Category: 3. Business

Background

Metabolic syndrome (MetS) is a cluster of chronic conditions, including abdominal obesity, hyperglycemia, hypertension, and dyslipidemia,¹ and has become a major global public health concern. The prevalence of MetS varies somewhat depending on the criteria used for the definition. A meta-analysis of global data from 28 million individuals reported a prevalence between 12.5% and 31.4% among adults worldwide.² In China, the prevalence of MetS grew from 8.8% in 1991–1995 to 29.3% in 2011–2015,³ and current estimates are up to 29.2% for men and even 35.4% for women,⁴ coinciding with the steep incline in the prevalence of obesity and diabetes. These high estimates necessitate a greater focus on MetS prevention.

MetS and its components are risk factors for cardiometabolic diseases (CMDs), such as type 2 diabetes (T2D), metabolic dysfunction-associated steatotic liver disease (MASLD), and cardiovascular diseases (CVDs)^5–8 and contribute to an increased mortality risk.^8–10 Comorbidities such as chronic kidney disease (CKD),^11,12 chronic obstructive pulmonary disease (COPD),^13,14 depression,¹⁵ and cognitive impairment¹⁶ are also more prevalent in populations suffering from MetS. Given the enormous public health and economic burden of MetS, it is essential to understand the underlying pathophysiology and natural course of MetS and its consequences.

The etiology and mechanisms of MetS are heterogeneous and remain to be fully elucidated. Its development is influenced by modifiable risk factors, including obesity, sedentariness, and a high-fat diet.^17,18 However, the pathways through which these factors contribute to MetS, and their interactions with genetic predisposition, are still not fully understood. Furthermore, evidence regarding the long-term dynamic changes in risk factors and their impact on the progression and consequences of MetS remains scarce, largely due to the limited availability of prospective cohorts with repeated measurements. Mechanistic studies have suggested that defective adipocyte differentiation and excessive visceral fat accumulation can drive the sustained release of proinflammatory cytokines, which may serve as primary triggers of MetS.^19,20 Against this background, exploring novel biomarkers may provide further opportunities to better characterize the pathophysiology of MetS and its consequences; however, biomarkers suitable for early diagnosis of MetS-related diseases, such as metabolic dysfunction-associated steatohepatitis (MASH), are still lacking. Early identification of high-risk subgroups within populations with MetS is of great value for decreasing the risk of serious complications, underscoring the importance of developing such biomarkers.

Although many prospective cohorts have previously been established, they were largely community-based and focused broadly on the prevention of MetS and relevant metabolic disorders, with limited emphasis on in-depth mechanistic exploration. Several large-scale biobanks, such as UK Biobank in Europe, the China Kadoorie Biobank in China, FinnGen in Finland, and All of Us Research Program in the US, have provided valuable insights into the epidemiology, genetic architecture, and risk factors of chronic diseases, including metabolic disorders. Their success has demonstrated the power of biobank-based resources in advancing disease prevention and precision medicine. However, few of these cohorts have incorporated multiple repeated measurements during follow-up, particularly after the onset of MetS, which restricts the ability to capture dynamic changes over time. Moreover, none of these existing biobanks were specifically designed to investigate MetS as the primary focus, nor did they systematically integrate multi-omics profiling. In addition, dietary behavior is closely related to the occurrence and development of metabolic diseases. Northwest China is characterized by a high-carbohydrate diet and distinct lifestyle patterns, leading to a disease profiling that may differ from that of other regions. To date, no large-scale studies with repeated follow-up assessments and ample biological samples have been established for this specific population. The BMSC cohort was therefore established to fill this critical gap by combining longitudinal repeated measurements with multi-omics data in a uniquely underrepresented population.

To better understand the pathophysiology and natural course of MetS, it is imperative to combine studies with biomarkers and longitudinal data. Thus, we now aim to establish a comprehensive databank and biobank in Northwest China, i.e., the BMSC. This biobank is designed to 1) further understand the pathophysiology and consequences of MetS; 2) explore novel biomarkers to prevent and diagnose MetS and its consequences; and 3) supply useful information for the treatment of MetS and relevant disorders in a longitudinal observational study. By providing longitudinal multi-omics data in a well-characterized population, the BMSC may also inform personalized prevention strategies, enable early risk prediction, and guide targeted interventions for MetS-related conditions. This paper will describe the study design and the protocol of data collection in detail.

Study Population and Design

Study Population

Men and women aged 18 to 75 years are invited to participate in the BMSC study if they have been diagnosed with at least one of the following metabolic disorders: pre-diabetes or T2D, body mass index (BMI) ≥ 24.0 kg/m², hypertension, and/or dyslipidemia. The definitions of these metabolic disorders are based on established international guidelines and were applied uniformly to all participants. Specifically, pre-diabetes is defined as a fasting plasma glucose (PG) level of 5.6–6.9 mmol/L or a 2-hour PG level of 7.8–11.0 mmol/L after an oral glucose tolerance test (OGTT), while diabetes is defined as a fasting PG ≥ 7.0 mmol/L or 2-h PG ≥ 11.1 mmol/L or glycosylated hemoglobin (HbA1c) ≥ 6.5%.²¹ Hypertension is defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, or the current use of antihypertensive medication, in line with the Chinese Hypertension Guidelines (2020, in Chinese). Dyslipidemia is defined as meeting any of the following criteria: total cholesterol ≥ 5.2 mmol/L, low-density lipoprotein cholesterol (LDL-C) ≥ 3.4 mmol/L, triglycerides ≥ 1.7 mmol/L, or high-density lipoprotein cholesterol (HDL-C) < 1.0 mmol/L.²² Those who have lived locally for a long time (> 1 year) and are willing to accept long-term follow-up are eligible for the BMSC study. Individuals will be excluded if they: 1) are judged to have a life expectancy of less than 5 years; 2) are addicted to drugs or have a history of drug abuse; 3) have viral hepatitis, sexually transmitted diseases such as AIDS and syphilis, and infectious diseases such as active tuberculosis; or 4) have any circumstances that could affect enrollment.

The Institutional Review Board has approved the study at the First Affiliated Hospital of Xi’an Jiaotong University (Xi’an, China). Investigators explain the research aims and protocol to eligible participants in a face-to-face manner, and those who agree to participate in the BMSC study need to sign the informed consent for participation, for storage of biological samples (including blood, urine, stool, and hair), and for obtaining medical records of both baseline and follow-up surveys.

The BMSC study started in August 2021 and is still ongoing. By August 2024, a total of 1589 participants were recruited. Of them, 951 were men (59.8%), and the mean age was 47 years. The characteristics of the participants are presented in Table 1.

Table 1 Baseline Characteristics of Participants in the BMSC Study Up to August 2024

Recruitment Strategies

Participants are recruited through two strategies. First, patients presented in the Department of Endocrinology and Metabolism at the First Affiliated Hospital of Xi’an Jiaotong University are evaluated by doctors. The patients who meet the inclusion criteria for the BMSC study are invited and referred to the investigators. Second, participants are recruited through online advertisements and posters posted in public areas.

Study Design

The BMSC study is a prospective observational study of participants aged 18–75 years. After an overnight fast for the baseline survey, eligible participants are invited to the research center or the inpatient ward. Trained researchers conduct the anthropometry according to standard methods. The participants are also asked to complete a structural questionnaire at the first visit to report the basic demographic information, history of disease and medication use, family history of disease, lifestyle and behaviors, physical activity, diet, life events, symptoms of osteoarthritis, sleep, depression, and anxiety. All participants need to provide biological samples according to the study protocol. Professional nurses collect fasted blood, while hair is collected by trained researchers. Urine and stool are collected by patients after the researchers explain the sampling methods. Extensive examinations, such as bioelectrical impedance analysis (BIA), electrocardiogram (ECG), ultrasonography, electromyography (EMG), and fundus photography, are also performed. Echocardiography is performed in a subgroup of patients who need this examination after their physician’s evaluation. The measurements are listed in Table 2.

Table 2 Overview Measurements within the BMSC Study

After successful enrollment, follow-up is conducted every 3 months thereafter until the 5-year mark. Anthropometry is performed at every follow-up, and biological samples are collected every two follow-ups. The changes in metabolic indicators and incidence of CMDs and mortality are followed up for at least 5 years (Figure 1).

Figure 1 The data framework of the Biobank for Metabolic Syndrome Consequences study. ① Height, weight, WC, BP; ② Smoking, drinking, sleeping, and dietary intake; ③ Depression, anxiety; ④ Blood, urine, stool, and hair; ⑤ CMDs, MetS-related complications; ⑥ Bioelectrical impedance analysis, electrocardiogram, and ultrasonography, etc.; ⑦ Glucose, glycosylated hemoglobin, serum lipid profile, renal function, and liver function, etc. Blue text indicates data actively collected by researchers as part of cohort requirements, whereas green text represents clinical data, with specific tests determined primarily by physicians according to patients’ conditions. Yellow and red text denote follow-up time points. Abbreviations: BP, blood pressure; CMD, cardiometabolic disease; MetS, metabolic syndrome; WC, waist circumference.

Data Collection

Questionnaires

The participants are asked to complete the structural questionnaire at the baseline survey, including questions on basic characteristics, history of diseases (including but not limited to diabetes mellitus, hypertension, hyperlipidemia, hyperuricemia, polycystic ovary syndrome, coronary heart disease, stroke, congestive heart failure, peripheral arterial disease, cancer, and thyroid disease), and medication use, disease history of first-degree relatives, lifestyle and behaviors, physical activity, life events, dietary intake, sleep, symptoms of osteoarthritis, and mental health (anxiety and depression). Socioeconomic data, including education level, occupation, household income, and insurance status, are collected through standardized, interviewer-administered questionnaires. Details on the requested information are as follows:

Physical Activity

Participants’ physical activity is evaluated by the Chinese version of the International Physical Activity Questionnaire (IPAQ)-long form, which has been well-validated in the Chinese population.^23,24

Dietary Intake

The participants report a long-term dietary intake through a semi-quantitative food frequency questionnaire (FFQ). Because the FFQ is relatively easy to use, inexpensive, and reflects a long-term dietary intake pattern, it has become the most common tool to evaluate the diet in large epidemiological studies. The FFQ used in the BMSC study covers eighteen categories: grain (11 items); beans (8 items); fresh beans (5 items); root vegetable (5 items); melon vegetable (7 items); leaf vegetable (16 items); fruit (4 items); nut (4 items); animal meat (13 items); poultry (5 items); milk (1 item); eggs (4 items); aquatic products (8 items); fungi foods (5 items); pickle (4 items); alcohol and other beverages (5 items); oil (6 items); condiments (8 items); and nutritious supplementation.

Sleep

Sleep assessment is performed via three questionnaires. Epworth sleepiness scale (ESS) is used to assess daytime sleepiness,²⁵ the Pittsburgh sleep quality index (PSQI) is used to evaluate the quality of sleep,²⁶ and the Berlin questionnaire is used for assessment of the presence of obstructive sleep apnea syndrome.²⁷

Symptoms of Osteoarthritis

Symptoms of osteoarthritis are scaled by the Knee Injury and Osteoarthritis Outcome Score (KOOS), which is developed to assess the patient’s opinion on knee health and related problems and has been validated in the Chinese population.²⁸

Mental Health

Both depression and anxiety are evaluated. The Zung Seff-rating Depression Scale (SDS) is used to determine depressive symptoms via twenty terms. Indicators of anxiety are collected using the Beck Anxiety Inventory (BAI). SDS²⁹ and BAI³⁰ have been well validated in the Chinese population.

Physical Examination

All participants undergo a physical examination at baseline survey, including anthropometry measurement, blood pressure, heart rate, subcutaneous fat, and visceral fat. Height and weight are measured using an ultrasonic height and weight meter (OMRON MEDICAL Beijing Co., Ltd. HNH-318) to the nearest 0.01 m and 0.1 kg, respectively. The waist circumference is the circumference of the midpoint line between the lowest point of the rib and the upper margin of the iliac crest (the narrowest point of the waist) measured at the end of exhalation and before the beginning of inhalation using a tape measure, with a precision of 0.1 cm. Hip circumference is measured as the maximum circumference of the buttocks. Abdomen circumference is measured at the iliac crest point at the end of exhalation but before the beginning of inhalation. The biceps circumference is measured at the upper 1/3 of the right arm, while the thigh circumference is measured at the upper 1/3 of the right thigh. An electronic blood pressure monitor (OMRON MEDICAL Beijing Co., Ltd. HEM-7121) is used to measure the blood pressure and heart rate, after the participants are asked to be quiet and rest for at least 5 minutes. The subcutaneous and visceral fat area is measured using a visceral fat detector (OMRON MEDICAL Beijing Co., Ltd. 3 DUALSCAN, HDS-2000), with a unit of cm².

Advanced examinations such as BIA, ECG, and ultrasonography are also performed. The body composition, including body fat (body fat percentage), muscle mass (skeletal muscle content), and visceral fat (visceral fat grade), is measured using the direct segmental multifrequency BIA method DSM-BIA (InBody H20) to the nearest 0.1 kg. A resting 12-lead ECG (Mortara Eli-350) is recorded and archived electronically at baseline survey. Carotid intima-media thickness is measured by color Doppler ultrasonography of the neck vessels. Peripheral arterial disease is determined with the help of color Doppler ultrasonography of lower limbs. Fundus photography of both eyes is performed to determine the presence of diabetic retinopathy. Surface EMG assessment is only performed to assist in the diagnosis of diabetic peripheral neuropathy. Echocardiography is performed in a subset of individuals needing examinations after their physicians’ evaluation.

Fasting Blood Sampling

A total of 20 mL peripheral venous blood is taken after an overnight fast of at least 8 hours, and used for the collection of serum, EDTA-plasma, RNA, and DNA, all stored in a −80°C freezer for future multi-omics analyses. Separate blood samples are taken for immediate tests, such as glucose, HbA1c levels, serum lipid profile (total cholesterol, triglycerides, HDL-C, LDL-C, apolipoprotein A1, total apolipoprotein B, and apolipoprotein E), indicators of liver function (aspartate transaminase, alanine transaminase, total protein, albumin, globulin, total bile acids, alkaline phosphatase, γ-glutamyltranspeptidase, total bilirubin, direct bilirubin, and indirect bilirubin), indicators of renal function (urea, cystatin C, uric acid, creatinine, glycated albumin, and retinol-binding protein), indicators of thyroid function (serum thyroid stimulating hormone, total and free thyroxine, total and free triiodothyronine), and blood cell count, mean red blood cell (RBC) volume, platelet concentration, platelet distribution width, mean platelet volume, and high-sensitivity C-reactive protein (CRP). Insulin release test, C-peptide release test, and serum insulin and C-peptide measurements are only performed in a subset of individuals who need these examinations according to the disease.

Urine Sampling

A tube of 15 mL urine is obtained from all participants at enrollment. The participants are asked to fast for at least 8 hours before the collection of midstream urine. Collected urine samples are stored in a −80°C freezer for future analyses. The urine samples used for routine analyses are separately collected. Creatinine and urinary microalbumin are tested using standard methods at the clinical laboratory.

Stool Sampling

After urination, two tubes of fecal samples are collected. After receiving the fecal samples, the researchers put them into liquid nitrogen for rapid freezing and then store them at −80°C freezer for future analyses.

Hair Sampling

Using blunt curved scissors, the researchers collect 30 to 50 hairs from the occipital bone, as close as possible to the root of the hair, taking 3 cm. The hair sample is rolled in tinfoil and stored at room temperature.

Ascertainment of Incident Diseases During Follow-Up

The primary endpoints of the BMSC study include major CMDs, such as CVDs (coronary heart disease, stroke, myocardial infarction, and congestive heart failure), MASLD, mortality, and other MetS-related diseases (T2D, depression, and osteoarthritis). Endpoints are ascertained through three complementary sources: (1) standardized questionnaires administered annually, including self-reported physician diagnoses; (2) biochemical indicators collected every six months, with prespecified thresholds (e.g., fasting glucose, HbA1c, lipid profile, liver function tests) used to define disease onset or progression; and (3) electronic medical records from the First Affiliated Hospital of Xi’an Jiatong University, linked and extracted two years after enrollment and subsequently at 1-year intervals. Diagnoses from medical records will be verified using ICD-10 codes and clinical criteria, and, where necessary, adjudicated by an independent panel of physicians to ensure accuracy. This multi-source and standardized approach is designed to enhance both the validity and reliability of endpoint determination, thereby improving the robustness of event-based analysis.

Biological Sample Processing Methods

As mentioned above, common clinical biomarkers, such as blood type and counts, glucose, HbA1c, lipids, indicators of liver function, kidney function, and thyroid function, are tested using automatic equipment in the hospital laboratory (Table 3). Other advanced assays are performed as follows:

Table 3 Laboratory Analyses at Baseline within the BMSC Study

Blood samples are used for genomics according to the standard protocols. After DNA is extracted from white cells, the samples are delivered to a professional sequencing company for high-throughput genotyping after strict quality control such as gel electrophoresis, NanoDrop, and Bioanalyzer (Infinium CoreExome-24 BeadChip is intended to be selected).

Plasma concentrations of cholesterol and its precursors, including desmosterol, are measured using rapid gas chromatogramtography-mass spectrometry (GC-MS). Plasma inflammatory factors such as ICAM-1, TNF-α, IL-6, and TGF-β are assessed by ELISA kits.

Fecal samples are mainly intended for microbiome analysis, according to established protocols. Genomic DNA is extracted from fecal samples using the QIAamp DNA Stool Mini Kit (Qiagen, Germany) according to the manufacturer’s instructions and then used for 16S rRNA gene sequencing.

Plasma and fecal samples are also intended for assessing metabolomics and lipidomics. Levels of steroid hormones in hair samples are determined through liquid chromatography-mass spectrometry (LC-MS).

Quality Control

Several strategies are conducted to ensure the quality of the BMSC study (Figure 2). First, the BMSC study is led by a professional data collection team, and every data collector must have attended a professional training program. Additionally, a handbook for data collection has been developed to facilitate the daily work. Second, both artificial and system queries are performed to ensure the quality of the investigation and collection of anthropometry data. Third, the biological sample should be sent to the Biobank as soon as possible to ensure the quality of the samples after they have been withdrawn. Last, in the laboratory where the analysis of samples takes place, researchers should operate with strict experimental methods to ensure the validity of experimental data.

Figure 2 The process of data collection and quality control of the Biobank for Metabolic Syndrome Consequences study. The blue texts and arrows represent the data and sample collection process, while the red color indicates the quality control process during data collection.

Statistical Analysis

The BMSC study encompasses multiple research aims and involves a wide range of exposures and outcomes. To ensure adequate statistical power, we performed a sample size estimation using T2D as the exposure and stroke as the outcome. Based on results from the Jinchang Cohort Study in Gansu Province, the incidence of stroke was estimated to be 5.26% among participants with T2D and 1.71% among those without T2D. Assuming a two-sided significance level (α) of 0.05, statistical power (1-β) of 80%, and a 1:1 matching ratio, the required sample size to detect a significant difference between groups was calculated to be 840. To account for potential loss to follow-up and withdrawal during long-term observation, we increased the sample size by 20%, resulting in 1008 participants. Considering that the study aims to investigate multiple outcomes beyond stroke, we determined that a baseline sample size of approximately 2000 participants would be appropriate.

Appropriate statistical methods will be used to analyze and present the basic characteristics. Regression models (e.g., logistic regression model) will be fitted to analyze the cross-sectional associations between influence factors and metabolic disorders, while potential prospective associations between endpoint diseases and influence factors will be assessed by linear mixed-effects models combined with Cox regression. Since BMSC is an open, prospective cohort, the baseline dates differ among participants based on their recruitment date. The variation in follow-up duration is fully acknowledged and will be addressed through time-to-event analysis. Most core covariates (age, sex, anthropometrics) are fully recorded at baseline. For questionnaire-derived data (e.g., lifestyle, socioeconomic status), missing covariates will be handled via multiple imputation where appropriate.

For microbiome measurements, the Kruskal–Wallis test or regression analysis will be conducted to compare the α-diversity index, such as the Shannon index, Observed feature, and the Gini-Simpson Index. Species-level analysis will be performed using MaAsLin or multiple regression.

For metabolomics and lipidomics data, the least absolute shrinkage and selection operator and principal component analysis will be used to reduce the dimensionality of the data. Correlation analysis, regression analysis, and machine learning methods (e.g., Light Gradient Boosting Machine) will be applied to identify associations between omics features and clinical outcomes. To integrate multi-omics datasets (genomics, metabolomics, microbiome) with epidemiological and clinical variables, we will employ data fusion approaches such as multi-view learning and network-based methods, enabling the identification of cross-omics biomarkers and molecular signatures. Pathway enrichment analysis will further aid in interpreting the biological relevance. This integrative framework is expected to support biomarker discovery, risk prediction, and provide mechanistic insights into the pathophysiology of MetS and its consequences.

Basic Characteristics of the Participants at Recruitment

Up to August 2024, a total of 1589 participants have been included in the BMSC study. Of them, 951 are men (59.8%) and 1420 (89.4%) are enrolled in the hospital. The age of participants ranged from 18 to 74 [mean = 47, standard deviation (SD): 14]. The average BMI was 27.0 kg/m² (SD: 5.6) for men and 29.2 kg/m² (SD: 6.9) for women. The total rate of biological sample collection was at least 78.5%. Hyperglycemia was the most prevalent metabolic disorder in the participants (80.9%). 37.6% of participants were obese, and the prevalence of MetS was 65.8%. Among the study population, the proportions of participants with 0, 1, 2, 3, 4, and 5 MetS components were 0.8%, 11.6%, 21.8%, 26.8%, 25.6%, and 13.5%, respectively (Table 1). Table 4 presents the distribution of several cardiometabolic biomarkers. Fasting plasma glucose, HbA1c, TyG, triglycerides, systolic blood pressure, diastolic blood pressure, and serum uric acid were higher in males, while total cholesterol, HDL-C, and LDL-C were higher in females (all P values ≤ 0.026).

Table 4 Cardiometabolic Biomarkers of Study Participants in the BMSC Study

Strengths and Limitations

The BMSC study is an ongoing prospective observational study of approximately 2000 adults with metabolic disorders. It has several strengths. First, the study’s deep phenotyping yields profiles of individual characteristics in many dimensions, including anthropometry, lifestyle factors, psychosocial characteristics, medical records, clinical biomarkers, and multi-omics profiles. Second, strict measures adopted during the project ensure high-quality data collection. Third, the standardized Biobank procedure guarantees the quality of biological samples, which is one of the distinctive strengths of the BMSC study. Fourth, repeated measurements and biological sampling across multiple time points make it possible to assess the dynamic change of influencing factors and biomarkers. However, some limitations should be acknowledged. First, participants in the BMSC study are recruited in Northwest China; hence, extrapolation of results to other regions or countries requires caution. Second, only participants with metabolic disorders meet the inclusion criteria of the BMSC study, which precludes the recruitment of healthy participants as controls. The absence of a control group limits the ability to determine whether the observed alterations are disease-specific or reflect normal variations, thereby reducing the capacity to infer causality and restricting the generalizability of our findings to broader populations. To address this limitation, we have initiated the recruitment of metabolically healthy individuals from the Department of Health Medicine of our hospital, who may serve as an appropriate control group in future analyses. This will allow us to better delineate disease-specific alterations and strengthen the robustness of our conclusions. Third, while observational cohort designs inherently limit causal inference, the BMSC study aims to elucidate potential mechanistic pathways and identify clinically relevant associations, rather than assert definitive causal relationships. In addition, the current sample size is modest compared to national mega-cohorts in China. However, the BMSC study especially focuses on deeply phenotyped, metabolically characterized individuals, with integrated multi-omics datasets and long-term biobanked biospecimens. Finally, several practical challenges should also be acknowledged. First, maintaining participant retention over a 5-year follow-up may be difficult, and loss to follow-up could reduce statistical power. Second, the management and analysis of high-dimensional multi-omics data are complex and will require rigorous bioinformatics pipelines and quality control procedures. Third, as the study is conducted in a single regional population, the generalizability of findings to other geographic or ethnic groups may be limited. These challenges will be carefully considered in the implementation and interpretation of the BMSC study.

Prospective Contributions of the BMSC Study

Although no study results are yet available, the BMSC protocol has several distinctive features that may provide novel insights into the etiology and progression of MetS and related chronic diseases. The repeated biospecimen collection combined with multi-omics profiling and clinical data enables comprehensive characterization of biological pathways. Moreover, the relatively high-frequency follow-up (every 3 months) enhances the granularity of longitudinal assessments, which is uncommon in large cohort studies. Together, these features make the BMSC study a valuable resource with strong potential to contribute to precision medicine research and to inform prevention and intervention strategies for metabolic and cardiovascular diseases. Beyond scientific discovery, the BMSC study may also have important implications for public health and clinical practice. For example, longitudinal biomarker profiling could help to refine risk stratification tools for MetS and related CMDs, thereby informing clinical guidelines for earlier detection and more personalized prevention strategies. In addition, the integration of multi-omics data with lifestyle and clinical outcomes may identify novel therapeutic targets, which could ultimately support the development of precision interventions for metabolic disorders. These potential applications highlight the translational value of the BMSC study beyond research contexts.

Conclusion

The BMSC study provides a new framework for a prospective MetS biobank with multi-dimensional information in an underrepresented population. This resource is expected to contribute to disease prediction, early diagnosis, and mechanistic understanding, thereby informing precision medicine and public health strategies. While we recognize practical challenges such as long-term participant retention, management of complex data, and limited generalizability beyond the study region, these can be addressed through rigorous methodology, robust infrastructure, and collaboration efforts. Continued stakeholder support and open opportunities for data sharing and collaboration will be critical to maximizing the value of the BMSC and ensuring its long-term impact.

Abbreviations

BAI, Beck Anxiety Inventory; BIA, Bioelectrical impedance analysis; BMSC, Biobank for Metabolic Syndrome Consequences; CKD, Chronic kidney disease; CMD, Cardiometabolic diseases; COPD, Chronic obstructive pulmonary disease; CRP, C-reactive protein; CVD, Cardiovascular disease; ECG, Electrocardiogram; EMG, Electromyography; ESS, Epworth sleepiness scale; FFQ, Food frequency questionnaire; HbA1c, Glycosylated hemoglobin; HDL-C, High-density lipoprotein cholesterol; IPAQ, International Physical Activity Questionnaire; KOOS, Knee Injury and Osteoarthritis Outcome Score; LDL-C, Low-density lipoprotein cholesterol; MASH, Metabolic dysfunction-associated steatohepatitis; MASLD, Metabolic dysfunction-associated steatotic liver disease; MetS, Metabolic syndrome; OGTT, Oral glucose tolerance test; PSQI, Pittsburgh sleep quality index; RBC, Red blood cell; SDS, Seff-rating Depression Scale; T2D, Type 2 diabetes.

Data Sharing Statement

All data used in this study are from the BMSC study and are available from the corresponding author (Prof. Yanan Wang) upon reasonable request.

Ethical Approval and Consent to Participate

This is an observational study. The Institutional Review Board of the First Affiliated Hospital of Xi’an Jiaotong University (Xi’an, China) has approved the study, and the institutional review board (IRB) reference number is No.XJTU1AF2021LSK-193. All participants provided informed consent. The study was conducted in accordance with the Declaration of Helsinki.

Acknowledgments

The BMSC study is supported by the Department of Endocrinology and Metabolism, Department of Hepatological Survey, and Biobank of First Affiliated Hospital of Xi’an Jiaotong University. We thank all contributing individuals who participate in the BMSC study. We also express our gratitude to all doctors who invite eligible participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Funding

The study is sponsored by the National Science and Technology Major Project of the Ministry of Science and Technology of China (No. 2024ZD0531702), the Fundamental Research Funds for the Central Universities (No. xtr052023011), the Plan for Strengthening Basic Disciplines of Xi’an (No. 21YXYJ0111), the China Postdoctoral Science Foundation (2024M762615), the National Natural Science Foundation of China (82170876), and the Key Research and Development Program of Shaanxi Province (No. 2025SF-YBXM-367).

Disclosure

The authors report no conflicts of interest in this work.

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Indonesia is exploring pathways to incorporate sustainable aviation fuel (SAF) into its national biofuel program, with used cooking oil (UCO) emerging as a promising feedstock. This research brief examines how the Indonesian government could establish a Used Cooking Oil Fund (UCOF) to support SAF production through export levy revenues, similar to the successful Palm Oil Estate Fund model used for biodiesel.  

The analysis surveys UCO collection practices across Asian countries and evaluates three potential service fee structures on UCO exports. Our findings indicate that implementing a service fee above $150 per ton could generate sufficient revenue to subsidize UCO-based hydroprocessed esters and fatty acids (HEFA) fuel production, helping Indonesia meet its 1% SAF blending target by 2027. 

Policy considerations:

• Centralize UCO collection regulations. Indonesia’s decentralized collection scheme has achieved below 50% collection rates. Central government oversight with clear producer responsibilities could significantly improve UCO supply.  
• Establish a Used Cooking Oil Fund. Following the successful model for palm oil biodiesel, a UCOF could provide incentives either for UCO collection or directly to HEFA producers to achieve price parity with conventional jet fuel. 
• Increase the UCO export service fee. Raising the current 9.5% service fee to above $150/ton would generate sufficient revenue to support the 1% SAF blending mandate while creating surplus funds for future program expansion. 

Almost all the external insulation fitted under the previous government’s energy efficiency scheme was installed so poorly it will have to be repaired or replaced, an investigation has found.

Thousands of homeowners who took advantage of the home insulation schemes have been left with incompetently fitted cladding that in some cases is likely to cause damp and mould.

Of the roughly 23,000 homes fitted with external wall insulation under the Energy Company Obligation (ECO) and Great British Insulation Scheme (GBIS), 98% need repairs, according to a National Audit Office (NAO) investigation.

A further 9,000 to 13,000 homes fitted with internal insulation also have major problems – 29% of those who had these works carried out, the NAO said.

And more than 3,000 installations of both kinds are likely to pose health and safety risks that need immediate remediation.

“The report reveals a system that has let cowboys through the front door,” said Simon Francis, coordinator of the End Fuel Poverty Coalition, “leaving thousands of victims living in misery and undermining public trust in efforts to tackle the cold, damp homes crisis facing many households.”

He added: “Insulation and ventilation, when done properly, are among the safest and most effective ways to bring down energy bills and keep people warm. But substandard delivery and weak oversight by the last government has turned what should have been a national success story into a cautionary tale.

“Now we need to fix the system, not abandon it.”

The ECO and GBIS initiatives sought to tackle fuel poverty and reduce carbon emissions across Britain by requiring energy companies to fund the installation of energy efficiency measures in homes.

But, the NAO said, weak government oversight and inadequate audit and monitoring led to thousands of poor-quality installations, leaving homes at risk from damp, mould, blocked ventilation shafts and exposed electrical cabling.

As a result of poorly executed works, homeowners were left unable to remortgage or sell homes, with insulation so badly fitted it could make cold, damp conditions worse. In January, almost 40 companies were blocked from installing insulation as part of the schemes as the outcry grew over the substandard works.

“People’s homes and lives have been damaged by these faulty installations, many living in fuel poverty, and lots have faced very difficult times as a result,” said Jess Ralston, an energy analyst at the Energy and Climate Intelligence Unit.

The NAO said: “The government created an overly complex system that ultimately failed.” It blamed “unclear and fragmented roles, responsibilities and accountabilities” among the scheme providers, the certification bodies, the regulator Ofgem, and the Department for Energy Security and Net Zero (DESNZ).

Installers were able to “game” the audit process either by being certified by multiple certification bodies or transferring their certification between bodies, meaning they would have less history with each.

Fraudsters were also able to scam millions out of the scheme, the NAO report revealed. Last November, Ofgem estimated that retrofit businesses had falsified claims for ECO installations in between 5,600 and 16,500 homes, potentially claiming between £56m and £165m from energy suppliers.

Sir Geoffrey Clifton-Brown MP, the chair of the Commons’ public accounts committee, which oversees the NAO, described the “failures” of the retrofitting schemes as “stark”.

“Despite allegations of fraud, lack of sufficient quality data means that overall levels of fraud in ECO remain unknown,” he said. “DESNZ and Ofgem have been quick to act after becoming aware of widespread problems, but their efforts remain hampered by weak government oversight and an overly complex consumer protection system.

“It is imperative that households receive clarity on how they can fix their homes and a system is put in place whereby these failings do not recur.”

Installers are liable for the whole cost of putting right any faulty insulation installations under the scheme. Affected households have been encouraged to contact Ofgem.

The minister for energy consumers, Martin McCluskey, said: “Today’s report shows unacceptable, systemic failings in the installation of solid wall insulation in these schemes, which have directly affected tens of thousands of families.”

He said the government had taken “decisive action” to protect households and ensure all poor installations of solid wall insulation were fixed at no cost to the consumer.

“We are fixing the broken system the last government left by introducing comprehensive reforms to make this process clear and straightforward, and in the rare cases where things go wrong, there will be clear lines of accountability, so consumers are guaranteed to get any problems fixed quickly,” McCluskey said.

Ad hoc announcement pursuant to article 53 LR

“We are very pleased with our continued good sales performance in the first nine months of 2025, against very strong prior year comparables. The natural hedges of Givaudan continue to support our strong performance across business segments, geographies and customer groups, despite the ongoing geopolitical, trade and macroeconomic challenges. Givaudan remains highly focused on supporting our customers’ growth in developing innovative products which consumers love.”

Gilles Andrier, CEO

Sales performance

In the first nine months of 2025 Givaudan recorded sales of CHF 5,743 million, an increase of 5.7% on a like-for-like¹ (LFL) basis and an increase of 1.7% in Swiss francs.

Givaudan continued the first nine months of the year with good volume growth and maintained its operations and global supply chain at a high level.

With higher input costs in 2025, including tariffs, the Company is implementing price increases in collaboration with its customers to fully compensate for the increases in input costs.

The good growth was supported by the 8.1% LFL in the high growth markets, the continued outperformance of local and regional customers across the group and the sustained strong performance of Fine Fragrance.

Fragrance & Beauty sales were CHF 2,923 million, an increase of 8.0% LFL and an increase of 5.1% in Swiss francs.

On a business unit basis, Fine Fragrance sales increased by 18.7% LFL against a high prior year comparable growth of 17.8%, and Consumer Products sales increased by 5.9% LFL against a strong prior year comparable growth of 15.9%. Sales of Fragrance Ingredients and Active Beauty increased by 1.5% LFL, with strong double-digit growth in Active Beauty offset by weaker performance in Fragrance Ingredients.

Taste & Wellbeing sales were CHF 2,820 million, an increase of 3.4% LFL and a decrease of -1.5% in Swiss francs.

On a regional basis, sales increased in South Asia, Middle East and Africa by 8.8% LFL, in Europe by 3.8% LFL, in North America by 3.9% LFL and in Latin America by 3.1% LFL. Sales decreased in Asia Pacific by -0.5% LFL. Within the product segments, there was broad based good growth in health care, snacks, sweet goods, and in dairy.

Our mid and long term ambitions

Our 2025 strategy, ‘Committed to Growth, with Purpose’, is our intention to deliver growth in partnership with our customers, through creating inspiring products for happier, healthier lives and having a positive impact on nature, people and communities.

Ambitious targets are an integral part of this strategy, with the Company aiming to achieve organic sales growth of 4–5% on a like-for-like basis and free cash flow² of at least 12%, both measured as an average over the five-year period strategy cycle. In addition, we aim to deliver on key non-financial targets around sustainability, diversity and safety, linked to Givaudan’s purpose.

With average like-for-like sales growth of 7.2% for the period 2021–2024 and the continued strong like-for-like growth in the first nine months of 2025 of 5.7%, Givaudan is highly likely to exceed the upper end of its average five-year sales growth target of 4–5% on a like-for-like basis for the period 2021–2025.

Our bold and ambitious long-term purpose goals are defined in four domains: creations, nature, people and communities. Our ambitions include doubling our business through creations that contribute to happier, healthier lives by 2030, becoming climate positive before 2050, becoming a leading employer for inclusion before 2025 and sourcing all materials and services in a way that protects the environment and people by 2030.

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Further information

Upcoming events
Full year results – 29 January 2026

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Contact
Claudia Pedretti, Head of Investor and Media Relations
T +41 52 354 01 32
E claudia.pedretti@givaudan.com

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Key tables

Sales performance for the nine month period ended September

	2025			2024
January to September In millions of Swiss francs	Group	Fragrance & Beauty	Taste &  Wellbeing	Group	Fragrance & Beauty	Taste & Wellbeing
Sales as reported	5,743	2,923	2,820	5,644	2,782	2,862
– growth in CHF (%)	1.7%	5.1%	-1.5%	7.2%	10.8%	3.9%
like-for-like¹ (%)	5.7%	8.0%	3.4%	13.0%	15.6%	10.7%
Acquisition impact (net) (a)	41	42	-1	17	26	-9
– acquisition impact (net) (%)	0.7%	1.5%	0.0%	0.3%	1.0%	-0.3%
Currency effects	-262	-123	-139	-324	-146	-178
– currency effects (%)	-4.7%	-4.4%	-4.9%	-6.1%	-5.8%	-6.5%

(a) Acquisitions and divestments

	2025			2024
January to September In millions of Swiss francs	Group	Fragrance & Beauty	Taste & Wellbeing	Group	Fragrance & Beauty	Taste & Wellbeing
Acquisitions and divestments	41	42	-1	17	26	-9
– Vollmens	2	2
– b.kolor	40	40		20	20
– Amyris				6	6
– Discontinued and disposed business	-1		-1	-9		-9

Sales performance for the three month period ended September

	2025			2024
Quarter only In millions of Swiss francs	Group	Fragrance  & Beauty	Taste &  Wellbeing	Group	Fragrance  & Beauty	Taste &  Wellbeing
Sales as reported	1,879	968	911	1,907	956	951
– growth in CHF (%)	-1.5%	1.3%	-4.3%	10.2%	13.9%	6.8%
– like-for-like¹ (%)	4.4%	6.8%	2.1%	14.1%	16.0%	12.4%
Acquisition impact (net) (b)	2	2		19	20	-1
– acquisition impact (net) (%)	0.1%	0.2%	0.0%	1.1%	2.4%	-0.1%
Currency effects	-115	-55	-60	-87	-37	-50
– currency effects (%)	-6.0%	-5.7%	-6.4%	-5.0%	-4.5%	-5.5%

(b) Acquisitions and divestments

	2025			2024
Quarter only In millions of Swiss francs	Group	Fragrance  & Beauty	Taste &  Wellbeing	Group	Fragrance  & Beauty	Taste &  Wellbeing
Acquisitions and divestments	2	2		19	20	-1
– Vollmens	2	2
– b.kolor				20	20
– Discontinued and disposed business				-1		-1

Sales performance by business activity

	2025	2024
January to September in %	Sales growth LFL¹	Sales growth LFL¹
Fragrance & Beauty	8.0%	15.6%
– Fine Fragrance	18.7%	17.8%
– Consumer Products	5.9%	15.9%
– Fragrance Ingredients and Active Beauty	1.5%	10.8%
Taste & Wellbeing	3.4%	10.7%
– Europe	3.8%	6.3%
– South Asia, Middle East and Africa	8.8%	17.9%
– North America	3.9%	5.1%
– Latin America	3.1%	28.9%
– Asia Pacific	-0.5%	10.1%

Sales performance by geography

	2025			2024
January to September In millions of Swiss francs	Sales reported	LFL¹ %	CHF %	Sales reported	LFL¹ %	CHF %
LATAM	643	5.7%	-4.3%	672	29.5%	5.7%
APAC	1,366	4.6%	-0.5%	1,373	12.1%	7.0%
NOAM	1,328	3.5%	0.3%	1,323	5.7%	3.9%
EAME	2,406	7.6%	5.7%	2,276	13.1%	9.8%
High growth markets	2,787	8.1%	6.5%	2,618	20.9%	10.5%
Mature markets	2,956	3.4%	-2.4%	3,026	6.6%	4.5%
Total Group	5,743	5.7%	1.7%	5,644	13.0%	7.2%

 

 

 

 

 

 

Translations: WSOC大会欢迎辞 – Mark Searle (pdf)

Introduction

 

Ministers, ladies and gentlemen, colleagues, welcome to the IATA World Safety and Operations Conference.

A special welcome to our VIPs:

• Wang Yongli, Executive Vice Governor of Fujian Provincial People’s Government
• Han Jun, Deputy Administrator of CAAC
• Wu Bing, Mayor of Xiamen Municipal People’s Government
• Ma Tao, Regional Director of ICAO Asia and Pacific Office
• Zhao Dong, Chairman of Xiamen Airlines

It is a pleasure to be in Xiamen, and I will start by thanking our host, Xiamen Airlines, for the warm welcome. This is the first time that WSOC is meeting in China. And it’s significant. China is an aviation powerhouse: one of the world’s largest markets for passenger services and air cargo. From the standpoint of safety and operations it presents several good examples to follow:

• Many carriers have signed the IATA Safety Leadership Charter
• In line with global standards, it is safeguarding critical spectrum bandwidth for aviation as it rolls out 5G telecommunications technology
• And new entry / exit points with neighbouring Tajikistan and Kyrgyzstan have created over 40 international waypoints, giving airlines more flexibility to use advanced navigation systems for safer, more efficient routes

Working together—industry and the authorities—we are supporting China to get the most out of its significant investments in aviation. Our last tally showed that aviation contributes $250 billion to China’s GDP and supports 10.2 million jobs.

The improvements that we have achieved here demonstrate the important role of leadership, global standards and data analysis in making aviation the safest mode of transport. We must never let that slip, even in the face of evolving risks.

And make no mistake, airlines are operating in an increasingly conflict-ridden environment with grave consequences that have been all too clear recently.

• An Azerbaijan Airlines jet was downed with 38 lives lost, and
• In Sudan, two further incidents together claimed 25 lives.

Fortunately, such tragedies are rare, but they remain completely unacceptable. Civilian aircraft should never face such risks, even by accident.

And we cannot forget that, in addition to these well reported tragedies, airlines face and safely manage disruptions from geopolitical instability every day.

• The war in Ukraine cancels up to 2,000 flights every day and reroutes another 1,500
• The India–Pakistan conflict forced more than 200 daily diversions, with traffic at some waypoints rising 70–80%
• Drone incursions, such as we are seeing in Poland, Germany, Denmark, and Norway, add further strain
• And, lastly, reports of GNSS interference have grown by more than 200% between 2021 and 2024

Even with established procedures, precautionary measures, restrictions and rerouting, confidence and connectivity is disrupted, journeys are longer, and costs and emissions are higher.  

As leaders of global aviation’s safety and operations, we have a duty to manage today’s risks while anticipating and preparing for the risks of tomorrow. That is the “future proofing” that is referenced in the theme of this conference.

Future proofing begins with your leadership—the role of which is expressed in the IATA Safety Leadership Charter. The Charter now encompasses some 90% of global traffic. It points us towards a safety culture that  focuses on the two fundamental tools we have to continue to improve safety and operations:

• Global standards which we must keep relevant, and
• Making the best use of the enormous amount of data we generate to improve our operations

That, of course, is nothing new but we can and must do more with both.

Global standards are the bedrock of global aviation. We could not provide the connectivity that the world needs if each country had its own rules. We must avoid fragmentation by ensuring that the standards we have are continuously adapted to be fit for purpose.

Data has long helped us make critical decisions. We are capturing more data than ever before. And, with the capabilities of artificial intelligence, our ability to turn that data into critical insights that deliver more relevant and powerful outcomes continues to grow.

Global standards and data will recur throughout the WSOC program. In anticipation of that, I’d like to help set the scene with some reflections on how these apply to IATA’s work on some of our most critical topics.

Global Standards

Let’s start with global standards, where we have an important agenda of standards that either need to be defended, implemented, or both. Here are four priority examples:

1. GNSS interference, which I mentioned earlier, is a critical example. Neither spoofing nor jamming of GNSS systems is acceptable. But with geopolitical tensions driving such risks, our crews are well trained to manage them. Together with EASA, IATA has launched a GNSS Resilience Plan built on four priorities: monitoring and reporting, prevention tools, backup infrastructure, and civil–military coordination. The next step is for ICAO to advance these solutions with global standards, guidance, and reporting.
2. The radio spectrum we rely on for navigation is defined in ITU’s global standards and must be protected for safety of operations. But the growing demand for spectrum from 5G and eventually 6G is challenging aviation’s allocations. In the US, Australia, and Canada, some 5G rollouts created interference risks near airports and forced costly retrofits. The lesson is clear: we need stronger coordination with telecom regulators and realistic timelines for sunsetting of mitigations, as well as future on-board systems that are more resilient.
3. Global standards ensure the safe carriage of lithium batteries by passengers and that matters because almost every traveler carries lithium-powered devices. An IATA survey found that while 57% of passengers believe they know the rules and another 36% say they know the basics, nearly half mistakenly think it’s safe to pack power banks or small devices in checked baggage or are unclear about power limits. To reinforce the standards, we are launching the Travel Smart with Lithium Batteries campaign to raise awareness on the rules that keep everyone safe.
4. The last example I’ll raise on global standards is accident reporting, set out clearly in Annex 13 of the Chicago Convention. Yet only 58% of accidents between 2019 and 2023 have, to date, delivered a final report. When reports are delayed, the industry loses vital safety insights and space is created for speculation, rumors, and conspiracy theories. That’s why we continue to remind governments of their obligations while also recognizing success, such as the timely preliminary reports published for recent accidents in India, South Korea, and the US.

Data

Turning to data, the first point I want to emphasize is how our growing use of safety and operational information is transforming the industry. The flagship is the Global Aviation Data Management (GADM) program, which turns millions of data points from our members into actionable intelligence.

This is clearly demonstrated with Turbulence Aware – included in GADM – which enables pilots and dispatchers to share information on this safety risk. Participation in the program has grown by 25% over the last year. The fleet of 3,200 Turbulence Aware aircraft now includes new joiners Air France, Etihad and the SAS. And with each new contributing aircraft the better our ability to mitigate the risks of turbulence.

We also see the potential in SafetyIS  which is so rich in-flight data from 217 airline contributors that we can now achieve predictive insight. For example, a spike in collision-avoidance alerts was identified at a major Latin American airport before it was noticed locally—allowing timely interventions that reduced risks and improved safety.

And lastly, we see the potential for data to transform the safety world in the rollout of risk-based IOSA. Data on risks guides how the audits are adapted to each airline. And, as a result, we are seeing more findings – some 8,000 corrective actions have already been identified and that number will grow.

I encourage all of you to make sure that your airline is getting the most out of this data revolution by joining two important communities:

• GADM which includes the Flight Data eXchange (FDX), Incident Data eXchange (IDX), and Maintenance Cost Data eXchange (MCX)—provides critical insights that help airlines and regulators make better decisions.        

• IATA Connect. Already 5,600 users from over 600 organizations have come together in a community that shares data and insights from IATA’s many safety programs that can make us all safer. Soon this community will expand to include ISAGO users adding another important dimension to its potential.

ICAO Assembly

 

Just before concluding my remarks, I have two additional points to those on leadership, data and standards. First, I would like to quickly report on the conclusions of the 42nd ICAO Assembly that took place earlier this month. We all know that ICAO is incredibly important for our industry as the ultimate keeper of global standards. That’s why every three years we make a major effort to ensure that the industry’s concerns are heard by the delegates and reflected in the Assembly’s conclusions.

In total this year, IATA submitted 14 papers, largely with very positive results. Some of the highlights include:

• Accepting our recommendation that data from its two key state audits USOAP (Universal State Oversight Audit Program) and the State Safety Program Implementation Audit (SSP-IA) should feed into the standard-setting process.
• Supporting a move forward to increase in pilot retirement age to 67
• Reaffirming the need for States to adhere to the framework, laid out in Annex 13, to complete accident investigations as internationally agreed.
• Ensure that aircraft equipment mandates, are achievable across all stakeholders that they will impact

Including these in the final Assembly report is of great consequence. And our job over the next three years is to use the Assembly’s endorsements to implement the required changes.

Supply Chain

 

Secondly the supply chain. Safety resilience also depends on the wider aviation system. And today, the supply chain is under strain.

• Aircraft deliveries fell to just 1,254 in 2024, 30% below pre-COVID peaks
• The backlog has grown to a record 17,000 aircraft
• Engine issues have grounded hundreds of aircraft

The financial hit will exceed $11 billion this year, but the greater concern is safety: stretched fleets, delayed maintenance, and limited spares erode the buffers that protect operations.

IATA is responding with tools like MRO SmartHub, which allows members to have better visibility of the serviceable used aircraft parts available  in the aftermarket and gives airlines real-time data to reduce parts delays and keep fleets flying safely.

Together with Oliver Wyman, we are releasing a new report at this conference. It calls for urgent action: expand capacity, promote fair competition and alternatives, and improve forecasting and data visibility,  practical steps to restore resilience and protect aviation’s safety margins.

Conclusion

 

On that note, on behalf of the whole IATA team, I look forward to working with you and your teams to provide the leadership needed to improve safety and operations with relevant global standards and the power of data.  

The challenges that we face are many and dynamic. But by keeping focused on leadership, standards and data, I know that we will be able to build an industry that is even safer, more efficient and fully able to provide the connectivity that the world needs to prosper.

I wish you all a productive and successful conference.

A US company has engineered a new type of wood that it says has up to 10 times the strength-to-weight ratio of steel, while also being up to six times lighter.

“Superwood” has just launched as a commercial product, manufactured by InventWood, a company co-founded by material scientist Liangbing Hu.

Over a decade ago, Hu set out on a quest to reinvent one of the oldest building materials known to humankind. While working at the University of Maryland’s Center for Materials Innovation, Hu, who’s now a professor at Yale, found innovative ways to re-engineer wood. He even made it transparent by removing part of one of its key components, lignin, which gives wood its color and some of its strength.

His real goal, however, was to make wood stronger, using cellulose, the main component of plant fiber and “the most abundant biopolymer on the planet,” according to Hu.

The breakthrough came in 2017, when Hu first strengthened regular wood by chemically treating it to enhance its natural cellulose, making it a better construction material.

The wood was first boiled in a bath of water and selected chemicals, then hot-pressed to collapse it at the cellular level, making it significantly denser. At the end of the weeklong process, the resulting wood had a strength-to-weight ratio “higher than that of most structural metals and alloys,” according to the study published in the journal Nature.

Now, after years of Hu perfecting the process and filing over 140 patents, Superwood has launched commercially.

“From a chemical and a practical standpoint, it’s wood,” explained InventWood CEO Alex Lau, who joined the business in 2021. In buildings, that would allow for structures potentially up to four times lighter than today, Lau said, meaning they would be more earthquake resistant, as well as easier on foundations, making construction faster and easier.

“It looks just like wood, and when you test it, it behaves like wood,” Lau added, “except it’s much stronger and better than wood in pretty much every aspect that we’ve tested.”

InventWood is manufacturing Superwood in its plant in Frederick, Maryland, and although the production time is now measured in hours rather than days, it will take some time to scale up, Lau said.

Initially, the company plans to focus on external applications such as decking and cladding, before moving on to internal applications such as wall paneling, flooring and home furniture sometime next year.

“People always complain that furniture breaks down over time, and that’s often because it sags or breaks down at the joints, which are currently made of metal because wood isn’t strong enough,” said Lau. Superwood could be used to replace these parts, he said, as well as screws, nails and other metal fasteners.

Eventually, Lau projects that an entire building could be constructed out of Superwood, although that would require more testing.

Much like in Hu’s original experiment, the wood is strengthened via a chemical process that alters the basic structure of the cellulose and is compressed very tightly without springing back. “In theory, we can use any kind of wooden material,” Lau said. “In practice, we’ve tested with 19 different kinds of species of wood as well as bamboo, and it’s worked on all of them.”

InventWood says Superwood is up to 20 times stronger than regular wood and up to 10 times more resistant to dents, because the natural porous structure of the wood has been collapsed and toughened. That makes it impervious to fungi and insects. It also gets the highest rating in standard fire resistance tests.

Superwood currently costs more than regular wood and also has a larger manufacturing carbon footprint, but Lau said that compared to steel manufacturing, the carbon emissions are 90% lower.

He added that the target is “not to be cheaper than wood, but to be competitive with steel,” when manufacturing scales up.

Other types of engineered wood have existed as construction materials for a long time, but InventWood says that these are simply rearranged pieces of wood that are held together with adhesives, rather than wood that has been altered at the molecular level like Superwood.

Timber construction has had a resurgence in recent years, and wood is now used to build skyscrapers. The city of Milwaukee — which already hosts the world’s tallest timber tower, the 284-foot (87-meter) Ascent MKE — has revealed plans to build an even taller one, at a whopping 600 feet (183 meters) in height.

Currently, concrete is by far the most-used construction material on Earth, and even though its production has plateaued in recent years, making concrete generates 7% of the world’s global carbon emissions.

Philip Oldfield, an architecture professor and head of the School of Built Environment at the University of New South Wales, in Australia, who is not involved with InventWood, said timber has environmental benefits over many other building materials as its production processes are less intensive than steel and concrete, and timber stores CO2 in its woody biomass through photosynthesis. “Wood products can be considered a long-term carbon storage system, and construction with wood could see our cities ‘lock in’ carbon emission in buildings for long periods of time,” he added.

However, he points out that existing engineered timber products are already competing with steel and concrete. “The barrier to more timber buildings isn’t really the need for more strength,” he explained, “it’s that the construction industry is risk averse and slow to change.”

To see more timber in buildings, he argued, we need better education, pilot projects and improved regulatory frameworks: “But stronger timber products like this Superwood could allow architects to create larger spans and more durable finishes with timber, which would certainly be beneficial and could foster greater timber uptake.”