Institution
Clinical Trial Service Unit
About: Clinical Trial Service Unit is a based out in . It is known for research contribution in the topics: Population & Stroke. The organization has 428 authors who have published 1387 publications receiving 181920 citations.
Papers published on a yearly basis
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TL;DR: The oppositely changing effects of tobacco on male and female mortality in China is assessed, with overall adult mortality rates falling, but as the adult population of China grows and the proportion of male deaths due to smoking increases, the annual number of deaths in China that are caused by tobacco increases.
298 citations
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TL;DR: Although diabetes was more common in urban areas, it was associated with greater excess mortality in rural areas, and diabetes was associatedwith increased mortality from a range of cardiovascular and noncardiovascular diseases.
Abstract: Importance In China, diabetes prevalence has increased substantially in recent decades, but there are no reliable estimates of the excess mortality currently associated with diabetes. Objectives To assess the proportional excess mortality associated with diabetes and estimate the diabetes-related absolute excess mortality in rural and urban areas of China. Design, Setting, and Participants A 7-year nationwide prospective study of 512 869 adults aged 30 to 79 years from 10 (5 rural and 5 urban) regions in China, who were recruited between June 2004 and July 2008 and were followed up until January 2014. Exposures Diabetes (previously diagnosed or detected by screening) recorded at baseline. Main Outcomes and Measures All-cause and cause-specific mortality, collected through established death registries. Cox regression was used to estimate adjusted mortality rate ratio (RR) comparing individuals with diabetes vs those without diabetes at baseline. Results Among the 512 869 participants, the mean (SD) age was 51.5 (10.7) years, 59% (n = 302 618) were women, and 5.9% (n = 30 280) had diabetes (4.1% in rural areas, 8.1% in urban areas, 5.8% of men, 6.1% of women, 3.1% had been previously diagnosed, and 2.8% were detected by screening). During 3.64 million person-years of follow-up, there were 24 909 deaths, including 3384 among individuals with diabetes. Compared with adults without diabetes, individuals with diabetes had a significantly increased risk of all-cause mortality (1373 vs 646 deaths per 100 000; adjusted RR, 2.00 [95% CI, 1.93-2.08]), which was higher in rural areas than in urban areas (rural RR, 2.17 [95% CI, 2.07-2.29]; urban RR, 1.83 [95% CI, 1.73-1.94]). Presence of diabetes was associated with increased mortality from ischemic heart disease (3287 deaths; RR, 2.40 [95% CI, 2.19-2.63]), stroke (4444 deaths; RR, 1.98 [95% CI, 1.81-2.17]), chronic liver disease (481 deaths; RR, 2.32 [95% CI, 1.76-3.06]), infections (425 deaths; RR, 2.29 [95% CI, 1.76-2.99]), and cancer of the liver (1325 deaths; RR, 1.54 [95% CI, 1.28-1.86]), pancreas (357 deaths; RR, 1.84 [95% CI, 1.35-2.51]), female breast (217 deaths; RR, 1.84 [95% CI, 1.24-2.74]), and female reproductive system (210 deaths; RR, 1.81 [95% CI, 1.20-2.74]). For chronic kidney disease (365 deaths), the RR was higher in rural areas (18.69 [95% CI, 14.22-24.57]) than in urban areas (6.83 [95% CI, 4.73-9.88]). Among those with diabetes, 10% of all deaths (16% rural; 4% urban) were due to definite or probable diabetic ketoacidosis or coma (408 deaths). Conclusions and Relevance Among adults in China, diabetes was associated with increased mortality from a range of cardiovascular and noncardiovascular diseases. Although diabetes was more common in urban areas, it was associated with greater excess mortality in rural areas.
297 citations
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University College London1, Imperial College London2, Clinical Trial Service Unit3, University of Oxford4, St Bartholomew's Hospital5, Wellcome Trust Centre for Human Genetics6, University of Glasgow7, Universidade Federal de Pelotas8, University of South Australia9, UCL Institute of Child Health10, European Bioinformatics Institute11, Charité12, University of Lübeck13, Max Planck Society14, Innsbruck Medical University15, Bradford Royal Infirmary16, University of Bristol17, St George's, University of London18, University of Edinburgh19, University of Lausanne20, University of Nicosia21, Cyprus University of Technology22, Utrecht University23, University of Turin24, Cancer Epidemiology Unit25, University of Cambridge26, Russian Academy27, Jagiellonian University28, Lithuanian University of Health Sciences29, University of Copenhagen30, Marshfield Clinic31, Children's Hospital of Philadelphia32, Group Health Research Institute33, Mayo Clinic34, Vanderbilt University35, George Washington University36, University of Newcastle37, Population Health Research Institute38, University Medical Center Groningen39, Leiden University Medical Center40, Uppsala University41, Stanford University42, Science for Life Laboratory43, Erasmus University Medical Center44, Greifswald University Hospital45, University of Regensburg46, University of London47, Robertson Centre for Biostatistics48, university of lille49, French Institute of Health and Medical Research50, University of Nantes51, University of Essex52, Brigham and Women's Hospital53, Fred Hutchinson Cancer Research Center54, University of Colorado Denver55, Pennsylvania State University56, Geisinger Health System57, University of Pennsylvania58
TL;DR: PCSK9 variants associated with lower LDL cholesterol were also associated with circulating higher fasting glucose concentration, bodyweight, and waist-to-hip ratio, and an increased risk of type 2 diabetes.
296 citations
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TL;DR: It is concluded that the addition of two courses of intensification therapy has produced a 14% improvement in disease-free survival and an 11% improved in overall survival for the randomised patients.
293 citations
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TL;DR: The hypothesis that higher plasma homocysteine levels are associated with more atrophy of the hippocampus and cortical regions in elderly at risk of Alzheimer's disease is supported.
Abstract: Patients with Alzheimer's disease have higher plasma homocysteine levels
than controls, but it is uncertain whether higher plasma homocysteine
levels are involved in the early pathogenesis of the disease. Hippocampal,
amygdalar and global brain atrophy on brain MRI have been proposed as
early markers of Alzheimer's disease. In the Rotterdam Scan Study, a
population-based study of age-related brain changes in 1077 non-demented
people aged 60-90 years, we investigated the association between plasma
homocysteine levels and severity of hippocampal, amygdalar and global
brain atrophy on MRI. We used axial T(1)-weighted MRIs to visualize global
cortical brain atrophy (measured semi-quantitatively; range 0-15) and a 3D
HASTE (half-Fourier acquisition single-shot turbo spin echo) sequence in
511 participants to measure hippocampal and amygdalar volumes. We had
non-fasting plasma homocysteine levels in 1031 of the participants and in
505 of the participants with hippocampal and amygdalar volumes.
Individuals with higher plasma homocysteine levels had, on average, more
cortical atrophy [0.23 units (95% CI 0.07-0.38 units) per standard
deviation increase in plasma homocysteine levels] and more hippocampal
atrophy [difference in left hippocampal volume -0.05 ml (95% CI -0.09 to
-0.01) and in right hippocampal volume -0.03 ml (95% CI -0.07 to 0.01) per
standard deviation increase in plasma homocysteine levels]. No association
was observed between plasma homocysteine levels and amygdalar atrophy.
These results support the hypothesis that higher plasma homocysteine
levels are associated with more atrophy of the hippocampus and cortical
regions in elderly at risk of Alzheimer's disease.
291 citations
Authors
Showing all 428 results
Name | H-index | Papers | Citations |
---|---|---|---|
Salim Yusuf | 231 | 1439 | 252912 |
Richard Peto | 183 | 683 | 231434 |
Cornelia M. van Duijn | 183 | 1030 | 146009 |
Rory Collins | 162 | 489 | 193407 |
Naveed Sattar | 155 | 1326 | 116368 |
Timothy J. Key | 146 | 808 | 90810 |
John Danesh | 135 | 394 | 100132 |
Andrew J.S. Coats | 127 | 820 | 94490 |
Valerie Beral | 114 | 471 | 53729 |
Mike Clarke | 113 | 1037 | 164328 |
Robert Clarke | 111 | 512 | 90049 |
Robert U. Newton | 109 | 753 | 42527 |
Richard Gray | 109 | 808 | 78580 |
Braxton D. Mitchell | 102 | 558 | 49599 |
Naomi E. Allen | 101 | 364 | 37057 |