title: Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population: The Kailuan Study.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  URL: https://www.chictr.org. Unique identifier: ChiCTRTNC-11001489.
authors.affiliation: Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Xiaoxue
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Liufu
authors.initials: L
authors.lastname: Cui
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
authors.forename: Anxin
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Xizhu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Qiaofeng
authors.initials: Q
authors.lastname: Song
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Jihong
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Health Care Center, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Shuohua
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
authors.forename: Chunpeng
authors.initials: C
authors.lastname: Ji
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Huxley
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia y.guo1@uq.edu.au drwusl@163.com.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China y.guo1@uq.edu.au drwusl@163.com.
authors.forename: Shouling
authors.initials: S
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D000072001:Diet, Healthy; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol
keywords: cardiovascular disease risk factors; cumulative exposure; diabetes mellitus; epidemiology; health status; ideal cardiovascular health