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Jagielski A.C.,University of Birmingham | Jiang C.Q.,Guangzhou Number 12 Peoples Hospital | Xu L.,University of Hong Kong | Taheri S.,King's College London | And 4 more authors.
Age and ageing | Year: 2015

AIMS: an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population.METHODS: the Guangzhou Biobank Cohort Study included 27,971 individuals (50-96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured.RESULTS: after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00-1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73-1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI -0.03 to -0.002) and 0.03 in MMSE score (P = 0.114, 95% CI -0.06-0.01).CONCLUSIONS: an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.


PubMed | Guangzhou Number 12 Peoples Hospital, University of Hong Kong, King's College London, University of Heidelberg and University of Birmingham
Type: Journal Article | Journal: Age and ageing | Year: 2014

an association between T2DM and cognitive impairment has been reported among Western populations, but data are limited in other settings. We investigated the cross-sectional association between fasting blood glucose (FBG) and cognition in an older Chinese population.the Guangzhou Biobank Cohort Study included 27,971 individuals (50-96 years, mean age 61.5 years, 72% female) with measures of cognitive function assessed using modified Delayed Word Recall Test (DWRT) and Mini-Mental State Examination (MMSE). Fasting glucose and lipids, and potential confounders were measured.after adjustment for potential confounders, the risk for cognitive impairment as measured by DWRT, significantly increased [odds ratio (OR) = 1.18, 95% CI 1.00-1.40] but the association was of borderline significance when measured by MMSE (OR = 1.04, 95% CI 0.73-1.47) in those with diabetes relative to those without diabetes. Fasting blood glucose was significantly negatively associated with cognitive function as measured by DWRT but not MMSE, with an increase of 1 mmol/l of FBG associated with a decrease of 0.02 in DWRT (P < 0.05, 95% CI -0.03 to -0.002) and 0.03 in MMSE score (P = 0.114, 95% CI -0.06-0.01).an FBG level indicative of T2DM was associated with increased risk for cognitive impairment. The findings also demonstrate that glycaemia is continuously associated with cognitive impairment, suggesting that dysfunction is associated with increasing glucose levels even in the normoglycaemic range.


Lam K.-B.H.,University of Birmingham | Jiang C.Q.,Guangzhou Number 12 Peoples Hospital | Thomas G.N.,University of Birmingham | Arora T.,University of Birmingham | And 5 more authors.
Sleep | Year: 2010

Study Objective: Intentional napping is very common, particularly in China. However, there are limited data regarding its potential health effects. We therefore examined the possible relationship between napping and type 2 diabetes. Design: Cross-sectional analysis of baseline data from the Guangzhou Biobank Cohort Study. Setting: Community-based elderly association in Guangzhou, China. Participants: 19,567 Chinese men and women aged 50 years or older. Measurements and Results: Self-reported frequency of napping was obtained by questionnaire and type 2 diabetes was assessed by fasting blood glucose and/or self-reports of physician diagnosis or treatment. Participants reporting frequent naps (4-6 days/week and daily) were 42% to 52% more likely to have diabetes. The relationships remained essentially unchanged after adjustments were made for demographics, lifestyle and sleep habits, health status, adiposity, and metabolic markers (odds ratio for diabetes 1.36 [95% CI 1.17-1.57] in 4-6 days/week, 1.28 [1.15-1.44] in daily nappers). Similar associations were found between napping and impaired fasting glucose. Removal of those with potential ill health and daytime sleepiness did not alter the observed associations. Conclusions: Napping is associated with elevated prevalence of diabetes and impaired fasting glucose in this older Chinese sample. Our finding suggests that it is less likely that diabetes leads to daytime sleepiness. This raises the possibility that napping may increase the risk of diabetes. Confirmation by longitudinal studies is needed.


Yang S.,Chinese PLA General Hospital | Jin Y.,Guangzhou Number 12 Peoples Hospital | He Y.,Chinese PLA General Hospital | Jiang C.,Guangzhou Number 12 Peoples Hospital | And 3 more authors.
PLoS ONE | Year: 2015

Objective: We examined the associations between childhood passive smoking exposure and age at menarche in women who had never smoked in southern China. Methods: Among 30,518 participants in Guangzhou Biobank Cohort Study (GBCS) from 2003-2008, 20,061 women who had never smoked and had complete outcome data were included. Childhood passive smoking exposure was defined as living with 1 or more smokers in the same household during childhood. Data on the number of smokers in the household and frequency of exposure (density and frequency) were also obtained. Age at menarche was measured as a continuous variable. Results: 11,379 (56.7%) participants were exposed to passive smoking during childhood. Compared to those with no passive smoking exposure during childhood, those with exposure ≥5 days/ week had menarche 0.19 year (95% confidence interval (CI): 0.13-0.25) earlier on average. Those exposed to more than two smokers had menarche 0.38 year earlier (95% CI: 0.29- 0.47). Childhood exposure was associated with early age at menarche (≤13 vs. >13 years), with an adjusted odds ratio of 1.34 (95% CI: 1.21-1.48) for high density, and 1.17 (95% CI: 1.09-1.26) for high frequency of exposure. Conclusion: Childhood passive smoking exposure was associated with earlier age at menarche, with a dose-response relationship in Chinese women who had never smoked. If causal, the results support the promotion of smoking cessation in families with children, particularly young girls. Copyright: © 2015 Yang et al.


Arora T.,University of Birmingham | Jiang C.Q.,Guangzhou Number 12 Peoples Hospital | Thomas G.N.,University of Birmingham | Lam K.-B.H.,University of Birmingham | And 4 more authors.
Diabetes Care | Year: 2011

OBJECTIVE - To examine the association between total sleep duration and the prevalence of metabolic syndrome (MetSyn) in older Chinese. RESEARCH DESIGN AND METHODS - Cross-sectional analysis of baseline data from the Guangzhou Biobank Cohort Study (GBCS) was performed. Participants (n = 29,333) were aged ≥50 years. Risk of MetSyn and its components were identified for self-reported total sleep duration. RESULTS - Participants reporting long (≥9 h) and short (<6 h) total sleep duration had increased odds ratio (OR) of 1.18 (95% CI 1.07-1.30) and 1.14 (1.05-1.24) for the presence of MetSyn, respectively. The relationship remained in long sleepers (OR 1.21 [1.10-1.34]) but diminished in short sleepers (0.97 [0.88-1.06]) after full adjustment. CONCLUSIONS - Long sleep duration was associated with greater risk of MetSyn in older Chinese. Confirmation through longitudinal studies is needed. The mechanisms mediating the link between long sleep duration and MetSyn require further investigation. © 2011 by the American Diabetes Association.


Lam K.B.H.,University of Birmingham | Yin P.,University of Birmingham | Yin P.,National Center for Chronic and Noncommunicable Disease Control and Prevention | Jiang C.Q.,Guangzhou Number 12 Peoples Hospital | And 7 more authors.
Respiratory Medicine | Year: 2012

The impact of occupational dust and gas/fume exposure on chronic obstructive pulmonary disease (COPD) in developing countries has not been quantified. We examined the relationship between past dust and fume exposure and prevalence of COPD and respiratory symptoms in a cross-sectional analysis of a large Chinese population sample. Participants in the Guangzhou Biobank Cohort Study (n = 8216; 27.3% men, mean age 61.9 ± 6.8 years) had spirometry and a structured interview including exposures, symptoms, and lifestyle. Self-reported intensity and duration of dust and gas/fume exposure was used to derive cumulative exposure. COPD was diagnosed from spirometry using lower limit of normal based on prediction equations. COPD was associated with high exposure to dust or gas/fume (exposed: 87/1206 v non-exposed: 191/3853; adjusted odds ratio: 1.41; 95% confidence interval (CI) 1.06, 1.87) with no evidence of effect modification by smoking. Respiratory symptoms were associated with exposures to dust and gas/fume, with adjusted odds ratios for chronic cough/phlegm of 1.57 (1.13, 2.17) and 1.39 (1.20, 1.60) for dyspnoea. The overall population attributable fraction for COPD due to occupational exposure was 10.4% (95% CI -0.9%, 19.5%). Occupational dust and gas/fume exposure is associated with an increased prevalence of COPD in this Chinese sample, independent of smoking. The population attributable fraction in Chinese is similar to that in Western populations. © 2012 Elsevier Ltd. All rights reserved.


Lam K.-B.H.,University of Birmingham | Jiang C.Q.,Guangzhou Number 12 Peoples Hospital | Jordan R.E.,University of Birmingham | Miller M.R.,University of Birmingham | And 4 more authors.
Chest | Year: 2010

Background: Prior pulmonary TB has been shown to be associated with a higher risk of airflow obstruction, which is the hallmark of COPD, but whether smoking modifi es this relationship is unclear. We investigated the relationships between prior TB, smoking, and airflow obstruction in a Chinese population sample. Methods: Participants in the Guangzhou Biobank Cohort Study underwent spirometry, chest radiography, and a structured interview on lifestyle and exposures. Prior TB was defi ned as the presence of radiologic evidence suggestive of inactive TB. Airflow obstruction was based on spirometric criteria. Results: The prevalence of prior TB in this sample (N = 8,066, mean age: 61.9 years) was 24.2%. After controlling for sex, age, and smoking exposure, prior TB remained independently associated with an increased risk of airflow obstruction (odds ratio = 1.37; 95% CI, 1.13-1.67). Further adjustment for exposure to passive smoking, biomass fuel, and dust did not alter the relationship. Smoking did not modify the relationship between prior TB and airflow obstruction. Conclusions: Prior TB is an independent risk factor for airflow obstruction, which may partly explain the higher prevalence of COPD in China. Clinicians should be aware of this long-term risk in individuals with prior TB, irrespective of smoking status, particularly in patients from countries with a high TB burden. © 2010 American College of Chest Physicians.


Lam K.-B.H.,University of Birmingham | Jordan R.E.,University of Birmingham | Jiang C.Q.,Guangzhou Number 12 Peoples Hospital | Thomas G.N.,University of Birmingham | And 5 more authors.
European Respiratory Journal | Year: 2010

There is some evidence that chronic obstructive pulmonary disease (COPD) and metabolic syndrome may be related, perhaps through systemic inflammation, which is common to both. However, the association between the two conditions has not yet been clearly shown. The present study involved 7,358 adults aged ≥50 yrs from a population-based survey who underwent spirometry, a structured interview and measurement of fasting metabolic marker levels. Airflow obstruction (forced expiratory volume in 1 s/forced vital capacity ratio of less than the lower limit of normal) was present in 6.7%, and the International Diabetes Federation metabolic syndrome criteria were met by 20.0%. The risk of metabolic syndrome was higher in those with airflow obstruction than in those without (odds ratio (OR) 1.47; 95% confidence interval (CI) 1.12-1.92), after controlling for potential confounders. Of the five components of metabolic syndrome, only central obesity was significantly associated with airflow obstruction (OR 1.43; 95% CI 1.09-1.88) after adjusting for body mass index. A similar association was observed in both never and current smokers. In this Chinese sample, airflow obstruction was associated with metabolic syndrome, and, in particular, its central obesity component. This may help explain the increased risk of cardiovascular diseases in COPD, and so could guide future clinical practice. Copyright©ERS Journals Ltd 2010.


Adab P.,University of Birmingham | Jiang C.Q.,Guangzhou Number 12 Peoples Hospital | Rankin E.,University of Birmingham | Tsang Y.W.,University of Birmingham | And 5 more authors.
Rheumatology (United Kingdom) | Year: 2014

Objective: Hormonal and reproductive factors are implicated in the aetiology of RA, but results of previous studies have been mixed. The aim of this cross-sectional study was to assess the relationships between RA, use of oral contraceptives (OCs) and history of breastfeeding in a population of older women from South China. Methods: We used baseline data from 7349 women ≥50 years of age in the Guangzhou Biobank Cohort. Questionnaires were used to obtain socio-demographic, lifestyle and obstetric history data, including parity, OC use and breastfeeding practices. The main outcome was RA. Women were asked about history of RA and were examined to assess joint swelling. RF levels were measured. The presence of RA was defined in two ways: (i) as reporting physician-diagnosed RA or pain and swelling in at least three joints (including the wrist), and (ii) also having at least one of the following: positive RF, morning stiffness or objective swelling of the small joints of the hands. Results: Compared with those who had never breastfed, breastfeeding was associated with half the risk of RA. The risk was lower with increasing duration of breastfeeding [adjusted odds ratio (OR) 0.54 (95% CI 0.29, 1.01) for breastfeeding at least 36 months; P for trend = 0.04]. OC use had no relationship with RA. Conclusion: Breastfeeding (especially longer duration) but not OC use is associated with a lower risk of RA. This has potentially important implications for future RA disease burden, given the declining rates of breastfeeding and the one-child policy in China. Further research is needed to explain the biological mechanism. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.


PubMed | Guangzhou Number 12 Peoples Hospital, University of Hong Kong, Chinese PLA General Hospital and University of Birmingham
Type: | Journal: Tobacco control | Year: 2016

Studies of secondhand smoke (SHS) exposure especially childhood SHS exposure and pregnancy loss are limited. We used baseline data of the Guangzhou Biobank Cohort Study (GBCS) to examine the association of childhood SHS exposure with a history of pregnancy loss.Never smoking women aged 50years or above in GBCS from 2003 to 2008 were included. Propensity score matching (PSM) was used to control for confounding. Negative binomial regression and logistic regression were used to examine the association of childhood SHS, assessed by number of smokers in childhood household and frequency of exposure, with past pregnancy loss.Of 19562 women, 56.7% (11096) had SHS exposure during childhood. In negative binomial regression, after adjusting for age, education, past occupational dust exposure, past home fuel exposure, oral contraceptive, adulthood SHS exposure, age at first pregnancy and age at first menarche, compared to non-exposure, the incidence rate ratio of one more pregnancy loss was 1.20 (95% CI1.05 to 1.37) in those who lived with 2 smokers in the same household, and 1.14 (95% CI 1.04 to 1.25) in those exposed 5 times/week. After similar adjustment, logistic regression showed that the OR of pregnancy loss 2 times (versus 0 to 1 time) was 1.25 (95% CI 1.00 to 1.57) and 1.20 (95% CI 1.03 to 1.40) for high density (2 smokers in the same household) and frequency (5 times/week) of childhood exposure, respectively.Childhood SHS exposure was associated with higher risks of pregnancy loss in middle-aged and older Chinese women.

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