Imperial College London

DrQueenieChan

Faculty of MedicineSchool of Public Health

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
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175 results found

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., 2021, Household air pollution and blood pressure, vascular damage and sub-clinical indicators of cardiovascular disease in older Chinese adults, American Journal of Hypertension, 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

Aljuraiban GS, Gibson R, Al-Freeh L, Al-Musharraf S, Shivappa N, Hebert JR, Oude Griep LM, Chan Qet al., 2021, Association between plant-based dietary indices, the dietary inflammatory index and inflammatory potential in female college students in Saudi Arabia: a cross-sectional study., J Acad Nutr Diet, ISSN: 2212-2672

BACKGROUND: Saudi Arabian diets are transitioning to more "Western" dietary patterns which have been associated with higher levels of inflammation. Emerging evidence suggests plant-based diets are related to lower levels of inflammation, however, the definition of plant-based diets varies. OBJECTIVE: The purpose of this study was to identify the extent to which an overall plant-based diet index (PDI), healthy-PDI (hPDI), and unhealthy-PDI (uPDI) versus energy-adjusted dietary inflammatory index (E-DII) correlate with high-sensitivity C-reactive protein (hs-CRP). DESIGN: This was a cross-sectional study carried out at King Saud University. Data on dietary intake, anthropometrics, and hs-CRP were collected. PARTICIPANTS/SETTING: Female students aged 19-35 (n=401) were recruited from King Saud University, Riyadh, Saudi Arabia between February and May 2019. MAIN OUTCOME MEASURES: The main outcome was hs-CRP. STATISTICAL ANALYSES PERFORMED: Pearson correlation and multivariate linear regression analyses were used to examine the associations between hs-CRP, each PDI, and E-DII. RESULTS: E-DII and uPDI scores had a moderate and a small positive correlation with hs-CRP levels (r=0.46 and 0.22, respectively), while PDI and hPDI scores had a small and a moderate inverse correlation with hs-CRP levels (r=-0.13 and -0.31, respectively). A 1-SD higher E-DII score was directly associated with a 1.05 mg/l higher hs-CRP (95% confidence interval (CI): 0.72, 1.38, p<0.0001) after adjusting for body mass index (BMI). Overall PDI score was not associated with hs-CRP levels. A 6-point higher hPDI and uPDI scores were associated with a 0.13 mg/l lower hs-CRP [95%CI: -0.08, -0.28] and a 0.15 mg/l higher hs-CRP [95%CI: 0.03, 0.31], respectively, after adjusting for lifestyle and dietary factors, however, results attenuated and were no longer statistically significant after BMI adjustment. CONCLUSIONS: While all indices had a small or moderate correlation with hs-CRP, only E-DI

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 Nutr, Pages: 1-9

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

Loo RL, Lu Q, Carter E, Liu S, Clark S, Wang Y, Jill B, Huiru T, Chan Qet al., 2021, A feasibility study of metabolic phenotyping of dried blood spot specimens in rural Chinese women exposed to household air pollution, Journal of Exposure Science and Environmental Epidemiology, Vol: 31, Pages: 328-344, ISSN: 1559-0631

Background: Exposure-response studies and policy evaluations of household air pollution (HAP) are limited by current methods of exposure assessment which are expensive and burdensome to participants.Methods: We collected 152 dried blood spot (DBS) specimens during the heating and non-heating seasons from 53 women who regularly used biomass-burning stoves for cooking and heating. Participants were enrolled in a longitudinal study in China. Untargeted metabolic phenotyping of DBS were generated using ultra-high performance liquid chromatography coupled with mass spectrometry to exemplify measurement precision and assessment for feasibility to detect exposure to HAP, evaluated by season (high pollution versus low pollution) and measured personal exposure to fine particulate matter <2.5µm diameters (PM) and black carbon (BC) in the 48-h prior to collecting the DBS specimen.Results: Metabolites e.g., amino acids, acyl-carnitines, lyso-phosphorylcholines, sphinganine, and choline were detected in the DBS specimens. Our approach is capable of detecting the differences in personal exposure to HAP whilst showing high analytical reproducibility, coefficient of variance (CV) <15%, meeting the U.S. Food and Drug Administration criteria.Conclusions: Our results provide a proof of principle that high resolution metabolic phenotypic data can be generated using a simple DBS extraction method thus remote, low-resource settings where the collection of serum and plasma is logistically challengingor infeasible. The analytical run time (19 mins/specimen) is similar to most global phenotyping methods and therefore suitable for large-scale application.

Journal article

Aljuraiban G, Chan Q, Gibson R, Stamler J, Daviglus ML, Dyer AR, Miura K, Wu Y, Ueshima H, Zhao L, Van Horn L, Elliott P, Oude Griep LMet al., 2021, Association between plant-based diets and blood pressure in the INTERMAP study, BMJ Nutrition, Prevention & Health, Vol: 3, Pages: 133-142, ISSN: 2516-5542

Background Plant-based diets are associated with a lower risk of cardiovascular diseases; however, little is known how the healthiness of the diet may be associated with blood pressure (BP). We aimed to modify three plant -based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) according to country-specific dietary guidelines to enable use across populations with diverse dietary patterns – and assessed their associations with BP.Design We used cross-sectional data including 4,680 men and women ages 40–59y in Japan, China, the United Kingdom, and the United States from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). During four visits, eight BP measurements, and four 24-h dietary recalls were collected. Multivariable regression coefficients were estimated, pooled, weighted, and adjusted extensively for lifestyle/dietary confounders.Results Modified PDI was not associated with BP. Consumption of hPDI higher by 1SD was inversely associated with systolic (-0.82 mm Hg;95% CI:-1.32,-0.49) and diastolic BP (-0.49 mm Hg; 95% CI:-0.91, -0.28). In contrast, consumption of an uPDI was directly associated with systolic (0.77 mm Hg;95% CI:0.30,1.20). Significant associations between hPDI with BP were attenuated with separate adjustment for vegetables and whole grains; associations between uPDI and BP were attenuated after adjustment for refined grains, sugar-sweetened beverages, and meat.Conclusion An hPDI is associated with lower BP while a uPDI is adversely related to BP. Plant-based diets rich in vegetables and whole grains and limited in refined grains, sugar-sweetened beverages, and total meat may contribute to these associations. In addition to current guidelines, the nutritional quality of consumed plant foods is as important as limiting animal-based components.

Journal article

Matsumoto-Yamauchi H, Kondo K, Miura K, Tanaka-Mizuno S, Segawa H, Ohno S, Miyagawa N, Zaid M, Okami Y, Okuda N, Nakagawa H, Sakata K, Saitoh S, Okayama A, Yoshita K, Chan Q, Masaki K, Elliott P, Stamler J, Ueshima Het al., 2021, Relationships of alcohol consumption with coronary risk factors and macro- and micro-nutrient intake in Japanese people: The INTERLIPID study, Journal of Nutritional Science and Vitaminology, Vol: 67, Pages: 28-38, ISSN: 0287-3516

Several studies have reported a J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk. However, the mechanisms of this relationship remain unclear. This study aimed to evaluate the relationships of alcohol consumption with established CHD risk factors and with macro-/micro-nutrient intake among Japanese people. Participants were 1,090 Japanese men and women aged 40–59 y enrolled in the INTERLIPID study, excluding former drinkers. Based on two 7-d alcohol records, participants were classified as non-drinkers (0 g/wk), light-drinkers (<100 g/wk), moderate-drinkers (100–299 g/wk), or heavy-drinkers (≥300 g/wk). Detailed macro-/micro-nutrient intake was evaluated using four in-depth 24-h dietary recalls and adjusted for total energy intake excluding alcohol. We analyzed the associations of CHD risk factors and nutrient intake with alcohol consumption. Serum high-density lipoprotein cholesterol and blood pressure were higher and low-density lipoprotein cholesterol was lower among those with higher alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smokers, number of cigarettes smoked, and prevalence of hypertension; these risk factors were lowest among light-drinkers. Carbohydrate and total fiber intakes were lower and protein and dietary cholesterol intakes were higher among those with higher alcohol consumption. These associations were similar for men and women. Alcohol consumption was related to nutrient intake as well as established CHD risk factors. Non-drinkers were higher on some CHD risk factors than were light-drinkers. These findings may influence the J-shaped relationship between alcohol consumption and CHD risk.

Journal article

Han Y, Chen W, Chatzidiakou L, Krause A, Yan L, Zhang H, Chan Q, Barratt B, Jones R, Liu J, Wu Y, Zhao M, Zhang J, Kelly FJ, Zhu Tet al., 2020, Effects of AIR pollution on cardiopuLmonary disEaSe in urban and peri-urban reSidents in Beijing: protocol for the AIRLESS study, Atmospheric Chemistry and Physics, Vol: 20, Pages: 15775-15792, ISSN: 1680-7316

Beijing, as a representative megacity in China, is experiencing some of the most severe air pollution episodes in the world, and its fast urbanization has led to substantial urban and peri-urban disparities in both health status and air quality. Uncertainties remain regarding the possible causal links between individual air pollutants and health outcomes, with spatial comparative investigations of these links lacking, particularly in developing megacities. In light of this challenge, Effects of AIR pollution on cardiopuLmonary disEaSe in urban and peri-urban reSidents in Beijing (AIRLESS) was initiated, with the aim of addressing the complex issue of relating multi-pollutant exposure to cardiopulmonary outcomes. This paper presents the novel methodological framework employed in the project, namely (1) the deployment of two panel studies from established cohorts in urban and peri-urban Beijing, with different exposure settings regarding pollution levels and diverse sources; (2) the collection of detailed measurements and biomarkers of participants from a nested case (hypertensive) and control (healthy) study setting; (3) the assessment of indoor and personal exposure to multiple gaseous pollutants and particulate matter at unprecedented spatial and temporal resolution with validated novel sensor technologies; (4) the assessment of ambient air pollution levels in a large-scale field campaign, particularly the chemical composition of particulate matter. Preliminary results showed that there is a large difference between ambient and personal air pollution levels, and the differences varied between seasons and locations. These large differences were reflected on the different health responses between the two panels.

Journal article

Lee M, Carter E, Yan L, Chan Q, Elliott P, Ezzati M, Kelly F, Schauer J, Wu Y, Yang X, Zhao L, Baumgartner Jet al., 2020, Determinants of personal exposure to PM2.5 and black carbon in Chinese adults: a 1 repeated-measures study in villages using solid fuel energy, Environment International, Vol: 146, ISSN: 0160-4120

Exposure to air pollution is a leading health risk factor. The variance components and contributions of indoor versus outdoor source determinants of personal exposure to air pollution are poorly understood, especially in settings of household solid fuel use. We conducted a panel study with up to 4 days of repeated measures of integrated gravimetric personal exposure to PM2.5 and black carbon in 787 men and women (ages 40-79) living in peri-urban villages in northern (Beijing and Shanxi) and southern (Guangxi) China. We simultaneously measured outdoor PM2.5 and collected questionnaire data on sociodemographic characteristics and indoor pollution sources including tobacco smoking and solid fuel stove use. We obtained over 2000 days of personal exposure monitoring which showed higher exposures in the heating season (geometric mean (GM): 108 versus 65 μg/m3 in the non-heating season for PM2.5) and among northern participants (GM: 90 versus 59 μg/m3 in southern China in the non-heating season for PM2.5). We used mixed-effects models to estimate within- and between-participant variance components and to assess the determinants of exposures. Within-participant variance in exposure dominated the total variability (68-95%). Outdoor PM2.5 was the dominant variable for explaining within-participant variance in exposure to PM2.5 (16%). Household fuel use (PM2.5: 8%; black carbon: 10%) and smoking status (PM2.5: 27%; black carbon: 5%) explained the most between-participant variance. Indoor sources (solid fuel stoves, tobacco smoking) were associated with 13-30% higher exposures to air pollution and each 10 μg/m3 increase in outdoor PM2.5 was associated with 6-8% higher exposure. Our findings indicate that repeated measurements of daily exposure are likely needed to capture longer-term exposures in settings of household solid fuel use, even within a single season, and that reducing air pollution from both outdoor and indoor sources is likely needed to achieve measurable

Journal article

Lau CH, Taylor-Bateman V, Vorkas PA, Gomes Da Graca G, Vu T-H, Hou L, Chekmeneva E, Ebbels T, Chan Q, Van Horn L, Holmes Eet al., 2020, Metabolic signatures of gestational weight gain and postpartum weight loss in a lifestyle intervention study of overweight and obese women, Metabolites, Vol: 10, ISSN: 2218-1989

BACKGROUND: Overweight and obesity amongst women of reproductive age are increasingly common in developed economies and are shown to adversely affect birth outcomes and both childhood and adulthood health risks in the offspring. Metabolic profiling in conditions of overweight and obesity in pregnancy could potentially be applied to elucidate the molecular basis of the adverse effects of gestational weight gain (GWG) and postpartum weight loss (WL) on future risks for cardiovascular disease (CVD) and other chronic diseases. METHODS: Biofluid samples were collected from 114 ethnically diverse pregnant women with body mass index (BMI) between 25 and 40 kg/m2 from Chicago (US), as part of a randomized lifestyle intervention trial (Maternal Offspring Metabolics: Family Intervention Trial; NCT01631747). At 15 weeks, 35 weeks of gestation, and at 1 year postpartum, the blood plasma lipidome and metabolic profile of urine samples were analyzed by liquid chromatography mass spectrometry (LC-MS) and 1H nuclear magnetic resonance spectroscopy (1H NMR) respectively. RESULTS: Urinary 4-deoxyerythronic acid and 4-deoxythreonic acid were found to be positively correlated to BMI. Seventeen plasma lipids were found to be associated with GWG and 16 lipids were found to be associated with WL, which included phosphatidylinositols (PI), phosphatidylcholines (PC), lysophospholipids (lyso-), sphingomyelins (SM) and ether phosphatidylcholine (PC-O). Three phospholipids found to be positively associated with GWG all contained palmitate side-chains, and amongst the 14 lipids that were negatively associated with GWG, seven were PC-O. Six of eight lipids found to be negatively associated with WL contained an 18:2 fatty acid side-chain. CONCLUSIONS: Maternal obesity was associated with characteristic urine and plasma metabolic phenotypes, and phospholipid profile was found to be associated with both GWG and postpartum WL in metabolically healthy pregnant women with overweight/obesity. Postpartu

Journal article

Rodriguez-Martinez A, Zhou B, Sophiea MK, Bentham J, Paciorek CJ, Iurilli ML, Carrillo-Larco RM, Bennett JE, Di Cesare M, Taddei C, Bixby H, Stevens GA, Riley LM, Cowan MJ, Savin S, Danaei G, Chirita-Emandi A, Kengne AP, Khang YH, Laxmaiah A, Malekzadeh R, Miranda JJ, Moon JS, Popovic SR, Sørensen TI, Soric M, Starc G, Zainuddin AA, Gregg EW, Bhutta ZA, Black R, Abarca-Gómez L, Abdeen ZA, Abdrakhmanova S, Abdul Ghaffar S, Abdul Rahim HF, Abu-Rmeileh NM, Abubakar Garba J, Acosta-Cazares B, Adams RJ, Aekplakorn W, Afsana K, Afzal S, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Othman AR, Al-Raddadi R, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Allin K, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiri P, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Ängquist L, Anjana RM, Ansari-Moghaddam A, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assah FK, Assunção MCF, Aung MS, Auvinen J, Avdicová M, Azevedo A, Azimi-Nezhad M, Azizi F, Azmin M, Babu BV, Bæksgaard Jørgensen M, Baharudin A, Bahijri S, Baker JL, Balakrishna N, Bamoshmoosh Met al., 2020, Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants, The Lancet, Vol: 396, Pages: 1511-1524, ISSN: 0140-6736

SummaryBackgroundComparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.MethodsFor this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence.FindingsWe pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became

Journal article

Loo RL, Chan Q, Antti H, Li JV, Ashrafian H, Elliott P, Stamler J, Nicholson JK, Holmes E, Wist Jet al., 2020, Manuscript Strategy for improved characterisation of human metabolic phenotypes using a COmbined Multiblock Principal components Analysis with Statistical Spectroscopy (COMPASS), Bioinformatics, Vol: 36, Pages: 5229-5236, ISSN: 1367-4803

MOTIVATION: Large-scale population omics data can provide insight into associations between gene-environment interactions and disease. However, existing dimension reduction modelling techniques are often inefficient for extracting detailed information from these complex datasets. RESULTS: Here we present an interactive software pipeline for exploratory analyses of population-based nuclear magnetic resonance spectral data using a COmbined Multiblock Principal components Analysis with Statistical Spectroscopy (COMPASS) within the R-library hastaLaVista framework. Principal component analysis models are generated for a sequential series of spectral regions (blocks) to provide more granular detail defining sub-populations within the dataset. Molecular identification of key differentiating signals is achieved by implementing statistical correlation spectroscopy (STOCSY) on the full spectral data to define feature patterns. Finally, the distributions of cross-correlation of the reference patterns across the spectral dataset is used to provide population statistics for identifying underlying features arising from drug intake, latent diseases and diet. The COMPASS thus provides an efficient semi-automated approach for screening population datasets. AVAILABILITY AND IMPLEMENTATION: Source code is available at https://github.com/cheminfo/COMPASS. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Journal article

Aljuraiban GS, Pertiwi K, Stamler J, Chan Q, Geleijnse JM, Van Horn L, Daviglus ML, Elliott P, Oude Griep LM, INTERMAP Research Groupet al., 2020, Potato consumption, by preparation method and meal quality, with blood pressure and body mass index: The INTERMAP study, Clinical Nutrition, Vol: 39, Pages: 3042-3048, ISSN: 0261-5614

BACKGROUND AND AIMS: Previous studies have reported associations between higher potato intake and higher blood pressure (BP) and/or risk of hypertension and obesity. These studies rarely considered preparation methods of potatoes, overall dietary pattern or the nutrient quality of the meals. These factors may affect the association of potato intake with BP and body mass index (BMI). This study investigated potato consumption by amount, type of processing, overall dietary pattern, and nutrient quality of the meals in relation to BP and BMI. METHODS: Cross-sectional analyses were conducted among 2696 participants aged 40-59 y in the US and UK samples of the International Study of Macro- and Micro-Nutrients and Blood Pressure (INTERMAP). Nutrient quality of individual food items and the overall diet was assessed with the Nutrient-Rich Foods (NRF) index. RESULTS: No associations with BP or BMI were found for total potato intake nor for boiled, mashed, or baked potatoes or potato-based mixed dishes. In US women, higher intake of fried potato was associated with 2.29 mmHg (95% CI: 0.55, 3.83) higher systolic BP and with 1.14 mmHg (95% CI: 0.10, 2.17) higher diastolic BP, independent of BMI. Higher fried potato consumption was directly associated with a +0.86 kg/m2 difference in BMI (95% CI: 0.24, 1.58) in US women. These associations were not found in men. Higher intakes of fried potato meals with a lower nutritional quality (NRF index≤ 2) were positively associated with systolic (3.88 mmHg; 95% CI: 2.63, 5.53) and diastolic BP (1.62 mmHg; 95% CI: 0.48, 2.95) in US women. No associations with BP were observed for fried potato meals with a higher nutritional quality (NRF index> 2). CONCLUSIONS: Fried potato was directly related to BP and BMI in women, but non-fried potato was not. Poor-nutrient quality meals were associated with intake of fried potatoes and higher BP, suggesting that accompanied dietary choices are key mediators of

Journal article

Chatzidiakou L, Krause A, Han Y, Chen W, Yan L, Popoola OAM, Kellaway M, Wu Y, Liu J, Hu M, Barratt B, Kelly FJ, Zhu T, Jones RLet al., 2020, Using low-cost sensor technologies and advanced computational methods to improve dose estimations in health panel studies: results of the AIRLESS project, Journal of Exposure Science and Environmental Epidemiology, Vol: 30, Pages: 981-989, ISSN: 1559-0631

BackgroundAir pollution epidemiology has primarily relied on fixed outdoor air quality monitoring networks and static populations.MethodsTaking advantage of recent advancements in sensor technologies and computational techniques, this paper presents a novel methodological approach that improves dose estimations of multiple air pollutants in large-scale health studies. We show the results of an intensive field campaign that measured personal exposures to gaseous pollutants and particulate matter of a health panel of 251 participants residing in urban and peri-urban Beijing with 60 personal air quality monitors (PAMs). Outdoor air pollution measurements were collected in monitoring stations close to the participants’ residential addresses. Based on parameters collected with the PAMs, we developed an advanced computational model that automatically classified time-activity-location patterns of each individual during daily life at high spatial and temporal resolution.ResultsApplying this methodological approach in two established cohorts, we found substantial differences between doses estimated from outdoor and personal air quality measurements. The PAM measurements also significantly reduced the correlation between pollutant species often observed in static outdoor measurements, reducing confounding effects.ConclusionsFuture work will utilise these improved dose estimations to investigate the underlying mechanisms of air pollution on cardio-pulmonary health outcomes using detailed medical biomarkers in a way that has not been possible before.

Journal article

Garcia Perez I, Posma JM, Serrano Contreras JI, Boulange C, Chan Q, Frost G, Stamler J, Elliott P, Lindon J, Holmes E, Nicholson Jet al., 2020, Identifying unknown metabolites using NMR-based metabolic profiling techniques, Nature Protocols, Vol: 15, Pages: 2538-2567, ISSN: 1750-2799

Metabolic profiling of biological samples provides important insights into multiple physiological and pathological processes, but is hindered by a lack of automated annotation and standardised methods for structure elucidation of candidate disease biomarkers. Here, we describe a system for identifying molecular species derived from NMR spectroscopy based metabolic phenotyping studies, with detailed info on sample preparation, data acquisition, and data modelling. We provide eight different modular workflows to be followed in a recommended sequential order according to their level of difficulty. This multi-platform system involves the use of statistical spectroscopic tools such as STOCSY, STORM and RED-STORM to identify other signals in the NMR spectra relating to the same molecule. It also utilizes 2D-NMR spectroscopic analysis, separation and pre-concentration techniques, multiple hyphenated analytical platforms and data extraction from existing databases. The complete system, using all eight workflows, would take up to a month, as it includes multidimensional NMR experiments that require prolonged experiment times. However, easier identification cases using fewer steps would take two or three days. This approach to biomarker discovery is efficient, cost-effective and offers increased chemical space coverage of the metabolome, resulting in faster and more accurate assignment of NMR-generated biomarkers arising from metabolic phenotyping studies. Finally, it requires basic understanding of Matlab in order to perform statistical spectroscopic tools and analytical skills to perform Solid Phase Extraction, LC-fraction collection, LC-NMR-MS and 1D and 2D NMR experiments.

Journal article

Posma JM, Garcia Perez I, Frost G, Aljuraiban G, Chan Q, Van Horn L, Daviglus M, Stamler J, Holmes E, Elliott P, Nicholson Jet al., 2020, Nutriome-metabolome relationships provide insights into dietary intake and metabolism, Nature Food, Vol: 1, Pages: 426-436, ISSN: 2662-1355

Dietary assessment traditionally relies on self-reported data which are often inaccurate and may result in erroneous diet-disease risk associations. We illustrate how urinary metabolic phenotyping can be used as alternative approach for obtaining information on dietary patterns. We used two multi-pass 24-hr dietary recalls, obtained on two occasions on average three weeks apart, paired with two 24-hr urine collections from 1,848 U.S. individuals; 67 nutrients influenced the urinary metabotype measured with ¹H-NMR spectroscopy characterized by 46 structurally identified metabolites. We investigated the stability of each metabolite over time and showed that the urinary metabolic profile is more stable within individuals than reported dietary patterns. The 46 metabolites accurately predicted healthy and unhealthy dietary patterns in a free-living U.S. cohort and replicated in an independent U.K. cohort. We mapped these metabolites into a host-microbial metabolic network to identify key pathways and functions. These data can be used in future studies to evaluate how this set of diet-derived, stable, measurable bioanalytical markers are associated with disease risk. This knowledge may give new insights into biological pathways that characterize the shift from a healthy to unhealthy metabolic phenotype and hence give entry points for prevention and intervention strategies.

Journal article

Hunt LC, Dashti HS, Chan Q, Gibson R, Vetter Cet al., 2020, Quantifying Diet Intake and Its Association with Cardiometabolic Risk in the UK Airwave Health Monitoring Study: A Data-Driven Approach, NUTRIENTS, Vol: 12

Journal article

Okuda N, Okayama A, Miura K, Yoshita K, Miyagawa N, Saitoh S, Nakagawa H, Sakata K, Chan Q, Elliott P, Ueshima H, Stamler Jet al., 2020, Food sources of dietary potassium in the adult Japanese population: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP), Nutrients, Vol: 12, ISSN: 2072-6643

A lower-than-recommended potassium intake is a well-established risk factor for increased blood pressure. Although the Japanese diet is associated with higher sodium intake and lower potassium intake, few studies have examined the source foods quantitatively. Studies on dietary patterns in association with potassium intake will be useful to provide dietary advice to increase potassium intake. Twenty-four-hour (hr) dietary recall data and 24-hr urinary potassium excretion data from Japanese participants (574 men and 571 women) in the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were used to calculate food sources of potassium and compare food consumption patterns among quartiles of participants categorized according to 24-hr urinary potassium excretion per unit of body weight (UK/BW). The average potassium intake was 2791 mg/day per participant, and the major sources were vegetables and fruits (1262 mg/day), fish (333 mg/day), coffee and tea (206 mg/day), and milk and dairy products (200 mg/day). Participants in the higher UK/BW quartile consumed significantly more vegetables and fruits, fish, and milk and dairy products, and ate less rice and noodles. Conclusion: Advice to increase the intake of vegetables and fruits, fish, and milk may be useful to increase potassium intake in Japan.

Journal article

Griep LMO, Chekmeneva E, Stamler J, Van Horn L, Chan Q, Daviglus M, Frost GS, Ebbels TM, Holmes E, Elliott Pet al., 2020, A Metabolome-wide Association Study of Plant Food Consumption With Blood Pressure, Scientific Sessions of the American-Heart-Association on Epidemiology and Prevention/Lifestyle and Cardiometabolic Health, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Chai JC, Moon J-Y, Yu B, Chen G, Graff M, Daviglus ML, Chan QM, Thyagarajan B, Castaneda S, Grove M, Xue X, Boerwinkle E, Kaplan R, Qi Qet al., 2020, Metabolomic Signatures of Sedentary Behavior and Cardiometabolic Traits in US Hispanics/Latinos: Hispanic Community Health Study / Study of Latinos (HCHS/SOL), Scientific Sessions of the American-Heart-Association on Epidemiology and Prevention/Lifestyle and Cardiometabolic Health, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Aljuraiban GS, Gibson R, Oude Griep LM, Okuda N, Steffen LM, Van Horn L, Chan Qet al., 2020, Perspective: the application of a priori diet quality scores to cardiovascular disease risk: a critical evaluation of current scoring systems, Advances in Nutrition, Vol: 11, Pages: 10-24, ISSN: 2156-5376

Healthy dietary habits are the cornerstone of cardiovascular disease (CVD) prevention. Numerous researchers have developed diet quality indices to help evaluate and compare diet quality across and within various populations. The availability of these new indices raises questions regarding the best selection relevant to a given population. In this perspective, we critically evaluate a priori–defined dietary indices commonly applied in epidemiological studies of CVD risk and mortality. A systematic literature search identified 59 observational studies that applied a priori–defined diet quality indices to CVD risk factors and/or CVD incidence and/or CVD mortality. Among 31 different indices, these scores were categorized as follows: 1) those based on country-specific dietary patterns, 2) those adapted from distinct dietary guidelines, and 3) novel scores specific to key diet-related factors associated with CVD risk.The strengths and limitations of these indices are described according to index components, calculation methods, and the application of these indices to different population groups. Also, the importance of identifying methodological challenges faced by researchers when applying an index are considered, such as selection and weighting of food groups within a score, since food groups are not necessarily equivalent in their associations with CVD. The lack of absolute cutoff values, emphasis on increasing healthy food without limiting unhealthy food intake, and absence of validation of scores with biomarkers or other objective diet assessment methods further complicate decisions regarding the best indices to use. Future research should address these limitations, consider cross-cultural and other differences between population groups, and identify translational challenges inherent in attempting to apply a relevant diet quality index for use in CVD prevention at a population level.

Journal article

Jaime Miranda J, Carrillo-Larco RM, Ferreccio C, Hambleton IR, Lotufo PA, Nieto-Martinez R, Zhou B, Bentham J, Bixby H, Hajifathalian K, Lu Y, Taddei C, Abarca-Gomez L, Acosta-Cazares B, Aguilar-Salinas CA, Andrade DS, Assuncao MCF, Barcelo A, Barros AJD, Barros MVG, Bata I, Batista RL, Benet M, Bernabe-Ortiz A, Bettiol H, Boggia JG, Boissonnet CP, Brewster LM, Cameron C, Candido APC, Cardoso VC, Chan Q, Christofaro DG, Confortin SC, Craig CL, d'Orsi E, Delisle H, de Oliveira PD, Dias-da-Costa JS, Diaz A, Donoso SP, Elliott P, Escobedo-de la Pena J, Ferguson TS, Fernandes RA, Ferrante D, Monterubio Flores E, Francis DK, Franco MDC, Fuchs FD, Fuchs SC, Goltzman D, Goncalves H, Gonzalez-Rivas JP, Bonet Gorbea M, Gregor RD, Guerrero R, Guimaraes AL, Gulliford MC, Gutierrez L, Hernandez Cadena L, Herrera VM, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Howitt C, Irazola VE, Magaly Jimenez-Acosta S, Joffres M, Kolsteren P, Landrove O, Li Y, Lilly CL, Fernanda Lima-Costa M, Louzada Strufaldi MW, Machado-Coelho GLL, Makdisse M, Margozzini P, Marques LP, Martorell R, Matijasevich A, Posso AJMD, McFarlane SR, McLean SB, Menezes AMB, Miquel JF, Mohanna S, Monterrubio EA, Moreira LB, Morejon A, Motta J, Neal WA, Nervi F, Noboa OA, Ochoa-Aviles AM, Anselmo Olinto MT, Oliveira IO, Ono LM, Ordunez P, Ortiz AP, Otero JA, Palloni A, Peixoto SV, Pereira AC, Perez CM, Reina DAR, Ribeiro R, Ritti-Dias RM, Rivera JA, Robitaille C, Rodriguez-Villamizar LA, Rojas-Martinez R, Roy JGR, Rubinstein A, Sandra Ruiz-Betancourt B, Salazar Martinez E, Sanchez-Abanto J, Santos IS, dos Santos RN, Scazufca M, Schargrodsky H, Silva AM, Santos Silva DA, Stein AD, Suarez-Medina R, Tarqui-Mamani CB, Tulloch-Reid MK, Ueda P, Ugel EE, Valdivia G, Varona P, Velasquez-Melendez G, Verstraeten R, Victora CG, Wanderley RS, Wang M-D, Wilks RJ, Wong-McClure RA, Younger-Coleman NO, Zuniga Cisneros J, Danaei G, Stevens GA, Riley LM, Ezzati M, Di Cesare Met al., 2020, Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: a pooled analysis of population-based surveys, The Lancet Global Health, Vol: 8, Pages: E123-E133, ISSN: 2214-109X

BackgroundDescribing the prevalence and trends of cardiometabolic risk factors that are associated with non-communicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014.MethodsWe did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg), and diabetes (fasting plasma glucose ≥7·0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas.Findings389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3·9% (95% CI 2·2–6·3) in 1980, to 18·6% (14·3–23·3) in 2014, in men; and from 12·2% (8·2–17·0) in 1980, to 30·5% (25·7–35·5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5·2% (2·1–10·4) in men and 6·4% (2·6–10·4) in women in 1980, to 11·1% (6·4–17·3) in men and 13·6% (8·2–21·0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27·6% (22·3–33·2) in men and 19·9% (15·8–24·4) in women in 1980, to 15·

Journal article

Wu Y, Baumgartner J, Chan Q, Yan L, Carter E, Fu Y, Guo D, Huang P, Xie G, Xie W, Zhu Y, Kelly F, Elliott P, Zhao L, Yang X, Ezzati Met al., 2020, Study protocol: The INTERMAP China Prospective (ICP) study, Wellcome Open Research, Vol: 4

Background: Unfavourable blood pressure (BP) level is an established risk factor for cardiovascular diseases (CVD), while the exact underlying reasons for unfavourable BP are poorly understood. The INTERMAP China Prospective (ICP) Study is a prospective cohort to investigate the relationship of environmental and nutritional risk factors with key indicators of vascular function (BP, arterial stiffness, carotid-intima media thickness) among middle-aged/older men and women. Methods: A total of 839 Chinese participants aged 40-59 years from three diverse regions of China were enrolled in INTERMAP in 1997/98; data collection included repeated BP measurements, 24-hour urine specimens, and 24-hour dietary recalls. In 2015/16, 574 of these 839 persons were re-enrolled along with 208 new participants aged 40-59 years that were randomly selected from the same study villages. Participant's environmental and dietary exposures and health outcomes were assessed in this open cohort study, including BP, 24-hour dietary recalls, personal exposures to air pollution, grip strength, arterial stiffness, carotid-media thickness and plaques, cognitive function, and sleep patterns. Serum and plasma specimens were collected with 24-hour urine specimens. A follow-up visit has been scheduled for 2020-2021. Discussion: Winter and summer assessments of a comprehensive set of vascular indicators and their environmental and nutritional risk factors were conducted with high precision. We will leverage advances in exposome research to identify biomarkers of exposure to environmental and nutritional risk factors and improve our understanding of the mechanisms and pathways of their hazardous cardiovascular effects. The ICP Study is observational by design, thus subject to several biases including selection bias (e.g., loss to follow-up), information bias (e.g., measurement error), and confounding that we sought to mitigate through our study design and measurements. However, extensive efforts will app

Journal article

Carter E, Yan L, Fu Y, Robinson B, Kelly F, Elliott P, Wu Y, Zhao L, Ezzati M, Yang X, Chan Q, Baumgartner Jet al., 2020, Household transitions to clean energy in a multi-provincial cohort study in China, Nature Sustainability, Vol: 3, Pages: 42-50, ISSN: 2398-9629

Household solid fuel (biomass, coal) burning contributes to climate change and is a leading health risk factor. How and why households stop using solid fuel stoves after adopting clean fuels has not been studied. We assessed trends in the uptake, use, and suspension of household stoves and fuels in a multi-provincial cohort study of 753 Chinese adults and evaluated determinants of clean fuel uptake and solid fuel suspension. Over one-third (35%) and one-fifth (17%) of participants suspended use of solid fuel for cooking and heating, respectively, during the past 20 years. Determinants of solid fuel suspension (younger age, widowed) and of earlier suspension (younger age, higher education, and poor self-reported health status) differed from the determinants of clean fuel uptake (younger age, higher income, smaller households, and retired) and of earlier adoption (higher income). Clean fuel adoption and solid fuel suspension warrant joint consideration as indicators of household energy transition. Household energy research and planning efforts that more closely examine solid fuel suspension may accelerate household energy transitions that benefit climate and human health.

Journal article

Kanagasabai T, Lee M, Carter E, Yan L, Guo D, Chan Q, Elliott P, Ezzati M, Wu Y, Baumgartner Jet al., 2019, EXPOSURE TO AIR POLLUTION IS ASSOCIATED WITH LOWER SLEEP DURATION AND HIGHER ODDS OF SNORING AND SUSPECTED OSA IN CHINA, Publisher: ELSEVIER, Pages: S186-S186, ISSN: 1389-9457

Conference paper

Gibson R, Lau C, Loo RL, Ebbels T, Chekmeneva E, Dyer A, Miura K, Ueshima H, Zhao L, Daviglus M, Stamler J, Van Horn L, Elliott P, Holmes E, Chan Qet al., 2019, The association of fish consumption and its urinary metabolites with cardiovascular risk factors: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP), American Journal of Clinical Nutrition, Vol: 111, Pages: 280-290, ISSN: 0002-9165

BackgroundResults from observational studies regarding associations between fish (including shellfish) intake and cardiovascular disease risk factors, including blood pressure (BP) and BMI, are inconsistent.ObjectiveTo investigate associations of fish consumption and associated urinary metabolites with BP and BMI in free-living populations.MethodsWe used cross-sectional data from the International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP), including 4680 men and women (40–59 y) from Japan, China, the United Kingdom, and United States. Dietary intakes were assessed by four 24-h dietary recalls and BP from 8 measurements. Urinary metabolites (2 timed 24-h urinary samples) associated with fish intake acquired from NMR spectroscopy were identified. Linear models were used to estimate BP and BMI differences across categories of intake and per 2 SD higher intake of fish and its biomarkers.ResultsNo significant associations were observed between fish intake and BP. There was a direct association with fish intake and BMI in the Japanese population sample (P trend = 0.03; fully adjusted model). In Japan, trimethylamine-N-oxide (TMAO) and taurine, respectively, demonstrated area under the receiver operating characteristic curve (AUC) values of 0.81 and 0.78 in discriminating high against low fish intake, whereas homarine (a metabolite found in shellfish muscle) demonstrated an AUC of 0.80 for high/nonshellfish intake. Direct associations were observed between urinary TMAO and BMI for all regions except Japan (P < 0.0001) and in Western populations between TMAO and BP (diastolic blood pressure: mean difference 1.28; 95% CI: 0.55, 2.02 mmHg; P = 0.0006, systolic blood pressure: mean difference 1.67; 95% CI: 0.60, 2.73 mmHg; P = 0.002).ConclusionsUrinary TMAO showed a stronger association with fish intake in the Japanese compared with the Western population sample. Urinary TMAO was directly associated with BP in the Western but not the Japanese popula

Journal article

Yan L, Carter E, Fu Y, Guo D, Huang P, Xie G, Xie W, Zhu Y, Kelly F, Elliott P, Zhao L, Yang X, Ezzati M, Wu Y, Baumgartner J, Chan Qet al., 2019, Study protocol: The INTERMAP China Prospective (ICP) study, Wellcome Open Research, Vol: 4, Pages: 154-154

<ns4:p><ns4:bold>Background:</ns4:bold> Unfavourable blood pressure (BP) level is an established risk factor for cardiovascular diseases (CVD), while the exact underlying reasons for unfavourable BP are poorly understood.  The INTERMAP China Prospective (ICP) Study is a prospective cohort to investigate the relationship of environmental and nutritional risk factors with key indicators of vascular function including BP, arterial stiffness, and carotid-intima media thickness.</ns4:p><ns4:p> <ns4:bold>Methods:</ns4:bold> A total of 839 Chinese participants aged 40-59 years from three diverse regions of China were enrolled in INTERMAP in 1997/98; data collection included repeated BP measurements, 24-hour urine specimens, and 24-hour dietary recalls.  In 2015/16, 574 of these 839 persons were re-enrolled along with 208 new participants aged 40-59 years that were randomly selected from the same study villages.  Participant’s environmental and dietary exposures and health outcomes were assessed in this open cohort study, including BP, 24-hour dietary recalls, personal exposures to air pollution, grip strength, arterial stiffness, carotid-media thickness and plaques, cognitive function, and sleep patterns.  Serum and plasma specimens were collected with 24-hour urine specimens.</ns4:p><ns4:p> <ns4:bold>Discussion:</ns4:bold>  Winter and summer assessments of a comprehensive set of vascular indicators and their environmental and nutritional risk factors were conducted with high precision.  We will leverage advances in exposome research to identify biomarkers of exposure to environmental and nutritional risk factors and improve our understanding of the mechanisms and pathways of their hazardous cardiovascular effects.  The ICP Study is observational by design, thus subject to several biases including selection bias (e.g., loss to follow-up), information bias (e.g., measu

Journal article

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