Imperial College London

DrQueenieChan

Faculty of MedicineSchool of Public Health

Honorary Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 3311q.chan

 
 
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Location

 

151Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

202 results found

Xu Y, Han Y, Chen W, Chatzidiakou L, Yan L, Krause A, Li Y, Zhang H, Wang T, Xue T, Chan Q, Barratt B, Jones RL, Liu J, Wu Y, Zhao M, Zhang J, Kelly FJ, Zhu Tet al., 2024, Susceptibility of hypertensive individuals to acute blood pressure increases in response to personal-level environmental temperature decrease., Environ Int, Vol: 185

BACKGROUND: Environmental temperature is negatively associated with blood pressure (BP), and hypertension may exacerbate this association. The aim of this study is to investigate whether hypertensive individuals are more susceptible to acute BP increases following temperature decrease than non-hypertensive individuals. METHODS: The study panel consisted of 126 hypertensive and 125 non-hypertensive (n = 251) elderly participants who completed 940 clinical visits during the winter of 2016 and summer of 2017 in Beijing, China. Personal-level environmental temperature (PET) was continuously monitored for each participant with a portable sensor platform. We associated systolic BP (SBP) and diastolic BP (DBP) with the average PET over 24 h before clinical visits using linear mixed-effects models and explored hourly lag patterns for the associations using distributed lag models. RESULTS: We found that per 1 °C decrease in PET, hypertensive individuals showed an average (95 % confidence interval) increase of 0.96 (0.72, 1.19) and 0.28 (0.13, 0.42) mmHg for SBP and DBP, respectively; and non-hypertensive participants showed significantly smaller increases of 0.28 (0.03, 0.53) mmHg SBP and 0.14 (-0.01, 0.30) mmHg DBP. A lag pattern analysis showed that for hypertensive individuals, the increases in SBP and DBP were greatest following lag 1 h PET decrease and gradually attenuated up to lag 10 h exposure. No significant BP change was observed in non-hypertensive individuals associated with lag 1-24 h PET exposure. The enhanced increase in PET-associated BP in hypertensive participants (i.e., susceptibility) was more significant in winter than in summer. CONCLUSIONS: We found that a decrease in environmental temperature was associated with acute BP increases and these associations diminished over time, disappearing after approximately 10 hours. This implies that any intervention measures to prevent BP increases due to temperature drop

Journal article

Aljuraiban GS, Gibson R, Chan DS, Van Horn L, Chan Qet al., 2024, The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies., Adv Nutr, Vol: 15

High blood pressure (BP) is a major pathological risk factor for the development of several cardiovascular diseases. Diet is a key modifier of BP, but the underlying relationships are not clearly demonstrated. This is an umbrella review of published meta-analyses to critically evaluate the wide range of dietary evidence from bioactive compounds to dietary patterns on BP and risk of hypertension. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception until October 31, 2021, for relevant meta-analyses of randomized controlled trials or meta-analyses of observational studies. A total of 175 publications reporting 341 meta-analyses of randomized controlled trials (145 publications) and 70 meta-analyses of observational studies (30 publications) were included in the review. The methodological quality of the included publications was assessed using Assessment of Multiple Systematic Reviews 2 and the evidence quality of each selected meta-analysis was assessed using NutriGrade. This umbrella review supports recommended public health guidelines for prevention and control of hypertension. Dietary patterns including the Dietary Approaches to Stop Hypertension and the Mediterranean-type diets that further restrict sodium, and moderate alcohol intake are advised. To produce high-quality evidence and substantiate strong recommendations, future research should address areas where the low quality of evidence was observed (for example, intake of dietary fiber, fish, egg, meat, dairy products, fruit juice, and nuts) and emphasize focus on dietary factors not yet conclusively investigated.

Journal article

Gibson R, Aljuraiban GS, Oude-Griep LM, Vu T-H, Steffen LM, Appel LJ, Rodriguez BL, Daviglus ML, Elliott P, Van Horn L, Chan Qet al., 2023, Relationship of calcium and magnesium intakes with the dietary approaches to stop hypertension score and blood pressure: the International Study of Macro/micronutrients and Blood Pressure, Journal of Hypertension, ISSN: 0263-6352

OBJECTIVE: Research investigating calcium and magnesium intakes from the Dietary Approaches to Stop Hypertension (DASH) pattern and other sources in association with blood pressure is limited. We aimed to characterize sources/intake levels of calcium and magnesium in relation to overall diet quality (DASH-score) and determine modification effects with DASH score and blood pressure. METHODS: Cross-sectional United States data (average dietary and supplement intake from four 24 h recalls and eight blood pressure measurements) from two separate visits, 2195 men and women (40-59 years) in the International Study of Macro/Micronutrients and Blood Pressure were analysed. Food-based adherence to the DASH diet was estimated. Linear models tested associations between each 1-point DASH score with blood pressure. Participants were stratified by adherence to sex-specific recommended allowance for magnesium and calcium intakes. Effect-modification was tested across DASH-score quintiles and median of urinary sodium. RESULTS: DASH-score was inversely associated with SBP in fully adjusted models (-0.27; 95%CI: -0.38 to -0.15 mmHg). SBP was inversely associated with dietary calcium intake from DASH food groups: -1.54 (95% CI: -2.65 to -0.43) mmHg; calcium intake from other non-DASH food groups: -1.62 (95% CI: -2.94 to -0.29) mmHg. Dietary magnesium intake from DASH food groups (-1.59; 95% CI: -2.79, -0.40 mmHg) and from other non-DASH foods (-1.92; 95% CI: -3.31, -0.53 mmHg) was inversely associated with SBP. CONCLUSION: A higher DASH score showed a consistent association with lower BP suggesting a relationship between intakes of calcium and Mg with BP regardless of whether the source is part of the DASH diet or not, even when adjusted for supplement intakes.The INTERMAP is registered as NCT00005271 at www.clinicaltrials.gov.

Journal article

Moon J-Y, Chai JC, Yu B, Song RJ, Chen G-C, Graff M, Daviglus ML, Chan Q, Thyagarajan B, Castaneda SF, Grove ML, Cai J, Xue X, Mossavar-Rahmani Y, Vasan RS, Boerwinkle E, Kaplan RC, Qi Qet al., 2023, Metabolomic Signatures of Sedentary Behavior and Cardiometabolic Traits in US Hispanics/Latinos: Results from HCHS/SOL., Med Sci Sports Exerc, Vol: 55, Pages: 1781-1791

PURPOSE: The aim of this study was to understand the serum metabolomic signatures of moderate-to-vigorous physical activity (MVPA) and sedentary behavior, and further associate their metabolomic signatures with incident cardiometabolic diseases. METHODS: This analysis included 2711 US Hispanics/Latinos from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) aged 18-74 yr (2008-2011). An untargeted, liquid chromatography-mass spectrometry was used to profile the serum metabolome. The associations of metabolites with accelerometer-measured MVPA and sedentary time were examined using survey linear regressions adjusting for covariates. The weighted correlation network analysis identified modules of correlated metabolites in relation to sedentary time, and the modules were associated with incident diabetes, dyslipidemia, and hypertension over the 6-yr follow-up. RESULTS: Of 624 metabolites, 5 and 102 were associated with MVPA and sedentary behavior at false discovery rate (FDR) <0.05, respectively, after adjusting for socioeconomic and lifestyle factors. The weighted correlation network analysis identified 8 modules from 102 metabolites associated with sedentary time. Four modules (branched-chain amino acids, erythritol, polyunsaturated fatty acid, creatine) were positively, and the other four (acyl choline, plasmalogen glycerol phosphatidyl choline, plasmalogen glycerol phosphatidyl ethanolamine, urea cycle) were negatively correlated with sedentary time. Among these modules, a higher branched-chain amino acid score and a lower plasmalogen glycerol phosphatidyl choline score were associated with increased risks of diabetes and dyslipidemia. A higher erythritol score was associated with an increased risk of diabetes, and a lower acyl choline score was linked to an increased risk of hypertension. CONCLUSIONS: In this study of US Hispanics/Latinos, we identified multiple serum metabolomic signatures of sedentary behavior and their associations with risk of

Journal article

Okami Y, Chan Q, Miura K, Kadota A, Elliott P, Masaki K, Okayama A, Okuda N, Yoshita K, Miyagawa N, Okamura T, Sakata K, Saitoh S, Sakurai M, Nakagawa H, Stamler J, Ueshima Het al., 2023, Small high-density lipoprotein and omega-3 fatty acid intake differentiates Japanese and Japanese-Americans: the INTERLIPID study, Journal of Atherosclerosis and Thrombosis, Vol: 30, Pages: 884-906, ISSN: 1340-3478

Aim: To identify the most differentiated serum lipids, especially concerning particle size and fractions, between Japanese living in Japan and Japanese-Americans in Hawaii, in the absence of possible genetic confounders, and cross-sectionally examine the associated modifiable lifestyle factors.Methods: Overall, 1,241 (aged 40–59 years) Japanese living in Japan and Japanese-Americans in Hawaii were included. We quantified 130 serum lipid profiles (VLDL 1-5, IDL, LDL 1-6, high-density lipoprotein [HDL] 1-4, and their subfractions) using Bruker’s 1H-nuclear magnetic resonance spectrometer for the primary outcome. Modifiable lifestyle factors included body mass index (BMI), physical activity, alcohol and smoking habits, and 70 nutrient parameters. We evaluated the different lipids between the groups using partial least squares-discriminant analysis and association between extracted lipids and lifestyle factors using multivariable linear regression analysis.Results: Concentrations of HDL4, HDL with the smallest particle size, were lower in Japanese than in Japanese-Americans of both sexes. Higher fish-derived omega-3 fatty acid intake and lower alcohol intake were associated with lower HDL4 concentrations. A 1% higher kcal intake of total omega-3 fatty acids was associated with a 9.8-mg/dL lower HDL4. Fish-derived docosapentaenoic acid, eicosapentaenoic acid, and docosahexaenoic acid intake were inversely associated with HDL4 concentration. There was no relationship between country, sex, age, or BMI.Conclusions: Japanese and Japanese-Americans can be differentiated based on HDL4 concentration. High fish intake among the Japanese may contribute to their lower HDL4 concentration. Thus, HDL particle size may be an important clinical marker for coronary artery diseases or a fish consumption biomarker.

Journal article

Fung E, Ng KH, Kwok T, Lui L-T, Palaniswamy S, Chan Q, Lim L-L, Wiklund P, Xie S, Turner C, Elshorbagy AK, Refsum H, Leung JCS, Kong APS, Chan JCN, Jarvelin M-R, Woo Jet al., 2023, Divergent Survival Outcomes Associated with Elevated Branched-Chain Amino Acid Levels among Older Adults with or without Hypertension and Diabetes: A Validated, Prospective, Longitudinal Follow-Up Study, BIOMOLECULES, Vol: 13

Journal article

Granot-Hershkovitz E, He S, Bressler J, Yu B, Tarraf W, Rebholz CM, Cai J, Chan Q, Garcia TP, Mosley T, Kristal BS, DeCarli C, Fornage M, Chen G-C, Qi Q, Kaplan R, Gonzalez HM, Sofer Tet al., 2023, Plasma metabolites associated with cognitive function across race/ethnicities affirming the importance of healthy nutrition, ALZHEIMERS & DEMENTIA, Vol: 19, Pages: 1331-1342, ISSN: 1552-5260

Journal article

Navarro SL, Gowda GAN, Bettcher LF, Pepin R, Nguyen N, Ellenberger M, Zheng C, Tinker LF, Prentice RL, Huang Y, Yang T, Tabung FK, Chan Q, Loo RL, Liu S, Wactawski-Wende J, Lampe JW, Neuhouser ML, Raftery Det al., 2023, Demographic, Health and Lifestyle Factors Associated with the Metabolome in Older Women, METABOLITES, Vol: 13

Journal article

Ezzati M, Mishra A, Zhou B, Rodriguez-Martinez A, Bixby H, Singleton R, Carrillo-Larco R, Sheffer K, Paciorek C, Bennett J, Lhoste V, Iurilli M, Di Cesare M, Bentham J, Phelps N, Sophiea M, Stevens G, Danaei G, Cowan M, Savin S, Riley L, Gregg E, Aekplakom W, Ahmad NA, Baker J, Chirita-Emandi A, Farzadfar F, Günther F, Heinen M, Ikeda N, Kengne AP, Khang Y-H, Laatikainen T, Laxmaiah A, Ma J, Monroy-Valle M, Padez C, Reynolds A, Soric M, Starc G, Wirth Jet al., 2023, Diminishing benefits of urban living for children and adolescents’ growth and development, Nature, Vol: 615, Pages: 874-883, ISSN: 0028-0836

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1,2,3,4,5,6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

Journal article

Aljuraiban GS, Gibson R, Chan DSM, Elliott P, Chan Q, Griep LMOet al., 2023, Lifestyle score and risk of hypertension in the airwave health monitoring study of British police force employees, International Journal of Environmental Research and Public Health, Vol: 20, Pages: 1-14, ISSN: 1660-4601

BACKGROUND: Evidence suggest that promoting a combination of healthy lifestyle behaviors instead of exclusively focusing on a single behavior may have a greater impact on blood pressure (BP). We aimed to evaluate lifestyle factors and their impact on the risk of hypertension and BP. METHODS: We analyzed cross-sectional health-screening data from the Airwave Health Monitoring Study of 40,462 British police force staff. A basic lifestyle-score including waist-circumference, smoking and serum total cholesterol was calculated, with a greater value indicating a better lifestyle. Individual/combined scores of other lifestyle factors (sleep duration, physical activity, alcohol intake, and diet quality) were also developed. RESULTS: A 1-point higher basic lifestyle-score was associated with a lower systolic BP (SBP; -2.05 mmHg, 95%CI: -2.15, -1.95); diastolic BP (DBP; -1.98 mmHg, 95%CI: -2.05, -1.91) and was inversely associated with risk of hypertension. Combined scores of other factors showed attenuated but significant associations with the addition of sleep, physical activity, and diet quality to the basic lifestyle-score; however, alcohol intake did not further attenuate results. CONCLUSIONS: Modifiable intermediary factors have a stronger contribution to BP, namely, waist-circumference and cholesterol levels and factors that may directly influence them, such as diet, physical activity and sleep. Observed findings suggest that alcohol is a confounder in the BP-lifestyle score relation.

Journal article

Miyagawa N, Sekikawa A, Miura K, Evans RW, Okuda N, Fujiyoshi A, Yoshita K, Chan Q, Okami Y, Kadota A, Willcox B, Masaki K, Rodriguez B, Sakata K, Nakagawa H, Saitoh S, Okayama A, Kuller LH, Elliott P, Stamler J, Ueshima Het al., 2023, Circulating plasma phospholipid fatty acid levels as a biomarker of habitual dietary fat intake: The INTERMAP/INTERLIPID Study, JOURNAL OF CLINICAL LIPIDOLOGY, Vol: 17, Pages: 131-141, ISSN: 1933-2874

Journal article

Posma JM, Perez IG, Karaman I, Gao H, Chan Q, Daviglus M, Van Horn L, Holmes E, Nicholson JK, Elliott Pet al., 2023, Host genomic influence on the gut microbial metabolite-blood pressure relationship, 29th Scientific Meeting of the International Society of Hypertension (Hypertension Kyoto 2022), Publisher: Lippincott, Williams & Wilkins, Pages: E240-E240, ISSN: 0263-6352

Conference paper

Aljuraiban GS, Gibson R, Chan DSM, Chan Q, Griep LMOet al., 2023, Evaluation of lifestyle scores in relation to blood pressure in young and older adults of the airwave health monitoring study of British police force employees, Publisher: CAMBRIDGE UNIV PRESS, ISSN: 0029-6651

Conference paper

Kanagasabai T, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, Kelly F, Xie G, Yang X, Zhao L, Guo D, Daskalopoulou SS, Wu Y, Baumgartner Jet al., 2022, Cross-sectional study of household solid fuel use and renal function in older adults in China, Environmental Research, Vol: 219, Pages: 1-11, ISSN: 0013-9351

BackgroundEmerging evidence links outdoor air pollution and declined renal function but the relationship between household air pollution and renal function is not well understood.MethodsUsing cross-sectional data from the multi-provincial INTERMAP-China Prospective Study, we collected blood samples and questionnaire information on stove use and socio-demographic factors. We calculated estimated glomerular filtration rate (eGFR) from serum creatinine to assess renal function. Participants with eGFR <60 mL/min per 1.73 m2 were defined as having chronic kidney disease (CKD) in this analysis. Generalized estimating equations were used to estimate the association of household fuel with renal function and prevalent CKD in models adjusting for confounders.ResultsAmong the 646 enrolled adults (40-79y; 56% female), one-third exclusively used clean fuel (gas and electric) cookstoves and 11% of northern China participants (n = 49 of 434) used only clean fuel heaters, whereas the rest used solid fuel. In multivariable models, use of solid fuel cookstoves was associated with 0.17 ml/min/1.73 m2 (95% CI: −0.30, 0.64) higher eGFR and 19% (0.86, 1.64) higher prevalence of CKD than exclusive clean fuel use. Greater intensity of solid fuel use was associated with 0.25 ml/min/1.73 m2 (−0.71, 0.21) lower eGFR per 5 stove-use years, though the confidence intervals included the null, while greater current intensity of indoor solid fuel use was associated with 1.02 (1.00, 1.04) higher prevalent CKD per 100 stove-use days per year. Larger associations between current solid fuel use and intensity of use with lower eGFR and prevalent CKD were observed among participants in southern China, those with hypertension or diabetes (eGFR only), and females (CKD only), through these groups had small sample sizes and some confidence intervals included the null.ConclusionWe found inconsistent evidence associating household solid fuel use and renal function in this cross-sectional study o

Journal article

Salman E, Kadota A, Okami Y, Kondo K, Yoshita K, Okuda N, Nakagawa H, Saitoh S, Sakata K, Okayama A, Chan Q, Elliott P, Stamler J, Ueshima H, Miura Ket al., 2022, Investigation of the urinary sodium-to-potassium ratio target level based on the recommended dietary intake goals for the Japanese population: The INTERMAP Japan, Hypertension Research, Vol: 45, Pages: 1850-1860, ISSN: 0916-9636

Growing epidemiological evidence has shown an association of the urinary sodium (Na) to potassium (K) ratio (Na/K ratio) with blood pressure and cardiovascular diseases. However, no clear cutoff level has been defined. We investigated the cutoff level of the urinary Na/K ratio under different dietary guidelines for Japanese individuals, especially that endorsed by the 2020 revised Japanese Dietary Reference Intakes (DRIs). A population of 1145 Japanese men and women aged 40 to 59 years from the INTERMAP study was examined. Using high-quality standardized data, the averages of two 24 h urinary collections and four 24 h dietary recalls were used to calculate the 24 h urinary and dietary Na/K ratios, respectively. Associations between the urinary and dietary Na/K ratios were tested by sex- and age-adjusted partial correlation. The optimal urinary Na/K ratio cutoff level was determined by receiver operating characteristic (ROC) curves and sex-specific cross tables for recommended dietary K and salt. Overall, the average molar ratio of 24 h urinary Na/K was 4.3. We found moderate correlations (P < 0.001) of the 24 h urinary Na/K ratio with 24 h urinary Na and K excretion (r = 0.52, r = −0.49, respectively) and the dietary Na/K ratio (r = 0.53). ROC curves showed that a 24 h urinary Na/K ratio of approximately 2 predicted Na and K intake that meets the dietary goals of the Japanese DRIs. The range of urinary Na/K ratios meeting the dietary goals of the Japanese DRIs for both Na and K was 1.6‒2.2 for men and 1.7‒1.9 for women. Accomplishing a urinary Na/K ratio of 2 would be desirable to achieve the DRIs dietary goals for both Na and K simultaneously in middle-aged Japanese men and women accustomed to Japanese dietary habits. This observational study is registered at www.clinicaltrials.gov as NCT00005271.

Journal article

Zhang H, Fan Y, Han Y, Yan L, Zhou B, Chen W, Cai Y, Chan Q, Zhu T, Kelly FJ, Barratt B, AIRLESS Team Bet al., 2022, Partitioning indoor-generated and outdoor-generated PM2.5 from real-time residential measurements in urban and peri-urban Beijing, Science of the Total Environment, Vol: 845, ISSN: 0048-9697

Limited number of projects have attempted to partition and quantify indoor- and outdoor-generated PM2.5 (PM2.5ig and PM2.5og) where strong indoor sources (e.g., solid fuel, tobacco smoke, or kerosene) exist. This study aimed to apply and refine a previous recursive model used to derive infiltration efficiency (Finf) to additionally partition pollution concentrations into indoor and outdoor origins within residences challenged by elevated ambient and indoor combustion-related sources. During the winter of 2016 and summer of 2017 we collected residential measurements in 72 homes in urban and peri-urban Beijing, 12 of which had additional paired residential outdoor measurements during the summer season. Local ambient measurements were collected throughout. We then compared the calculated PM2.5ig and using (i) outdoor and (ii) ambient measurements as model inputs. The results from outdoor and ambient measurements were not significantly different, which suggests that ambient measurements can be used as a model input for pollution origin partitioning when paired outdoor measurements are not available. From the results calculated using ambient measurements, the mean percentage contribution of indoor-generated PM2.5 was 19 % (σ = 22 %), and 7 % (11 %) of the total indoor PM2.5 for peri-urban and urban homes respectively during the winter; and 18 % (18 %) and 6 % (10 %) of the total indoor PM2.5 during the summer. Partitioning pollution into PM2.5ig and PM2.5og is important to allow investigation of distinct associations between health outcomes and particulate mixes, often with different physiochemical composition and toxicity. It will also inform targeted interventions that impact indoor and outdoor sources of pollution (e.g., domestic fuel switching vs. power generation), which are typically radically different in design and implementation.

Journal article

Chan Q, Wren G, Lau CH, Ebbels T, Gibson R, Loo RL, Aljuraiban G, Posma J, Dyer A, Steffen L, Rodriguez B, Appel L, Daviglus M, Elliott P, Stamler J, Holmes E, Van Horn Let al., 2022, Blood pressure interactions with the DASH dietary pattern, sodium, and potassium: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP), The American Journal of Clinical Nutrition, Vol: 116, Pages: 216-229, ISSN: 1938-3207

BackgroundAdherence to the Dietary Approaches to Stop Hypertension (DASH) diet enhances potassium intake and reduces sodium intake and blood pressure (BP), but the underlying metabolic pathways are unclear.ObjectiveAmong free-living populations, delineate metabolic signatures associated with the DASH diet adherence, 24-hr urinary sodium and potassium excretions and the potential metabolic pathways involved.Design24-hr urinary metabolic profiling by proton nuclear magnetic resonance spectroscopy was used to characterize the metabolic signatures associated with the DASH dietary pattern score (DASH score) and 24-hr excretion of sodium and potassium among participants in the United States (n=2,164) and United Kingdom (n= 496) enrolled in the International Study of Macro- and Micronutrients and Blood Pressure (INTERMAP). Multiple linear regression and cross-tabulation analyses were used to investigate the DASH-BP relation and its modulation by sodium and potassium. Potential pathways associated with DASH adherence, sodium and potassium excretion, and BP were identified using mediation analyses and metabolic reaction networks.ResultsAdherence to DASH diet was associated with urinary potassium excretion (correlation coefficient, r = 0.42, P<0.0001). In multivariable regression analyses, a five-point higher DASH score (range 7 to 35) was associated with a lower systolic BP by 1.35 mmHg (95% confidence interval: -1.95, -0.80, P=1.2 × 10−5); control of the model for potassium but not sodium attenuated the DASH-BP relation. Two common metabolites (hippurate and citrate) mediated the potassium-BP and DASH-BP relationships, while five metabolites (succinate, alanine, S-methyl cysteine sulfoxide, 4-hydroxyhippurate, phenylacetylglutamine) were found specific to the DASH-BP relation.ConclusionsGreater adherence to DASH diet is associated with lower BP and higher potassium intake across levels of sodium intake. The DASH diet recommends greater intake of fruits, veget

Journal article

Tseng T-WJ, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, Kelly F, Schauer JJ, Wu Y, Yang X, Zhao L, Baumgartner Jet al., 2022, Household air pollution from solid fuel use as a dose-dependent risk factor for cognitive impairment in northern China, Scientific Reports, Vol: 12, ISSN: 2045-2322

The relationship between exposure to household air pollution (HAP) from solid fuel use and cognition remains poorly understood. Among 401 older adults in peri-urban northern China enrolled in the INTERMAP-China Prospective Study, we estimated the associations between exposure to HAP and z-standardized domain-specific and overall cognitive scores from the Montreal Cognitive Assessment. Interquartile range increases in exposures to fine particulate matter (53.2-µg/m3) and black carbon (0.9-µg/m3) were linearly associated with lower overall cognition [- 0.13 (95% confidence interval: - 0.22, - 0.04) and - 0.10 (- 0.19, - 0.01), respectively]. Using solid fuel indoors and greater intensity of its use were also associated with lower overall cognition (range of point estimates: - 0.13 to - 0.03), though confidence intervals included zero. Among individual cognitive domains, attention had the largest associations with most exposure measures. Our findings indicate that exposure to HAP may be a dose-dependent risk factor for cognitive impairment. As exposure to HAP remains pervasive in China and worldwide, reducing exposure through the promotion of less-polluting stoves and fuels may be a population-wide intervention strategy to lessen the burden of cognitive impairment.

Journal article

Aljuraiban GS, Gibson R, Al-Freeh L, Al-Musharaf S, Shivappa N, Hebert JR, Griep LMO, Chan Qet al., 2022, Associations Among Plant-Based Dietary Indexes, the Dietary Inflammatory Index, and Inflammatory Potential in Female College Students In Saudi Arabia: A Cross-Sectional Study, JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS, Vol: 122, Pages: 771-+, ISSN: 2212-2672

Journal article

Granot-Hershkovitz E, He S, Bressler J, Yu B, Tarraf W, Rebholz CM, Cai J, Chan Q, Garcia TP, Mosley T, Kristal BS, DeCarli C, Fornage M, Chen G-C, Qi Q, Kaplan R, Gonzalez HM, Sofer Tet al., 2022, Plasma metabolites associated with cognitive function across race/ethnicities affirming the importance of healthy nutrition

<jats:title>Abstract</jats:title><jats:sec><jats:title>INTRODUCTION</jats:title><jats:p>We studied the replication and generalization of previously identified metabolites potentially associated with global cognitive function in multiple race/ethnicities and assessed the contribution of diet to these associations.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>We tested metabolite-cognitive function associations in U.S.A. Hispanic/Latino adults (n= 2,222) from the Community Health Study/ Study of Latinos (HCHS/SOL) and in European (n=1,365) and African (n=478) Americans from the Atherosclerosis Risk In Communities (ARIC) Study. We applied Mendelian Randomization (MR) analyses to assess causal associations between the metabolites and cognitive function and between Mediterranean diet and cognitive function.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>Six metabolites were consistently associated with lower global cognitive function across all studies. Of these, four were sugar related (e.g., ribitol). MR analyses provided weak evidence for a potential causal effect of ribitol on cognitive function and bi-directional effects of cognitive performance on diet.</jats:p></jats:sec><jats:sec><jats:title>DISCUSSION</jats:title><jats:p>Several diet-related metabolites were associated with global cognitive function across studies with different race/ethnicities.</jats:p></jats:sec>

Journal article

Loo RL, Chan Q, Nicholson JK, Holmes Eet al., 2022, Balancing the equation: a natural history of trimethylamine and trimethylamine-N-oxide., Journal of Proteome Research, Vol: 21, Pages: 560-589, ISSN: 1535-3893

Trimethylamine (TMA) and its N-oxide (TMAO) are ubiquitous in prokaryote and eukaryote organisms as well as in the environment, reflecting their fundamental importance in evolutionary biology, and their diverse biochemical functions. Both metabolites have multiple biological roles including cell-signaling. Much attention has focused on the significance of serum and urinary TMAO in cardiovascular disease risk, yet this is only one of the many facets of a deeper TMA-TMAO partnership that reflects the significance of these metabolites in multiple biological processes spanning animals, plants, bacteria, and fungi. We report on analytical methods for measuring TMA and TMAO and attempt to critically synthesize and map the global functions of TMA and TMAO in a systems biology framework.

Journal article

Kanagasabai T, Xie W, Yan L, Zhao L, Carter E, Guo D, Chan Q, Daskalopoulou S, Elliott P, Ezzati M, Yang X, Xie G, Kelly F, Wu Y, Baumgartner Jet al., 2022, Household air pollution and blood pressure, vascular damage and sub-clinical indicators of cardiovascular disease in older Chinese adults, American Journal of Hypertension, Vol: 35, Pages: 121-131, ISSN: 0895-7061

BackgroundLimited data suggest that household air pollution from cooking and heating with solid fuel (i.e., coal and biomass) stoves may contribute to the development of hypertension and vascular damage.MethodsUsing mixed-effects regression models, we investigated the associations of household air pollution with blood pressure (BP) and vascular function in 753 adults (ages 40-79y) from three diverse provinces in China. We conducted repeated measures of participants’ household fuel use, personal exposure to fine particulate air pollution (PM2.5), BP, brachial-femoral pulse wave velocity (bfPWV), and augmentation index. Ultrasound images of the carotid arteries were obtained to assess intima-media thickness (CIMT) and plaques. Covariate information on socio-demographics, health behaviors, 24-h urinary sodium, and blood lipids was also obtained.ResultsAverage estimated yearly personal exposure to PM2.5 was 97.5 μg/m 3 (SD: 79.2; range: 3.5-1241), and 65% of participants cooked with solid fuel. In multivariable models, current solid fuel use was associated with higher systolic (2.4 mmHg, 95%CI: -0.4, 4.9) and diastolic BP (1.4 mmHg, 95%CI: -0.1, 3.0) and greater total area of plaques (1.7 mm 2, 95%CI: -6.5, 9.8) compared with exclusive use of electricity or gas stoves. A 1-ln(µg/m 3) increase in PM2.5 exposure was associated with higher systolic (1.5 mmHg, 95%CI: 0.2, 2.7) and diastolic BP (1.0 mmHg, 95%CI: 0.4, 1.7) and with greater CIMT (0.02 mm, 95%CI: 0.00, 0.04) and total area of plaques (4.7 mm 2, 95%CI: -2.0, 11.5). We did not find associations with arterial stiffness, except for a lower bfPWV (-1.5 m/s, 95%CI: -3.0, -0.0) among users of solid fuel heaters.ConclusionsThese findings add to limited evidence that household air pollution is associated with higher BP and with greater CIMT and total plaque area.

Journal article

Lai A, Lee M, Carter E, Chan Q, Elliott P, Ezzati M, Yan L, Wu Y, Yang X, Zhao L, Baumgartner J, Schauer Jet al., 2021, A chemical investigation of household solid fuel use and outdoor air pollution contributions to personal PM2.5 exposures, Environmental Science and Technology (Washington), Vol: 55, Pages: 15969-15979, ISSN: 0013-936X

In communities with household solid fuel use, transitioning to clean stoves/fuels often results in only moderate reductions in fine particulate matter (PM2.5) exposures; the chemical composition of those exposures may help explain why. We collected personal exposure (men and women) and outdoor PM2.5 samples in villages in three Chinese provinces (Shanxi, Beijing, and Guangxi) and measured chemical components, including water-soluble organic carbon (WSOC), ions, elements, and organic tracers. Source contributions from chemical mass balance modeling (biomass burning, coal combustion, vehicles, dust, and secondary inorganic aerosol) were similar between outdoor and personal PM2.5 samples. Principal component analysis of organic and inorganic components identified analogous sources, including a regional ambient source. Chemical components of PM2.5 exposures did not differ significantly by gender. Participants using coal had higher personal/outdoor (P/O) ratios of coal combustion tracers (picene, sulfate, As, and Pb) than those not using coal, but no such trend was observed for biomass burning tracers (levoglucosan, K+, WSOC). Picene and most levoglucosan P/O ratios exceeded 1 even among participants not using coal and biomass, respectively, indicating substantial indirect exposure to solid fuel emissions from other homes. Contributions of community-level emissions to exposures suggest that meaningful exposure reductions will likely require extensive fuel use changes within communities.

Journal article

Ezzati M, Chan Q, 2021, Trends and inequalities in the incidence of acute myocardial 2 infarction among Beijing townships, 2007–2018, International Journal of Environmental Research and Public Health, Vol: 18, Pages: 1-12, ISSN: 1660-4601

Acute myocardial infarction (AMI) poses a serious disease burden in China, but studies on small-area characteristics of AMI incidence are lacking. We therefore examined temporal trends and geographic variations in AMI incidence at the township level in Beijing. In this cross-sectional analysis, 259,830 AMI events during 2007–2018 from the Beijing Cardiovascular Disease Surveillance System were included. We estimated AMI incidence for 307 consistent townships during consecutive 3-year periods with a Bayesian spatial model. From 2007 to 2018, the median AMI incidence in townships increased from 216.3 to 231.6 per 100,000, with a greater relative increase in young and middle-aged males (35–49 years: 54.2%; 50–64 years: 33.2%). The most pronounced increases in the relative inequalities was observed among young residents (2.1 to 2.8 for males and 2.8 to 3.4 for females). Townships with high rates and larger relative increases were primarily located in Beijing’s northeastern and southwestern peri-urban areas. However, large increases among young and middle-aged males were observed throughout peri-urban areas. AMI incidence and their changes over time varied substantially at the township level in Beijing, especially among young adults. Targeted mitigation strategies are required for high-risk populations and areas to reduce health disparities across Beijing.

Journal article

Fung E, Lui L-T, Huang L, Cheng KF, Lau GHW, Chung YT, Ahmadabadi BN, Xie S, Lee JSW, Hui E, So WY, Sung JJY, King I, Goggins WB, Chan Q, Jarvelin M-R, Ma RCW, Chow E, Kwok Tet al., 2021, Characterising frailty, metrics of continuous glucose monitoring, and mortality hazards in older adults with type 2 diabetes on insulin therapy (HARE): a prospective, observational cohort study, LANCET HEALTHY LONGEVITY, Vol: 2, Pages: E724-E735, ISSN: 2666-7568

Journal article

Vu T-HT, Van Horn L, Daviglus ML, Chan Q, Dyer AR, Zhong VW, Gibson R, Elliott P, Stamler Jet al., 2021, Association between egg intake and blood pressure in the USA: the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP)., Public Health Nutrition, Vol: 24, Pages: 1-9, ISSN: 1368-9800

OBJECTIVES: To investigate associations of egg intake with blood pressure (BP) and the role of dietary variables and other macro- and micro-nutrients in the association. DESIGN: We used cross-sectional data for the USA as part of the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). INTERMAP was surveyed between 1996 and 1999, including four 24-h dietary recalls, two 24-h urine collections and eight measurements of systolic BP and diastolic BP (SBP, DBP). Average egg intake (g/d) was calculated. Multivariable linear regression models were used to estimate the association between egg intake (per each 50 g/d or per quintile) and BP. The roles of dietary variables and other macro- and micro-nutrients in this association were also investigated. SETTING: In the USA. PARTICIPANTS: In total, 2195 US INTERMAP men and women aged 40-59 years. RESULTS: Participants were 50 % female, 54 % non-Hispanic White and 16 % non-Hispanic Black. Mean egg intake (sd) in men and women was 30·4(29·8) and 21·6(20·5) g/d, respectively. Adjusting for demographics, socio-economics, lifestyle and urinary Na:K excretion ratios, we found non-linear associations with BP in non-obese women (P-quadratic terms: 0·004 for SBP and 0·035 for DBP).The associations remained after adjusting for dietary variables, macro/micro nutrients or minerals. Dietary cholesterol was highly correlated with egg intake and may factor in the association. No association was found in obese women and in obese or non-obese men. CONCLUSION: Egg intake was non-linearly associated with SBP and DBP in non-obese women, but not in obese women or men. Underlying mechanisms require additional study regarding the role of obesity and sex.

Journal article

Posma JM, Garcia-Perez I, Frost G, Aljuraiban GS, Chan Q, Van Horn L, Daviglus M, Stamler J, Holmes E, Elliott P, Nicholson JKet al., 2021, Nutriome-metabolome relationships provide insights into dietary intake and metabolism (vol 1, pg 426, 2020), NATURE FOOD, Vol: 2, Pages: 541-542

Journal article

Posma JM, Stamler J, Garcia-Perez I, Chan Q, Wijeyesekera A, Daviglus M, Van Horn L, Holmes E, Nicholson J, Elliott Pet al., 2021, Urinary metabolic phenotype of blood pressure, 19TH INTERNATIONAL SHR SYMPOSIUM SHR, Publisher: Lippincott, Williams & Wilkins, Pages: E70-E70, ISSN: 0263-6352

Objective: Metabolic phenotyping (metabolomics) captures systems-level information on metabolic processes by simultaneously measuring hundreds of metabolites using spectroscopic techniques. Concentrations of these metabolites are affected by genetic (host, microbiome), environmental and dietary factors and may provide insights into biochemical pathways underlying raised blood pressure (BP) in populations.Design and method: Two separate, timed 24hr urine specimens were obtained from 2,031 women and men, aged 40–59, from 8 USA population samples in the INTERMAP Study. Proton Nuclear Magnetic Resonance (1H NMR) was used to characterize a urinary metabolic signature; this was unaffected by diurnal variability and sampling time as it captures end-products of metabolism over a 24hr period. Demographic, population, medical, lifestyle and anthropometric factors were accounted for in regression models to define a urinary metabolic phenotype associated with BP.Results: 29 structurally identified urinary metabolites covaried with systolic BP (SBP), after adjustment for demographic variables, and 18 metabolites with diastolic BP (DBP), with 16 metabolites overlapping between SBP and DBP. These included metabolites related to energy metabolism, renal function, diet and gut microbiota. After adjustment for medical and lifestyle covariates, 22/14 metabolites remained associated with SBP/DBP. Joint covariate-metabolite penalized regression models identified Body Mass Index, age and family history as most important contributors, with 14 metabolites, including gut microbial co-metabolites, also included in the model. Metabolites were mapped in a symbiotic metabolic reaction network, that includes reactions mediated by 3,344 commensal gut microbial species, to highlight affected pathways (Figure). Significant single nucleotide polymorphisms (SNPs) from genome-wide association studies on cardiometabolic risk factors were mapped to genes in this network. This revealed multiple sub

Conference paper

NCD Risk Factor Collaboration NCD-RisC, Iurilli N, 2021, Heterogeneous contributions of change in population distribution of body-mass index to change in obesity and underweight, eLife, Vol: 10, ISSN: 2050-084X

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.

Journal article

Han Y, Chatzidiakou L, Yan L, Chen W, Zhang H, Krause A, Xue T, Chan Q, Liu J, Wu Y, Barratt B, Jones RL, Zhu T, Kelly FJet al., 2021, Difference in ambient-personal exposure to PM2.5 and its inflammatory effect in local residents in urban and peri-urban Beijing, China: results of the AIRLESS project, Faraday Discussions, Vol: 226, Pages: 569-583, ISSN: 1359-6640

Measurement of ambient fine particulate matter (PM2.5) is often used as a proxy of personal exposure in epidemiological studies. However, the difference between personal and ambient exposure, and whether it biases the estimates of health effects remain unknown. Based on an epidemiological study (AIRLESS) and simultaneously launched intensive monitoring campaigns (APHH), we quantified and compared the personal and ambient exposure to PM2.5 and the related health impact among residents in Beijing, China. In total, 123 urban and 128 peri-urban non-smoking participants were recruited from two well-established cohorts in Beijing. During winter 2016 and summer 2017, each participant was instructed to carry a validated personal air monitor (PAM) to measure PM2.5 concentration at high spatiotemporal resolution for seven consecutive days in each season. Multiple inflammatory biomarkers were measured, including exhaled NO, blood monocytes counts and C-reactive protein. Linear mixed-effect models were used for the associations between exposure and health outcomes with adjustment for confounders. The average level of daily personal exposure to PM2.5 was consistently lower than using corresponding ambient concentration, and the difference is greater during the winter. The personal to ambient (P/A) ratio of exposure to PM2.5 exhibited an exponentially declining trend, and showed larger variations when ambient PM2.5 levels < 25 μg m−3. Personal exposure to PM2.5 was significantly associated with the increase in respiratory and systemic inflammatory biomarkers; however, the associations were weaker or became insignificant when ambient concentrations were used. Exposure to ambient PM2.5 might not be a good proxy to estimate the health effect of exposure to personal PM2.5.

Journal article

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