Our WELL China team has been hard at work collecting Data and Publishing their work!

Recruitment

WELL China is part of the Stanford Global WELL For Life Study. It is a collaboration between Stanford University and Zhejiang University (ZJU) in China. Professor Ann Hsing of Stanford University and Professor Shuankuan Zhu of ZJU co-lead the WELL China study with a team of over 35 WELL China staff. 

Recruitment began in November 2016 in Hangzhou metropolitan area, China. Cohort 1 recruited 3,000 individuals from Xihu district from November 2016 to July 2017. Cohort 2 recruited 3,000 individuals from Shangcheng district from November 2017 to April 2018. Cohort 3 recruited 4,000 individuals from Gongshu district from October 2018 to June 2019. To date, the study has enrolled 10,204 individuals . Active follow-up will commence in October 202

Data Collection and Clinical Examinations

At baseline, WELL China integrates individuallevel information from four arms: in-person surveys, functionality examinations, clinical examinations, andv bioassays.  The study has collected over 1,200 data items as well as radiological and ophthalmological images from all participants. 

Clinical examinations were conducted and included in the data storage. Dual X-ray absorptiometry (DXA) scan characterizes bone density and body composition. Abdominal ultrasound assesses liver diseases. Eye examination includes slit lamp photography, fundus photography, anterior chamber exam, and visual acuity test. Laboratory examination measures 60 biomarkers. The study collects hair, nail, blood, and stool for future biochemical and molecular studies and stores over 100,000 aliquots of specimen for future studies, averaging 10 aliquots per individual. All of this data is shared with the study participants. 

 

WELL Biobank

Learn more about what biospecimens and biomarkers are stored in the WELL Biobank. 

 

This includes: Blood, DNA, Stool, Hair, Nail, Whole Blood Panel, Liver Panel, Lipid Panel, Metabolic Panel, Kidney Function Tests, Plasma Glucose, HbA1c, Reactive Protein C (CRP), Cortisol, Fasting Insulin, Leptin, DHEAS, Metabolomics, Microbiome

WELL Publications

All of the data the WELL China has collected, with the support of our wonderful study participants, has helped us advance the science behind well-being. Check out some of the publications and submitted manuscripts written with the WELL-China data below!

Associations Between Body Fat, Muscle Mass, and Nonalcoholic Fatty Liver Disease: A Population-Based Study

Nonalcoholic fatty liver disease (NAFLD) is one of the most common forms of liver disease worldwide and has emerged as a significant public health concern in China. A better understanding of the etiology of NAFLD can inform effective management strategies for this disease. We examined factors associated with NAFLD in two districts of Hangzhou, China, focusing on the relationship of regional body fat distribution, muscle mass, and NAFLD. Multivariate logistic regressions were performed to assess independent associations between NAFLD and metabolic risk factors and dual x-ray absorptiometry (DX A)-derived measures (e.g., android fat ratio [AFR] and skeletal muscle index [SMI]). According to our analysis, android fat ration (AFR), insulin resistance, high alanine aminotransferase levels, smoking, and male sex were positively associated with NAFLD risk, while skeletal muscle index (SMI) was inversely associated with NAFLD risk.


Julianna C. Hsing, M. Nguyen, B. Yang, Y. Min, S. Han, E. Pung, S. J. Winter, X. Zhao, D. Gan, A. W. Hsing, S. Zhu. C. J. Wang. “Associations Between Body Fat, Muscle Mass, and Nonalcoholic Fatty Liver Disease: A Population-Based Study,” Hepatology Communications 0, no. 0, accessed July 12, 2019, https://doi.org/10.1002/hep4.1392.


Sex-specific Association Between Gut Microbiome and Fat Distribution

The gut microbiome has been linked to host obesity; however, sex-specific associations between microbiome and fat distribution are not well understood. Here we show sex-specific microbiome signatures contributing to obesity despite both sexes having similar gut micro-biome characteristics, including overall abundance and diversity. Our comparisons of the taxa associated with the android fat ratio in men and women found that there is no widespread species-level overlap. We did observe overlap between the sexes at the genus and family levels in the gut microbiome, such as Holdemanella and Gemmiger; however, they had opposite correlations with fat distribution in men and women. Our findings support a role for fat distribution in sex-specific relationships with the composition of the microbiome. Our results suggest that studies of the gut microbiome and abdominal obesity-related disease outcomes should account for sex-specific differences.

Min, Yan, Xiaoguang Ma, Kris Sankaran, Yuan Ru, Lijin Chen, Mike Baiocchi, and Shankuan Zhu. "Sex-specific Association between Gut Microbiome and Fat Distribution." Nature Communications10, no. 1 (June 03, 2019). doi:10.1038/s41467-019-10440-5.

Dry eye and sleep quality: a large community-based study in Hangzhou

Dry eye and sleep dysfunction draw global  public health concerns with their high prevalence and extensive adverse effects. Our study discovered a strong association between these two conditions. This is the firstpopulation-based study to evaluate the association of dry eye and sleep quality using previously validated tools, the Ocular Surface Disease Index (OSDI) and the Chinese version of the Pittsburg Sleep Quality index (CPS!I), respectively. Results indicated a strong positive association between poor sleep quality and higher severity for dry eye. It is plausible to suggest that improvement of sleep quality would alleviate the syndromes of dry eye, and vice versa. Our large comunity-based study showed a strong association between poor sleep quality and an increased severity of dry eye, suggesting that preventing either one of the discomforts might alleviate the other. 

Zhu S, Yao K. Dry eye and sleep quality: a large community-based study in Hangzhou. Sleep. 2019 Jul 15. pii: zsz160. doi: 10.1093/sleep/zsz160. [Epub ahead of pring] PubMed PMID: 31310315.

Check out submitted manuscripts below!

WELL Living Laboratory in China

Author list: Yan Min, Xueyin Zhao, Randall S. Stafford, Xiaoguang Ma, Shih-Hua Chen, Da Gan, Chen Wei, Chao Huang, Lijin Chen, Peng Gao, Fei Yang, Sandra J. Winter, Joyce Wu, Catherine A Heaney, Mike Baiocchi, John P.A Ioannidis, Ann W. Hsing, Shankuan Zhu 
Journal: International Journal of Epidemiology
Submission Date: 11/04/2019

 

Characterization of dietary patterns in a large-Chinese population and assesment of their relationships with metabolite profiles

Author list: Yuan Ru, Ninglin Wang, Xuemiao Wang, Meng Duan, Xiaochen Xu, Xueyin Zhao, Yan Min, Ying Lu, Valerie McGuire, Yi-Hsuan Wu, Ann Hsing,  Shankuan Zhu

 

Manuscripts in Progress:

Metabolites Mediated Sex-Specific Associations Between Microbiome and Fat Distribution

Author list: Yan Min, Kris Sankaran, Ann Hsing, Ying Lu, Shankuan Zhu 
Potential Journal: Lancet Diabetes and Endocrinology
Potential Submission Date: TBD

 

Sleep and Cardiometabolic conditions: a community-based study in Taiwan

Author list: Chun-Yu Liang, Yi-Hsuan Wu, Janice Zhang, Katy Peng, Huiting Yang, San Lin You, Chien An Sun, Jawtown Lin, Ying Lu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD

 

Metabolomics and Non-Alcoholic Fatty Liver Disease

Author list: George Cholankeril, Yan Min, Julianna C. Hsing, Ying Lu, Sherry Zhou, Shankuan Zhu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD

 

Non-alcoholic fatty liver screening and risk factors in a community based study in China

Author list: Caroline Young, Yan Min, Julianna C. Hsing, Mindie Nguyen, Ying Lu, Sherry Zhou, Shankuan Zhu, Ann W. Hsing
Potential Journal: TBD
Potential Submission Date: TBD