China suboptimal health cohort study: rationale, design and baseline characteristics.

Qing Gao,Mohamed Ali Alzain,Jing Qiu,Anxin Wang,Wei Wang,Siqi Ge,Youxin Wang,Zhongyao Zhao,Honghong Fang,Jie Zhang,Manshu Song,Yong Zhou,Hao Wang,Xinwei Yu,Yuxiang Yan

doi:10.1186/s12967-016-1046-y

Abstract

BackgroundSuboptimal health status (SHS) is a physical state between health and disease, characterized by the perception of health complaints, general weakness, chronic fatigue and low energy levels. SHS is proposed by the ancient concept of traditional Chinese medicine (TCM) from the perspective of preservative, predictive and personalized (precision) medicine. We previously created the suboptimal health status questionnaire 25 (SHSQ-25), a novel instrument to measure SHS, validated in various populations. SHSQ-25 thus affords a window of opportunity for early detection and intervention, contributing to the reduction of chronic disease burdens.Methods/designTo investigate the causative effect of SHS in non-communicable chronic diseases (NCD), we initiated the China suboptimal health cohort study (COACS), a longitudinal study starting from 2013. Phase I of the study involved a cross-sectional survey aimed at identifying the risk/protective factors associated with SHS; and Phase II: a longitudinal yearly follow-up study investigating how SHS contributes to the incidence and pattern of NCD.Results(1) Cross-sectional survey: in total, 4313 participants (53.8 % women) aged from 18 to 65 years were included in the cohort. The prevalence of SHS was 9.0 % using SHS score of 35 as threshold. Women showed a significantly higher prevalence of SHS (10.6 % in the female vs. 7.2 % in the male, P < 0.001). Risk factors for chronic diseases such as socioeconomic status, marital status, highest education completed, physical activity, salt intake, blood pressure and triglycerides differed significantly between subjects of SHS (SHS score ≥35) and those of ideal health (SHS score <35). (2) Follow up: the primary and secondary outcomes will be monitored from 2015 to 2024.ConclusionsThe sex-specific difference in prevalence of SHS might partly explain the gender difference of incidence of certain chronic diseases. The COACS will enable a thorough characterization of SHS and establish a cohort that will be used for longitudinal analyses of the interaction between the genetic, lifestyle and environmental factors that contribute to the onset and etiology of targeted chronic diseases. The study together with the designed prospective cohort provides a chance to characterize and evaluate the effect of SHS systemically, and it thus generates an unprecedented opportunity for the early detection and prevention of chronic disease.

Highlights

Suboptimal health status (SHS) is a physical state between health and disease, characterized by the perception of health complaints, general weakness, chronic fatigue and low energy levels
The China suboptimal health cohort study (COACS) will enable a thorough characterization of SHS and establish a cohort that will be used for longitudinal analyses of the interaction between the genetic, lifestyle and environmental factors that contribute to the onset and etiology of targeted chronic diseases
The study together with the designed prospective cohort provides a chance to characterize and evaluate the effect of SHS systemically, and it generates an unprecedented opportunity for the early detection and prevention of chronic disease

Summary

Introduction

Suboptimal health status (SHS) is a physical state between health and disease, characterized by the perception of health complaints, general weakness, chronic fatigue and low energy levels. SHSQ-25 affords a window of opportunity for early detection and intervention, contributing to the reduction of chronic disease burdens. Major chronic diseases such as hypertension, heart disease, stroke, cancer, chronic obstructive pulmonary disease and diabetes caused an estimated 35 million deaths in 2005, 80 % of which occurred in low and middle income countries such as China [1,2,3]. The rapid environmental changes accompanied with urbanization lead to the increasing prevalence of the major risk factors for NCD, including work stress, physical inactivity, unhealthy diet, and tobacco use; as a result, the prevalence of NCD will continue to increase [7]

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