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China Kadoorie Biobank of 0.5 million people: survey methods, baseline characteristics and long-term follow-up
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BACKGROUND: Large blood-based prospective studies can provide reliable assessment of the complex interplay of lifestyle, environmental and genetic factors as determinants of chronic disease. METHODS: The baseline survey of the China Kadoorie Biobank took place during 2004-08 in 10 geographically defined regions, with collection of questionnaire data, physical measurements and blood samples. Subsequently, a re-survey of 25,000 randomly selected participants was done (80% responded) using the same methods as in the baseline. All participants are being followed for cause-specific mortality and morbidity, and for any hospital admission through linkages with registries and health insurance (HI) databases. RESULTS: Overall, 512,891 adults aged 30-79 years were recruited, including 41% men, 56% from rural areas and mean age was 52 years. The prevalence of ever-regular smoking was 74% in men and 3% in women. The mean blood pressure was 132/79 mmHg in men and 130/77 mmHg in women. The mean body mass index (BMI) was 23.4 kg/m(2) in men and 23.8 kg/m(2) in women, with only 4% being obese (>30 kg/m(2)), and 3.2% being diabetic. Blood collection was successful in 99.98% and the mean delay from sample collection to processing was 10.6 h. For each of the main baseline variables, there is good reproducibility but large heterogeneity by age, sex and study area. By 1 January 2011, over 10,000 deaths had been recorded, with 91% of surviving participants already linked to HI databases. CONCLUSION: This established large biobank will be a rich and powerful resource for investigating genetic and non-genetic causes of many common chronic diseases in the Chinese population.
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“GWAS using siblings (within-sibship GWAS) (Fig. 2) have been previously limited by available data, but are now feasible by combining well-established family studies with recent large biobanks that incidentally or by design contain thousands of sibships35–39.”
From Within-sibship genome-wide association analyses decrease bias in estimates of direct genetic effects (2022) · cites this paper as [38]
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“Similar initiatives have been conducted in other countries, such as the China Kadoorie Biobank 86 and Biobank Japan 87 .”
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“These biobank efforts, pioneered in studies such as the Framingham Cohort70 and the efforts of DeCODE in Iceland71,72, now encompass a growing inventory of national cohorts in North America, Europe, Asia and beyond73–76.”
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“PLA2G7 V279F (rs76863441) was genotyped in 91 428 individuals from the China Kadoorie Biobank (CKB), 35 with follow-up through health record linkage for median 7 years.”
BackgroundMethodInfluentialLacey, B., Lewington, S., Clarke, R., Kong, X. L., Chen, Y., Yu, C., Yang, L., Bennett, D., Bragg, F., Bian, Z., et al. (2018) · The Lancet Global Health · doi:10.1016/s2214-109x(18)30217-1 · Cited by 180
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“%] and 0.9 years [11%]), CRD (0.6 years [7”
InfluentialSelf-citationAssociation of Physical Activity With Risk of Major Cardiovascular Diseases in Chinese Men and Women
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Self-citationLong-Term Prognosis After Coronary Artery Calcification Testing in Asymptomatic Patients
Shaw, L. J., Giambrone, A. E., Blaha, M. J., Knapper, J. T., Berman, D. S., Bellam, N., Quyyumi, A. A., Budoff, M. J., Callister, T. Q., & Min, J. K. (2015) · Annals of Internal Medicine · doi:10.7326/m14-0612 · Cited by 170
Grace, S. L., Turk-Adawi, K. I., Contractor, A., Atrey, A., Campbell, N. R. C., Derman, W. E., Ghisi, G. L. D. M., Sarkar, B. K., Yeo, T. J., López-Jiménez, F. A., et al. (2016) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2016.08.004 · Cited by 178
“8%.(19,116) Lower socioeconomic status is associated with worse compliance.”
BackgroundCohort profile: design and methods in the eye and vision consortium of UK Biobank
Chua, S. Y. L., Thomas, D., Allen, N. E., Lotery, A. J., Desai, P., Patel, P. J., Muthy, Z. A., Sudlow, C. L. M., Pető, T., Khaw, P. T., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025077 · Cited by 167
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“Details of the CKB design, survey methods and population characteristics have been described elsewhere.(19) Briefly, 512,891 participants (210,222 men and 302,669 women)”
MethodSelf-citationCancer incidence and mortality: A cohort study in China, 2008–2013
Pan, R., Zhu, M., Yu, C., Lv, J., Guo, Y., Bian, Z., Yang, L., Chen, Y., Hu, Z., Chen, Z., et al. (2017) · International Journal of Cancer · doi:10.1002/ijc.30825 · Cited by 163
“Cancer profiles in urban areas were transiting to Western distributions, which were characterized with high incidences of breast cancer and colorectal cancer; while cancers of the esophagus, liver and cer- vix uteri were still common in rural areas of China.”
BackgroundMethodInfluentialSelf-citationThe World Heart Federation's vision for worldwide cardiovascular disease prevention
Yusuf, S., Wood, D., Ralston, J., & Reddy, K. S. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60265-3 · Cited by 160
Role of diet and gut microbiota on colorectal cancer immunomodulation
Almeida, C. V. D., de Camargo, M. R., Russo, E., & Amedei, A. (2018) · World Journal of Gastroenterology · doi:10.3748/wjg.v25.i2.151 · Cited by 160
Genotyping and population characteristics of the China Kadoorie Biobank
Walters, R. G., Millwood, I. Y., Lin, K., Schmidt, D., McDonnell, P., Hacker, A., Avery, D., Edris, A., Fry, H., Cai, N., et al. (2023) · Cell Genomics · doi:10.1016/j.xgen.2023.100361 · Cited by 155
Self-citationFunctional foods and their role in cancer prevention and health promotion: a comprehensive review.
Aghajanpour, M., Nazer, M. R., Obeidavi, Z., Akbari, M., Ezati, P., & Kor, N. M. (2017) · PubMed Central · Cited by 145
Nam, Y., Kim, J., Jung, S., Woerner, J., Suh, E. H., Lee, D. A., Shivakumar, M., Lee, M. E., & Kim, D. (2024) · Annual Review of Biomedical Data Science · doi:10.1146/annurev-biodatasci-102523-103801 · Cited by 156
Accurate and Scalable Construction of Polygenic Scores in Large Biobank Data Sets
Yang, S., & Zhou, X. (2020) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2020.03.013 · Cited by 138
Insomnia symptoms and risk of cardiovascular diseases among 0.5 million adults
Zheng, B., Yu, C., Lv, J., Guo, Y., Bian, Z., Zhou, M., Yang, L., Chen, Y., Li, X., Zou, J., et al. (2019) · Neurology · doi:10.1212/wnl.0000000000008581 · Cited by 142
“Ascertainment of CVD outcomes Information on CVD incidence was collected through linkages with established disease registries, the new national health insurance claim databases, and local residential records.(15) Electronic linkage to the national health insurance databases has covered 95% of the participants in 2013…”
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“Funding This project is a major public health service project supported by the Ministry of Finance of China and National Health and Family Planning Commission of China, and the National Key Technology R&D Program (2013BAI09B01) from the Ministry of Science and Technology of China.”
BackgroundMethodResultInfluentialSelf-citationDu, H., Li, L., Bennett, D., Yu, C., Turnbull, I. J., Yang, L., Bragg, F., Bian, Z., Chen, Y., Chen, J., et al. (2017) · PLoS Medicine · doi:10.1371/journal.pmed.1002279 · Cited by 144
Self-citationCho, M. H., Hobbs, B. D., & Silverman, E. K. (2022) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(21)00510-5 · Cited by 146
Biobanks and Electronic Medical Records: Enabling Cost-Effective Research
Bowton, E., Field, J. R., Wang, S., Schildcrout, J. S., Driest, S. L. V., Delaney, J. T., Cowan, J. D., Weeke, P. E., Mosley, J. D., Wells, Q. S., et al. (2014) · Science Translational Medicine · doi:10.1126/scitranslmed.3008604 · Cited by 130
Benn, M., & Nordestgaard, B. G. (2018) · Cardiovascular Research · doi:10.1093/cvr/cvy045 · Cited by 133
Season, temperature and blood pressure: A complex interaction
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“The availability of indoor temperature control at home or in the working place (which reduces the seasonal changes in living ambient temperature) has been shown to significantly attenuate the BP increase from summer to winter [9] and seasonal BP changes are more pronounced in areas where indoor temperature control is…”
BackgroundQin, C., Lv, J., Yu, C., Bian, Z., Si, J., Yang, L., Chen, Y., Zhou, Y., Zhang, H., Liu, J., et al. (2018) · Heart · doi:10.1136/heartjnl-2017-312651 · Cited by 134
Self-citationYu, K., Lv, J., Qiu, G., Yu, C., Guo, Y., Bian, Z., Yang, L., Chen, Y., Wang, C., Pan, A., et al. (2020) · The Lancet Global Health · doi:10.1016/s2214-109x(19)30525-x · Cited by 127
Self-citationInterethnic analyses of blood pressure loci in populations of East Asian and European descent
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“participants from CKDGen consortium (11), UK Biobank (12), Nord-Trøndelag Health (HUNT) Study (13), Biobank Japan (14), China Kadoorie Biobank (15) and Japan-KidneyBiobank/ToMMo consortium, in conjunction with the largest available genome-wide .”
BackgroundMethodSelf-citationBody mass index and mortality in China: a 15-year prospective study of 220 000 men
Chen, Z., Yang, G., Offer, A. R., Zhou, M., Smith, M. C., Peto, R., Ge, H., Yang, L., & Whitlock, G. (2012) · International Journal of Epidemiology · doi:10.1093/ije/dyr208 · Cited by 123
Self-citationon behalf of the China Kadoorie Biobank Collaborative Group, Zhu, N., Yu, C., Guo, Y., Bian, Z., Han, Y., Yang, L., Chen, Y., Du, H., Li, H., et al. (2019) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-019-0860-z · Cited by 123
Self-citationPeters, S. A. E., Yang, L., Guo, Y., Chen, Y., Bian, Z., Du, J., Yang, J., Li, S., Li, L., Woodward, M., et al. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.117.006081 · Cited by 118
“Methods Study Population Detailed information about the study design and procedures of China Kadoorie Biobank has been previously reported.(17) Briefly, between 2004 and 2008, 302 669 women and 210 222 men aged 35 to 79 years were recruited from 5 urban and 5 rural areas of China.”
Self-citationBovijn, J., Krebs, K., Chen, C.-Y., Boxall, R., Censin, J. C., Ferreira, T., Pulit, S. L., Glastonbury, C. A., Laber, S., Millwood, I. Y., et al. (2020) · Science Translational Medicine · doi:10.1126/scitranslmed.aay6570 · Cited by 119
“Individuals were recruited between the years of 2004–2008 from five urban and five rural regions across China, as previously described (94).”
Self-citationAdherence to a healthy lifestyle and the risk of type 2 diabetes in Chinese adults
Lv, J., Yu, C., Guo, Y., Bian, Z., Yang, L., Chen, Y., Hu, X., Hou, W., Chen, J., Chen, Z., et al. (2017) · International Journal of Epidemiology · doi:10.1093/ije/dyx074 · Cited by 122
“We identified incident diabetes since the participants’ enrollment into the study at baseline using linkage with local disease and death registries, with the recently established national health insurance system and by active followup.(17) Trained staff, blinded to the baseline information, coded all cases with the 10…”
BackgroundMethodSelf-citationTranslational Research in the Era of Precision Medicine: Where We Are and Where We Will Go
Maria, R. D., Sante, G. D., Piro, G., Carbone, C., Tortora, G., Boldrini, L., Pietragalla, A., Daniele, G., Tredicine, M., Cesario, A., et al. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11030216 · Cited by 124
Genetics: Implications for Prevention and Management of Coronary Artery Disease
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“In the coming years, this need should be fulfilled by megabiobanks involving at least a half-million participants, including, but not limited to, the UK Biobank, the China Kadoorie Biobank, the Million Veteran Program, and the soon-to-beestablished NIH Precision Medicine Initiative cohort (161-164).”
BackgroundYu, C., Tang, H., Guo, Y., Bian, Z., Yang, L., Chen, Y., Tang, A., Zhou, X. P., Yang, X., Chen, J., et al. (2018) · Annals of Internal Medicine · doi:10.7326/m17-2000 · Cited by 113
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Self-citationMetabolomic Consequences of Genetic Inhibition of PCSK9 Compared With Statin Treatment
Sliz, E., Kettunen, J., Holmes, M. V., Williams, C. O., Boachie, C., Wang, Q., Männikkö, M., Sebert, S., Walters, R., Lin, K., et al. (2018) · Circulation · doi:10.1161/circulationaha.118.034942 · Cited by 109
Self-citation
Metadata
- Authors
- Chen, Z., Chen, J., Collins, R., Guo, Y., Peto, R., Wu, F., Li, L., & on behalf of the China Kadoorie Biobank (CKB) collaborative group
- Affiliations
- Chinese Center For Disease Control and Prevention (CN)
- Corresponding author
- Chen, Z.
- Li, L.
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-09-21
- Volume
- 40
- Issue
- 6
- Pages
- 1652-1666
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- PMC
- PMC3235021
- OpenAlex
- W2105079646
- Cited by
- 1,034
- References
- 43
- Citations by year
- 2026: 109 · 2025: 122 · 2024: 134 · 2023: 110 · 2022: 107 · 2021: 116 · 2020: 75 · 2019: 66 · 2018: 55 · 2017: 51 · 2016: 30 · 2015: 26 · 2014: 14 · 2013: 12 · 2012: 6
- FWCI
- 7.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Epidemiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Wellcome Trust (088158/Z/09/Z)
- Cancer Research UK
- British Heart Foundation
- Chinese Center for Disease Control and Prevention
- Kadoorie Charitable Foundation
- Centers for Disease Control and Prevention
- Medical Research Council
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- China Kadoorie Biobank, prospective cohort, biobanks, baseline characteristics, smoking prevalence, blood pressure, body mass index, diabetes prevalence, cause-specific mortality, hospitalization, chronic disease, Chinese adults
- MeSH terms
- Adult, Age Factors, Aged, Blood Pressure, Body Weights and Measures, China, Chronic Disease, Data Collection, Environment, Female, Follow-Up Studies, Genetic Testing, Humans, Life Style, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Residence Characteristics, Rural Population, Sex Factors, Smoking, Socioeconomic Factors, Health Behavior, Body Mass Index, Databases, Factual, Genetic Predisposition to Disease, Databases, Genetic
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