Weisen Zhang

Guangzhou First People's Hospital, Shengcheng, Guangdong, China

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Publications (27)103.92 Total impact

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    ABSTRACT: The role of estrogen in cardiovascular health remains contested with discrepancies between findings from randomized controlled trials and observational studies. Mendelian randomization, which assesses the effect of lifelong endogenous exposure, may help elucidate these discrepancies.
    No preview · Article · Feb 2016
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    ABSTRACT: Objective: The objective of this study was to examine the role of stress across the life course in the development of depression among older adults in a non-Western developing setting. Methods: Multivariable linear and multinomial logistic regression were used in cross-sectional analyses of 9729 Chinese participants (mean age 60.2 years) from phase 3 of the Guangzhou Biobank Cohort Study (2006-2008) to investigate the association of childhood adversities and adulthood stressors with depression. Results: Childhood adversities were associated with mild depression (odds ratio (OR) 1.78, 95% confidence interval (CI) 1.58, 2.02) and moderate-to-severe depression (OR 2.30, 95% CI 1.68, 3.15), adjusted for age, sex, education and childhood socio-economic status. Past-year adulthood stressors were also associated with mild depression (OR 1.96, 95% CI 1.54, 2.02) and moderate-to-severe depression (OR 3.55, 95% CI 2.21, 5.68), adjusting additionally for occupation and income. Adulthood stressors were more strongly associated with depressive symptoms among individuals with a history of childhood adversities. Conclusions: Childhood adversities and adulthood stressors were independently associated with an increased risk of depression among older ambulatory adults, although adulthood stressors were more strongly associated with depression following exposure to childhood adversities. This is consistent with evidence from Western settings in which the social context of risk and protective factors for depression may differ and implies that the role of stress in the aetiology of depression is not context specific. Copyright © 2015 John Wiley & Sons, Ltd.
    No preview · Article · Oct 2015 · International Journal of Geriatric Psychiatry
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    ABSTRACT: 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.
    Preview · Article · Jul 2015 · PLoS ONE
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    ABSTRACT: Western observational studies show that moderate alcohol use is associated with lower cardiovascular disease (CVD) risk, but these associations may be confounded by the healthier attributes of moderate users in these settings. Mendelian randomization analysis may help to ascertain the causal effect of moderate alcohol use on specific factors related to CVD and thereby clarify the role of alcohol. We used Mendelian randomization analysis with the aldehyde dehydrogenase 2 gene (ALDH2) as an instrumental variable to examine the association of alcohol units (10 g of ethanol) per day with heart rate-corrected QT interval and heart rate assessed from electrocardiogram among 4,588 older southern Chinese men in the Guangzhou Biobank Cohort Study (2003-2008). The F statistic was 77 for ALDH2 on alcohol use, suggesting little weak-instrument bias. Instrumental variable analysis showed that alcohol units were not associated with the corrected QT interval, with β = 1.04 (95% confidence interval: -0.61, 2.70) milliseconds, but they were associated with increased heart rate, with β = 0.98 (95% confidence interval: 0.04, 1.92) beat per minute. This study suggests that moderate alcohol use in men is not beneficial for heart function via QT interval or heart rate but could be detrimental. Future studies using specific cardiovascular outcomes may elucidate how alcohol affects different aspects of the cardiovascular system and, hence, the overall effects of alcohol on CVD can be estimated. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Preview · Article · Jul 2015 · American journal of epidemiology
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    ABSTRACT: Observationally, testosterone is negatively associated with systemic inflammation, but this association is open to both residual confounding and reverse causality. Large-scale randomized controlled trials (RCTs), assessing exogenous effects, are presently unavailable. We examined the association of endogenous testosterone with well-established systemic inflammatory markers (white blood cell, granulocyte, lymphocyte and high-sensitivity C-reactive protein (hsCRP)) using a separate-sample Mendelian randomization analysis to minimize reverse causality. A genetic prediction rule for serum testosterone was developed in 289 young Chinese men with mean age of 21.0, using selected testosterone-related SNPs (rs10046, rs1008805 and rs1256031). Multivariable linear regression was used to examine the association of genetically predicted serum testosterone with inflammatory markers among 4,212 older Chinese men from the Guangzhou Biobank Cohort Study. Genetically predicted testosterone was unrelated to white blood cell count (-0.01 109/L per nmol/L testosterone, 95% confidence interval (CI) -0.05 to 0.04), granulocyte count (-0.02 109/L, 95% CI -0.06 to 0.02), lymphocyte count (0.005 109/L, 95% CI -0.01 to 0.02) and hsCRP (-0.05 mg/L, 95% CI -0.15 to 0.06). Our findings did not corroborate any anti-inflammatory effects of testosterone or corresponding potentially protective effects of testosterone on chronic diseases resulting from reduced low-grade systemic inflammation.
    Preview · Article · May 2015 · PLoS ONE
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    ABSTRACT: QT interval prolongation, a predictor of cardiac arrhythmias, and elevated heart rate are associated with higher risk of cardiovascular mortality. Observationally testosterone is associated with shorter corrected QT interval and slower heart rate; however, the evidence is open to residual confounding and reverse causality. We examined the association of testosterone with electrocardiogram (ECG) parameters using a separate-sample instrumental variable (SSIV) estimator. To minimize reverse causality, a genetic score predicting testosterone was developed in 289 young Chinese men from Hong Kong, based on a parsimonious set of single nuclear polymorphisms (rs10046, rs1008805 and rs1256031). Linear regression was used to examine the association of genetically predicted testosterone with QT interval, corrected QT interval [using the Framingham formula (QTf) and Bazett formula (QTb)] and heart rate in 4212 older (50+ years) Chinese men from the Guangzhou Biobank Cohort Study. Predicted testosterone was not associated with QT interval [-0.08 ms per nmol/l testosterone, 95% confidence interval (CI) -0.81 to 0.65], QTf interval (0.40 ms per nmol/l testosterone, 95% CI -0.12 to 0.93) or heart rate (0.26 beats per minute per nmol/l testosterone, 95% CI -0.04 to 0.56), but was associated with longer QTb interval (0.66 ms per nmol/l testosterone, 95% CI 0.02 to 1.31). Our findings do not corroborate observed protective associations of testosterone with QT interval or heart rate among men, but potentially suggest effects in the other direction. Replication in a larger sample is required. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
    Preview · Article · Dec 2014 · International Journal of Epidemiology
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    ABSTRACT: To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese. 10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history, physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level, association between FPG and SUA. Levels of hyperuricemia (HUA) were evaluated. The SUA levels and the incidence of HUA showed trends of increasing, with the increasing FPG levels in women, with statistically significant differences seen among all the FPG groups (P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group (DM group) and impaired fasting glucose (IFG) groups were non-significant (P > 0.05) but it was higher than normal FPG group in men (P < 0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age, smoking status, drinking status, physical activity, hypertension, body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group, the risk of women suffering from HUA increased by 40% (95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals, the risk of diabetic patients suffering from HUA also increased by 44% (95% CI:1.15-1.79) in women. However, the risk of suffering from HUA did not relate to the increase of FPG in men. The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA, but not in men.
    No preview · Article · Oct 2014 · Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi
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    ABSTRACT: Purpose In Asia moderate alcohol users have better lung function. Never users have more inactive aldehyde dehydrogenase 2 (ALDH2) alleles (A) potentially generating confounding, because inactive alleles may increase acetaldehyde exposure and reduce lung function. Methods We examined the association of ALDH2 genotypes with percentage predicted lung function (forced expiratory volume in 1 second (FEV1); forced vital capacity (FVC)) for age, sex and height among 5,641 older Chinese using multivariable linear regression. Results ALDH2 genotypes were associated with alcohol use and height but not other attributes. Inactive alleles were inversely associated with lung function (% predicted FEV1 -1.52%, 95% confidence interval (CI) -2.52% to -0.51% for one inactive allele and -2.05%, 95% CI -3.85% to -0.26% for two inactive alleles compared to two active alleles; and for % predicted FVC -1.25%, 95% CI -2.15% to -0.35% and -1.65%, 95% CI -3.25% to -0.04%). The association of moderate use with lung function was attenuated after adjusting for ALDH2, in addition to other potential confounders. Conclusions Previous findings in Chinese may be confounded by ALDH2. High frequency of inactive ALDH2 alleles in East Asia may exacerbate the effect of environmental acetaldehyde exposure on lung function, and potentially on chronic obstructive pulmonary disease.
    No preview · Article · Aug 2014 · Annals of Epidemiology
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    ABSTRACT: Dairy products consumption is increasingly common globally. Most of the evidence concerning dairy products comes from observational studies in western populations which are inevitably open to confounding. To triangulate the evidence concerning dairy products, we examined the associations of whole cow's milk consumption with cardiovascular risk factors in a non-Western setting with a different pattern of milk consumption and cardiovascular diseases from Western populations. We used multivariable censored linear or logistic regression to examine cross-sectionally the adjusted associations of whole cow's milk consumption (none (n = 14892), 1-3/week (n = 2689) and 3+/week (n = 2754)) with cardiovascular risk factors in Chinese (≥50 years) in the Guangzhou Biobank Cohort Study. Whole cow's milk consumption was negatively associated with systolic blood pressure (3+/week compared to none -2.56 mmHg, 95% confidence interval (CI) -3.63 to -1.49), diastolic blood pressure (-1.32 mmHg, 95% CI -1.87 to -0.77) and triglycerides (-0.06 mmol/L, 95% CI -0.11 to -0.002), but was positively associated with HDL-cholesterol (0.02 mmol/L,95% CI 0.01 to 0.04) and fasting glucose (0.08 mmol/L, 95% CI 0.01 to 0.16) adjusted for age, sex, phase of study, socio-economic position, lifestyle (smoking, alcohol use and physical activity) and adiposity, but had no obvious association with LDL-cholesterol or the presence of diabetes. Whole cow's milk consumption had heterogeneous associations with cardiovascular risk factors. Higher whole cow's milk consumption was associated with lower levels of specific cardiovascular risk factors which might suggest risk factor specific biological pathways with different relations to blood pressure and lipids than glucose.
    Preview · Article · Jan 2014 · PLoS ONE
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    ABSTRACT: Observationally lower testosterone is associated with an unhealthier cardiovascular (CVD) risk profile, but this association is open to confounding and reverse causality. The authors examined the association of testosterone with well-established cardiovascular disease (CVD) risk factors (blood pressure, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL)cholesterol and fasting glucose) and the Framingham score using a Mendelian randomization analysis with a separate-sample instrumental variable estimator. To minimize reverse causality, a genetic score predicting testosterone was developed in 289 young Chinese men from Hong Kong, based on three selected testosterone-related single nucleotide polymorphisms (rs10046, rs1008805 and rs1256031). Multivariable censored and linear regressions were used to examine the association of genetically predicted testosterone levels with CVD risk factors and Framingham score among 4212 older Chinese men from the Guangzhou Biobank Cohort Study. Predicted testosterone was unrelated to systolic blood pressure [-0.11 mmHg, 95% confidence interval (CI) -0.70 to 0.48], diastolic blood pressure (0.04 mmHg, 95% CI -0.27 to 0.36), fasting glucose (0.02 mmol/l, 95% CI -0.02 to 0.06) or Framingham score (0.02, 95% CI -0.0001 to 0.03) but associated with higher LDL-cholesterol (0.02 mmol/l, 95% CI 0.01 to 0.04) and lower HDL-cholesterol (-0.01 mmol/l, 95% CI -0.02 to -0.001), after adjustment for potential confounders (age, education, smoking status, use of alcohol and body mass index). Our findings did not corroborate observed protective effects of testosterone on cardiovascular risk factors or risk of ischaemic heart disease among men, but raises the possibility that higher testosterone may be associated with an unhealthier lipid profile.
    No preview · Article · Dec 2013 · International Journal of Epidemiology
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    ABSTRACT: Observational studies show moderate alcohol use negatively associated with ischemic heart disease (IHD) and cardiovascular disease (CVD). However, healthier attributes among moderate users compared to never users may confound the apparent association. A potentially less biased way to examine the association is Mendelian randomization, using alcohol metabolizing genes which influence alcohol use. We used instrumental variable analysis with aldehyde dehydrogenase 2 (ALDH2) genotypes (AA/GA/GG) as instrumental variables for alcohol use to examine the association of alcohol use (10 g ethanol/day) with CVD risk factors (blood pressure, lipids and glucose) and morbidity (self-reported IHD and CVD) among men in the Guangzhou Biobank Cohort Study. ALDH2 genotypes were a credible instrument for alcohol use (F-statistic 74.6). Alcohol was positively associated with HDL-cholesterol (0.05 mmol/L per alcohol unit, 95% confidence interval (CI) 0.02 to 0.08) and diastolic blood pressure (1.15 mmHg, 95% CI 0.23 to 2.07) but not with systolic blood pressure (1.00 mmHg, 95% CI -0.74 to 2.74), LDL-cholesterol (0.03 mmol/L, 95% CI -0.03 to 0.08), log transformed triglycerides (0.03 mmol/L, 95% CI -0.01 to 0.08) or log transformed fasting glucose (0.01 mmol/L, 95% CI -0.006 to 0.03), self-reported CVD (odds ratio (OR) 0.98, 95% CI 0.76 to 1.27) or self-reported IHD (OR 1.10, 95% CI 0.83 to 1.45). Low to moderate alcohol use among men had the expected effects on most CVD risk factors but not fasting glucose. Larger studies are needed to confirm the null associations with IHD, CVD and fasting glucose.
    Full-text · Article · Jul 2013 · PLoS ONE
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    ABSTRACT: Background: Mendelian randomization studies provide a means of assessing causal relations without interventions, but require valid genetic instruments. We assessed the credibility of aldehyde dehydrogenase 2 (ALDH2) as a genetic instrument for alcohol use in Southern Chinese men. Methods: We genotyped the single nucleotide polymorphism rs671 of ALDH2 in 4867 men from the Guangzhou Biobank Cohort Study. We used linear regression to assess the strength of the association of ALDH2 variants with alcohol use, whether ALDH2 variants were independently associated with socio-economic position or other potential confounders and whether associations of ALDH2 variants with cardiovascular risk factors (systolic and diastolic blood pressure, HDL- and LDL-cholesterol, fasting glucose), triglycerides, body mass index, self reported cardiovascular disease, self-reported ischaemic heart disease, cognitive function (delayed 10-word recall and Mini Mental State Examination score) and liver function (alanine transaminase and aspartate transaminase) were fully mediated by alcohol use. Results: The minor allele frequency (A) of ALDH2 was 0.29. The F statistic for ALDH2 variants was 75.0, suggesting that substantial weak instrument bias is unlikely. ALDH2 variants were not associated with socio-economic position, smoking or physical activity. ALDH2 variants were only associated with diastolic blood pressure and HDL-cholesterol, but these genetic associations with blood pressure and HDL-cholesterol were attenuated after adjusting for alcohol use, suggesting the apparent genetic associations were possibly mediated by alcohol use. Conclusions: ALDH2 variants are a credible genetic instrument for Mendelian randomization studies of alcohol use and many attributes of health in Southern Chinese men.
    Preview · Article · Dec 2012 · International Journal of Epidemiology
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    ABSTRACT: A male epidemic of ischaemic heart disease (IHD) emerges with economic development. It has previously been hypothesised that this epidemic is due to nutritionally driven levels of pubertal sex steroids, which lead to a more atherogenic body shape and lipid profile in boys but not girls, without any sex-specific effects on glucose metabolism. This study tests this hypothesis by examining the association of childhood meat eating with IHD risk in a developing Chinese population. Multivariable linear and censored regression was used in a cross-sectional study of 19,418 Chinese older (≥ 50 years) men and women from the Guangzhou Biobank Cohort Study (phases 2 and 3) to assess the adjusted associations of childhood meat eating with waist to hip ratio (WHR), high-density lipoprotein cholesterol and fasting plasma glucose. Adjusted for age, childhood hunger, life-course socioeconomic position and current lifestyle childhood almost daily meat eating compared with less than weekly meat eating was associated with higher WHR (0.007, 95% CI 0.0003 to 0.01) in men but not women. No association with fasting glucose was observed. Given the potential limitations of this study, especially the crude nature of the exposure and modest findings, the results should be considered as preliminary. However, they do lend support to the hypothesis that the male epidemic of premature IHD and sexual divergence in IHD rates that occur with economic development may be nutritionally driven in childhood. In elucidating the developmental origins of non-communicable chronic diseases, more attention should be focused on the sociohistorical context and the role of puberty.
    No preview · Article · Jun 2011 · Journal of epidemiology and community health
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    ABSTRACT: In observational studies from western countries childhood emotional adversity is usually associated with adult cardiovascular disease. These findings are open to contextual biases making evidence from other settings valuable. We examined the association of a potential marker of childhood emotional adversity with cardiovascular disease risk factors in a developing country. We used multivariable regression in cross-sectional analysis of older (≥50 years) men (n = 7,885) and women (n = 20,886) from the Guangzhou Biobank Cohort Study (2003-8) to examine the adjusted association of early life (<18 years) parental death (none, one or two deaths) with blood pressure, fasting glucose, LDL-cholesterol, HDL-cholesterol, triglycerides, body mass index (BMI), waist-hip ratio (WHR) and white blood cell count (WBC). We used seated height and delayed 10-word recall to assess content validity of parental death as a measure of childhood emotional adversity. We also examined whether associations varied by sex. Early life parental death was associated with shorter age- and sex-adjusted seated height. It was also associated with lower 10-word recall score adjusted for age, sex, socio-economic position, leg length and lifestyle. Similarly, adjusted early life parental death was not associated with blood pressure, fasting glucose, LDL-cholesterol or HDL-cholesterol but was associated with lower BMI (-0.40, 95% confidence interval (CI) -0.62 to -0.19 for 2 compared with no early life parental deaths) and triglycerides. Associations varied by sex for WHR and WBC. Among men only, early life parental death was associated with lower WHR (-0.008, 95% CI -0.015 to -0.001) and WBC (-0.35 10(9)/L, 95% CI -0.56 to -0.13). In a non-western population from a developing country, childhood emotional adversity was negatively associated with some cardiovascular risk factors, particularly among men. Our study suggests that some of the observed associations in western populations may be socially rather than biologically based or may be population specific.
    Full-text · Article · May 2011 · PLoS ONE
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    ABSTRACT: Women usually report attributes of masculinity as attractive. These are attributes are metabolically expensive. We examined the trade off of a key attribute of masculinity, muscularity, proxied by recalled adolescence build, with lifetime reproductive success in the developing country setting of Southern China. We used poisson multivariable regression in 19,168 older (≥ 50 years) Chinese from the Guangzhou Biobank Cohort Study (phases 2 and 3) to examine the sex-stratified, adjusted associations of recalled adolescent relative weight (light (n = 6730), average (n = 9344), and heavy (n = 3094)) with number of offspring. Among men, recalled heavy adolescent weight compared with light was associated with an incident rate ratio for offspring of 1.08 (95% confidence interval [CI] 1.04-1.13) adjusted for age. This estimate was unchanged by adjustment for life course socio-economic position. There was no such association in women. Male physical attractiveness, possibly representing levels of testosterone, was rewarded by lifetime reproductive success, despite potential costs. Socio-economic development may facilitate an inevitable move toward environmentally driven higher levels of testosterone with corresponding public health implications for any conditions or societal attributes driven by testosterone. Further investigation is warranted.
    No preview · Article · Jan 2011 · Annals of epidemiology
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    ABSTRACT: With economic development, there is an emerging epidemic of diabetes in China despite relatively low levels of obesity. Muscle mass, for which adolescence is a key developmental window, may reduce vulnerability to diabetes. We examined the association of recalled adolescent build with diabetes in a large sample from the developing country setting of southern China. We used multivariable regression in cross-sectional data (2005-2008), from the Guangzhou Biobank Cohort Study (phases 2 and 3) for 19,524 older (≥ 50 years) Chinese to examine the adjusted associations of recalled adolescent relative weight (light [n = 6843], average [n = 9529], and heavy [n = 3152]) with clinically measured diabetes. As older adults, heavy adolescents had a lower risk of diabetes (odds ratio = 0.86, 95% confidence interval: 0.75-0.99) than light adolescents adjusted for age, sex, education, smoking, leg length, and seated height. This association was stronger after additional adjustment for waist/hip ratio and body mass index. Poor living conditions during adolescence, resulting in low muscle mass, could contribute to vulnerability to diabetes, which, if confirmed, could be relevant to the emerging epidemic of diabetes in the developing world, as well as to minorities and migrants elsewhere.
    No preview · Article · Jan 2011 · Annals of epidemiology
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    ABSTRACT: Earlier pubertal maturation in women may be associated with better cognition. It is unclear whether or not this also occurs in men. We tested the hypothesis that earlier pubertal development in men was associated with better cognition in later adulthood in a developing Chinese population. Multivariable linear regression was used in cross-sectional study of 2463 older, Chinese men from the Guangzhou Biobank Cohort Study. Mean pubertal age was calculated as the mean of recalled ages of first nocturnal emission, voice breaking and pubarche. We assessed the association of mean pubertal age with delayed 10-word recall and mini-mental state examination (MMSE) scores. Adjusted for age and education, 1 year earlier mean pubertal age was associated with higher delayed 10-word recall (0.06 [95% confidence interval = 0.02-0.10]) and higher MMSE (0.08 [0.03-0.13]) scores. Additional adjustment for childhood and adulthood socio-economic position, sitting height, and leg length did not change the results. These preliminary findings suggest earlier maturation in men is associated with better cognitive function in later adulthood. Whether pubertal timing is a marker of earlier life exposures or reflects a biological relation between somatrophic and/or gonadotrophic hormones and cognitive development is unclear.
    No preview · Article · Dec 2010 · Annals of epidemiology
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    ABSTRACT: Observational studies in Western settings show moderate alcohol use associated with better cognitive function, but they are vulnerable to contextual bias. Evidence from non-Western settings may be useful to verify causality. We examined such association in southern China where alcohol use is low. We used multivariable linear regression in cross-sectional data from the Guangzhou Biobank Cohort Study to assess sex-stratified associations of alcohol use (never, occasional, moderate, heavy and former drinker) with delayed 10-word recall score for all 3 phases (N = 28,537) and Mini-Mental State Examination (MMSE) score in phase 3 (N = 9,571). Delayed 10-word recall scores were higher in moderate drinkers compared with never drinkers among men (0.30 words, 95% confidence interval [CI]: 0.18 to 0.42) but not women (0.02; 95% CI: -0.12 to 0.17), adjusted for sociodemographic factors. Occasional alcohol users also had higher 10-word recall scores among men (0.27; 95% CI: 0.18 to 0.37) and women (0.30; 95% CI: 0.23 to 0.37). These estimates were little altered by further adjustment for cardiovascular risk factors. Results for MMSE scores were similar. Alcohol may not drive the association between moderate use and better cognitive function, which instead may be due to confounding by general moderation in lifestyle.
    No preview · Article · Dec 2010 · Annals of epidemiology
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    ABSTRACT: Estrogen has neurotrophic and neuroprotective properties in animal and in vitro studies. Epidemiological studies are inconclusive, but suggest a positive association between endogenous estrogen exposure (measured by reproductive period, the number of years between menarche and menopause) and later life cognitive function. Structural equation modeling was used in a cross-sectional study of 11,094 naturally postmenopausal multiparous Chinese older (≥50 years) women from the Guangzhou Biobank Cohort Study (phases 2 and 3) to assess the interrelationship of four proxies of higher endogenous estrogen exposure (longer reproductive period, older age of first pregnancy, lower parity and shorter average duration of breast feeding per child) with immediate and the delayed 10-word recall score in phases 2 and 3, and with the mini-mental state examination (MMSE) score in phase 3 (5641 women). Adjusted for age, education, childhood and adulthood socio-economic position and physical activity, longer reproductive period was associated with higher scores (0.02 words per year, 95% confidence interval (CI) 0.008-0.02 for delayed recall and 0.05 MMSE score, 95%CI 0.04-0.07, respectively). Lower parity and shorter average duration of breast-feeding per child were also associated with better cognitive function. In a large cohort of naturally postmenopausal Chinese women proxies of greater endogenous estrogen exposure were associated with better cognitive function. These findings support biological evidence for a cognitively protective role of endogenous estrogen.
    No preview · Article · Dec 2010 · Psychoneuroendocrinology
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    ABSTRACT: Physical activity may modify the association of adiposity with type 2 diabetes. We investigated the independent and joint association of adiposity and physical activity with fasting plasma glucose, impaired fasting glucose, and type 2 diabetes in a Chinese population. Middle-aged and older Chinese (n=28,946, ≥50 years, 72.4%women) from the Guangzhou Biobank Cohort Study were examined in 2003-2008. Multivariable regression was used in a cross-sectional analysis. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with type 2 diabetes after multiple adjustment, most strongly for WHR with odds ratio (OR) of 3.99 (95% CI 3.60-4.42) for highest compared with lowest tertile. Lack of moderate-to-vigorous physical activity, but not walking, was associated with diabetes with an OR of 1.29 (1.17-1.41). The association of moderate-to-vigorous activity with fasting glucose varied with WHR tertiles (P=0.01 for interaction). Within the high WHR tertile, participants who had a lack of moderate-to-vigorous activity had an OR of 3.87 (3.22-4.65) for diabetes, whereas those who were active had an OR of 2.94 (2.41-3.59). In this population, WHR was a better measure of adiposity-related diabetes risk than BMI or waist circumference. Higher moderate-to-vigorous activity was associated with lower diabetes risk, especially in abdominally obese individuals.
    Full-text · Article · Nov 2010 · Diabetes care

Publication Stats

313 Citations
103.92 Total Impact Points

Institutions

  • 2010-2015
    • Guangzhou First People's Hospital
      Shengcheng, Guangdong, China
  • 2014
    • University of Birmingham
      Birmingham, England, United Kingdom
    • Guangzhou Medical University
      Shengcheng, Guangdong, China
  • 2007
    • Southern Medical University
      • School of Public Health and Tropical Medicine
      Shengcheng, Guangdong, China