This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Pa...This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Participants were drawn from two Chinese cohorts and the UK Biobank,excluding those with lipid-lowering medications,coronary heart disease(CHD),stroke,cancer,clinically diagnosed chronic obstructive pulmonary disease,low body mass index(<18.5 kg·m^(-2))at baseline,and deaths within the first two years to minimize reverse causality.Individual cholesterol changes were assessed in a subset who attended the resurvey after over four years.Mortality data were linked to registries,and risks were estimated using Cox proportional hazards models.A total of 163115 Chinese and 317305 UK adults were included(mean age,49-61 years),with 43%,81%,and 44%males in Dongfeng-Tongji,Kailuan,and UK Biobank cohorts,respectively.During a median follow-up of 9.7-12.9 years,9553 and 15760 deaths were documented in the Chinese cohorts and UK Biobank,respectively.After multivariate adjustments,nonlinear relationships were observed between total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and non-high-density lipoprotein cholesterol(non-HDL-C)levels and mortality.In both populations,high cholesterol was primarily associated with CHD mortality,while low cholesterol associated with all-cause and cancer mortality(Pnonlinear≤0.0161).The optimal levels for all-cause mortality risk in Chinese adults(TC:200 mg·dL^(-1);LDL-C:130 mg·dL^(-1);non-HDL-C:155 mg·dL^(-1))were lower than those in the UK Biobank but consistent with guideline recommendation.Additionally,decreasing cholesterol levels over four years were associated with higher all-cause and cancer mortality in the Chinese cohorts(P_(nonlinear)≤0.0100).Participants with low TC,LDL-C,or non-HDL-C levels at both baseline and resurvey experienced elevated all-cause mortality risks in both populations,as did those with low/medium baseline levels and>20%reductions over time in Chinese adults.In conclusion,higher TC,LDL-C,and non-HDL-C levels are associated with elevated CHD mortality.Importantly,low and/or longitudinally decreasing cholesterol levels are robustly associated with increased all-cause and cancer mortality,potentially serving as markers of premature death.Regular cholesterol monitoring,with attention to both high and low levels,is recommended to inform guideline updates and clinical strategies.展开更多
Gut microbiota plays an important role in coronary heart disease, but its compositional and functional changes in unstable angina(UA) remain unexplored. We performed metagenomic sequencing of 133 newly diagnosed UA pa...Gut microbiota plays an important role in coronary heart disease, but its compositional and functional changes in unstable angina(UA) remain unexplored. We performed metagenomic sequencing of 133 newly diagnosed UA patients and 133 sex-and age-matched controls, and profiled the fecal and plasma metabolomes in 30 case-control pairs. The alpha diversity of gut microbiota was increased in UA patients:the adjusted odds ratios(ORs) per standard deviation increase in Shannon and Simpson indices were 1.30(95% confidence interval, 1.01-1.70) and 1.36(1.05-1.81), respectively. Two common species(depleted Klebsiella pneumoniae and enriched Streptococcus parasanguinis;P ≤ 0.002) and three rare species(depleted Weissella confusa, enriched Granulicatella adiacens and Erysipelotrichaceae bacterium 6_1_45;P ≤ 0.005) were associated with UA. The UA-associated gut microbiota was depleted in the pathway of Lphenylalanine degradation(P = 0.001), primarily contributed by Klebsiella pneumoniae. Consistently, we found increased circulating phenylalanine in UA patients(OR = 2.76 [1.17-8.16]). Moreover, Streptococcus parasanguinis was negatively correlated with fecal citrulline(Spearman's r_(s)=-0.470, P = 0.009), a metabolite depleted in UA patients(OR = 0.26 [0.08-0.63]). These findings are informative to help understand the metabolic connection between gut microbiota and UA.展开更多
Background: Evidence on the relations of the American Heart Association’s ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained uncl...Background: Evidence on the relations of the American Heart Association’s ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps. Methods: A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis. Results: During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed. Conclusions: ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.展开更多
Palaeolimnological studies should ideally be based upon continuous, undisturbed sediment sequences with reliable chronologies. However for some lake cores, these conditions are not met and palaeolimnologists are often...Palaeolimnological studies should ideally be based upon continuous, undisturbed sediment sequences with reliable chronologies. However for some lake cores, these conditions are not met and palaeolimnologists are often faced with dating puzzles caused by sediment disturbances in the past. This study chooses Esthwaite Water from England to illustrate how to identify sedimentation discontinuities in lake cores and how chronologies can be established for imperfect cores by correlation of key sediment signatures in parallel core records and with long-term monitoring data （1945-2003）. Replicated short cores （ESTH1, ESTH7, and ESTH8） were collected and subjected to loss-on-ignition, radiometric dating （210Pb, 137Cs, and 14C）, particle size, trace metal, and fossil diatom analysis. Both a slumping and a hiatus event were detected in ESTH7 based on comparisons made between the cores and the long-term diatom data. Ordination analysis suggested that the slumped material in ESTH7 originated from sediment deposited around 1805-1880 AD. Further, it was inferred that the hiatus resulted in a loss of sediment deposited from 1870 to 1970 AD. Given the existence of three superior 14C dates in ESTH7, ESTH 1 and ESTH7 were temporally correlated by multiple palaeolimnological proxies for age-depth model development. High variability in sedimentation rates was evident, but good agreement across the various palaeo- limnological proxies indicated coherence in sediment processes within the coring area. Differences in sedimenta- tion rates most likely resulted from the natural morphology of the lake basin. Our study suggests that caution is required in selecting suitable coring sites for palaeolimno-logical studies of small, relatively deep lakes and that proximity to steep slopes should be avoided wherever possible. Nevertheless, in some cases, comparisons between a range of contemporary and palaeolimnological records can be employed to diagnose sediment distur- bances and establish a chronology.展开更多
基金supported by the National Natural Science Foundation of China(82021005,82192903,81930092)the Chief Scientist Research Project of Hubei Shizhen Laboratory(HSL2024SX0003)+1 种基金the Fundamental Research Funds for the Central Universities(2019kfyXMBZ015)the 111 Project and the Program for Changjiang Scholars and Innovative Research Team in University.
文摘This prospective study aimed to investigate the associations of untreated cholesterol levels and their longitudinal changes,especially low levels,with all-cause and cause-specific mortality in different populations.Participants were drawn from two Chinese cohorts and the UK Biobank,excluding those with lipid-lowering medications,coronary heart disease(CHD),stroke,cancer,clinically diagnosed chronic obstructive pulmonary disease,low body mass index(<18.5 kg·m^(-2))at baseline,and deaths within the first two years to minimize reverse causality.Individual cholesterol changes were assessed in a subset who attended the resurvey after over four years.Mortality data were linked to registries,and risks were estimated using Cox proportional hazards models.A total of 163115 Chinese and 317305 UK adults were included(mean age,49-61 years),with 43%,81%,and 44%males in Dongfeng-Tongji,Kailuan,and UK Biobank cohorts,respectively.During a median follow-up of 9.7-12.9 years,9553 and 15760 deaths were documented in the Chinese cohorts and UK Biobank,respectively.After multivariate adjustments,nonlinear relationships were observed between total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and non-high-density lipoprotein cholesterol(non-HDL-C)levels and mortality.In both populations,high cholesterol was primarily associated with CHD mortality,while low cholesterol associated with all-cause and cancer mortality(Pnonlinear≤0.0161).The optimal levels for all-cause mortality risk in Chinese adults(TC:200 mg·dL^(-1);LDL-C:130 mg·dL^(-1);non-HDL-C:155 mg·dL^(-1))were lower than those in the UK Biobank but consistent with guideline recommendation.Additionally,decreasing cholesterol levels over four years were associated with higher all-cause and cancer mortality in the Chinese cohorts(P_(nonlinear)≤0.0100).Participants with low TC,LDL-C,or non-HDL-C levels at both baseline and resurvey experienced elevated all-cause mortality risks in both populations,as did those with low/medium baseline levels and>20%reductions over time in Chinese adults.In conclusion,higher TC,LDL-C,and non-HDL-C levels are associated with elevated CHD mortality.Importantly,low and/or longitudinally decreasing cholesterol levels are robustly associated with increased all-cause and cancer mortality,potentially serving as markers of premature death.Regular cholesterol monitoring,with attention to both high and low levels,is recommended to inform guideline updates and clinical strategies.
基金supported by grants from Foundation of the National Key Research and Development Program of China (2016YFC0900800)the National Natural Science Foundation of China (81930092)+2 种基金the Fundamental Research Funds for the Central University (2019kfy XMBZ015)the 111 Projectthe Program for Changjiang Scholars and Innovative Research Team in University。
文摘Gut microbiota plays an important role in coronary heart disease, but its compositional and functional changes in unstable angina(UA) remain unexplored. We performed metagenomic sequencing of 133 newly diagnosed UA patients and 133 sex-and age-matched controls, and profiled the fecal and plasma metabolomes in 30 case-control pairs. The alpha diversity of gut microbiota was increased in UA patients:the adjusted odds ratios(ORs) per standard deviation increase in Shannon and Simpson indices were 1.30(95% confidence interval, 1.01-1.70) and 1.36(1.05-1.81), respectively. Two common species(depleted Klebsiella pneumoniae and enriched Streptococcus parasanguinis;P ≤ 0.002) and three rare species(depleted Weissella confusa, enriched Granulicatella adiacens and Erysipelotrichaceae bacterium 6_1_45;P ≤ 0.005) were associated with UA. The UA-associated gut microbiota was depleted in the pathway of Lphenylalanine degradation(P = 0.001), primarily contributed by Klebsiella pneumoniae. Consistently, we found increased circulating phenylalanine in UA patients(OR = 2.76 [1.17-8.16]). Moreover, Streptococcus parasanguinis was negatively correlated with fecal citrulline(Spearman's r_(s)=-0.470, P = 0.009), a metabolite depleted in UA patients(OR = 0.26 [0.08-0.63]). These findings are informative to help understand the metabolic connection between gut microbiota and UA.
基金supported by grants from the National Nature Science Foundation of China(Nos.81930124 and 82021005)The Dongfeng-Tongji cohort was supported by the National Key Research and Development Program of China(Nos.2016YFC0900801 and 2017YFC0907504)+2 种基金The China Kadoorie Biobank study was funded by the National Natural Science Foundation of China(Nos.82192901,82192900,and 81390540)the National Key Research and Development Program of China(No.2016YFC0900500)and the Chinese Ministry of Science and Technology(No.2011BAI09B01).
文摘Background: Evidence on the relations of the American Heart Association’s ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps. Methods: A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis. Results: During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed. Conclusions: ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.
文摘Palaeolimnological studies should ideally be based upon continuous, undisturbed sediment sequences with reliable chronologies. However for some lake cores, these conditions are not met and palaeolimnologists are often faced with dating puzzles caused by sediment disturbances in the past. This study chooses Esthwaite Water from England to illustrate how to identify sedimentation discontinuities in lake cores and how chronologies can be established for imperfect cores by correlation of key sediment signatures in parallel core records and with long-term monitoring data （1945-2003）. Replicated short cores （ESTH1, ESTH7, and ESTH8） were collected and subjected to loss-on-ignition, radiometric dating （210Pb, 137Cs, and 14C）, particle size, trace metal, and fossil diatom analysis. Both a slumping and a hiatus event were detected in ESTH7 based on comparisons made between the cores and the long-term diatom data. Ordination analysis suggested that the slumped material in ESTH7 originated from sediment deposited around 1805-1880 AD. Further, it was inferred that the hiatus resulted in a loss of sediment deposited from 1870 to 1970 AD. Given the existence of three superior 14C dates in ESTH7, ESTH 1 and ESTH7 were temporally correlated by multiple palaeolimnological proxies for age-depth model development. High variability in sedimentation rates was evident, but good agreement across the various palaeo- limnological proxies indicated coherence in sediment processes within the coring area. Differences in sedimenta- tion rates most likely resulted from the natural morphology of the lake basin. Our study suggests that caution is required in selecting suitable coring sites for palaeolimno-logical studies of small, relatively deep lakes and that proximity to steep slopes should be avoided wherever possible. Nevertheless, in some cases, comparisons between a range of contemporary and palaeolimnological records can be employed to diagnose sediment distur- bances and establish a chronology.
