Kailuan General Hospital

Insulin resistance is an important risk factor for the development of colorectal cancer (CRC), and triglyceride-glucose (TyG) related indices, as emerging biomarkers of insulin resistance, have not been thoroughly studied in the context of CRC risk assessment. This study aimed to evaluate the relationships between three TyG-related indices-specifically triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference index (TyG-WC), and triglyceride glucose-waist to height ratio index (TyG-WHtR)-and CRC risk within a large prospective cohort from the Kailuan Study (2006-2019), which included 173,342 cancer-free participants. During a median follow-up of 14.23 years, 977 incident CRC cases were identified. Multivariable Cox proportional hazards models revealed significant positive associations between the TyG-related indices and CRC risk: for TyG-BMI, those in the third and fourth quartiles had hazard ratios (HRs) of 1.22 (95% CI: 1.01-1.48) and 1.35 (95% CI: 1.11-1.64), respectively; for TyG-WC, the fourth quartile had an HR of 1.43 (95% CI: 1.17-1.74); and for TyG-WHtR, the third and fourth quartiles had HRs of 1.28 (95% CI: 1.05-1.57) and 1.37 (95% CI: 1.12-1.68), respectively. Dose-response analyses demonstrated linear relationships for all indices (all p for overall = 0.001, p for non-linear >0.05). The results show a significant association between elevated TyG indices and increased colorectal cancer (CRC) risk, suggesting that these markers may have potential value in risk stratification.

The body roundness index (BRI) is a more comprehensive anthropometric measure than the body mass index (BMI) because it reflects the distribution of visceral fat more accurately. This study evaluated the separate and joint associations of cumulative BRI (cumBRI) exposure and its variability with the risk of fragility fractures in the Chinese population. This study included 47,240 individuals from the Kailuan Study who underwent three consecutive health examinations between 2006 and 2010 (2006–2007, 2008–2009, and 2010–2011) and were followed up until December 31, 2022. Cumulative BRI exposure was calculated using the time-weighted average (TWA), and variability in BRI was assessed using indices of variability. Cox models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analysis and interaction testing performed. The C-index, discriminatory improvement (IDI), and net reclassification index (NRI) were used to assess fracture risk prediction. During a median follow-up of 12.03 years, 725 participants developed fragility fractures. After adjusting for confounders, the HR for fragility fracture was 1.52 (95% CI 1.15–1.99) in the highest TWA BRI quartile, 1.38 (95% CI 1.08–1.75) in those with a cumulative burden of > 0, and 1.55 (95% CI 1.20-2.00) for those with ≥ 4 years of exposure duration. Greater BRI variability was associated with an increased risk of fragility fractures (HR 1.29, 95% CI 1.05–1.60]). The risk of fragility fractures was higher in individuals with a high TWA BRI and high BRI variability than in those with a low TWA BRI and low BRI variability. Combined measures of cumulative BRI and variability were better able to predict the risk of fracture than traditional metrics. Cumulative exposure to a high cumBRI and greater BRI variability in the BRI were independently associated with a higher incidence of fragility fractures, and their coexistence could may further increase the risk further. In terms of predicting the fracture risk, the combined effects of cumulative cumBRI exposure and variability predicting fracture risk are slightly superior to the predictive ability of obesity-related indices.

High cardiometabolic index (CMI) is a risk factor for heart failure (HF), but the long-term impact of cumulative CMI exposure on incident HF remains unclear. We examined the association between cumulative CMI and HF risk in a large prospective cohort. A total of 44 773 participants (mean age 53.1 ± 11.9 years; 78.6% men) from the Kailuan Study who attended three health examinations in 2006, 2008, and 2010 and were free of cardiovascular disease or cancer at baseline were included. Cumulative CMI was calculated as the weighted sum of mean CMI across time intervals and categorized into quartiles. Incident HF was identified through medical records and death registries until 31 December 2022. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. Over a median follow-up of 12.0 years (IQR 11.7-12.3), 1018 HF events occurred. Compared with the lowest quartile, adjusted hazard ratios (95% confidence intervals) were 1.18 (0.95-1.50), 1.32 (1.05-1.65), and 1.40 (1.11-1.76) for Q2-Q4 (P for trend < 0.001). A significant interaction was observed between cumulative CMI and diabetes (P = 0.043), but not with age, sex, or hypertension. Sensitivity analyses yielded consistent results. High cumulative CMI was independently associated with increased HF risk. Long-term monitoring and maintenance of an optimal CMI level may aid in early identification and prevention of HF in the general population.

ObjectivesThis study aimed to investigate the association between the Systemic Immune Inflammation Index (SII) and the prolonged length of hospital stay (PLOS) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsA retrospective analysis was conducted involving 986 patients aged ≥ 40 years with AECOPD admitted to Kailuan General Hospital between January 2018 and December 2024. PLOS was defined as a stay exceeding 7 days. Complete blood counts were collected within 24 h of admission to calculate the SII, which was the log-transformed and denoted as In-SII. Logistic regression analysis was employed to compare the predictive value of In-SII and In-NLR (neutrophil-to-lymphocyte ratio) for PLOS in patients with AECOPD. Additionally, restricted cubic splines (RCS) and decision curves analysis (DCA) were utilized to explore the nonlinear relationship and clinical net benefit between In-SII and PLOS in patients with AECOPD.ResultsIn-SII was an independent risk factor for PLOS in patients with AECOPD (odds ratios for Model 1, Model 2, and Model 3 were 1.527, 1.294, and 1.496, respectively; p < 0.05). Its predictive performance is superior to In-NLR. According to RCS curves, there was a linear association between In-SII and PLOS in patients with AECOPD (Model 1: p for nonlinear = 0.664; Model 2: p for nonlinear = 0.663; Model 3: p for nonlinear = 0.571). Additionally, DCA indicated a significant net clinical benefit when the In-SII threshold ranged from 0.41 to 0.80.ConclusionHigh SII serves as an independent risk factor for PLOS in patients with AECOPD. This indicated that patients with AECOPD exhibiting high SII levels have poorer outcomes, necessitating earlier implementation of more robust intervention measures and close monitoring of disease progression.

An innovative insulin resistance (IR)-related index of cholesterol, high-density lipoprotein, and glucose (CHG) has been linked to cardiovascular disease (CVD) risk, but there is limited evidence for the effect of a long-term pattern of CHG on CVD and all-cause mortality. This study aimed to examine the associations between cumulative CHG and the occurrence of CVD and all-cause mortality. We incorporated 53 700 participants from the Kailuan cohort. Cumulative CHG was computed using data from the 2006 to 2010 surveys and was defined as the average CHG for each pair of subsequent surveys, multiplied by the time intervals between these surveys. A multivariate Cox proportional hazards regression model was employed to evaluate the risk of CVD and all-cause mortality from 2010 to 2021, reporting hazard ratios (HR) and 95% confidence intervals (95% CI). All participants were divided into four groups according to the quartiles of cumulative CHG, and the exposure duration of high CHG was quantified as 0, 2, 4, and 6 years. A total of 3739 CVD and 4853 all-cause mortality events occurred during a median follow-up of 11.06 years. After adjusting for potential covariates, participants in the highest quartile exhibited significantly increased risks of incident CVD (HR, 1.70; 95% CI: 1.55-1.88) and all-cause mortality (HR, 1.22; 95% CI: 1.13-1.33) compared to those in the lowest quartile. Participants in the 6-year exposure to high CHG exhibited significantly increased risks of incident CVD (HR, 1.79; 95% CI: 1.61-1.98) and all-cause mortality (HR, 1.23; 95% CI: 1.13-1.34) compared to those without exposure to high CHG. Receiver operating characteristic curve analysis revealed that cumulative CHG had superior predictive value for CVD and all-cause mortality compared to baseline CHG, outperforming other indices of IR. The high cumulative CHG was associated with an increased risk of CVD and all-cause mortality, demonstrating superior predictive performance compared to both baseline CHG and other cumulative metabolic indices. The study highlights the significance of the long-term monitoring of the CHG index in clinical practice.

Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) are at increased risk of both hepatic and extrahepatic adverse outcomes. However, the evidence regarding lean MASLD and its prognosis remains controversial. To comprehensively investigate the long-term prognosis of lean patients with MASLD versus non-lean MASLD in Western and Asian populations. This prospective multicohort study included 153 192 patients with MASLD from UK Biobank (UKB), 29 700 from Kailuan cohort and 3329 from China Kadoorie Biobank (CKB). Lean MASLD was defined as body mass index (BMI)<23 kg/m² in Kailuan and CKB and <25 kg/m² in UKB. Primary endpoints were liver-related events (LREs), all-cause mortality, liver-related mortality (LRM), cardiovascular disease (CVD) mortality, CVD, hepatocellular carcinoma (HCC) and extrahepatic cancer. Overall, 181 191 non-lean and 5030 lean patients with MASLD were included. During a median of 14.2-year follow-up (median 14.1, 14.8 and 13.4 years in UKB, Kailuan and CKB), 2501 incident LREs, 22 482 all-cause deaths, 28 722 incident CVD cases, 326 HCC and 25 258 extrahepatic cancer cases were identified, with 375 LRM and 4511 CVD deaths. Pooled analysis of three cohorts showed lean MASLD had higher risks of LREs (HR=2.14; 95% CI 1.27 to 3.62), all-cause mortality (HR=1.26; 95% CI 1.14 to 1.39), LRM (HR=2.31; 95% CI 1.54 to 3.46) and CVD mortality (HR=1.22; 95% CI 1.05 to 1.41). By contrast, lean MASLD exhibited comparable HCC risk (HR=1.76; 95% CI 0.84 to 3.71) and extrahepatic cancer risk (HR=1.14; 95% CI 0.88 to 1.48), but reduced CVD risk (HR=0.89; 95% CI 0.83 to 0.95) versus non-lean MASLD. Lean patients with MASLD have worse liver outcomes and greater risk of all-cause mortality, but similar risk of HCC and extrahepatic cancer, and lower CVD risk.

With the continuous growth in global coal demand, the impact of magma intrusion on coal micro-components, pore structure, and gas storage characteristics has gradually become a significant factor influencing the economic efficiency and safety of coal mining operations. This study focuses on the Qianjiaying, Lvjiatuo, Fangezhuang, and Linxi mines in the Kailuan mining area, systematically analyzing the mechanisms of magma intrusion and its potential threats to mining safety. The study reveals that the impact range of vitrinite reflectance changes is smaller than the actual thermal influence range of magma. Magma intrusion causes significant changes in coal micro-components, particularly the carbonization of vitrinite and inertinite, as well as a marked increase in natural coke. Vitrinite is notably more sensitive to thermal effects than inertinite. Additionally, magma intrusion alters the pore structure of coal seams through thermo-mechanical coupling, significantly affecting the development of mesopores and micropores. The results show that as the distance from magma increases, micropores first increase, then decrease, and later increase again, while mesopores rapidly decrease and eventually stabilize. In areas close to the magma, pore structures tend to become more uniform, while those further from the intrusion gradually return to normal. Furthermore, magma intrusion enhances the secondary hydrocarbon generation in coal seams, producing large amounts of gas. The form of magma intrusion, whether continuous or discontinuous, has different effects on gas accumulation and release: continuous magma beds facilitate gas accumulation, while discontinuous magma dikes cause gas to escape. The findings provide important theoretical insights for coal mining, utilization, and gas prevention strategies. • Magmatic intrusion alters macerals: vitrinite reflectance zone < thermal zone; vitrinite rises, inertinite stable, coke enriched. • Intrusion reshapes pores: temperature drives maturity, pressure compresses; mesopores shrink, micropores rise then decline to stable. • Intrusion controls gas: heating boosts CH₄, CO₂; porosity loss limits adsorption; beds trap gas, dikes let gas escape.

The triglyceride-glucose (TyG) index was associated with an increased risk of cardiovascular disease (CVD) in patients with prediabetes. However, this association has not yet been evaluated in prospective studies. Hence, we aimed to investigate the association between the TyG index and the risk of incident CVD in patients with prediabetes. Participants with prediabetes were enrolled from the Kailuan study and were followed up for clinical events until 2022. The exposure variable was TyG index. The primary outcomes were the incidence of CVD events, including ischemic heart disease and stroke, while the secondary outcomes were each specific type of CVD events. Cox proportional hazards regression models and restricted cubic spline analysis were used to calculate multivariable-adjusted hazard ratios and investigate exposure-response association, respectively. Over a mean follow-up period of 14.19 years, 13.81% (n = 2,537) of the 18,364 participants with prediabetes developed CVD events. Compared with participants in the lowest TyG index quartile (Q1, TyG index < 8.45), those in Q2 (TyG index 8.45-8.81), Q3 (TyG index 8.81-9.23), and Q4 (TyG index ≥ 9.23) were associated with an increased risk of CVD, with hazard ratios (HRs) of 1.18 (95% confidence interval [CI] 1.05-1.34), 1.29 (95% CI 1.15-1.46), and 1.45 (95% CI 1.28-1.63), respectively. For each unit increase in TyG index, the risk of CVD events increased by 12% in prediabetes patients. We also found a linear association between baseline TyG index and CVD events in prediabetes patients (P-non-linear = 0.12). TyG index is an independent risk factor for incident CVD in the prediabetes patients.

Objective: To investigate the association of Chinese visceral adiposity index (CVAI) with arterial stiffness progression. Methods: This study was a prospective cohort study, which included participants who completed at least 1 measurement of brachial-ankle pulse wave velocity (baPWV) between 2010 and 2016, with complete physical examination data during the same period, and completed baPWV measurement during follow-up. The time of completing the first baPWV measurement was defined as the baseline. All participants were divided into 4 groups according to quartiles of baseline CVAI (<60.84, 60.84-89.67, 89.68-117.45,≥117.46). The baPWV progression was calculated (baPWV progression=(baPWVfollow-up-baPWVbaseline)/duration of follow-up). We assessed the association of CVAI groups with baPWV progression using multivariate linear regression models. Results: A total of 17 261 participants were included. Of these, the age was (47.6±11.6) years, and 11 285 (65.38%) were males. The results of multivariate linear regression models showed that compared with the CVAI<60.84 group, the baPWV at baseline increased by 39.62 cm/s (95%CI 28.57-50.67, P<0.01) in the 60.84-89.67 group, 76.37 cm/s (95%CI 64.71-88.04, P<0.01) in the 89.68-117.45 group, and 92.83 cm/s (95%CI 80.53-105.14, P<0.01) in the≥117.46 group. The median follow-up time was 2.49 years. Compared with the CVAI<60.84 group, annual change of baPWV progression increased by 17.17 cm/s (95%CI 10.36-23.97, P<0.01) in the 60.84-89.67 group, 24.59 cm/s (95%CI 17.38-31.80, P<0.01) in the 89.68-117.45 group, and 25.75 cm/s (95%CI 18.13-33.36, P<0.01) in the ≥117.46 group. Conclusion: Higher CVAI is closely associated with the progression of arterial stiffness, and the arterial stiffness progression accelerates with increased CVAI.