Publications by authors named "Zhanxin Yao"

34 Publications

Low dietary quercetin intake by food frequency questionnaire analysis is not associated with hypertension occurrence.

Clin Nutr 2021 Jun 12;40(6):3748-3753. Epub 2021 May 12.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China. Electronic address:

Background & Aims: Quercetin is one of the most abundant flavonoids in plant kingdom. Because of its strong anti-inflammatory and antioxidant effect, it is of potential in anti-hypertension. The objective of the present study was to explore the relationship between dietary quercetin and hypertension incidence in a Chinese population.

Methods: Participants aged 17-87 years were recruited at baseline. Those people who did not have hypertension, cardiovascular disease or cancer and finished physical checkup were included in this prospective cohort study. A food frequency questionnaire (FFQ) was performed. Follow-up was conducted once a year. The intake of quercetin was calculated based on FFQ and Chinese food composition table. Three Cox proportional hazard regression models were used to investigate the relationship between quercetin intake and incidence of hypertension.

Results: The data of 15,662 participants, including 7340 males and 8322 females, were analyzed. The median follow-up period was 3.0 year and the follow-up rate is 85.2%. A total of 2463 subjects developed hypertension during the follow-up period. The mean of daily quercetin intake was 24.7 ± 13.8 mg/day in this population. In the multivariate adjusted Cox proportional hazard regression model, the hazard ratios (95% CI) for hypertension across the ascending quartiles of quercetin intake were: 1.00 (reference), 1.04 (0.92, 1.17), 0.99 (0.87, 1.12), and 1.06 (0.92, 1.21). No significant association was observed between quercetin intake and the incidence of hypertension.

Conclusion: The dietary intake of quercetin alone does not reach a level sufficient to affect the incidence of hypertension in Chinese population.
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http://dx.doi.org/10.1016/j.clnu.2021.04.047DOI Listing
June 2021

Saltwater fish but not freshwater fish consumption is positively related to handgrip strength: The TCLSIH Cohort Study.

Nutr Res 2021 06 25;90:46-54. Epub 2021 Apr 25.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China. Electronic address:

Fish contain many important nutrients and are primarily known for high n-3 polyunsaturated fatty acids (n-3 PUFA) content. Studies have shown that supplementation of fish oil-derived n-3 PUFA improves muscle mass and strength. Here, we hypothesized that fish consumption might improve muscle strength. To test this hypothesis, we performed this cross-sectional study (n = 29,084) in Tianjin, China. The frequency of fish consumption was assessed using a valid self-administered food frequency questionnaire. Handgrip strength (HGS) was used as the indicator of muscle strength, and was measured using a handheld digital dynamometer. Analysis of covariance was used to examine the relationship between fish consumption and HGS. In men, after adjusted potential confounding factors, the least square means (95% confidence intervals) of HGS across saltwater fish consumption categories were 41.5 (41.1, 43.7) kg for <1 time/week, 44.6 (43.2, 45.8) kg for 1 time/week, and 44.7 (43.3, 46.1) kg for ≥2 to 3 times/week (P for trend <0.001). In men, the least square means (95% confidence intervals) of HGS across the ascending quartiles of dietary n-3 PUFA intake were 43.6 (43.2, 44.4) kg, 43.7 (43.2, 44.6) kg, 44.4 (43.0, 45.8) kg, and 44.6 (43.1, 46.0) kg (P for trend <0.01). The results showed that saltwater fish consumption was positively related to HGS in men, but not in women, suggesting that saltwater fish contain nutrients that may be used to improve HGS.
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http://dx.doi.org/10.1016/j.nutres.2021.04.002DOI Listing
June 2021

Consumption of Preserved Egg Is Associated with Modestly Increased Risk of Nonalcoholic Fatty Liver Disease in Chinese Adults.

J Nutr 2021 May 28. Epub 2021 May 28.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Although preserved egg is a traditional Chinese delicacy widely consumed in China and Southeast Asian countries, whether habitual preserved egg consumption is associated with nonalcoholic fatty liver disease (NAFLD) remains unknown.

Objectives: This study aimed to examine the association between preserved egg consumption and risk of NAFLD in a cohort of Chinese adults.

Methods: This prospective cohort study included 15,883 participants aged 19-88 y (58% women) from the TCLSIH (Tianjin Chronic Low-grade Systemic Inflammation and Health) cohort study who were free of liver diseases, cancer, and cardiovascular disease at baseline. Preserved egg consumption was assessed using an FFQ at baseline. NAFLD was diagnosed by transabdominal sonography during an annual health examination. Multivariable Cox proportional hazards regression models were used to calculate HRs and 95% CIs across categories of preserved egg consumption.

Results: During 56,002 person-years of follow-up, 3683 first incident cases of NAFLD were recorded. After adjustment for sociodemographic characteristics, lifestyle risk factors, total energy intake, egg intake, and eating patterns, the multivariable HRs (95% CIs) of incident NAFLD according to categories of preserved egg consumption were 1.00 (reference) for never, 1.05 (0.98, 1.14) for <1 time/wk, 1.09 (0.96, 1.24) for 1 time/wk, and 1.26 (1.09, 1.46) for ≥2 times/wk (P-trend < 0.01). The results were robust to a series of sensitivity analyses.

Conclusions: Habitual preserved egg consumption is associated with a modestly higher risk of NAFLD among the Chinese adult population. The mechanism underlying this association warrants further research.This trial was registered at www.umin.ac.jp/ctr/ as UMIN000027174.
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http://dx.doi.org/10.1093/jn/nxab163DOI Listing
May 2021

Higher plain water intake is related to lower newly diagnosed nonalcoholic fatty liver disease risk: a population-based study.

Eur J Clin Nutr 2021 Apr 9. Epub 2021 Apr 9.

Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.

Background/objectives: High plain water intake (PWI) lowered body weight, reduced total energy intake, and increased fat oxidation and energy consumption. Because such factors are closely linked to metabolic disorders, which are the main risk factors for nonalcoholic fatty liver disease (NAFLD) onset, it was speculated that higher PWI was associated with a lower risk of NAFLD. However, no prior human studies have examined such relationship. Therefore, the purpose of this study was to evaluate the relationship between PWI and newly diagnosed NAFLD in a large-scale adult population.

Subjects/methods: A total of 16,434 participants from 2010 to 2019 in Tianjin, China, were included in this cross-sectional study. PWI was assessed by using a validated self-administered food frequency questionnaire, and it was categorized into three subgroups for analysis: ≤3 cups/day, 4-7 cups/day, and >7 cups/day. NAFLD was diagnosed by abdominal ultrasound. Logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the relationship between PWI and NAFLD.

Results: Among 16,434 participants, 20.5% (3,364) had newly diagnosed NAFLD. After controlling for demographic characteristics, lifestyle risk factors, and dietary intake, the adjusted ORs (95% CIs) for having NAFLD across PWI categories were 1.00 (reference) for ≤3 cups/day, 0.84 (0.72, 0.97) for 4-7 cups/day, and 0.77 (0.63, 0.94) for >7 cups/day in males and 1.00 (reference) for ≤3 cups/day, 1.02 (0.81, 1.27) for 4-7 cups/day, and 1.08 (0.78, 1.49) for >7 cups/day in females, respectively.

Conclusions: This study is the first to show that higher PWI is independently related to lower newly diagnosed NAFLD among males, but not females. Further studies are needed to explore the causal relationship.
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http://dx.doi.org/10.1038/s41430-021-00891-9DOI Listing
April 2021

Soft drink consumption and risk of nonalcoholic fatty liver disease: results from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study.

Am J Clin Nutr 2021 05;113(5):1265-1274

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Epidemiological evidence for the association of soft drink consumption with nonalcoholic fatty liver disease (NAFLD) is inconsistent, and such association has not been prospectively examined in the general adult population.

Objectives: We aimed to investigate the prospective association between soft drink consumption and the risk of NAFLD in a Chinese adult population.

Methods: This prospective cohort study investigated 14,845 participants [mean age: 39.3 y; 6203 (41.8%) men] who were free of liver disease, cardiovascular disease, and cancer at baseline. Soft drink consumption (mainly sugar-containing carbonated beverages) was measured at baseline using a validated FFQ. NAFLD was diagnosed based on abdominal ultrasound without significant alcohol consumption and other causes of liver disease. Hepatic steatosis index (HSI) was calculated based on sex, BMI, and blood transaminase levels. Cox proportional hazards regression models were used to examine the association of soft drink consumption with incident NAFLD.

Results: A total of 2888 first-incident cases of NAFLD occurred during 42,048 person-years of follow-up (median follow-up: 4.2 y). After adjusting for demographic characteristics, lifestyle factors, dietary intake, and inflammatory markers, the multivariable HRs (95% CIs) for incident NAFLD were 1.00 (reference) for <1 serving/wk, 1.18 (1.03, 1.34) for 1 serving/wk, 1.23 (1.08, 1.40) for 2-3 servings/wk, and 1.47 (1.25, 1.73) for ≥4 servings/wk, respectively (P for trend < 0.0001). Further sensitivity analysis showed that the corresponding multivariable HRs (95% CIs) for incident HSI-defined NAFLD were 1.00 (reference), 0.96 (0.70, 1.31), 1.16 (0.83, 1.62), and 1.59 (1.07, 2.37), respectively (P for trend < 0.0001).

Conclusions: The results from our prospective study indicate that soft drink consumption is associated with an increased risk of NAFLD in Chinese adults. This study was registered at UMIN Clinical Trials Registry as UMIN000027174.
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http://dx.doi.org/10.1093/ajcn/nqaa380DOI Listing
May 2021

Quercetin improves gut dysbiosis in antibiotic-treated mice.

Food Funct 2020 Sep;11(9):8003-8013

Institute of Environmental and Operational Medicine, Tianjin, China.

The diversity and activity of the gut microbiota residing in humans and animals are significantly influenced by the diet. Quercetin, one of the representative polyphenols in human diets, possesses a wide range of biological properties. The aim of this study was to investigate the prebiotic effects of quercetin in antibiotic-treated mice. Gut dysbiosis was successfully induced in mice by treatment with an antibiotic cocktail. Gas chromatography and 16S rDNA high-throughput sequencing techniques were used to investigate short-chain fatty acid content and gut microbial diversity and composition. The results showed that quercetin supplementation significantly improved the diversity of the gut bacterial community in antibiotic-treated mice (P < 0.05). Meanwhile, intestinal barrier function was also recovered remarkably as indicated by a decrease in the content of serum d-lactic acid and the activity of serum diamine oxidase (P < 0.05). The length of intestinal villi and mucosal thickness were also significantly increased in response to quercetin treatment (P < 0.05). Furthermore, the production of butyrate in faeces was enhanced significantly in quercetin-treated mice (P < 0.05). In conclusion, quercetin is effective in recovering gut microbiota in mice after antibiotic treatment and may act as a prebiotic in combatting gut dysbiosis.
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http://dx.doi.org/10.1039/d0fo01439gDOI Listing
September 2020

Association between consumption frequency of honey and non-alcoholic fatty liver disease: results from a cross-sectional analysis based on the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study.

Br J Nutr 2021 03 17;125(6):712-720. Epub 2020 Aug 17.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin300070, People's Republic of China.

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Recent evidence has suggested the protective effects of honey consumption against the metabolic syndrome, but the association between honey intake and NAFLD is still unclear. We investigated how the consumption frequency of honey was associated with NAFLD in the general population. This was a cross-sectional study of 21 979 adults aged 20-90 years. NAFLD was diagnosed based on the ultrasound-diagnosed fatty liver without significant alcohol intake and other liver diseases. Diet information, including consumption frequency of honey, was assessed by a validated 100-item FFQ. OR with 95 % CI were calculated by the binary logistic regression model, adjusting for confounding factors identified by the directed acyclic graph. Overall, 6513 adults (29·6 %) had NAFLD. Compared with participants consuming ≤1 time/week of honey, the multivariable OR of NAFLD were 0·86 (95 % CI 0·77, 0·97) for 2-6 times/week and 1·10 (95 % CI 0·95, 1·27) for ≥1 times/d (Pfor trend = 0·90). The results were generally similar in subgroups of BMI at a cut-point of 24·0 kg/m2 (Pfor interaction = 0·10). In this large-scale study, consuming honey 2-6 times/week was inversely associated with NAFLD, whereas consuming honey ≥1 times/d had no association with NAFLD. These results need replication in other large-scale prospective studies.
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http://dx.doi.org/10.1017/S0007114520003190DOI Listing
March 2021

The association between banana consumption and the depressive symptoms in Chinese general adult population: A cross-sectional study.

J Affect Disord 2020 03 5;264:1-6. Epub 2019 Dec 5.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.

Background: Banana contains many kinds of substances that are beneficial to depressive symptoms. However, there are no epidemiological researches directly to explore the association between banana consumption and depressive symptoms. This study aimed to investigate whether the banana consumption is related to depressive symptoms in a general adult population.

Methods: A cross-sectional study was performed in 24,673 adults in Tianjin. Banana consumption was evaluated via a validated food frequency questionnaire. Depressive symptoms were assessed by using Self-Rating Depression Scale (SDS). The association between banana consumption and depressive symptoms was analyzed by multiple logistic regression analysis.

Results: The prevalence of depressive symptoms was 16.1% in males and 18.4% in females (SDS ≥ 45), respectively. In males, comparing to the reference group (almost never), the multivariable adjusted odds ratios (ORs) (95% confidence intervals) of depressive symptoms across banana consumption were 0.86 (0.74, 0.99) for <1 time/week, 0.76 (0.66, 0.88) for 1-3 times/week and 0.97 (0.82, 1.16) for ≥4 times/week. By contrast, the multivariable adjusted ORs (95% confidence intervals) were 1.11 (0.94, 1.32) for <1 time/week, 0.99 (0.85, 1.16) for 1-3 times/week and 1.22 (1.02, 1.46) for ≥4 times/week in females. Similar association was observed when other cut-offs (SDS ≥ 48 and 50) were used to define depressive symptoms.

Limitation: This is a cross-sectional study, causality remains unknown.

Conclusion: Findings from this study suggested a negative association between moderate banana consumption and depressive symptoms in males. In females, high banana consumption is positively related to depressive symptoms.
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http://dx.doi.org/10.1016/j.jad.2019.12.008DOI Listing
March 2020

Associations between honey consumption and prehypertension in adults aged 40 years and older.

Clin Exp Hypertens 2020 Jul 23;42(5):420-427. Epub 2019 Nov 23.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

: Honey has been shown to have multiple positive effects on human health. However, data on the associations of honey consumption with prehypertension are scarce. The aim of this study was to investigate whether honey consumption is associated with prehypertension in a Chinese population. : A cross-sectional study was conducted in 4,561 individuals aged ≥40 years. A validated 100-item semi-quantitative food frequency questionnaire was used to assess honey consumption. Blood pressure was measured at least twice by trained nurses. Multiple logistic regression models were used to explore the associations between honey consumption and prehypertension. : After adjustment for potential confounders, the odds ratios and 95% confidence intervals of prehypertension across increasing frequency of honey consumption were 1.00 (reference) for almost never, 1.17 (0.96, 1.41) for ≤6 times/week, and 1.25 (0.86, 1.84) for ≥7 times/week in men (  = 0.09); 1.00 (reference) for almost never, 0.76 (0.62, 0.92) for ≤6 times/week, and 0.84 (0.63, 1.12) for ≥7 times/week in women (  = 0.055), respectively. : Our results showed that light-to-moderate intake of honey was associated with lower prevalence of prehypertension in women, but not men. Future studies are required to confirm these associations.
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http://dx.doi.org/10.1080/10641963.2019.1693584DOI Listing
July 2020

Riboflavin deficiency alters cholesterol homeostasis partly by reducing apolipoprotein B100 synthesis in HepG2 cells.

Int J Vitam Nutr Res 2021 Jun 28;91(3-4):204-211. Epub 2019 Oct 28.

Department of Nutrition and Food Hygiene, Institute of Environmental and Operational Medicine, Tianjin, PR China.

Riboflavin deficiency led to lower blood cholesterol level and higher content of hepatic cholesterol in rats and the mechanisms are not clarified yet. We hypothesized that riboflavin deficiency might alter cholesterol homeostasis via apolipoprotein B100, one of the important proteins in cholesterol transport. To test this hypothesis, HepG2 cells were cultured in riboflavin-deficient media for 4 days to develop riboflavin deficiency. Compared to riboflavin-sufficient cells, the mRNA (0. 37 ± 0.04 1.03 ± 0.29 relative expression level, n = 3) and protein expressions of apolipoprotein B100 (intracellular: 173.7 ± 14.4 254.8 ± 47.2 μg/mg protein; extracellular: 93.8 ± 31.1 161.6 ± 23.9 μg/mg protein; n = 3) were significantly reduced in riboflavin-deficient cells ( < 0.05). Endoplasmic reticulum oxidoreductin 1 and protein disulfide isomerase, two enzymes involved in the oxidative folding of apolipoprotein B100, were also lower remarkably in expression at both mRNA and protein levels. Meanwhile, intracellular cholesterol was increased (256.3 ± 17.1 μM/g protein 181.4 ± 23.9 μM/g protein, n = 4) and extracellular cholesterol decreased (110.0 ± 23.2 μM/g protein 166.2 ± 34.6 μM/g protein, n = 4) significantly in riboflavin-deficient cells ( < 0.05). Very low-density lipoprotein was also diminished (29.0 ± 6.1 μM/g protein 67.0 ± 11.0 μM/g protein, n = 4) in the culture media ( < 0.05). These findings suggest that riboflavin deficiency alters cholesterol homeostasis partly by reducing apolipoprotein B100 synthesis in HepG2 cells.
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http://dx.doi.org/10.1024/0300-9831/a000610DOI Listing
June 2021

Association between edible mushroom intake and the prevalence of newly diagnosed non-alcoholic fatty liver disease: results from the TCLSIH Cohort Study in China.

Br J Nutr 2019 Oct 17:1-26. Epub 2019 Oct 17.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Animal studies have suggested that mushroom intake can alleviate non-alcoholic fatty liver disease (NAFLD) due to its anti-inflammatory and antioxidant properties. However, the association between mushroom intake and NAFLD is unknown in humans. We aimed to investigate the association of mushroom intake with NAFLD among Chinese adults. This is a cross-sectional study of 24,236 adults (mean [standard deviation] age: 40.7 [11.9] years; 11,394 men [47.0%]). Mushroom intake was assessed via a validated food frequency questionnaire. Newly diagnosed NAFLD was identified based on the results of annual health examinations, including ultrasound findings and a self-reported history of the disease. Multiple logistic models were used to examine the association between mushroom intake and NAFLD. The prevalence of newly diagnosed NAFLD was 19.0%. Compared to those consuming mushrooms less frequently (≤1 time/week), the fully adjusted odds ratios (95% confidence intervals) of newly diagnosed NAFLD were 0.95 (0.86, 1.05) for those consuming 2-3 times/week and 0.76 (0.63, 0.92) for those consuming ≥4 times/week, respectively (P for trend = 0.01). The inverse association was consistent in subgroups defined by age, sex, and body mass index. In conclusion, higher mushroom intake was significantly associated with lower prevalence of NAFLD among Chinese adults. Future research is required to understand the causal association between mushroom intake and NAFLD.
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http://dx.doi.org/10.1017/S0007114519002605DOI Listing
October 2019

Association between dietary raw garlic intake and newly diagnosed nonalcoholic fatty liver disease: a population-based study.

Eur J Endocrinol 2019 Dec;181(6):591-602

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background And Aims: The protective effect of garlic against nonalcoholic fatty liver disease (NAFLD) has been reported in animal studies. However, in humans, the association between garlic consumption and NAFLD is unclear. The study sought to explore the association between habitual raw garlic intake and newly diagnosed NAFLD among Chinese adults.

Methods: We performed a study of 11,326 men and 12,780 women aged 20-90 years. Habitual food intake was assessed using a validated and standardized 100-item food frequency questionnaire. Diagnosis of NAFLD was based on the liver ultrasonography and self-reported alcohol intake. Multiple logistic regression was used to evaluate the association of raw garlic intake with newly diagnosed NAFLD.

Results: The prevalence of newly diagnosed NAFLD was 28.9% in men and 10.1% in women, respectively. In men, the fully adjusted odds ratios (95% confidence interval) of having NAFLD across increasing frequency of raw garlic intake were 1.00 (reference) for <1 time/week, 0.81 (0.73, 0.90) for 1-3 times/week, 0.66 (0.54, 0.80) for 4-6 times/week, and 0.71 (0.55, 0.90) for ≥7 times/week (P for trend <0.0001). The odds ratio for NAFLD associated with each 1 g of raw garlic/1000 kcal was 0.93 (0.90, 0.97) in men. In women, no significant association between raw garlic intake and NAFLD was identified. These associations between raw garlic intake and NAFLD were consistent in several sensitivity analyses.

Conclusions: Frequent consumption of raw garlic is inversely associated with NAFLD in Chinese men. Further investigations are needed to confirm this finding.
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http://dx.doi.org/10.1530/EJE-19-0179DOI Listing
December 2019

Raw garlic consumption is inversely associated with prehypertension in a large-scale adult population.

J Hum Hypertens 2020 01 24;34(1):59-67. Epub 2019 Sep 24.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Previous studies have shown that allicin can lower blood pressure (BP) by reducing oxidative stress and inflammation. However, the association between habitual raw garlic intake (as allicin source) and prehypertension are unclear. The aim of this study was to investigate how raw garlic consumption is associated with prehypertension in an adult population. A cross-sectional study was conducted with 22,812 adults (mean [standard deviation] age: 39.4 [10.7] years; males, 47.7%) in Tianjin, China. Raw garlic consumption was assessed using a validated food frequency questionnaire. BP was measured at least twice by trained nurses using an automatic device. Prehypertension was defined as systolic BP of 120-139 mmHg and/or diastolic BP of 80-89 mmHg without taking antihypertensive medication. Multiple logistic regression models were used to assess the association between raw garlic consumption and prehypertension. The prevalence of prehypertension was 49.9%. After fully adjusting for potential confounders, the ORs (95% confidence intervals) of having prehypertension by increasing frequency of raw garlic consumption were 1.00 (reference) for ≤3 times/week, 0.96 (0.87, 1.06) for 4 times/week to 1 time/day, and 0.69 (0.52, 0.90) for ≥2 times/day (p for trend = 0.06). In contrast, no associations were observed between other kinds of allium vegetables consumption and prehypertension. In conclusion, our results suggested that a more frequent consumption of raw garlic was inversely associated with prehypertension. This is the first large-scale study on the association between raw garlic consumption and prehypertension in the general population.
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http://dx.doi.org/10.1038/s41371-019-0257-0DOI Listing
January 2020

Association between habitual yogurt consumption and newly diagnosed non-alcoholic fatty liver disease.

Eur J Clin Nutr 2020 03 2;74(3):491-499. Epub 2019 Sep 2.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background/objectives: Many studies have suggested that probiotics may be applied as a therapeutic agent for non-alcoholic fatty liver disease (NAFLD). However, the effects of frequent yogurt consumption (as a natural probiotic source) on NAFLD remain poorly understood. This study was to examine the association of habitual yogurt consumption with newly diagnosed NAFLD in the general adult population.

Subject/methods: Overall, 24,389 adults were included in this cross-sectional study. Yogurt consumption was estimated by using a validated self-administered food frequency questionnaire. NAFLD was diagnosed by abdominal ultrasonography. We used logistic regression models to assess the association between yogurt consumption categories and newly diagnosed NAFLD.

Results: The multivariable odds ratios with 95% confidence interval of newly diagnosed NAFLD were 1.00 (0.88, 1.14) for 1 time/week, 0.91 (0.81, 1.02) for 2-3 times/week, and 0.86 (0.76, 0.98) for ≥4 times/week (P for trend = 0.01), compared with those who consumed <1 time/week yogurt. The inverse association was observed in a sensitivity analysis.

Conclusion: Higher yogurt consumption was inversely associated with the prevalence of newly diagnosed NAFLD. These results are needed to be confirmed in randomized controlled trials or prospective studies.
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http://dx.doi.org/10.1038/s41430-019-0497-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062629PMC
March 2020

Dietary myricetin intake is inversely associated with the prevalence of type 2 diabetes mellitus in a Chinese population.

Nutr Res 2019 08 22;68:82-91. Epub 2019 Jun 22.

Institute of Environmental and Operational Medicine, Tianjin 300050, China. Electronic address:

Myricetin is a natural plant-derived inhibitor for α-glucosidase and α-amylase and possesses strong antioxidant activity. Myricetin is reported to be effective in treating many symptoms that are associated with type 2 diabetes mellitus (T2DM), therefore, we hypothesized that myricetin plays a preventive role in the development of T2DM. To test this hypothesis, we designed a cross-sectional population study, which included 24 138 subjects, with 1357 of them diagnosed with T2DM. A validated 100-item food frequency questionnaire was used to collect dietary information. Daily intakes of myricetin and nutrients were calculated, based on the Chinese food composition tables. Multiple logistic regression analysis models were used to analyze the relationship between the quartiles of myricetin intake and the prevalence of T2DM. We found that, in this Chinese population, the daily intake of myricetin was 120.5 ± 95.7 mg, with apple, peach, orange, pineapple, and sweet potato being the main food sources. Significant inverse trends were observed between intakes of myricetin and prevalence of T2DM in multivariable models (all p-trend <0.0001). The odds ratios (95% CI) for T2DM across the ascending quartiles of myricetin intake were: 1.00 (reference), 0.73 (0.61, 0.87), 0.61 (0.50, 0.75), and 0.51 (0.40, 0.64). This study showed that myricetin intake was inversely related to the prevalence of T2DM in this Chinese population, suggesting a protective effect of myricetin in the development of T2DM.
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http://dx.doi.org/10.1016/j.nutres.2019.06.004DOI Listing
August 2019

The relationship between red blood cell distribution width and atrial fibrillation in Asian population: A cross-sectional study.

Pacing Clin Electrophysiol 2019 09 20;42(9):1197-1203. Epub 2019 Aug 20.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Red blood cell distribution width (RDW) was related with increased risk of mortality and adverse cardiovascular outcomes. However, it is uncertain whether RDW is related to the prevalence of atrial fibrillation (AF) in Asian population. The aim of this study was to assess the relationship between RDW and AF in a large Chinese population.

Methods: We performed a cross-sectional study to examine the relationship between RDW and AF among 106 998 subjects who were from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. AF was diagnosed using electrocardiography, and RDW was measured using an automated hematology analyzer. Multiple logistic regression models were conducted to examine the relation between tertiles of RDW and AF.

Results: The overall prevalence of AF was 0.1% (129/106 998). After adjustments for potential confounding factors, the odds ratios (95% confidence intervals) of AF across increasing tertiles of RDW were 1.00 (reference), 1.08 (0.69, 1.67), and 2.65 (1.75, 4.07) (P for trend < .0001), respectively.

Conclusions: The study demonstrated that elevated RDW is significantly related to higher prevalence of AF in a general Chinese population. Large prospective studies are needed to confirm this finding.
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http://dx.doi.org/10.1111/pace.13776DOI Listing
September 2019

Relationship between serum levels of immunoglobulins and metabolic syndrome in an adult population: A population study from the TCLSIH cohort study.

Nutr Metab Cardiovasc Dis 2019 09 14;29(9):916-922. Epub 2019 May 14.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, China. Electronic address:

Background And Aims: Metabolic syndrome (MetS) is a combination of metabolic disorders that increase the risk of developing cardiovascular disease, and inflammation is considered as a pathological basis for MetS. Immunoglobulins (Igs) are the major secretory products of the adaptive immune system. However, no large-scale population study has focused on a possible relationship between Igs and MetS. We designed a cross-sectional study to investigate the relationship between Igs and prevalence of MetS in a large-scale adult population.

Methods And Results: A total of 10,289 participants were recruited among residents in Tianjin, China. Metabolic syndrome was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. Serum levels of Igs were determined by immunonephelometry. Multiple logistic regression models were used to assess the relationship between the quintiles of serum levels of Igs and the prevalence of MetS. The overall prevalence of MetS was 36.1%. The mean (standard deviation) values of Igs (IgG, IgE, IgM, and IgA) were 1205.7 (249.3) mg/dL, 93.1 (238.9) IU/mL, 105.7 (57.3) mg/dL, and 236.2 (97.6) mg/dL, respectively. The adjusted odds ratios (95% confidence interval) of MetS for the highest quintile of Igs (IgG, IgE, IgM, and IgA), when compared to the lowest quintile, were 0.81 (0.70, 0.95), 0.97 (0.83, 1.12), 1.13 (0.97, 1.33), and 1.52 (1.30, 1.77), respectively.

Conclusions: This study demonstrated that decreased IgG and increased IgA are independently related to a higher prevalence of MetS. The results indicate that the Igs might be useful predictive factors for MetS in the general adult population.
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http://dx.doi.org/10.1016/j.numecd.2019.05.053DOI Listing
September 2019

Association of dietary patterns with depressive symptoms in Chinese postmenopausal women.

Br J Nutr 2019 11 26;122(10):1168-1174. Epub 2019 Jul 26.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, People's Republic of China.

Many components in diet have regulated oxidative stress, inflammatory reaction and even balance oestrogen levels. Because these factors are closely associated with depressive symptoms in postmenopausal women, it is considered that dietary factors are able to prevent and control depressive symptoms. On the other hand, a dietary pattern that considers the correlations and synergies between foods and nutrients is expected to have a greater impact on disease risk. The aim of the present study is to evaluate whether dietary patterns are associated with depressive symptoms in Chinese postmenopausal women. A cross-sectional study of 2051 postmenopausal women (mean age: 58·8 (sd 7·4) years) was conducted in Tianjin, China. Dietary consumption was assessed by a valid self-administered FFQ. Principal component analysis was used to derive three major dietary patterns: 'healthy', 'sweets' and 'traditional Tianjin' from eighty-eight food items. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale, and cut-off point of 48 indicating serious depressive symptoms. The association between quartile of dietary patterns and depressive symptoms was assessed using multiple logistic regression analysis. The multivariable-adjusted OR of having depressive symptoms for increasing quartile of dietary patterns were as follows: healthy, 1·00, 0·79 (95 % CI 0·49, 1·28), 0·62 (95 % CI 0·37, 1·04) and 0·57 (95 % CI 0·33, 0·97); sweets, 1·00, 0·75 (95 % CI 0·42, 1·3), 1·08 (95 % CI 0·64, 1·81) and 1·66 (95 % CI 1·03, 2·71); and traditional Tianjin, 1·00, 1·02 (95 % CI 0·58, 1·79), 0·96 (95 % CI 0·54, 1·71) and 2·53 (95 % CI 1·58, 4·16), respectively. The present study demonstrated that a healthy dietary pattern was inversely associated with depressive symptoms. On the contrary, greater adherence to sweets and traditional Tianjin dietary patterns was associated with a higher prevalence of depressive symptoms.
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http://dx.doi.org/10.1017/S0007114519001867DOI Listing
November 2019

The relationship between Helicobacter pylori infection and depressive symptoms in the general population in China: The TCLSIH cohort study.

Helicobacter 2019 Oct 22;24(5):e12632. Epub 2019 Jul 22.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background: Depressive symptoms are a common, debilitating, and costly public health issue. Helicobacter pylori (H pylori) infection cause changes in the normal physiological state of the gastrointestinal (GI) flora. Although the physiological state of the GI tract is closely related to mental disorders, few population studies have examined the relationship between H pylori infection and depressive symptoms in the general population. The aim of this study was to examine whether H pylori infection is related to depressive symptoms among the general adult population.

Materials And Methods: This cross-sectional study included 5558 inhabitants of Tianjin, China. H pylori infection was diagnosed with the carbon 13 breath test. Depressive symptoms were assessed using the Chinese version of 20-item Self-rating Depression Scale (SDS) with three cutoffs (45, 48, and 50) to indicate elevated depressive symptoms. Multiple logistic regression analysis were conducted to assess the association between H pylori infection and depressive symptoms.

Results: The prevalence of depressive symptoms (SDS ≥ 45) was 12.7% in men and 17.4% in women. In multivariable models, the odds ratios and 95% confidence interval of having depressive symptoms by H pylori infection were 1.25 (1.01-1.56), 1.46 (1.11-1.91), and 1.46 (1.05-2.06) for three cutoffs: 45, 48, and 50 in women. However, no significant difference was found between H pylori infection and depressive symptoms in men.

Conclusions: This study firstly suggested that H pylori infection was related to depressive symptoms in women in the general adult population. Further prospective studies or randomized trials are required to clarify the causality.
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http://dx.doi.org/10.1111/hel.12632DOI Listing
October 2019

Riboflavin deficiency affects lipid metabolism partly by reducing apolipoprotein B100 synthesis in rats.

J Nutr Biochem 2019 08 14;70:75-81. Epub 2019 May 14.

College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, People's Republic of China. Electronic address:

Lipid metabolism is dependent on riboflavin status. Apolipoprotein B100 plays an important role in lipids transportation. This study was aimed to investigate the effect of riboflavin status on lipid metabolism and explore its association with apolipoprotein B100 synthesis in vivo. Riboflavin deficiency was developed in rats by feeding riboflavin-deficient diets. Compared to the control rats, the mRNA and protein expressions of apolipoprotein B100 were significantly reduced in riboflavin-deficient rats. Endoplasmic reticulum oxidoreductin 1 (ERO1) and protein disulfide isomerase (PDI), two enzymes involved in the oxidative folding of apolipoprotein B100, were also lowered remarkably in expression at protein level. Meanwhile, total cholesterol and triglyceride levels were decreased in the plasma and increased in the liver of riboflavin-deficient rats. The plasma very low-density lipoprotein cholesterol (VLDL-c) and low-density lipoprotein cholesterol (LDL-c) were also reduced in riboflavin-deficient rats. Our findings demonstrate that riboflavin deficiency affects lipid metabolism partly by reducing apolipoprotein B100 synthesis.
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http://dx.doi.org/10.1016/j.jnutbio.2019.04.011DOI Listing
August 2019

Relationship between consumption of raw garlic and handgrip strength in a large-scale adult population.

Clin Nutr 2020 04 23;39(4):1234-1241. Epub 2019 May 23.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China. Electronic address:

Background: Garlic-derived organosulfur compounds have numerous potential benefits (e.g. antioxidant and anti-inflammatory effects) on human health. Although these functions might be related to the onset and progression of muscle strength decline, no studies have explored the relationship between garlic consumption and muscle strength in the general population. The aim of this study was to investigate whether raw garlic consumption is related to handgrip strength in a large-scale adult population.

Methods: A cross-sectional study (n = 28,958) was performed in Tianjin, China. Frequency of raw garlic consumption was assessed using a valid self-administered food frequency questionnaire. Handgrip strength was measured using a handheld digital dynamometer. Analysis of covariance and multiple logistic regression were used to evaluate the relationship between raw garlic consumption and handgrip strength.

Results: In males, after adjusted potential confounding factors, the least square means (95% confidence intervals) of handgrip strength across raw garlic consumption categories were 42.5 (40.2-44.9) for almost never; 43.0 (40.7-45.5) for <1 time/week; 43.4 (41.0-45.8) for 1 time/week; and 43.8 (41.5-46.3) for ≥2-3 times/week (P for trend <0.0001). The adjusted odds ratios (95% confidence intervals) of low handgrip strength (<20th percentile of handgrip strength) across the categories of raw garlic consumption in males were 1.00, 0.86 (0.76, 0.98), 0.76 (0.67, 0.87), and 0.66 (0.58, 0.74) (P for trend <0.0001). Similar results were also observed in females.

Conclusions: The study firstly revealed a positive correlation between raw garlic consumption and handgrip strength in both males and females. Further studies are needed to explore the casual relationship.
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http://dx.doi.org/10.1016/j.clnu.2019.05.015DOI Listing
April 2020

Association between nut consumption and non-alcoholic fatty liver disease in adults.

Liver Int 2019 09 26;39(9):1732-1741. Epub 2019 Jun 26.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Background & Aims: Increased nut consumption has been associated with reduced inflammation, insulin resistance, and oxidative stress. Although these factors are closely involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD), few studies have focused on the association between nut consumption and NAFLD in the general population. We aimed to investigate the association of nut consumption and NAFLD in an adult population.

Methods: A total of 23 915 participants from Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) Cohort Study were included in this study. Information on dietary intake was collected using a validated food frequency questionnaire. Abdominal ultrasonography was done to diagnose NAFLD. Multivariable logistic regression was used to assess the association of nut consumption with NAFLD.

Results: After adjusting for sociodemographic, medical, dietary, and lifestyle variables, the odds ratios (95% confidence interval) for NAFLD across categories of nut consumption were 1.00 (reference) for <1 time/week, 0.91 (0.82, 1.02) for 1 time/week, 0.88 (0.76, 1.02) for 2-3 times/week, and 0.80 (0.69, 0.92) for ≥4 times/week (P for trend < 0.01). These associations were attenuated but remained significant after further adjustment for blood lipids, glucose, and inflammation markers.

Conclusions: Higher nut consumption was significantly associated with lower prevalence of NAFLD. Further prospective studies and randomized trials are required to ascertain the causal association between nut consumption and NAFLD.
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http://dx.doi.org/10.1111/liv.14164DOI Listing
September 2019

Relationship Between Grip Strength and Prediabetes in a Large-Scale Adult Population.

Am J Prev Med 2019 06 17;56(6):844-851. Epub 2019 Apr 17.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China. Electronic address:

Introduction: Prediabetes has been a growing health problem in China, and it is a high-risk state for developing diabetes and cardiovascular disease. In previous studies, low grip strength has been associated with diabetes. However, few population-based studies have examined the relationship between grip strength and prediabetes. Thus, the purpose of this study was to investigate whether grip strength is related to prediabetes in a large-scale adult population.

Methods: A total of 27,295 participants aged 20 to 90 years were included from the 2013-2016 Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. Grip strength was assessed using an electronic hand-grip dynamometer and the greatest force was normalized to body weight. Prediabetes was diagnosed based on the American Diabetes Association criteria. Multiple logistic regression analysis was conducted in 2018 to assess the relationship of grip strength to the prevalence of prediabetes, while controlling for age, BMI, smoking, drinking, physical activities, dietary patterns, and other confounders.

Results: Of the 27,295 participants, 28.5% (7,783) had prediabetes. After adjusting for potential confounders, a one unit increase in grip strength per body weight was associated with 52% lower odds of having prediabetes for men (OR=0.48, 95% CI=0.30, 0.74, p<0.01) and 62% lower odds of having prediabetes for women (OR=0.38, 95% CI=0.20, 0.70, p<0.01).

Conclusions: Increased grip strength is independently associated with lower prevalence of prediabetes in Chinese adults, suggesting that grip strength may be a useful marker for screening individuals at risk of prediabetes.
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http://dx.doi.org/10.1016/j.amepre.2019.01.013DOI Listing
June 2019

Vitamin D is related to handgrip strength in adult men aged 50 years and over: A population study from the TCLSIH cohort study.

Clin Endocrinol (Oxf) 2019 05 15;90(5):753-765. Epub 2019 Mar 15.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Objective: Handgrip strength (HGS) begins an accelerating decline around 50 years. Many of the studies performed in old adults have demonstrated a significant relationship between vitamin D and HGS, but the studies performed in participants with a broad age range have yielded conflicting results. The purpose of the study was to investigate the relationship between vitamin D and HGS using age 50 as a specific cut-off.

Design: Population-based, cross-sectional study.

Participants: Totally 5102 participants (2911 males, 2191 females) from the TCLSIH Cohort.

Measurements: Serum concentration of 25-hydroxyvitamin D (25(OH)D) was measured using an enzyme immunoassay. We divided participants into quartiles according to 25(OH)D, and the ranges for increasing quartiles were as follows: (males [≥50 years]: 10.94-31.85, 31.88-43.01, 43.20-56.06, 56.20-143.0; males [<50 years]: 11.11-34.68, 34.71-46.91, 46.96-59.45, 59.50-143.7; females [≥50 years]: 7.21-30.01, 30.02-40.18, 40.21-52.44, 52.49-275.4; females [<50 years]: 5.29-28.91, 28.92-40.19, 40.20-51.90, 51.91-140.2). HGS was measured with a hydraulic hand-held dynamometer. Analysis of covariance was employed to explore the relationship.

Results: Among males aged above 50 years, the means (95% confidence interval) for HGS per body weight across the categories of serum 25(OH)D concentration were 0.523 (0.430-0.638), 0.545 (0.447-0.664), 0.543 (0.446-0.661), 0.546 (0.449-0.664) (P  < 0.01) after adjustment for potential confounding factors. However, no relationships were observed between serum 25(OH)D concentration and HGS in males aged below 50 years and females in the whole age range.

Conclusions: Serum 25(OH)D concentration was significantly related to HGS in males aged above 50 years, independent of confounding factors. Future studies are needed to clarify the age and sex relationship between serum 25(OH)D concentration and HGS.
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http://dx.doi.org/10.1111/cen.13952DOI Listing
May 2019

Handgrip strength is inversely associated with metabolic syndrome and its separate components in middle aged and older adults: a large-scale population-based study.

Metabolism 2019 04 25;93:61-67. Epub 2019 Jan 25.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health; Center for International Collaborative Research on Environment, Nutrition and Public Health. Electronic address:

Background: Muscle weakness is followed by insulin resistance which is associated with metabolic disorders leading to metabolic syndrome (MetS). Therefore, muscle strength decline may be associated with MetS. The aim of this study was to investigate the relationships between muscle strength and MetS and its separate components.

Methods: A cross-sectional study was performed in 17,703 participants aged 40 years and older living in Tianjin, China. Handgrip strength was measured using a handheld digital dynamometer. MetS was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. Multiple logistic regression analyses were used to assess the association between handgrip strength and MetS and its separate components.

Results: The overall prevalence of MetS was 33.6%. The prevalence of MetS was significantly higher in men than in women (41.6% vs 22.9%, P < 0.0001). After adjustment for potential confounding factors (including sociodemographic variables, lifestyle factors, total energy intake, and family history of disease), the odds ratios (95% confidence interval) of MetS across decreasing handgrip strength quartiles were: 1.00 (reference), 1.87 (1.66, 2.11), 2.40 (2.13, 2.71), and 3.36 (2.97, 3.80) in men and 1.00 (reference), 1.80 (1.48, 2.21), 2.77 (2.29, 3.36), and 3.89 (3.22, 4.71) in women, respectively (P for all trend <0.0001). Similarly, handgrip strength was also observed to be negatively associated with separate components of MetS both in men and women.

Conclusions: Muscle strength is inversely associated with MetS and its separate components. Further prospective studies are needed to confirm this issue.
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http://dx.doi.org/10.1016/j.metabol.2019.01.011DOI Listing
April 2019

Association between neutrophil to lymphocyte ratio and depressive symptoms among Chinese adults: A population study from the TCLSIH cohort study.

Psychoneuroendocrinology 2019 05 9;103:76-82. Epub 2019 Jan 9.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China. Electronic address:

Background: The prevalence of depression in the general population has risen sharply over the past few decades and has become a major health problem throughout the world. Increasing evidence suggests that inflammation plays an important role in the pathogenesis of depression. To better understand the role of inflammation in the pathogenesis of depression we can use the neutrophil-to-lymphocyte ratio (NLR) because it is a simple and effective marker of inflammation and immunity.

Methods: This cross-sectional study was conducted among adults from the healthy general population in Tianjin, China. NLR was measured according to the complete blood count. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS), and a cutoff score of 45 was used to indicate the presence of depressive symptoms in the study participants. The relationship between NLR and the prevalence of depressive symptoms was evaluated separately for men and women using the multiple logistic regression analysis.

Results: In the present study, the overall prevalence of depressive symptoms was 17.0% among all participants. In women, the multivariable-adjusted OR of having depressive symptoms was 1.28 (95% CI 1.10, 1.49; p for trend <0.01) for the fifth compared with the first quintile of NLR, and was 1.22 (95% CI 1.07,1.39; p < 0.01) per unit increase of NLR. However, no significant association was found between NLR and depressive symptoms in men.

Conclusion: This study suggests that increased NLR levels are independently related to depressive symptoms in women, but not in men. Further research is required to investigate this relationship with longitudinal data to establish the temporal ordering between these variables.
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http://dx.doi.org/10.1016/j.psyneuen.2019.01.007DOI Listing
May 2019

Relationship between high-sensitivity C-reactive protein and subclinical carotid atherosclerosis stratified by glucose metabolic status in Chinese adults.

Clin Cardiol 2019 Jan 10;42(1):39-46. Epub 2018 Dec 10.

Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.

Background: Atherosclerosis is an inflammatory disease. Many studies demonstrated that hyperglycemia is not only increased inflammatory response, but also is a cause of atherosclerosis, implying that glucose metabolic status may be an important stratification factor when analyzing the relationship between inflammatory levels and subclinical carotid atherosclerosis. The aim of the present study is to assess the relationship between inflammatory levels and subclinical carotid atherosclerosis, stratified by different glucose metabolic status in a general population.

Methods: An assessment was performed in 7975 participants living in Tianjin, China. In the present study, we examined subclinical carotid atherosclerosis, as defined by increased carotid intima-media thickness [IMT] and plaques. Measurements were performed using a carotid artery B-mode ultrasound system. The glucose metabolic status was defined by the criteria of the American Diabetes Association, and high-sensitivity C-reactive protein (hs-CRP) as an inflammatory indicator, was measured by immunoturbidimetric assay. Multiple logistic models were used to assess a stratified relationship between hs-CRP levels and subclinical carotid atherosclerosis. Strata were defined according to glucose metabolic status.

Results: The prevalence of increased IMT and plaques were 27.3% and 21.3%, respectively. The adjusted odds ratios (95% confidence interval) for IMT across hs-CRP quartiles were as follows: 1.00 (reference), 1.10(0.88-1.38), 1.08(0.86-1.35) and 1.32(1.06-1.66) in blood glucose-normal subjects; 1.00 (reference), 1.33(0.92-1.91), 1.33(0.93-1.91), and 1.59(1.10-2.30) in prediabetic subjects; 1.00 (reference), 0.94(0.54-1.62), 1.17(0.65-2.12) and 0.98(0.55-1.76) in diabetic subjects, respectively. Similar results were observed for plaques.

Conclusions: Our results suggest that inflammatory levels are differently related to subclinical carotid atherosclerosis by the different glucose metabolic status.
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http://dx.doi.org/10.1002/clc.23095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436522PMC
January 2019

Relationship between thyroid function and elevated blood pressure in euthyroid adults.

J Clin Hypertens (Greenwich) 2018 10 8;20(10):1541-1549. Epub 2018 Sep 8.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Thyroid hormones (THs) have profound effects on cardiovascular functions, suggesting that THs may contribute to the development of elevated blood pressure (BP). Few studies, however, have systematically assessed the relationship between THs and elevated BP. We therefore conducted a cross-sectional study to examine how serum THs concentrations are related to the prevalence of elevated BP in a euthyroid population. This study (n = 12 487) was performed in Tianjin, China. Serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) levels were measured by chemiluminescence immunoassay. Elevated BP was defined according to the JNC 8 criteria. Analysis of covariance and multiple logistic regression models were used to assess the relationships between FT3, FT4, and TSH quartiles and elevated BP. The multivariable-adjusted odds ratios (95% confidence interval) of elevated BP for gradual increase in the FT3, FT4, and TSH quartiles, when compared to the lowest quartiles were 1.08 (0.97, 1.21), 1.24 (1.12, 1.39), and 1.32 (1.18, 1.47); 1.18 (1.06, 1.32), 1.18 (1.06, 1.31), and 1.24 (1.11, 1.38); 1.06 (0.96, 1.19), 1.06 (0.95, 1.18), and 1.03 (0.93, 1.15), respectively. Our study demonstrated that FT3 and FT4 are positively related to the prevalence of elevated BP in euthyroid adults, but no significant relationship was found between TSH and elevated BP.
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http://dx.doi.org/10.1111/jch.13369DOI Listing
October 2018

Estimated daily quercetin intake and association with the prevalence of type 2 diabetes mellitus in Chinese adults.

Eur J Nutr 2019 Mar 12;58(2):819-830. Epub 2018 May 12.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.

Purpose: Quercetin is one of potential antidiabetic substances because of its powerful antioxidant and anti-inflammatory actions. The purpose of this study is to estimate daily quercetin intake and assess the relationship between dietary quercetin intake and the prevalence of type 2 diabetes mellitus (T2DM) in a Chinese population.

Methods: Dietary intake was investigated by a validated 100-item food frequency questionnaire. Daily intakes of quercetin and nutrients were calculated accordingly. T2DM was diagnosed based on the criteria of the American Diabetes Association. Adjusted logistic regression models were used to analyze the relationship between the quartiles of quercetin intake and the prevalence of T2DM.

Results: The prevalences of T2DM were 8.35% in men and 4.68% in women. The main food sources of quercetin were apple, orange, and green tea. Daily intake of quercetin was 20.9 ± 2.32 mg/day (mean ± SD). After adjusting for potentially confounding factors, the odds ratios (95% CI) for T2DM across the ascending quartiles of quercetin intake were: 1.00 (reference), 0.75 (0.60-0.95), 0.76 (0.59-0.99), and 0.63 (0.51-0.94).

Conclusions: The results of the present study showed that quercetin intake was inversely related to the prevalence of T2DM in the Chinese population, suggesting a protective effect of quercetin in the development of T2DM.
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http://dx.doi.org/10.1007/s00394-018-1713-2DOI Listing
March 2019

The association between thyroid function and incidence of metabolic syndrome in euthyroid subjects: Tianjin chronic low-grade systemic inflammation and health cohort study.

Clin Endocrinol (Oxf) 2018 05 12;88(5):735-743. Epub 2018 Mar 12.

Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.

Objective: Thyroid hormones (THs) are primarily responsible for the regulation of energy homeostasis and metabolism. However, few prospective studies have assessed the association between THs and metabolic syndrome (MetS) in a general population. We therefore designed a cohort study to examine whether serum TH levels within the reference range are predictive factors for developing MetS in adults.

Design: Prospective cohort study.

Participants: A prospective study (n = 6119) was performed in Tianjin, China. Participants without a history of MetS were followed up for 1 to 3 years with a median follow-up duration of 2 years.

Measurements: Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels were measured by chemiluminescence immunoassay. MetS was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. THs, TSH levels and MetS were assessed yearly during the follow-up. Adjusted Cox proportional hazards regression models were used to assess the associations between FT3, FT4 and TSH quintiles and MetS.

Results: The incidence of MetS was 17.7% (96 per 1000 person-years). In the final multivariate models, the hazard ratios (95% confidence interval) for MetS across serum FT3 quintiles were 1.00 (reference), 1.03 (0.84, 1.25), 1.14 (0.94, 1.38), 1.09 (0.90, 1.32) and 1.33 (1.11, 1.61), respectively (P for trend <.01). However, no significant associations between FT4, TSH and MetS were observed.

Conclusions: This population-based prospective cohort study suggests that increased serum FT3 level, rather than FT4 and TSH, is an independent predictor for developing MetS in euthyroid subjects.
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http://dx.doi.org/10.1111/cen.13576DOI Listing
May 2018
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