Guangdong Biobank Cohort (GDBC) study.

The global rise of non-communicable diseases (NCDs) presents an urgent public health challenge, particularly in regions undergoing rapid economic and demographic transitions. Guangdong Province, China's most populous and economically advanced region, is experiencing a substantial and accelerating burden of NCDs. However, large-scale, population-based cohorts from this region remain scarce, limiting insights into region-specific disease determinants and prevention strategies. The Guangdong Biobank Cohort (GDBC) was established in 2017, enrolling 35,081 participants aged 40-84 years from urban and rural areas of Zhongshan City in the Pearl River Delta. At baseline, comprehensive data on 346 variables-including lifestyle, environmental exposures, medical histories, physical examinations, and laboratory profiles-were collected via a cloud-based member management information system (MMIS), alongside blood and saliva samples for biobanking. A sub-cohort underwent genome-wide genotyping (N = 2,530) and oral microbiome profiling via 16 S rRNA sequencing (N = 2,049). During dynamic follow-up, 44.2% (N = 15,499) completed Phase I resurvey with repeated measurements and updated biospecimens. Disease outcomes, including hypertension, diabetes, and cancer, were ascertained through active surveillance and regional registry linkage until December 2023. Baseline prevalence of hypertension, diabetes, and cancer was 25.3%, 8.0%, and 3.6%, respectively. Over follow-up, 1,767 hypertension cases, 814 diabetes cases, and 558 cancers were recorded, yielding crude incidence rates of 1,804.6, 649.7, and 423.1 per 100,000 person-years, respectively. The GDBC provides a comprehensive, dynamically updated resource to dissect gene-microbiome-environment interactions and develop precision prevention strategies to inform public health policies.