Genetic Correlation and Bidirectional Causal Association Between Type 2 Diabetes and Pulmonary Function

Background Observational studies have shown possible bidirectional association between type 2 diabetes (T2D) and pulmonary function, but the causality is not well defined. The purpose of this study is to investigate genetic correlation and causal relationship of T2D and glycemic traits with pulmonary function. Methods By leveraging summary statistics from large-scale genome-wide association studies, linkage disequilibrium score regression was first implemented to quantify genetic correlations between T2D, glycemic traits, and several spirometry indices. Then both univariable and multivariable Mendelian randomization analyses along with multiple pleiotropy-robust methods were performed in two directions to assess the causal nature of these relationships. Results Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) showed significant genetic correlations with T2D and fasting insulin levels and suggestive genetic correlations with fasting glucose and hemoglobin A1c. In Mendelian randomization analyses, genetically predicted higher FEV1 (OR = 0.77; 95% CI = 0.63, 0.94) and FVC (OR = 0.82; 95% CI = 0.68, 0.99) were significantly associated with lower risk of T2D. Conversely, genetic predisposition to higher risk of T2D exhibited strong association with reduced FEV1 (beta = -0.062; 95% CI = -0.100, -0.024) and FEV1 (beta = -0.088; 95% CI = -0.126, -0.050) and increased FEV1/FVC ratio (beta = 0.045; 95% CI = 0.012, 0.078). We also found a suggestive causal effect of fasting glucose on pulmonary function and of pulmonary function on fasting insulin and proinsulin. Conclusions The present study provided supportive evidence for genetic correlation and bidirectional causal association between T2D and pulmonary function. Further studies are warranted to clarify possible mechanisms related to lung dysfunction and T2D, thus offering a new strategy for the management of the two comorbid diseases

Cancer Mortality in Chinese Chrysotile Asbestos Miners: Exposure-Response Relationships

Objective: This study was conducted to assess the relationship of mortality from lung cancer and other selected causes to asbestos exposure levels. Methods: A cohort of 1539 male workers from a chrysotile mine in China was followed for 26 years. Data on vital status, occupation and smoking were collected from the mine records and individual contacts. Causes and dates of death were further verified from the local death registry. Individual cumulative fibre exposures (f-yr/ml) were estimated based on converted dust measurements and working years at specific workshops. Standardized mortality ratios (SMRs) for lung cancer, gastrointestinal (GI) cancer, all cancers and nonmalignant respiratory diseases (NMRD) stratified by employment years, estimated cumulative fibre exposures, and smoking, were calculated. Poisson models were fitted to determine exposure-response relationships between estimated fibre exposures and cause-specific mortality, adjusting for age and smoking. Results: SMRs for lung cancer increased with employment years at entry to the study, by 3.5-fold in ≥10 years and 5.3-fold in ≥20 years compared with <10 years. A similar trend was seen for NMRD. Smokers had greater mortality from all causes than nonsmokers, but the latter also had slightly increased SMR for lung cancer. No excess lung cancer mortality was observed in cumulative exposures of <20 f-yrs/ml. However, significantly increased mortality was observed in smokers at the levels of ≥20 f-yrs/ml and above, and in nonsmokers at ≥100 f-yrs/ml and above. A similarly clear gradient was also displayed for NMRD. The exposure-response relationships with lung cancer and NMRD persisted in multivariate analysis. Moreover, a clear gradient was shown in GI cancer mortality when age and smoking were adjusted for. Conclusion: There were clear exposure-response relationships in this cohort, which imply a causal link between chrysotile asbestos exposure and lung cancer and nonmalignant respiratory diseases, and possibly to gastrointestinal cancer, at least for smokers

Lung Cancer Decreased Sharply in First 5 Years After Smoking Cessation in Chinese Men

BackgroundThe rate of decline in lung cancer risk after smoking cessation among male population and the importance of the magnitude of the early decline were not sufficiently defined in the earlier studies. We evaluated the detailed duration-response relationship between years since smoking cessation and lung cancer risk across major histological types in a population-based case-referent study.MethodsWe recruited 1208 consecutive incident cases of primary lung cancer among Chinese males from the largest oncology center in Hong Kong during 2004–2006, and 1069 male community referents frequency-matched in 5-year age groups. We performed unconditional multiple logistic regression and generalized additive model incorporating smoothing spline to model the potential nonlinear effect of years since cessation on lung cancer.ResultsAll histological types of lung cancer were strongly associated with current smoking. We observed a rapidly decreasing odds ratio of lung cancer (>50%) across all major histological types of lung cancer (except for the large cell type) within the first 5 years of quitting; the odds ratio continued to decrease but at a slower rate in the subsequent years.ConclusionThe substantial benefits obtainable within a short period of 5 years' abstinence should convey an encouraging message to chronic smokers, clinicians, and public health workers

Cultural and generational factors shape Asians’ sustainable food choices:Insights from choice experiments and information nudges

Promoting sustainable diets is crucial for mitigating global greenhouse gas emissions. We investigated the potential for large-scale dietary shifts to address the impacts of climate change on agriculture and food through surveys and choice experiments in China, Japan, and Vietnam (n = 5,089). Our findings reveal that Asian consumers are largely unwilling to deviate from current dietary habits, particularly regarding the consumption of animal proteins. This reluctance persists despite significant preferences for environmental certification as a proxy for greater sustainability in food production, as expressed by wealthier and younger respondents. Information experiments demonstrate that altruistic messaging fails to induce change, and positive information about climate impacts weakens the influence of certification. However, self-enhancement framing, particularly effective with individuals aged 60 years and above, shows promise. Our findings provide valuable insights for researchers and policymakers seeking effective strategies to encourage sustainable diets, shedding light on challenges and potential avenues for successful intervention

A school-based comprehensive lifestyle intervention among Chinese kids against Obesity (CLICK-Obesity) in Nanjing City, China: The baseline data

Background: urgent development of effective interventions to prevent rapidly rising childhood obesity in China is needed. Methods: Between May 2010 and December 2013, a cluster randomized controlled trial was conducted among 4 graders in eight urban primary schools randomly assigned to intervention or control groups in Nanjing, China. A multi-component intervention program was implemented within the treatment group, while students in the control group followed their usual health education curriculum without additional intervention. Results: At baseline, 638 and 544 students were enrolled in the intervention and control group, respectively. The prevalence of excess body weight was 26.8%, with 27.4% in the intervention group and 26.1% in the control group (p=0.61). The mean (SD) BMI and WC was 18.7 (3.0) and 63.0 (9.2) for participants in intervention schools, and 18.5 (2.9) and 63.6 (8.7) for students in control group, separately (p=0.24 and 0.41, respectively). Compared to those who were not aware of what lifestyle/behavior factors were unhealthy, students who were aware of the unhealthy lifestyle/ behavior factors consumed fewer fried snacks (0.46±0.76 serves/week vs 0.65±0.91 serves/week;

Are Current or Future Mesothelioma Epidemics in Hong Kong the Tragic Legacy of Uncontrolled Use of Asbestos in the Past?

BACKGROUND: Because of the long latent period of asbestos-related mesothelioma, investigators suggest that the high incidence of this disease will continue in the coming decades. OBJECTIVES: We describe the time trends of mesothelioma incidence and its relationship to historical consumption of asbestos in Hong Kong and project future trends of mesothelioma incidence. METHODS: We obtained local annual consumption of total asbestos for 1960-2006 (converted to kilograms per person per year). Age-standardized incidence rates (ASIRs) of mesothelioma were computed and depicted on graphs using the centered moving average method. Indirectly standardized rates were regressed on a transformation of consumption data that assumed that the latency between asbestos exposure and mesothelioma diagnosis followed a normal distribution with a mean ± SD of 42 ± 10.5 years. RESULTS: ASIRs for males started to increase substantially in 1994 and were highest in 2004; for females, ASIRs climbed in the 1980s and in the early 1990s but have fluctuated without obvious trends in recent years. The highest asbestos consumption level in Hong Kong was in 1960-1963 and then decreased sharply afterward. Using past asbestos consumption patterns, we predict that the mesothelioma incidence rate for males will peak in 2009, with the number of cases peaking in 2014, and then slowly decline in the coming decades. CONCLUSIONS: Hong Kong experienced an epidemic of mesothelioma from 2000 to 2006 that corresponded with the peak of local asbestos consumption in the early 1960s assuming an average latent period of 42 years. The incidence is anticipated to decline in the coming decades but may not decrease back to the background risk level (the risk unrelated to asbestos exposure)

The Prevalence of Metabolically Healthy and Unhealthy Obesity according to Different Criteria

Objective: Obesity-related disease risks may vary depending on whether the subject has metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO). At least 5 definitions/criteria of obesity and metabolic disorders have been documented in the literature, yielding uncertainties in a reliable international comparison of obesity phenotype prevalence. This report aims to compare differences in MHO and MUO prevalence according to the 5 most frequently used definitions. Methods: A random sample of 4,757 adults aged 35 years and older (male 51.1%) was enrolled. Obesity was defined either according to body mass index or waist circumference, and the definitions of metabolic abnormalities were derived from 5 different criteria. Results: In MHO, the highest prevalence was obtained when using the homeostasis model assessment (HOMA) criteria (13.6%), followed by the Chinese Diabetes Society (11.4%), Adult Treatment Panel III (10.3%), Wildman (5.2%), and Karelis (4.2%) criteria; however, the MUO prevalence had an opposite trend to MHO prevalence. The magnitude of differences in the age-specific prevalence of MHO and MUO varied greatly and ranked in different orders. The proportion of insulin resistance for MHO and MUO individuals differed significantly regardless of which metabolic criterion was used. Conclusion: The prevalence of MHO and MUO in the Chinese population varies according to different definitions of obesity and metabolic disorders

Disparities of time trends and birth cohort effects on invasive breast cancer incidence in Shanghai and Hong Kong pre- and post-menopausal women

© 2017 The Author(s). Background: Breast cancer is the leading cause of cancer morbidity among Shanghai and Hong Kong women, which contributes to 20-25% of new female cancer incidents. This study aimed to describe the temporal trend of breast cancer and interpret the potential effects on the observed secular trends. Methods: Cancer incident data were obtained from the cancer registries. Age-standardized incidence rate was computed by the direct method using the World population of 2000. Average annual percentage change (AAPC) in incidence rate was estimated by the Joinpoint regression. Age, period and cohort effects were assessed by using a log-linear model with Poisson regression. Results: During 1976-2009, an increasing trend of breast cancer incidence was observed, with an AAPC of 1.73 [95% confidence interval (CI): 1.54-1.92)] for women in Hong Kong and 2.83 (95% CI, 2.26-3.40) in Shanghai. Greater upward trends were revealed in Shanghai women aged 50 years old or above (AAPC = 3.09; 95% CI, 1.48-4.73). Using age at 50 years old as cut-point, strong birth cohort effects were shown in both pre- and post-menopausal women, though a more remarkable effect was suggested in Shanghai post-menopausal women. No evidence for a period effect was indicated. Conclusions: Incidence rate of breast cancer has been more speedy in Shanghai post-menopausal women than that of the Hong Kong women over the past 30 years. Decreased birth rate and increasing environmental exposures (e.g., light-at-night) over successive generations may have constituted major impacts on the birth cohort effects, especially for the post-menopausal breast cancer; further analytic studies are warranted.Link_to_subscribed_fulltex

Personal exposure to fine particles (PM2.5) and respiratory inflammation o common residents in Hong Kong

Background: Given the lack of research on the personal exposure to fine particles (PM2.5) in Hong Kong, we examined the association between short-term personal exposure to PM2.5 and their constituents and inflammation in exhaled breath in a sample of healthy adult residents