Cohort Profile: The Taiwan MJ Cohort: half a million Chinese with repeated health surveillance data

Wu, Xifeng; Tsai, Shan P.; Tsao, Chwen Keng; Chiu, Mu-Lin; Tsai, Min Kuang; Lu, Po Jung; Lee, June Han; Chen, Chien Hwa; Wen, Christopher; Chang, Shu‐Sen; Hsu, Chung Y.; Wen, Chi Pang

doi:10.1093/ije/dyw282

Cited by 89 publications

(84 citation statements)

References 27 publications

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“…Study participants This study was based on an ongoing large prospective cohort whose details were described previously [17][18][19][20]. In brief, this cohort study recruited more than 0.6 million participants between 1994 and 2014.…”

Section: Methodsmentioning

confidence: 99%

Long-term exposure to ambient fine particulate matter (PM2.5) and incident type 2 diabetes: a longitudinal cohort study

et al. 2019

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Aims/hypothesis Information on the associations of long-term exposure to fine particulate matter (with an aerodynamic diameter less than 2.5 μm; PM 2.5) with the development of type 2 diabetes is scarce, especially for southeast Asia, where most countries are experiencing serious air pollution. This study aimed to investigate the long-term effects of exposure to ambient PM 2.5 on the incidence of type 2 diabetes in a population of Taiwanese adults. Methods A total of 147,908 participants without diabetes, at least 18 years of age, were recruited in a standard medical examination programme between 2001 and 2014. They were encouraged to take medical examinations periodically and underwent at least two measurements of fasting plasma glucose (FPG). Incident type 2 diabetes was identified as FPG ≥7 mmol/l or self-reported physician-diagnosed diabetes in the subsequent medical visits. The PM 2.5 concentration at each participant's address was estimated using a satellite-based spatiotemporal model with a resolution of 1 × 1 km 2. The 2 year average of PM 2.5 concentrations (i.e. the year of and the year before the medical examination) was treated as an indicator of longterm exposure to ambient PM 2.5 air pollution. We performed Cox regression models with time-dependent covariates to analyse the long-term effects of exposure to PM 2.5 on the incidence of type 2 diabetes. A wide range of covariates were introduced in the models to control for potential effects, including age, sex, education, season, year, smoking status, alcohol drinking, physical activity, vegetable intake, fruit intake, occupational exposure, BMI, hypertension and dyslipidaemia (all were treated as timedependent covariates except for sex). Results Compared with the participants exposed to the first quartile of ambient PM 2.5 , participants exposed to the second, third and fourth quartiles of ambient PM 2.5 had HRs of 1.28 (95% CI 1.18, 1.39), 1.27 (95% CI 1.17, 1.38) and 1.16 (95% CI 1.07, 1.26), respectively, for the incidence of type 2 diabetes. Participants who drank occasionally or regularly (more than once per week) or who had a lower BMI (<23 kg/m 2) were more sensitive to the long-term effects of exposure to ambient PM 2.5. Conclusions/interpretation Long-term exposure to ambient PM 2.5 appears to be associated with a higher risk of developing type 2 diabetes in this Asian population experiencing high levels of air pollution.

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Section: Methodsmentioning

confidence: 99%

Long-term exposure to ambient fine particulate matter (PM2.5) and incident type 2 diabetes: a longitudinal cohort study

et al. 2019

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“…Furthermore, the use of satellite data enabled us to track changes in PM 2:5 exposure over time and account for the effects of such changes on lung health. Finally, the data were collected through a standard medical screening program (Wu et al 2017). This may minimize investigator bias.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…It is difficult to perform spirometry in large-scale studies, especially in children and adolescents, and many factors might have contributed to these unsuccessful tests, such as participant cooperation and technician skill. However, we collected the data from a standard and routine medical screening program (Wu et al 2017), and there is no evidence showing that participants with an unsuccessful spirometry are more likely to be associated with PM 2:5 exposure. Thus, the exclusion is unlikely to have yielded any bias.…”

Section: Environmental Health Perspectivesmentioning

confidence: 99%

Long-Term Exposure to Ambient Fine Particulate Matter (PM2.5) and Lung Function in Children, Adolescents, and Young Adults: A Longitudinal Cohort Study

Guo

Hoek

Chang

et al. 2019

Environ Health Perspect

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BACKGROUND: The association between long-term exposure to ambient fine particulate matter with aerodynamic diameter ≤2:5 lm (PM 2:5) and lung function in young people remains uncertain, particularly in Asia, where air pollution is generally a serious problem. OBJECTIVES: This study investigated the association between long-term exposure to ambient PM 2:5 and lung function in Taiwanese children, adolescents, and young adults. METHODS: This study comprised 24,544 participants 6-24 years of age, with 33,506 medical observations made between 2000 and 2014. We used a spatiotemporal model to estimate PM 2:5 concentrations at participants' addresses. Spirometry parameters, i.e., forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1), and maximum midexpiratory flow (MMEF), were determined. A generalized linear mixed model was used to examine the associations between long-term exposure to ambient PM 2:5 and lung function. The odds ratios (ORs) of poor lung function were also calculated after adjusting for a range of covariates. RESULTS: Every 10-lg=m 3 increase in the 2-y average PM 2:5 concentration was associated with decreases of 2.22% [95% confidence interval (CI):

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“…Lack of information on other potentially important variables (e.g., energy intake, medications, family history of CVD) is also a major limitation in the present work. Another limitation is that participants may not be representative of the general population of Taiwan because they had somewhat higher socioeconomic status; however, the prevalence of obesity and other characteristics in this cohort are similar to those in the Taiwanese population . Also, these analyses should be replicated in other Asian and non‐Asian cohorts because the results may differ.…”

Section: Discussionmentioning

confidence: 95%

“…This research was conducted using the Taiwan MJ Cohort resource, an ongoing and dynamic prospective study of women and men who participated in a large health checkup program run by the MJ Health Management Institution, Taiwan (http://www.mjclinic.com.tw). The details of the MJ Cohort study population and data collection methods have been reported elsewhere . Briefly, the MJ Cohort has enrolled around 600,000 Taiwanese individuals since 1994.…”

Section: Methodsmentioning

confidence: 99%

Association of Changes in Physical Activity and Incidence and Remission of Overall and Abdominal Obesity in 113,950 Adults

Martínez‐Gómez

Hamer

Ortega

et al. 2020

Obesity

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Objective This study examined the dose‐response relationship between changes in physical activity (PA) and subsequent incidence or remission of overall and abdominal obesity. Methods A total of 113,950 healthy individuals aged ≥ 18 years participating in the Taiwan MJ Cohort were included. Two‐year changes in PA between the first and second examination were linked to subsequent development and remission of overall and abdominal obesity. Results During a mean 5.6‐year follow‐up after the second examination, 9,991 and 11,488 individuals developed overall and abdominal obesity, respectively; also, 3,588 and 3,156 participants with obesity lost sufficient weight or reduced their waist circumference to be classified as nonobese. Compared with no changes in PA, the multivariable hazard ratio (95% CI) of overall obesity was 0.95 (0.90‐1.00) for a PA increase of 0.01 to 3.74 metabolic equivalent hours (MET‐h) per week and 0.86 (0.80‐0.91) for a PA increase of ≥ 3.75 MET‐h per week. Corresponding values for remission of obesity were 1.00 (0.91‐1.09) and 1.16 (1.05‐1.28). Similar results were observed for the development and remission of abdominal obesity. Any decrease in PA was not associated with the risk of obesity outcomes when compared with a stable pattern (0 MET‐h/week). Conclusions Increasing PA was consistently associated with a progressively lower incidence and higher remission of overall and abdominal obesity.

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Cohort Profile: The Taiwan MJ Cohort: half a million Chinese with repeated health surveillance data

Cited by 89 publications

References 27 publications

Long-term exposure to ambient fine particulate matter (PM2.5) and incident type 2 diabetes: a longitudinal cohort study

Long-term exposure to ambient fine particulate matter (PM2.5) and incident type 2 diabetes: a longitudinal cohort study

Long-Term Exposure to Ambient Fine Particulate Matter (PM2.5) and Lung Function in Children, Adolescents, and Young Adults: A Longitudinal Cohort Study

Association of Changes in Physical Activity and Incidence and Remission of Overall and Abdominal Obesity in 113,950 Adults

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