Abstract Background Higher intakes of cruciferous vegetables or their constituents have been shown to lower inflammation in animal studies. However, evidence for this anti-inflammatory effect of ...cruciferous vegetable consumption in humans is scarce. Objective/Design In this cross-sectional analysis, we evaluated associations of vegetable intake with a panel of inflammatory and oxidative stress markers among 1,005 middle-aged Chinese women. Dietary intake of foods was assessed by a food frequency questionnaire. Results Multivariable-adjusted circulating concentrations of tumor necrosis factor-α (TNF-α), interlukin-1β (IL-1β), and IL-6 were lower among women with higher intakes of cruciferous vegetables. The differences in concentrations of inflammatory biomarkers between extreme quintiles of cruciferous vegetable intake were 12.66% for TNF-α ( Ptrend =0.01), 18.18% for IL-1β ( Ptrend =0.02), and 24.68% for IL-6 ( Ptrend =0.02). A similar, but less apparent, inverse association was found for intakes of all vegetables combined but not for noncruciferous vegetables. Levels of the urinary oxidative stress markers F2 -isoprostanes and their major metabolite, 2,3-dinor-5,6-dihydro-15-F2t -IsoP, were not associated with intakes of cruciferous vegetables or all vegetables combined. Conclusions This study suggests that the previously observed health benefits of cruciferous vegetable consumption may be partly associated with the anti-inflammatory effects of these vegetables.
Abstract Background Soy and some of its constituents, such as isoflavones, have been shown to affect the inflammatory process in animal studies. The association between soy food intake and ...inflammatory markers has not been evaluated adequately in humans. Objective Our aim was to evaluate whether higher intake of soy foods was inversely associated with inflammatory markers in 1,005 middle-aged Chinese women. Design In this cross-sectional study, dietary intake of soy foods was assessed by a validated food frequency questionnaire and by a 24-hour recall when biospecimens were procured. A general linear model was used to estimate the geometric means of selected inflammatory markers, including interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNFα), soluble IL-6 receptor, soluble GP130, soluble TNF receptors 1 and 2, and C-reactive protein, across categories of soy food intake after adjusting for age, lifestyle and dietary factors, and history of infectious or inflammation-related diseases. Results We found that multivariable-adjusted geometric mean concentrations of IL-6 and TNFα were inversely associated with quintiles of soy food intake, with a difference between the highest and lowest quintiles of 25.5% for IL-6 ( P for trend=0.008) and 14% for TNFα ( P for trend=0.04). Similar inverse associations were found for TNFα ( P for trend = 0.003), soluble TNF receptor 1 ( P for trend=0.01), soluble TNF receptor 2 ( P for trend=0.02), IL-1β ( P for trend=0.05), and IL-6 ( P for trend=0.04) when soy food consumption was assessed by the frequency of consumption in the preceding 24 hours. No significant associations were found for other markers studied. Conclusions This study suggests that soy food consumption is related to lower circulating levels of IL-6, TNFα, and soluble TNF receptors 1 and 2 in Chinese women.
Purpose Gallstone disease is more common among overweight individuals, particularly in women. We conducted a cross-sectional case-control study of Chinese women nested in the Shanghai Women's Health ...Study (SWHS) to evaluate the association of gallstone disease with body mass index (BMI), waist to hip ratio (WHR), and physical activity (PA). Methods The study included 8,485 women with self-reported, physician-diagnosed, prevalent gallstone disease and 16,970 frequency-matched controls by birth year and age at gallstone diagnosis (4-year intervals). Information on height, weight history, waist and hip circumferences, physical activities, and other exposures was obtained by in-person interview. Results : Usual BMI ( p trend < 0.001) and WHR ( p trend < 0.001) were both related to a high prevalence of gallstone disease, and a significant interaction between BMI and WHR on gallstone risk was found (odds ratio OR = 3.82, 95%CI 95% confidence interval 2.47–5.23 for those with both highest BMI and WHR relative to those with lowest BMI and WHR, p interaction = 0.03). Gallstone risk was positively associated with cumulative occupational sitting time ( p trend = 0.01) and inversely associated with occupational cumulative energy expenditure ( p trend = 0.03) as well as with household PA ( p trend = 0.02). Conclusions Our findings further support that overall and central excessive adiposity is an independent risk factor for gallstones in women. In addition, regardless of adiposity level, being physically active may ameliorate the risk of this disease.
Abstract Purpose To assess the associations between cruciferous vegetable (CV) intake, GST gene polymorphisms, and colorectal cancer (CRC) in a population of Chinese men. Methods Using incidence ...density sampling, CRC cases ( N = 340) diagnosed before December 31, 2010 within the Shanghai Men's Health Study were matched to noncases ( N = 673). CV intake was assessed from a food frequency questionnaire and by isothiocyanate levels from spot urine samples. GSTM1 and GSTT1 were categorized as null (0 copies) versus non-null (1 or 2 copies). Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals for the association between CV intake and GST gene variants with CRC, and statistical interactions were evaluated. Results CRC risk was not associated with CV intake, whether measured by self-report or by urinary isothiocyanate nor with GST gene variants. No statistical interactions were detected between CV intake and GST gene variants on the odds of CRC. Stratifying by timing of urine sample collection and excluding CRC cases diagnosed in the first 2 years did not materially alter the results. Conclusions This study provides no evidence supporting the involvement of CV intake in the development of CRC in Chinese men.
Background Following adoption of a Western lifestyle, China is experiencing a decline in physical activity levels, which is projected to contribute to future increases in the burden of chronic ...diseases. Purpose This study aims to target public health interventions and identify personal characteristics associated with physical activity and sedentary behavior in urban Chinese adults. Methods In a sample of 576 men and women aged 40–74 years from Shanghai, multiple logistic regression was used to examine demographic, anthropometric, and lifestyle factors in relation to levels of physical activity and sedentary behavior assessed by Actigraph accelerometers. Results Participants spent 317 minutes/day in physical activity and 509 minutes/day sedentary. In multivariate models, people aged ≥60 years were significantly less likely than those aged <50 years to engage in physical activity (OR=0.29, 95% CI=0.17, 0.49) and more likely to spend time sedentary (OR=2.77, 95% CI=1.53, 5.05). Similarly, obese individuals were less likely to be physically active (OR=0.34, 95% CI=0.17, 0.66) and they were suggestively more likely to be sedentary (OR=1.87, 95% CI=0.94, 3.71) than normal-weight individuals. Furthermore, current cigarette smokers were less physically active than those who formerly or never smoked (OR=0.47, 95% CI=0.28, 0.78). Conclusions Physical activity promotion programs in urban China should target older people, obese individuals, and cigarette smokers, as these population subgroups exhibited low levels of physical activity.
Small cell lung cancer (SCLC) is a highly fatal disease, but its treatment has remained relatively unchanged for decades. Randomized clinical trials evaluating radiation therapy (RT) dosing and ...fractionation have yielded mixed results on overall survival (OS).
We identified 2261 patients with limited-stage (LS) SCLC undergoing definitive RT at 1.5, 1.8, and 2.0 Gy dose per fraction, concurrently with chemotherapy, between 2004 and 2015 within the National Cancer Database. Overall survival (OS) was evaluated using the Kaplan-Meier method, and Cox proportional hazards regression was used to investigate whether there was any survival difference among patients who received hyperfractionated, twice-daily RT at 1.5 Gy per fraction (HF1.5) and once-daily, standard fractionation RT at 1.8 Gy (SF1.8) or 2.0 Gy (SF2.0) per fraction. Subgroup analyses by age, sex, race, time to RT, facility type, and Charlson comorbidity index were also performed.
All stage median OS rates for HF1.5, SF1.8, and SF2.0 Gy groups were 21.6, 18.9, and 19.4 months, respectively (log-rank P = .0079). Multivariate analyses adjusting for demographic factors, socioeconomic status, tumor characteristics, and year of diagnosis showed SF1.8 (hazard ratio HR = 1.30, 1.03-1.63) and SF2.0 (HR = 1.20, 1.00-1.45) was associated with worse 1-year survival compared with HF1.5. This association was more evident in stage IIb-stage III than stage I to stage IIa patients. Propensity score–weighted analysis showed similar results. Stratified analyses showed the significant associations were confined to male or black patients, those aged >65 years, with 1 comorbidity, who had waited >60 days to start RT or were treated at an academic medical center.
Analyses of real-world treatment outcome data showed that receiving hyperfractionated, twice-daily RT was associated with improved survival among patients with LS-SCLC compared with standard, once-daily fractionation regimens at 1 year after diagnosis, particularly for subsets of patients. Some associations retained statistical significance 3 years postdiagnosis.
Abstract Background : American women are five times more likely to be at risk for breast cancer than women from Asian countries. Epidemiologic studies have linked energy balance to an increased risk ...of breast cancer, yet few studies have investigated potential mediators of this association with Chinese women. We examined the above association by blood levels of insulin-like growth factors (IGFs), binding proteins, and C-peptide in the Shanghai Breast Cancer Study (SBCS), a case–control study conducted among 1459 breast cancer cases and 1556 healthy Chinese women from 1996 and 1998. Methods : In-person surveys were used to collect data on energy intake, anthropometric measures, exercise/sport activity, and occupational activity. The present analyses consisted of 397 cases and 397 controls whose blood samples were measured for levels of IGFs, insulin growth-factor binding protein 3 (IGFBP-3), C-peptide, and the relationship with physical activity status, total energy intake, and body fat distribution. Results : Body mass index (BMI) and waist-to-hip ratio (WHR) were significantly positively correlated with IGFBP-3 and C-peptide. Adult exercise/sport activity was significantly negatively correlated with insulin-like growth factor 1 (IGF-I). C-peptide levels increased with increasing quartiles of WHR ( p for trend < 0.01). Additional analyses were performed to evaluate whether the association of energy balance measures with breast cancer risk changed after adjustment for IGFs, IGFBP-3, and C-peptide biomarkers. The associations attenuated, but none of them changed substantially. Conclusion : Insulin resistance biomarkers may partially explain the association between positive energy balance and breast cancer risk, but future studies are needed to identify the underlying complex biological mechanisms of action for breast cancer prevention.
The criteria used to identify persons with asthma in epidemiologic studies are varying and, depending on the method used, can be challenging and resource consuming.
To develop a nomogram (scoring ...system) to identify adult patients with asthma using a combination of variables collected via a validated questionnaire.
We studied the first 268 women aged 40 to 69 years in the Shanghai Women's Asthma and Allergy Study who reported signs and symptoms of asthma and underwent either methacholine challenge testing or test of reversibility during the asthma screening survey between 2003 and 2007. These women were defined as having definite asthma (n=106) or not (n=162). Multivariable logistic regression analysis was performed to develop a predictive model for identifying asthma using survey information alone.
Clinically relevant questions were used for the predictive multivariable logistic regression model and included the following: ever wheezing or whistling in the chest, current medication use for asthma, self-reported ever asthma, self-reported ever allergic rhinitis, family history of allergy, and age. The area under the receiver operating characteristic curve of the prediction model was 0.75 (95% confidence interval, 0.69-0.81). A nomogram was developed to assess the individual probability of asthma based on individually weighted variables in the predictive model.
In clinical or epidemiologic studies, this asthma nomogram could be used as a tool to assess the probability of asthma for an individual patient by incorporating asthma-related predictor variables obtained through a field questionnaire.
Purpose We sought to determine the association of hip circumference with risk of type 2 diabetes in a relatively lean population. Methods The relationship between hip circumference for a given waist ...circumference or BMI and risk of type 2 diabetes was investigated in 56,100 men and 68,273 women, aged 40 to 74, from the Shanghai Men’s Health Study and the Shanghai Women’s Health Study. Cox analyses were used. Results Over an average of 4.0 years and 7.8 years of follow-up of the men and women, respectively, 2754 new diabetes cases (955 males; 1799 females) were documented. After adjustment for body mass index (BMI), waist circumference, and other potential confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes in quintiles 2 to 5 compared with the first quintile of hip circumference were 0.95 (95% CI, 0.76–1.18), 0.72 (95% CI, 0.57–0.91), 0.83 (95% CI, 0.67–1.04), 0.78 (95% CI, 0.63–0.97), respectively, among men and 0.83 (95% CI, 0.72–0.96), 0.74 (95% CI, 0.64–0.86), 0.72 (95% CI, 0.62–0.84), and 0.65 (95% CI, 0.56–0.75) among women. This relationship was stronger for men and women with a BMI less than or equal to the median (23.6 kg/m2 for each gender; interaction p -value = .04 for men and .01 for women). Conclusions A greater hip circumference for a given waist circumference and BMI is associated with a reduced risk of type 2 diabetes.
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