Data were extracted from a computerised database established by the Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The present analysis initially included all study participants who were at least 20 years old with at least two visits between 2010 and 2016 (n=685 277). Participants were excluded at baseline if they had no available weight and height measurements (n=103 946), no available information on gender (n=1), extreme BMI values (<15 kg/m2 or >55 kg/m2) (n=152) or no available fasting plasma glucose value (n=31 370). We further excluded participants with visit intervals less than 2 years (n=324 233), participants diagnosed with diabetes at baseline (2997 participants diagnosed by self-report and 4115 diagnosed by a fasting plasma glucose ≥7.0 mmol/L), and participants with undefined diabetes status at follow-up (n=6630). Finally, a total of 211 833 participants (116 123 male and 95 710 female) were included in the analysis. Cohort entry was defined as the date of the initial visit. Compared with individuals excluded from the present analyses, those included in the analyses were with similar age (42.1 vs 41.9 years old) and similar BMI (23.2 vs 23.3 kg/m2), and with a relatively higher proportion of males (54.8% vs 52.1%).
In each visit to the health check centre, participants were requested to complete a detailed questionnaire assessing demographic, lifestyle, medical history and family history of chronic disease. Height, weight and blood pressure were measured by trained staff. Body weight was measured in light clothing with no shoes to the nearest 0.1 kg. Height was measured to the nearest 0.1 cm. BMI was derived from weight in kilograms divided by height in metres squared. Blood pressure was measured by standard mercury sphygmomanometers.
Fasting venous blood samples were collected after at least a 10 hours fast at each visit. Serum triglyceride (TG), total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol were measured on an autoanalyzer (Beckman 5800). Plasma glucose levels were measured by the glucose oxidase method on an autoanalyzer (Beckman 5800).
In each visit to the health check centre, participants were requested to complete a detailed questionnaire assessing demographic, lifestyle, medical history and family history of chronic disease. Height, weight and blood pressure were measured by trained staff. Body weight was measured in light clothing with no shoes to the nearest 0.1 kg. Height was measured to the nearest 0.1 cm. BMI was derived from weight in kilograms divided by height in metres squared. Blood pressure was measured by standard mercury sphygmomanometers.
Fasting venous blood samples were collected after at least a 10 hours fast at each visit. Serum triglyceride (TG), total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol were measured on an autoanalyzer (Beckman 5800). Plasma glucose levels were measured by the glucose oxidase method on an autoanalyzer (Beckman 5800).