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Kurmi O.P.,University of Oxford | Li L.,Peking University | Li L.,Chinese Academy of Sciences | Wang J.,University of Oxford | And 138 more authors.
International Journal of COPD | Year: 2015

Purpose: In adult Chinese men, smoking prevalence is high, but little is known about its association with chronic respiratory disease, which is still poorly diagnosed and managed. Methods: A nationwide study recruited 0.5 million men and women aged 30–79 years during 2004–2008 from ten geographically diverse areas across the Mainland China. Information was collected from each participant regarding smoking and self-reported physician diagnosis of chronic bronchitis/emphysema (CB/E), along with measurement of lung function indices. Logistic regression was used to yield sex-specific odds ratios (ORs) relating smoking to airflow obstruction (AFO), defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.7 and CB/E, adjusting for age, areas, education, and income. Results: Overall 74% of men were ever regular smokers; among them, 7.2% had AFO compared with 5.4% in never-smokers, yielding an OR of 1.42 (95% confidence interval [CI]: 1.34–1.50). The risk was strongly associated with amount smoked and starting to smoke at a younger age. Among ex-smokers, the OR was more extreme for those who had quit due to illness (OR: 1.86, 95% CI: 1.77–1.96) than those who had quit by choice (OR:1.08, 95% CI: 1.01–1.16). CB/E prevalence was also significantly elevated in ex-smokers who had quit because of ill health (OR:2.79, 95% CI: 2.64–2.95), but not in regular smokers (OR:1.04, 95% CI: 0.96–1.11). Female smokers was rare (3%), but carried an excess risk for AFO (OR:1.53, 95% CI: 1.43–1.65) and, to a lesser extent, for CB/E (OR:1.28, 95% CI: 1.15–1.42). Conclusion: In Mainland China, adult smokers, particularly ex-smokers who had quit because of illness, had significantly higher prevalence of chronic respiratory disease. AFO appeared to be more strongly associated with smoking than self-reported chronic respiratory disease. © 2015 Kurmi et al. Source


Chen Z.,University of Oxford | Smith M.,University of Oxford | Du H.,University of Oxford | Guo Y.,Chinese Academy of Sciences | And 146 more authors.
International Journal of Epidemiology | Year: 2015

Background: Greater adiposity is associated with higher blood pressure. Substantial uncertainty remains, however, about which measures of adiposity most strongly predict blood pressure and whether these associations differ materially between populations. Methods: We examined cross-sectional data on 500 000 adults recruited from 10 diverse localities across China during 2004-08. Multiple linear regression was used to estimate the effects on systolic blood pressure (SBP) of general adiposity [e.g. body mass index (BMI), body fat percentage, height-adjusted weight] vs central adiposity [e.g. waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR)], before and after adjustment for each other. The main analyses excluded those reported taking any antihypertensive medication, and were adjusted for age, region and education. Results: The overall mean [standard deviation (SD)] BMI was 23.6 (3.3) kg/m2 and mean WC was 80.0 (9.5) cm. The differences in SBP (men/women, mmHg) per 1SD higher general adiposity (height-adjusted weight: 6.6/5.6; BMI: 5.5/4.9; body fat percentage: 5.5/5.0) were greater than for central adiposity (WC: 5.0/4.3; HC: 4.8/4.1; WHR: 3.7/3.2), with a 10 kg/m2 greater BMI being associated on average with 16 (men/women: 17/14) mmHg higher SBP. The associations of blood pressure with measures of general adiposity were not materially altered by adjusting for WC and HC, but those for central adiposity were significantly attenuated after adjusting for BMI (WC: 1.1/0.7; HC: 0.3/-0.2; WHR: 0.6/0.6). Conclusion: In adult Chinese, blood pressure is more strongly associated with general adiposity than with central adiposity, and the associations with BMI were about 50% stronger than those observed in Western populations. © The Author 2015. Source


Sun D.,Peking University | Lv J.,Peking University | Chen W.,Peking University | Chen W.,Tulane University | And 25 more authors.
BMC Public Health | Year: 2014

Background: Few animal experiments and volunteer-based intervention studies have showed a controversial effect of spicy foods on weight management; however, information is scant on the association between spicy food intake and obesity. This study aims to examine the impact of spicy food on quantitative adiposity measures in the Chinese population; a population with a low prevalence of general obesity, but a high prevalence of central obesity. Methods: A total of 434,556 adults (255,094 females), aged 30-79 years, were included from the China Kadoorie Biobank (CKB) study. Information on spicy food intake was obtained using a questionnaire survey. Body mass index (BMI), percentage body fat (BF%), waist circumference (WC), and WC/height ratio (WHtR) were analyzed as continuous variables. Results: The prevalence of daily spicy food eating was 30.4% in males and 30.0% in females, with dramatically geographic diversity (ranging from 99.4% in Hunan to 2.7% in Zhejiang). The covariates-adjusted BMI, BF%, WC, and WHtR significantly increased with increasing frequency, strength, and duration of spicy food eating regardless of gender (p < 0.001). Among regular spicy food consumers, strength of spicy food eating showed significant and positive association with all adiposity measures in both genders (except for BF% in males). Compared with non-consumers, daily spicy food eating was significantly associated with an increase of 0.44 and 0.51 of BMI (kg/m2), 0.79 and 1.01 of BF%, 1.4 and 1.0 of WC (cm), and 0.008 and 0.006 of WHtR in males and females, respectively. In stratified analyses of 18 consecutive BMI subgroups, a significantly increasing trend in the effect of daily spicy food eating on WC and WHtR with increasing BMI was noted in males; whereas a decreasing trend was seen in females. Conclusions: The data indicate that spicy food intake is a risk factor for obesity in Chinese adult population, especially for central obesity in males. Further studies are needed to elucidate the mechanisms underlying this association. © 2014 Sun et al. Source

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