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 and Wu, Shouling (2016) Cumulative exposure to ideal cardiovascular health and incident diabetes in a Chinese population: the Kailuan Study. Journal of the American Heart Association, 5 9: . doi:10.1161/JAHA.116.004132


Author 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
Title Cumulative exposure to ideal cardiovascular health and incident diabetes in a Chinese population: the Kailuan Study
Journal name Journal of the American Heart Association   Check publisher's open access policy
ISSN 2047-9980
Publication date 2016-09-01
Sub-type Article (original research)
DOI 10.1161/JAHA.116.004132
Open Access Status DOI
Volume 5
Issue 9
Total pages 10
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2705 Cardiology and Cardiovascular Medicine
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.
Formatted 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.
Keyword Cardiovascular disease risk factors
Cumulative exposure
Diabetes mellitus
Epidemiology
Health status
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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Created: Sun, 18 Sep 2016, 05:07:29 EST by Yuming Guo on behalf of School of Public Health