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Heart Disease Prediction in Urban China

January 8, 2014

Longjian LiuAccording to two new studies, researchers from China and the Drexel University School of Public Health highlight that the risk of heart disease has become a serious public health issue in China with a particular concern on urban areas.  The researchers examined data of a large-scale longitudinal study in China to measure metabolic risk factors, such as high blood pressure, obesity, dyslipidemia and high glucose, as predictors for cardiovascular disease.

The studies, “A Longitudinal Cohort Based Association Study Between Uric Level and Metabolic Syndrome in Chinese Han Urban Male Population” published in BMC Public Health and “Identification of Cardiovascular Risk Components in Urban Chinese with Metabolic Syndrome and Application to Coronary Heart Disease Prediction: A Longitudinal Study” published in PLOS ONE, were co-authored by Longjian Liu, MD, PhD, MPH, FAHA, an associate professor at the Drexel University School of Public Health, along with senior co-authors Dr. Fuzhong Xue, Professor and Associate Dean for Research at the Shandong University School of Public Health, and Dr. Chengqi Zhang, Professor and Vice-President at Shandong Provincial QianFoShan Hospital in Jinan, China.

The urban Chinese population based study is one of the largest longitudinal studies in China, and is the first study using robust analysis approaches to investigate the complex associations between serum biomarkers and metabolic syndrome and risk for coronary heart disease in the Chinese population.

“With a rapid development of urbanization in China, a country with the world’s largest population, heart disease is the leading cause of death.  In part because of the changes towards “westernized lifestyles” among Chinese people, and one-child police in the last three decades, China has become the largest old-aged population around the world,” said Liu. “Noncommunicable diseases including heart disease and diabetes have posed serious public health issues for the Chinese population. Therefore, early detection and prevention of these diseases are urgently needed.”

“The present urban Chinese population study provides new insights into large-scale population based research,” said Liu.  “Findings from the study are very informative for clinical practice and prevention of metabolic disorders and heart disease at both individual and population levels.”

The study measuring serum uric acid (UA) level (a novel biomarker for cardiovascular disease) and metabolic syndrome included 2,222 male participants at least 25 years of age with an average of 3.5 reported measures of UA per person in the Health Management Center of Shandong Provincial Hospital, Shandong, China.

The study on cardiovascular risk components included 5,311 Hans Chinese participants (4,574 males and 737 females) with metabolic syndrome in the cohort of all participants who completed physical examinations and the measurements of the study of biomarkers (n=28,200) to extract cardiovascular disease-related factors with specific clinical significance from 16 biomarkers tested in routine health check-up.  Using factor analysis technique, eight factors were extracted. Then, the predictive effects of the eight factors on risk of coronary heart disease were validated using a sample of 1,923 participants who had no coronary heart disease at baseline in the cohort of 28,200 participants and followed up for five years. Finally, a synthetic predictor (SP) was created by weighting each factor with their risks for coronary heart disease to develop a risk matrix to predicting coronary heart disease in the practice of routine health check-ups.

The authors recommend that the studies provide a basis to develop a risk assessment model for predicting metabolic syndrome and coronary heart disease using data from routine health check-ups in China.