new-onset proteinuria (OR, 1.43; 95%CI: 1.07-1.91) and progression of proteinuria (OR, 1.23; 95%CI: 1.03-1.46) was found in those in quartile 4 (≥2.99). Moreover, the positive association was consistent in participants with or without general obesity, abdominal obesity, and dyslipidemia (all P-interactions > 0.05).

Conclusions: There was a positive association between VAI levels and the risk of new-onset proteinuria in hypertensive patients.
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http://dx.doi.org/10.1016/j.clnu.2020.05.031DOI Listing
February 2021

and variants associated with angiotensin-converting enzyme inhibitor-induced cough: a nested case-control genome-wide study.

Pharmacogenomics 2020 06 13;21(9):601-614. Epub 2020 May 13.

Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China.

We aimed to identify genetic variants associated with ACE inhibitor (ACEI)-induced cough.  A nested case-control study was performed among hypertensive Chinese patients receiving enalapril-only therapy. Whole-exome sequencing and genome-wide association analysis were performed. We identified that rs13015243 (odds ratio [OR]: 0.47; 95% CI: 0.34-0.66; p = 7.45 × 10), rs13009649 (OR: 0.48; 95% CI: 0.35-0.67; p = 9.96 × 10) and rs1044147 (OR: 2.67; 95% CI: 1.71-4.17; p = 9.91 × 10) were significantly associated with ACEI-induced cough. Nearly genome-wide significant associations in previously reported candidate risk genes , , , , , or were detected in our dataset.  Our results suggest that ACEI-induced cough is associated with noncoding SNPs of and , all of which are independent of the bradykinin pathway. NCT03259399.
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http://dx.doi.org/10.2217/pgs-2019-0167DOI Listing
June 2020

Positive association of serum uric acid with new-onset diabetes in Chinese women with hypertension in a retrospective analysis of the China Stroke Primary Prevention Trial.

Diabetes Obes Metab 2020 09 21;22(9):1598-1606. Epub 2020 May 21.

Division of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory for Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Aims: To investigate the association of baseline serum uric acid (UA) with new-onset diabetes, and to explore the possible effect modifiers in Chinese adults with hypertension.

Materials And Methods: A total of 14 943 hypertensive patients with available UA measurements and without diabetes at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). Participants were randomly assigned to a double-blind daily treatment with 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥7.0 mmol/L at the exit visit.

Results: Over a median follow-up of 4.5 years, 1623 participants (10.9%) developed diabetes. Overall, there was a positive association between baseline UA and new-onset diabetes in women (per SD increment; adjusted odds ratio [OR] 1.14, 95% confidence interval [CI] 1.07, 1.23), but not in men (adjusted OR 1.01, 95% CI 0.92, 1.10). Moreover, a stronger positive association between baseline UA and new-onset diabetes was found among women with lower time-averaged on-treatment systolic blood pressure during the treatment period (<140 vs. ≥140 mmHg; P-interaction = 0.024), higher baseline body mass index (<24 vs. ≥24 kg/m ; P-interaction = 0.012), or higher baseline waist circumference (<80 vs. ≥80 cm; P-interaction = 0.032).

Conclusions: Our study suggested that higher baseline UA was significantly associated with increased risk of new-onset diabetes in hypertensive Chinese women, but not in men. Further prospective studies are required to validate the differential association by sex.
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http://dx.doi.org/10.1111/dom.14072DOI Listing
September 2020

Association between plasma retinol levels and the risk of all-cause mortality in general hypertensive patients: A nested case-control study.

J Clin Hypertens (Greenwich) 2020 05 30;22(5):906-913. Epub 2020 Apr 30.

National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.

To evaluate the association between plasma retinol levels with all-cause mortality and investigate the possible effect modifiers in general hypertensive patients with no previous cardiovascular disease (CVD). This case-control study was nested in the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The current study included 617 cases of all-cause mortality and 617 controls matched on age (≤1 year), sex, treatment group, and study site. All-cause mortality was the main outcome in this analysis, which included death due to any reason. The median follow-up duration was 4.5 years. Overall, there was a U-shaped relation of plasma retinol with all-cause mortality. In the threshold effect analysis, the risk of all-cause mortality significantly decreased with the increase in plasma retinol (per 10 μg/dL increments: OR, 0.73; 95% CI: 0.61-0.87) in participants with plasma retinol <58.3 μg/dL and increased with the increase in plasma retinol (per 10 μg/dL increments: OR, 1.08; 95% CI: 1.01-1.16) in those with plasma retinol ≥58.3 μg/L. In participants with plasma retinol <58.3 μg/dL, a stronger inverse association was observed in those with higher time-averaged SBP (≥140 vs <140 mm Hg; P-interaction = .034), or higher vitamin E levels (≥11.5 [quartile 4]; vs <11.5 μg/mL; P-interaction = .013). The present study demonstrated that there was a U-shaped relationship of plasma retinol levels with the risk of all-cause mortality in general hypertensive patients, with a turning point around 58.3 μg/dL.
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http://dx.doi.org/10.1111/jch.13866DOI Listing
May 2020

Association of brachial-ankle pulse wave velocity and carotid plaque in Chinese hypertensive adults: effect modification by age.

Hypertens Res 2020 08 17;43(8):808-816. Epub 2020 Apr 17.

Department of Cardiology, Peking University First Hospital, 100034, Beijing, China.

We aimed to investigate the association of brachial-ankle pulse wave velocity (baPWV) with carotid plaque presence and carotid plaque number in a Chinese hypertensive population. A total of 13,554 hypertensive subjects from the China Stroke Primary Prevention Trial (CSPPT) were recruited. Arterial stiffness and carotid plaque were evaluated by baPWV and B-mode ultrasonography, respectively. Multivariate logistic regression analysis was used to determine the correlation of baPWV and carotid plaque presence. Multinomial logistic regression analysis was used to determine the correlation of baPWV and carotid plaque number. Further interactions between baPWV and carotid plaque presence were examined using subgroup analysis. Continuous baPWV was positively correlated with carotid plaque presence (OR = 1.05, 95% CI: 1.04-1.07) and carotid plaque number (one- to two-plaque group: OR = 1.04, 95% CI: 1.02-1.06; three-or-more-plaque group: OR = 1.09, 95% CI: 1.07-1.12). When baPWV was classified into quartiles, with the lowest quartile as reference, the ORs for having one, two, or three or more plaques increased in parallel with the quartiles of baPWV, indicating a dose-dependent effect. In a subgroup analysis, the association of baPWV and carotid plaque presence was more pronounced among younger participants (OR: 1.14 vs. 1.06 and 1.03 for the age groups <60 years, 60 ≤ 70 years, and ≥70 years, respectively, P for interaction <0.001). In a Chinese hypertensive population, baPWV was positively associated with carotid plaque presence and carotid plaque number. A more pronounced positive association between baPWV and carotid plaque presence was observed in younger participants.
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http://dx.doi.org/10.1038/s41440-020-0432-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7363666PMC
August 2020

Plasma magnesium and the risk of new-onset hyperuricaemia in hypertensive patients.

Br J Nutr 2020 Mar 26:1-8. Epub 2020 Mar 26.

Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing100083, People's Republic of China.

We aimed to evaluate the relationship of plasma Mg with the risk of new-onset hyperuricaemia and examine any possible effect modifiers in hypertensive patients. This is a post hoc analysis of the Uric acid (UA) Sub-study of the China Stroke Primary Prevention Trial (CSPPT). A total of 1685 participants were included in the present study. The main outcome was new-onset hyperuricaemia defined as a UA concentration ≥417 μmol/l in men or ≥357 μmol/l in women. The secondary outcome was a change in UA concentration defined as UA at the exit visit minus that at baseline. During a median follow-up duration of 4·3 years, new-onset hyperuricaemia occurred in 290 (17·2 %) participants. There was a significantly inverse relation of plasma Mg with the risk of new-onset hyperuricaemia (per sd increment; OR 0·85; 95 % CI 0·74, 0·99) and change in UA levels (per sd increment; β -3·96 μmol/l; 95 % CI -7·14, -0·79). Consistently, when plasma Mg was analysed as tertiles, a significantly lower risk of new-onset hyperuricaemia (OR 0·67; 95 % CI 0·48, 0·95) and less increase in UA levels (β -8·35 μmol/l; 95 % CI -16·12, -0·58) were found among participants in tertile 3 (≥885·5 μmol/l) compared with those in tertile 1 (<818·9 μmol/l). Similar trends were found in males and females. Higher plasma Mg levels were associated with a decreased risk of new-onset hyperuricaemia in hypertensive adults.
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http://dx.doi.org/10.1017/S0007114520001099DOI Listing
March 2020

Study on the substitution effects of zinc benzoate terpyridine complexes on photoluminescence, antiproliferative potential and DNA binding properties.

J Biol Inorg Chem 2020 03 28;25(2):311-324. Epub 2020 Feb 28.

School of Chemistry and Chemical Engineering, Guangxi University, Nanning, 530004, PR China.

Six zinc(II) complexes, [Zn(OCOPh)L] (R = 1, 2, 3, 4, 5, 6) were synthesized by the reaction of zinc benzoate and six para-substituted 4-phenyl-terpyridine complexes and their structures were confirmed by elemental analysis, FT-IR, H NMR and X-ray single crystal diffraction analysis. Their photoluminescent properties in solid and in solutions of DMSO were studied. Three human cancer cell lines were used for antiproliferative potential: human lung cancer cell line (A549), human esophageal cancer cell line (Eca-109) and human breast cancer cell line (MCF-7). The results have shown that these zinc complexes have good inhibitory effects on cancer cells, which are better than that of the commonly used clinical drug cisplatin. The ability of the complexes to binding to CT-DNA was studied by UV spectroscopy and fluorescence titration, while the interaction between the complexes and CT-DNA, AT6, GC6 short-chain DNA sequences and G-quadruplex were analyzed by circular dichroism (CD). It is found that these complexes can bind to DNA, and the binding mode is mainly intercalator. The docking of the complexes with the DNA fragment was simulated using molecular docking software. All the results clearly display that the substituents at these ligands of the complexes have the substitution effects on the properties of photoluminescence, antiproliferative potential and DNA binding study.
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http://dx.doi.org/10.1007/s00775-020-01763-6DOI Listing
March 2020

Relationship of Body Mass Index and Waist Circumference With Risk of New-Onset Proteinuria in Hypertensive Patients.

J Clin Endocrinol Metab 2020 03;105(3)

National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Context: The association of the combination of body mass index (BMI) and waist circumference (WC) with the risk of proteinuria has previously not been comprehensively investigated and results have been inconclusive.

Objective: To examine BMI and WC in relation to new-onset proteinuria in Chinese hypertensive patients.

Design And Setting: Post hoc analysis of the renal substudy of the China Stroke Primary Prevention Trial (CSPPT).

Patients: 10 805 hypertensive patients without proteinuria at baseline.

Main Outcome Measure: The primary outcome was new-onset proteinuria, defined as a urine dipstick protein reading ≥ 1 + at the exit visit, after a median follow-up duration of 4.4 years.

Results: When analyzed separately, increased BMI (≥ 28 kg/m2, quartile 4; odds ratio [OR], 1.36; 95% confidence interval [CI], 1.08-1.72), or increased WC (≥ 91cm for females, quartile 4; OR, 1.35; 95% CI, 1.01-1.80; and ≥ 79 cm for males, quartile 2-4; OR, 1.60; 95% CI, 1.03-2.50) were each significantly associated with higher risk of new-onset proteinuria. When analyzed jointly, participants without increased BMI and increased WC had the lowest risk, while those with both increased BMI and increased WC had the highest risk of proteinuria (OR, 1.61; 95% CI, 1.21-2.13). Notably, participants with only increased WC also had significantly increased risk of proteinuria (OR, 1.39; 95% CI, 1.04-1.85).

Conclusion: In Chinese hypertensive patients, increased BMI and increased WC were individually and jointly associated with a higher risk of new-onset proteinuria, underscoring the value of monitoring both BMI and WC in assessing proteinuria risk.
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http://dx.doi.org/10.1210/clinem/dgaa026DOI Listing
March 2020

Carotid Intima-Media Thickness and the Risk of First Stroke in Patients With Hypertension.

Stroke 2020 02 17;51(2):379-386. Epub 2020 Jan 17.

From the Department of Cardiology, Peking University First Hospital, Beijing, China (P.S., Y. Zhang, Y.Y., J.L., Y.H.).

Background and Purpose- This study aimed to investigate the association between mean carotid intima-media thickness (cIMT) and the risk of first stroke and examine any possible effect modifiers in patients with hypertension. Methods- A total of 11 547 hypertensive participants without history of stroke from the CSPPT (China Stroke Primary Prevention Trial) were included in this analysis. The primary outcome was first stroke. Results- Over a median follow-up of 4.4 years, 726 first strokes were identified, of which 631 were ischemic, and 90 were hemorrhagic. A per SD increase in mean cIMT was positively associated with the risk of first stroke (hazard ratio [HR], 1.11 [95% CI, 1.03-1.20]), and first ischemic stroke (HR, 1.10 [95% CI, 1.01-1.20]). Moreover, when cIMT was categorized in quartiles, the higher risks of first stroke (HR, 1.31 [95% CI, 1.06-1.61]) and first hemorrhagic stroke (HR, 2.25 [95% CI, 1.11-4.58]) were found in participants in quartile 2 to 4 (≥0.66 mm), compared with those in quartile 1 (<0.66 mm). More importantly, the cIMT-first stroke association was significantly stronger in participants with higher mean arterial pressure (≥109.3 [quintile 5] versus <109.3 mm Hg, -interaction=0.024) or diastolic blood pressure levels (≥90.7 [quintile 5] versus <90.7 mm Hg, -interaction=0.009). Conclusions- There was a significant positive association between baseline cIMT and the risk of first stroke in patients with hypertension. This association was even stronger among those with higher mean arterial pressure or diastolic blood pressure levels.
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http://dx.doi.org/10.1161/STROKEAHA.119.026587DOI Listing
February 2020