Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population

The Kailuan Study

Xiaoxue Liu, Liufu Cui, Anxin Wang, Xizhu Wang, Qiaofeng Song, Shanshan Li, Jihong Shi, Xiaohong Zhao, Shuohua Chen, Xin Du, Chunpeng Ji, Rachel Huxley, Yuming Guo, Shouling Wu

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13 Citations (Scopus)

Abstract

Background: It is unclear whether ideal cardiovascular health (CVH), and particularly cumulative exposure to ideal CVH (cumCVH), is associated with incident diabetes. We aimed to fill this research gap. Methods and Results: The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006-2007 and who were subsequently followed up at 2- (Exam 2), 4- (Exam 3), and 6 (Exam 4)-year intervals after baseline. The main analysis is restricted to those individuals with complete follow-up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal CVH (cumCVH) was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cumCVH and incident diabetes. In fully adjusted models, compared with the lowest quintile of cumCVH, individuals in the highest quintile had ~68% (95% confidence interval [CI] 60-75) lower risk for incident diabetes (compared with 61% [95% CI 52-69] lower risk when using baseline CVH). Every additional year lived with a 1-unit increase in ideal CVH was associated with a 24% (95% CI 21-28) reduction in incident diabetes. Conclusions: Ideal CVH is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of CVH exposure are used. Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes. Clinical Trial Registration: URL: https://www.chictr.org. Unique identifier: ChiCTRTNC-11001489.

Original languageEnglish
Article numbere004132
Number of pages21
JournalAmerican Heart Association. Journal. Cardiovascular and Cerebrovascular Disease
Volume5
Issue number9
DOIs
Publication statusPublished - 1 Sep 2016
Externally publishedYes

Cite this

Liu, Xiaoxue ; Cui, Liufu ; Wang, Anxin ; Wang, Xizhu ; Song, Qiaofeng ; Li, Shanshan ; Shi, Jihong ; Zhao, Xiaohong ; Chen, Shuohua ; Du, Xin ; Ji, Chunpeng ; Huxley, Rachel ; Guo, Yuming ; Wu, Shouling. / Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population : The Kailuan Study. In: American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease. 2016 ; Vol. 5, No. 9.
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abstract = "Background: It is unclear whether ideal cardiovascular health (CVH), and particularly cumulative exposure to ideal CVH (cumCVH), is associated with incident diabetes. We aimed to fill this research gap. Methods and Results: The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006-2007 and who were subsequently followed up at 2- (Exam 2), 4- (Exam 3), and 6 (Exam 4)-year intervals after baseline. The main analysis is restricted to those individuals with complete follow-up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal CVH (cumCVH) was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cumCVH and incident diabetes. In fully adjusted models, compared with the lowest quintile of cumCVH, individuals in the highest quintile had ~68{\%} (95{\%} confidence interval [CI] 60-75) lower risk for incident diabetes (compared with 61{\%} [95{\%} CI 52-69] lower risk when using baseline CVH). Every additional year lived with a 1-unit increase in ideal CVH was associated with a 24{\%} (95{\%} CI 21-28) reduction in incident diabetes. Conclusions: Ideal CVH is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of CVH exposure are used. Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes. Clinical Trial Registration: URL: https://www.chictr.org. Unique identifier: ChiCTRTNC-11001489.",
author = "Xiaoxue Liu and Liufu Cui and Anxin Wang and Xizhu Wang and Qiaofeng Song and Shanshan Li and Jihong Shi and Xiaohong Zhao and Shuohua Chen and Xin Du and Chunpeng Ji and Rachel Huxley and Yuming Guo and Shouling Wu",
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Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population : The Kailuan Study. / Liu, Xiaoxue; Cui, Liufu; Wang, Anxin; Wang, Xizhu; Song, Qiaofeng; Li, Shanshan; Shi, Jihong; Zhao, Xiaohong; Chen, Shuohua; Du, Xin; Ji, Chunpeng; Huxley, Rachel; Guo, Yuming; Wu, Shouling.

In: American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, Vol. 5, No. 9, e004132, 01.09.2016.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population

T2 - The Kailuan Study

AU - Liu, Xiaoxue

AU - Cui, Liufu

AU - Wang, Anxin

AU - Wang, Xizhu

AU - Song, Qiaofeng

AU - Li, Shanshan

AU - Shi, Jihong

AU - Zhao, Xiaohong

AU - Chen, Shuohua

AU - Du, Xin

AU - Ji, Chunpeng

AU - Huxley, Rachel

AU - Guo, Yuming

AU - Wu, Shouling

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background: It is unclear whether ideal cardiovascular health (CVH), and particularly cumulative exposure to ideal CVH (cumCVH), is associated with incident diabetes. We aimed to fill this research gap. Methods and Results: The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006-2007 and who were subsequently followed up at 2- (Exam 2), 4- (Exam 3), and 6 (Exam 4)-year intervals after baseline. The main analysis is restricted to those individuals with complete follow-up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal CVH (cumCVH) was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cumCVH and incident diabetes. In fully adjusted models, compared with the lowest quintile of cumCVH, individuals in the highest quintile had ~68% (95% confidence interval [CI] 60-75) lower risk for incident diabetes (compared with 61% [95% CI 52-69] lower risk when using baseline CVH). Every additional year lived with a 1-unit increase in ideal CVH was associated with a 24% (95% CI 21-28) reduction in incident diabetes. Conclusions: Ideal CVH is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of CVH exposure are used. Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes. Clinical Trial Registration: URL: https://www.chictr.org. Unique identifier: ChiCTRTNC-11001489.

AB - Background: It is unclear whether ideal cardiovascular health (CVH), and particularly cumulative exposure to ideal CVH (cumCVH), is associated with incident diabetes. We aimed to fill this research gap. Methods and Results: The Kailuan Study is a prospective cohort of 101 510 adults aged 18 to 98 years recruited in 2006-2007 and who were subsequently followed up at 2- (Exam 2), 4- (Exam 3), and 6 (Exam 4)-year intervals after baseline. The main analysis is restricted to those individuals with complete follow-up at all 4 examinations and who had no history of diabetes until Exam 3. Cumulative exposure to ideal CVH (cumCVH) was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (score×year). Logistic regression models were used to assess the association between cumCVH and incident diabetes. In fully adjusted models, compared with the lowest quintile of cumCVH, individuals in the highest quintile had ~68% (95% confidence interval [CI] 60-75) lower risk for incident diabetes (compared with 61% [95% CI 52-69] lower risk when using baseline CVH). Every additional year lived with a 1-unit increase in ideal CVH was associated with a 24% (95% CI 21-28) reduction in incident diabetes. Conclusions: Ideal CVH is associated with a reduced incidence of diabetes, but the association is likely to be underestimated if baseline measures of CVH exposure are used. Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes. Clinical Trial Registration: URL: https://www.chictr.org. Unique identifier: ChiCTRTNC-11001489.

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U2 - 10.1161/JAHA.116.004132

DO - 10.1161/JAHA.116.004132

M3 - Article

VL - 5

JO - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

JF - American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease

SN - 2047-9980

IS - 9

M1 - e004132

ER -