Cohort profile: the West-China hospital alliance longitudinal epidemiology wellness (WHALE) study

The West-China Hospital Alliance Longitudinal Epidemiology Wellness (WHALE) Study establishes a robust, multidimensional database to provide comprehensive insights into health-to-disease transitions, advancing proactive healthcare and enhancing understanding of the interplay among genetic, behavioral, and environmental factors in disease. The WHALE Study includes a database and a cohort. The WHALE Database, established in 2010, integrates health check-up data from 11 hospitals, covering sociodemographic, lifestyle, medical history, and clinical data. The WHALE Health Trajectory Cohort, launched in November 2024, recruits adults with at least three health check-ups, featuring biennial active follow-ups and passive linkage with regional healthcare databases. As of January 2025, the WHALE Database includes over 3.4 million health records from 1,526,686 participants, with a mean age of 40.3 years and a balanced gender distribution. Notably, 23.88% of participants had at least three health check-ups, and 3.31% had more than ten, highlighting a significant proportion with repeated measurements. The study provides key insights into health trajectories by examining the associations of biomarker data and their trajectory patterns with aging, pre-disease conditions, and disease diagnoses. The strengths of the WHALE Study include its large sample size, longitudinal design, diverse representation, comprehensive data, and robust quality control. Limitations include potential selection bias, data variability across centers, and reliance on self-reported data for some variables.