The PRECISE Consortium: a national cohort of 2.2 million Chinese adults for precision nutrition, chronic disease, and mortality research
Jianping Li, Chen Mao, Hai Ma, Qing Dong, Yefeng Cai, Binyan Wang, Xianhui Qin, Dafang Chen, Lishun Liu, Yun Song, Fan Fan Hou, Xiaoshu Cheng, Hanping Shi, Maigeng Zhou, Yong Huo,Background:
China is undergoing rapid demographic, nutritional and lifestyle transitions, with chronic noncommunicable diseases now accounting for a large proportion of mortality. Nutrition and lifestyle are major modifiable determinants of these outcomes, yet they vary substantially across China’s diverse geographic, socioeconomic, and cultural settings. The PRECISE Consortium was established as a large-scale national cohort platform, integrating nutritional, lifestyle, clinical, and biomarker data with long-term mortality follow-up.
Methods:
PRECISE comprises 10 cohorts in China, including randomized clinical trials and community-based prospective cohorts. PRECISE eligible participants were adults aged 18 years or older with baseline information on age, sex, body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The study participants underwent standardized baseline assessments, including demographic characteristics and physical examinations. Nutritional and genetic biomarkers, including folate, vitamin B12, homocysteine, vitamin D, and MTHFR C677T genotype, were measured in a subset of the cohorts. Mortality outcomes were ascertained through linkage to the China National Mortality Surveillance System (NMSS), with causes of death classified according to the World Health Organization International Classification of Diseases, Tenth Revision (ICD-10). Core demographic, nutritional, lifestyle, clinical, and laboratory variables have been harmonized across the cohorts.
Results:
PRECISE currently includes 2,181,318 participants enrolled between 2008 and 2024, representing 31 provincial-level administrative regions in mainland China. Women comprise 51.7% of participants, and 66.5% reside in rural areas. The median age at enrollment was 61.2 years (interquartile range [IQR], 52.2–69.0). Serum homocysteine concentrations are available for 734,026 participants, providing a uniquely large resource to investigate a major modifiable risk factor for cardiovascular disease and stroke in China. To date, PRECISE has documented 139,843 deaths over 8.77 million person-years of follow-up, including 70,962 deaths from circulatory system diseases and 33,211 deaths from neoplasms.
Conclusions:
PRECISE is one of the largest, nationwide, Chinese consortium designed to investigate the interplay of nutrition, metabolic health, lifestyle, chronic disease, and cause-specific mortality. Its scale, broad geographic coverage, rural representation, harmonized deep phenotyping, and linkage to national mortality data provide a powerful platform for discovery, replication, and translation. PRECISE aims to support global efforts to advance precision nutrition, reduce the burden of chronic diseases, and promote healthy longevity.